9 days on Lantus and Obies Numbers are between 335 and 460

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Obie

Obie

Member Since 2014
Obie's numbers have been hovering between around 350 to 460.
Yesterday I upped his dose from 1 unit to 1.5 unit on the second shot. It was 456 in the morning and 335 in the pm.
Today his numbers were 423 in the AM and 435 when I checked an hour ago.
This morning when I came down stairs he had a plastic grocery store bag wrapped around his neck and one leg.
He wasn't choking, but I'm sure he panicked for most of the night and probably ran around like crazy.
This morning I had a hard time testing him, he ate an entire can of one of the low carb fancy feast meals that was suggested in this forum just so i could keep him still enough to test.
I am hoping that tomorrows numbers are at least closer to the 200s in the morning.
Since I've been testing him, I've only seen his numbers at 204 once,287 once,263 once.
He is a big framed cat and I don't feed him dry. I've even started adding a little extra water to his food so he will get as much as he can (Plus it slows him down a little).
I am really afraid to do anything drastic as messing with his dose just yet on my own.

Here is how the mornings go for testing. I set up everything for the deed.
He gets a tiny bit of chicken or tuna to eat while I go all psycho on his ear with the lancer.
And he eats while I fight to capture the blood droplet with the alphatrak 2 butterfly strip.
Then I shoot him toward hid hind quarters with the Insulin. I know I'm getting it in because I never feel any moisture or stickiness or smell anything. I'm sure it's possible that I have missed and didn't realize it.
For the second Reading of the day, I go through basically the same routine.
Is there anything in all of this that I am doing wrong?
Any advice?
Thank you.
I'm worried so much about my boy. :)
 
Re: 9 days on Lantus and Obies Numbers are between 335 and 4

Okay first off....BREATHE!!

There feel better?

Now as for testing...you shouldn't have to go psycho on his ears. Ditch the device, grab just the lancet, expose the sharp point and SLIDE it into the ear at a 45 degree angle. Pretend he has a splinter in the very edge of his ear and you're using the lancet to pick it out.

Next, personally I'd got get yourself a human meter that has reasonably priced strips unless you're independently wealthy. :-D Walmart's Relion Prime (what I use) is $16 for the meter and $9 for 50 strips. Why because to dose Lantus correctly you need at least 3 tests a day, preferably 4 and a curve (testing every 2 hours shot to shot ) unless you can test a lot daily. Because Lantus dose changes are based of the nadir not preshots. Alphatrak will cost you a small fortune in strips alone.

Too much insulin will cause higher numbers just like too little. The only way to tell the difference is by getting spot checks. Plus you'll catch any potentially dangerous hypos long before your boy is in trouble. And can walk him out of it with food. Don't trust him to give you outward signs. My girl can fall into the 20s without a single outward sign.

Lastly I can't make heads or tails out of the numbers you've given so here's what I need you to do since you don't have a spreadsheet.

Give me the numbers again like this:
Date: date the readings were taken
AMPS: a.m. preshot #
Then the numbers denoted by the numbers of hours after injection.

Example: 7/29/14
Amps 491
+3-348
+6-158
Pmps-289

Mel and The Fur Gang
 
Re: 9 days on Lantus and Obies Numbers are between 335 and 4

I think I will take your advice on the meter.
I ran out of strips and since I needed them and couldn't get them quick enough, the vet charge me 94 bucks.
I asked about the other devices and they were adamant about me getting the alpha trak.

On the test, I only have done one curve 2 days ago.
I was told by the vet every 4 hours to test.
Here are those numbers
6:00 am 438
10:00 am 395
2:00 pm 413
6:00 pm 461

Todays
6:00 am 423
6:15 pm 435

I have been giving the shot 2 times a day at 6 and 6.
I just read an article about 10 minutes ago where they say lantus wears off in 10 hours.
http://www.diabeticcatcare.com/DCCCOK/InsulinScales.htm
That could have a bit to do with it maybe.
Another page says that most cats achieve regulation in 10 days.
http://www.veterinarypartner.com/Content.plx?A=1812
 
Re: 9 days on Lantus and Obies Numbers are between 335 and 4

Go back and reread those links. Diabetic Cat Care clearly states the Lantus lasts 12+ hours so +10 dosing is advised. In other words it isn't safe to redose until after at least 10 hours from the first shot because of overlapping.I can find nothing in the other link that says most cats are regulated in 10 days. In fact it talks about how tricky cats are to regulate and that a Curve should be run every week or two for the first month. Second it says Lantus is the only long lasting insulin on the market. This may have been true in 2004 when it was written however much has changed since then. There is now Pro Zinc, BCP PZI, Lantus and Levemir. Both of my insulin dependent are on Levemir. Regulation can take weeks, months or longer.

