Advice from fellow Lantus users on regulating diabetic cat

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Marvin

Member Since 2012
Hi everyone,

Our cat seven year old cat Marvin was diagnosed with diabetes. We realized that he had diabetes because his water intake and urine output had increased dramatically as well as some weight loss. Once we found out he was diabetic, we switched him to DM canned food (half can in the morning, half can at night) and an 1/8 cup of DM dry food as treats. The insulin we give him is Lantus. We started with 0.5 units twice a day and have progressively increased to 2 units. We were instructed by the vet to always test before giving the shot and if his level is 10 mmol or lower, do not give the shot in case he goes hypoglycemic. After almost 4 months of treatment, his BG levels are still very inconsistent. For instance, this morning he was at 17.3 mmol. About 3 hours after his morning shot, he was down to 2.8 mmol. Before today's evening shot, he measured at 8.9 mmol so I didn't give him a shot. About three hours later, he is at 20 mmol. I imagine that his level for his morning shot is going to be quite high. This yo-yo effect has been happening for almost the entire time we have been treating him with insulin and it's very frustrating, disheartening and discouraging. He is also ALWAYS hungry and wakes us up at all hours of night begging for food. If anyone has any advice to share, we would greatly appreciate it!

Cheers,
Carolyn
 
Re: Advice from fellow Lantus users on regulating diabetic c

Hello Carolyn,

I have a few thoughts for you.
The first one is you will need to get a spreadsheet started and posted. That will really help everyone here advise you better.

Without seeing your spreadsheet, I would say that it sounds like you are observing that the lantus is working because the numbers drop, however,
the foods you are feeding are probably what is causing the spikes up and down.

There are no good dry foods. They are all too high in carbs. You will want to get rid of the dry. It is the reason you still having problems.
Even the prescription foods that the vets peddle are too high in carbs.

I can't find the specific number of carbs for the wet food that you have but I constantly see that one being posted as to quit using it too. It's too high.
The european cat food reference link isn't working but I will keep looking for it to share with you.
You will want to find a lower carb.. Most of us pick food that are 10% or lower in carbs.

The fact that he is still hungry all the time shows that his diet isn't addressing his needs. And yes, his dosage will need to react to his bg.
The motto here is go low and go slow.
You will most likely need to go down to 1 unit when you take away the dry to see the effect and then determine the dosage. ( As a general rule,
wait 3 days to see how it i going with the changes)
And as you take away the dry completely, his numbers will drop as much as 100 less right away. that is why you will lower the dosage.
Otherwise you risk a hypo.
It will help with his hunger also if you can feed several small meals a day, it keeps their blood sugar most constant thru out the day.


Once there is a chart for you that all can see, we will all be able to give better dosing advise.
It is good that you are home testing.
The first step to getting this all corrected is the food change and the lower dose to observe the effect of the food change.

I'm going to go look for the food list for you.


Can someone help her get a chart up? I'm not good at that one.
 
Re: Advice from fellow Lantus users on regulating diabetic c

First of all- WELCOME!

The dry food is what keeps sending up the BG and the DM isn't that great, either. I would suggest switching. What country do you live in? We have people all over the world and could find someone in that country and find out what they feed.

You already home test, which is AWSOME :mrgreen: . That is good for when you take out the carbs Marvin's BG will drop and you will probably have to decrease the insulin as a result. Even now it seems that the 2u is too high but I don't use Lantus so am not really sure but the yo-yo effect is crazy like that. Tracking the numbers and food on a spread sheet (ss) is a good thing.

As an uncontrolled diabetic Marvin is literally STARVING and needs to eat more than normal. This will go down once he is more regulated and on a higher protein/lower carb diet (it might take a few weeks though). Once the carbs are out and the insulin has a chance to work on a level field Marvin's water consumption AND food intake will most likely decrease. Sneakers was eating about 20oz/day and is down to 10-13oz (but she has a condition called acro and will always be hungry, so not always the best role model :roll: )

Most of us feed several small meals during the day/night. Eventually Marvin should decrease on his own to just eating around 4-10 oz/day. If you worry about leaving it out- add water to it to keep it moist (I add as much water as I have food, makes it soupy and she slurps it like gravy :lol: ) or freeze it and set it out to thaw. You could do this at night. Sneakers used to wake me up every two hours for food- now it is only once during the night so there is hope in the horizon.

