A hard case: Lantus and pates and numbers too high

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Steph

Steph

Member Since 2013
I am completely stumped: Stubbie is eating pates:
Merrick Duck, Merrick Beef, Halo Spots' Chicken: The first two have no carbs at all that I can see. The Halo has "some" alfalfa, sweet potato and carrot. I will not feed Friskies canned.

He gets Wysong 90% meat dry food, with no starch, or EVO Cat & Kitten. He's been getting 3 units 2X a day of Lantus and nothing is happening. Preshot today is 377, and nadir yesterday was 220. I upped to 3.5 this morning.

This is not good, and the little guy has cataracts from being untreated before I adopted him. I know he is incurring damage here. My vets do not have this conversation very well.

I appreciate any thoughts. Change insulin? I've had Stubbie 1.5 years and was formerly able to get his numbers at least to the mid to high 100s until recently. He is very lethargic; all other bloodwork is good. He is six or seven, we think. Adopted via DCIN.

Thank you.
 
Im not familiar with Lantus except the things I have read about having to stick with a specific dose for several cycles and it looks like your doses change. Also is it possible to get any evening input?
 
I have been holding with 3 units for two weeks. I raised this morning for the first time to 3.5.
 
The dates on the spreadsheet say 2013; is this accurate? If so, we really can't provide useful feedback without current numbers.
 
This "preshot today is 377, and nadir yesterday was 220" is promising since it shows a go drop. However, you did not list the preshot that went with the 220. Unless the preshot was similar to 377 matching a low from the day before with a later preshot provides no useful information.
 
Stubbie has been on Lantus for 1.5 years at 2 IU @2Xday until recently. His 14-day average is 276 now.
He was formerly in the mid-100s--several months ago and last year. His nadir numbers have been running 250s to low 300s in the past month. That's unacceptable. I am not home to test him every hour.

The numbers have risen for no reason, in my opinion. Bloodwork showed slightly elevated cholesterol. And he's a big cat now: 12 pounds, and came to me a skin and bones, literally.

I wonder if I need to explore another insulin as this is a radical change. That's all. He has cataracts, has lost teeth from his diabetes. When I flew him from a vet clinic in Illinois to SoCal, I was told he was age two: He's at least seven. My goal is always to do what's best, and this is a change. Big one. At 3.5 does 2X day, he's still WAY too high. ?
 
You don't need to test hourly.
Test pre-shot to make sure it is safe to give insulin.
A before bed test lets you know if you can sleep or if you need to stay up to steer the glucose.
When you can - on a weekend, a day off, or even sometimes setting the clock to get up in the night - you snag a test in the +5 to +7 hours post shot.
When you have a day, maybe even do a curve where you take serial tests every 2 hours or a mini-curve testing every 3 hours - this is what provides the data to allow you to adjust the dose safely and to see how well the insulin is working.

Are you following one of our protocols for Lantus/Levemir? Both offer guidelines for dose increases based on test taken around the nadir, or lowest glucose post shot. This is often between +5 to +7 hours after the shot but can vary with cats.
Tight Regulation
Start Low, Go Slow
 
Yes, I am doing this: sometimes the +5 or +7. His numbers are just abnormally high. You schooled me well with
a neighbor's cat that I got off the juice two years ago. I don't believe the insulin is now doing its job.

I'm a national healthcare journalist so I am not unfamiliar with the semantics and protocols. That's why I feel
my concerns are warranted. I know when anything changes with my cats, and this is a change that prompted me
to write. I also studied the nutrition data at catinfo.com and found that all the pates are actually very low
in carbs--and I know the two dry foods are too. I will do another curve, but the numbers will be high.

Hope this makes sense. Stephanie Stephens
 
Further damage to the pancreas may have happened. A high dose condition may be present. Continue making dose increases as needed.
 
I was afraid of that. This little guy has been through so much and of course no one will insure him and they balk
at any bill I incur that isn't even related to his condition.

s.
 
So you wind up paying for it directly, like a lot of us do. I have so many cats (16 in the house; 12 mine), the cost of insurance on each is more than I'd spend on most routine vet bills.
 
I am SO lucky that we insured our boys almost as soon as we got them.

Monty has cost us more in premiums than we've been paid out in vet bills (which is actually a good thing in terms of his good health!) but Dweezy...from the first few months and years of regular urinary issues, to the nose lump surgery to the scratched cornea procedure to the sedative needed when he freaked out when seeing other cats outside, and now this! :)
 
Minnie's Mom, it is good through Oct 2016 and another through Jan. 2017. Now I have a real problem. He's been running low 300s, high 200s and tonight he is at 78. I have no idea what to do here. I'll start the Excel sheet--meanwhile, no shot tonight.
 
Unopened, it is good through those dates. Once you start using a vial or pen, you've got about 6 months before it wimps out.
 
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