Remission and Regulation are very different things. My Autumn is well regulated but she will never be in remission. Cassanova is still getting completely regulated and may or may not go into remission and my Maxwell has been in remission for 4 years. So what's the difference? Remission (OTJ) is when the cat can remain in normal blood sugar range without insulin. It is also called diet controlled, because they are still diabetic but it is controlled by diet alone. They can never eat a high carb diet without going back into insulin use again.

Regulation is controlled by insulin therapy. Well regulated is preshots lower than 250 with nadirs in the 100s or lower without dropping below 40 (human meter values Alphatrak reads 30 pts higher on average) while on insulin.

Tightly regulated is holding the BGs in normal range between 40-120 on a human meter with insulin.

Mel and The Fur Gang
 
Re: 9 days on Lantus and Obies Numbers are between 335 and 4

Obie's mom - I just wanted to chime in and recommend one of the ReliOn meters too. I use the Confirm, from Walmart. I like it because it only needs .3ml of blood. A tiny drop! The strips are a little pricey, $36 for 100, but not nearly as bad as what you're paying now. I've only been testing for 25 days and I'm already halfway through my second 100 pack. :razz:

It will make such a difference when you can afford to get multiple tests in and put together a spread sheet. I was so confused when I got here a month ago, but having that spread sheet to refer to really helped clarify things in my mind. I call it "Alice's roadmap to recovery" and that's exactly what it's been.

It really will get easier, for you and for Obie.
Wishing you the best! :YMHUG:
 
Re: 9 days on Lantus and Obies Numbers are between 335 and 4

I must be not getting his shot in.
His numbers yesterday were
423 at 6 am
435 at 615 pm
467 at 9 pm and 506 this morning.
could it be my needles? I know they are going in because I cant push them any further.
my syringes are 8 mm 5/16 31 gauge
I am at wits end. And I wont dose him in 10 hours.
Thank you all
 
Re: 9 days on Lantus and Obies Numbers are between 335 and 4

If you just upped his dose the night before last the dose increase hasn't taken effect yet. It takes 3-5 DAYS of the shed to adjust. Lantus doesn't work immediately.

There also can be a host of reasons for high numbers. So let's start eliminating a few of the most common ones.

What exactly are you feeding him? How much? And when in relationship to his shots?

Mel and The Fur Gang
 
Re: 9 days on Lantus and Obies Numbers are between 335 and 4

He is eating about 2 cans of fancy feast (The low carb/cal ones mentioned here) with maybe a tablespoon of tuna or chicken and a pill pocket.
This morning I tried shooting lantus in his scruff and I apparently went all of the way through because his neck stinks highly of insulin. I usually shot him in the back quarter of his body, but I wasn't sure if I was getting it in. I talked to my vet, and she said my needles are correct and I should shoot it in his rear area of his body.
I believe it is a case of me shooting all of the way through his skin.
I give him his next injection in 3.5 hours. I will check his glucose before his shot and 3 hours later to see how he is doing.
It's funny, I've given 3 other cats fluids reliably multiple times, but a tiny insulin needle is kicking my butt.
And my poor kittys butt.
 
Re: 9 days on Lantus and Obies Numbers are between 335 and 4

Okay diet is correct. Pill pockets unless they are the duck and pea flavor (dog version) are high carb.

I shoot both my cats in the scruff without problem. I pull up the skin and go straight down with the same short needles your using neither of mine tolerate being shot in the flank although you can shoot anywhere there is loose skin. Just want to make sure you're going under the skin and not into the muscle.

The other things to rule out would be infection or bad teeth. Since he's newly diagnosed I'm assuming your vet has already ruled those out

So next would be dose. He may just need a higher dose or he could need less it's hard to call without being able to look at a spreadsheet to see if I can spot a pattern that would tell me which way to go.

The last possible explanation at this point is that Lantus isn't the right insulin for Obie. Some cats do better on either Levemir or one of the PZIs. There are other high dose conditions but we don't start worrying about those until we start seeing doses in the 5-10u. range bid.

Mel and The Fur Gang
 
Re: 9 days on Lantus and Obies Numbers are between 335 and 4

Figuring out how this all works is so frustrating and stressful, particularly because you know the whole time that you're tinkering with your cat's health, so decisions can really matter. I know exactly how you feel; in fact, all of us here do! That's why it's such an awesome community and you're lucky to have found it so early on.

I read the two articles you posted earlier and agree with Mel on them. In the first they're talking about how Lantus lasts a very long time and is released slowly, so dosing before 10 hours since the last dose can be lethal. "Beginning to leave the system" in this context means that the dosing effect is no longer increasing and is slowly lessening starting around +8 or +10, but not that the dose has worn off.

In the second, I found the place at the very bottom where they say that most cats achieved regulation in 10 days:
Because of the strong chance of a cat going into remission (i.e. becoming non-diabetic), it is important for the cat on glargine to have a glucose curve conducted weekly for the first 4 weeks of treatment. This many curves may not be needed when other insulins are used, or, if they are needed, they need not be scheduled so close to one another. Most cats on glargine have achieved regulation after 10 days.
Click to expand...

Again, I think Mel's spot on to clarify that regulation and remission are not the same thing. And I'd also like to add that this is a claim I did not see myself in the actual study that she's obviously pulling most of this from (Roomp K, RAND JS Evaluation of intensive blood glucose control using glargine in diabetic cats. Vet Intern Med 2008; 22 (3):770), and since there aren't references for the sources of these numbers, I can't check this claim beyond that. The study I'm sure she's referencing for a few numbers focused on remission specifically and says:
For cats that began the protocol before or after 6 months of diagnosis, remission rates were 81% and 42%, respectively (P = 0.14).
Click to expand...

So, hopefully you'll be looking at being insulin-free by the 6-month mark, but there were still 19% of cats on the trial who didn't get there at all. And 1 in 5 is a lot who still need insulin much longer-term. Trying to get to regulation is actually the goal and if remission happens, it'll happen while pursuing or maintaining regulation.

Holding the dose steady for now while learning how Obie reacts is what you're doing now and it's really important for the rest. It's frustrating not to see the numbers dropping right away, but in order to change the dose safely, it's critical to have some information about how he looks now and what his body does with the Lantus. It's all helping him and you're doing great!
 
Re: 9 days on Lantus and Obies Numbers are between 335 and 4

He gets roughly 5 pill pockets a day. I wonder how many carbs are in 5 pillpockets?
Thank you for the kind words.
:) Now how do you get that funky insulin smell off of your cat. :YMSIGH: and does it hurt him in any way if he licks his fur where it's sticky?
 
Re: 9 days on Lantus and Obies Numbers are between 335 and 4

Hi. I'm newly on Lantus with my cat Calley. She is experiencing higher bg numbers than what she had previously on her old N insulin and I'm having a heck of a time being patient trying to see how the lantus helps her.

I am here to just send my thoughts and well wishes to you and support, like I have been given and still getting. I know how tough this is. Each test I do on Calley I look for the lower numbers and each time I do not get them, I feel defeated. I'm on the fence that this is going to work for her...but that is my issue.

What is a pill pocket anyways? LOL

And for giving the shot....do you part the fur at all to make sure you are getting it under the skin? I didn't use to do that and it was always a question if it got under the skin. But now I part the fur to make sure it goes in.

Keep up the great work for your sweet baby. :)
 
Re: 9 days on Lantus and Obies Numbers are between 335 and 4

hy
my kitty also started lantus almost 3 weeks ago and i am only now starting to see his numbers come slowly down. i am new to this but just wanted to give you a little encouragement. they say slow and steady and after 3 weeks i am just seeing some improvement so hang in there . also yes it is easier to pull up the skin and part the fur so you can see it's going into the skin. good luck. we are all with you.
nadine
 
Re: 9 days on Lantus and Obies Numbers are between 335 and 4

Thank you,guys!
My problem is that the needles are 31 gauge and I keep bending them. I bent one tonight giving him his shot. I felt all over the area where I shot it and it isn't sticky/stinky/or wet. I can't find or smell it anywhere so it had to go in.
I am going test him again at 9:00pm which is 3 hours after the shot.
Yesterday his first number was 506 at 6am. His second was 508 at 6pm. Both because of a furshot(Or two)
at 6pm yesterday I got a good shot in him! his 9pm reading was 430
This morning at 6:00 am his number was 457
his 6pm reading today was 317! Still high, but a boatload better than 500!
I have some 29 gauge needles coming tomorrow. Kris10mo , these are the pill pockets. They do work!
http://www.chewy.com/s/pill-pockets?gclid=CLu406bi8L8CFaTm7AodhkwAOQ are the Greenies
 
Re: 9 days on Lantus and Obies Numbers are between 335 and 4

Well here's part of your problem with high numbers depending on which flavor you're feeding. I just grabbed the ingredients from the feline chicken flavor

Chicken, glycerin, wheat flour, natural flavors, dried corn syrup, corn flour, wheat gluten, chicken liver meal, vegetable oil, lecithin, brewer’s dried yeast, potassium sorbate (to preserve freshness), methylcellulose, ascorbic acid (source of vitamin C), mixed tocopherols, vitamin E supplement

Those ingredients are extremely high in both carbs and sugar. While I don't have the actual carb values I would hazard to guess that 5 a day is about the equalization of a teaspoon or more of gravy food that we use too bring up low numbers.

Is there a specific reason you need to use pill pockets? Are you having to pill him 5 times a day or giving 5 different meds?

Mel and The Fur Gang
 
Re: 9 days on Lantus and Obies Numbers are between 335 and 4

I started using less of them.
Here is why I was using 5 lately. He was getting 1/2 an Acarbose pill twice a day(Carb Blocker). Well, he eats 4 small meals a day,so I was cutting the pills in 1/4s and pill pocketing them.
I have been only using as much of the pillpocket required to hide the pill and pinching the rest off and trashing it, but today I discovered that if I just hide it in his food at that size, he eats it without noticing it.
The 5th pocket was for half a famotidine pill for his acid stomach. I am cutting back on the pockets. I think I may just use 1 a day on him.
 
Re: 9 days on Lantus and Obies Numbers are between 335 and 4

He was 138 this morning.
I'm afraid to give him a shot.
1.5 units might kick him to low
Hell, 1 unit might kick him to low.
he has been on lantus for 11 days now
 
Re: 9 days on Lantus and Obies Numbers are between 335 and 4

Well you have 3 choices, stall for 30 minutes without feeding and see if he's rising and closer to 200.

2) Shoot a reduced dose or a full dose if you can stay with him to monitor

Or

3) skip altogether and realize he's going to be high tonight.

You hold the syringe and know your comfort level and Obie best. Eventually you will have to learn to shoot low to stay low. But that doesn't have to be today if you can't stay with him or just aren't ready for it yet.

Whatever your decision we'll be here to support you.

Mel and The Fur Gang
 
Re: 9 days on Lantus and Obies Numbers are between 335 and 4

Are you writing down all of Obie's numbers somewhere? Being able to see the whole pattern of how he's responded to the Lantus so far in one place would really help people giving dosing advice.

Here's How to set up your Spreadsheet.
 
Re: 9 days on Lantus and Obies Numbers are between 335 and 4

I called my vet and she had me run home and test him. 5 1/2 hours after being 138 his glucose shot up to 513! :(
She thinks that during the night he bottomed out and his body compensated for it.
My last shot last night was 1.5 u she wants me to give him .5u for a couple days to see how he reacts,
He has a ton of energy,he has a big appetite.
My poor boy.

I just found this. I'll bet anything that it's what is happening to my boy.
"So what happens if you're giving too much insulin to a cat. Remarkably, after the blood glucose goes too low, it may immediately bounce back to a very high level. Let's say in our example above we were giving too much insulin, and at 10:00 the blood glucose was too low, but not low enough to cause seizures. Well, at 12:00, the blood glucose may bounce back and go even higher than it would have. A measurement taken at that time might indicate that more insulin was needed, and the result is your seizuring cat again."
http://www.yourpetdoc.com/medicalconditions/felinediabetes.html
 
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