Good luck.

heather
 
Re: Advice from fellow Lantus users on regulating diabetic c

Marvin said:
Hi everyone,

Our cat seven year old cat Marvin was diagnosed with diabetes. We realized that he had diabetes because his water intake and urine output had increased dramatically as well as some weight loss. Once we found out he was diabetic, we switched him to DM canned food (half can in the morning, half can at night) and an 1/8 cup of DM dry food as treats. The insulin we give him is Lantus. We started with 0.5 units twice a day and have progressively increased to 2 units. We were instructed by the vet to always test before giving the shot and if his level is 10 mmol or lower, do not give the shot in case he goes hypoglycemic. After almost 4 months of treatment, his BG levels are still very inconsistent. For instance, this morning he was at 17.3 mmol. About 3 hours after his morning shot, he was down to 2.8 mmol. Before today's evening shot, he measured at 8.9 mmol so I didn't give him a shot. About three hours later, he is at 20 mmol. I imagine that his level for his morning shot is going to be quite high. This yo-yo effect has been happening for almost the entire time we have been treating him with insulin and it's very frustrating, disheartening and discouraging. He is also ALWAYS hungry and wakes us up at all hours of night begging for food. If anyone has any advice to share, we would greatly appreciate it!

Cheers,
Carolyn
Click to expand...

Hello and welcome from one Carolyn to another! :mrgreen:

A few thoughts for you...

1. A BG of 2.8 (if I did my calculations right) would be equal to about 50mg/dl. That to me signals your cat is possibly getting too much insulin, especially if you got that number so early in the cycle. He could have gone lower as the day progressed. Then his liver panics and dumps a bunch of glucose into his body (for protection), thus the high reading later on in the evening. If you ever get a reading that low, it is important to continue testing every 30-60 minutes (minimum) and be prepared with a hypo kit: http://www.felinediabetes.com/FDMB/viewtopic.php?f=14&t=2354
More info on hypoglycemia (low blood sugar):
http://www.felinediabetes.com/FDMB/viewtopic.php?f=14&t=1122
Finally, info on how to treat "low" numbers:
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=147

2. Lantus works best when you can consistently give it on a 12/12 schedule. When you skip shots, what we call the "depot or shed" start draining, and has to rebuild again. This can cause erratic numbers. When you cannot give insulin because of lower numbers at shot time, it is an indication a lower dose may be needed. Here is some information on the "shed":
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=150

3. Diet- As suggested, you may want to reconsider feeding any dry. Since you are giving such a small amount, you could substitute it with some freeze dried chicken treats. Or, boil some chicken and freeze it. Thaw some pieces out before 'snack' time and let him have at it. :mrgreen: I no longer have a diabetic cat. I still feed my foster kitty 4x/day. She gets breakfast. Then I put a small snack in a timed feeder to open 2hrs after I leave the house. She then gets dinner and a bedtime snack. Remember, if you change his diet (eliminating dry and switching the wet food brand), you will need to be vigilant with testing. And yes, considering you are already bordering on possibly too high of a dose, you will want to consider reducing the insulin as well.

4. SInce you know how to hometest (YA! :thumbup ), I would recommend doing a few full curves. This would mean testing every 3hrs during a 12hr cycle. I would do this a few times. If you just do it once, you could be catching a cycle when he is riding high after being low earlier in the past 24hrs. On days when you are not doing the curves, try and get some random tests around mid cycle. This will help you get more of a full picture as to what is going on. You can plug the information into a spreadsheet, as suggested. It makes it much easier for you and others to see patterns. Here is information on how to set up a spreadsheet:
http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

Well, Carolyn. I am glad you are here. I know all of this information is overwhelming. Take it in slowly. In the meantime, you are doing the most important thing...testing your cat to make sure he stays safe. Everything else will come in time, and hopefully his blood sugar will fall in line as well.

Let us know if you have anymore questions.
 
Re: Advice from fellow Lantus users on regulating diabetic c

Would you tell us where you are from?

It will help us to suggest canned foods for you to try?

Are you able to get fancy feast? Many of the classics are lower in carbs. Some of the friskies are .
Wellness chicken , chicken and beef, chicken and herring, kitten, salmon and trout, turkey and turkey and salmon.
Only 2 of the wellness cans go higher in carbs than 10 %. that would be chicken and lobster, and sardines shrimp and crab.
 
Re: Advice from fellow Lantus users on regulating diabetic c

Hi everyone,

Thanks so much for your advice and encouragement! We live in Toronto, Canada. We used to feed him Fancy Feast (the white fish or tuna which I think I saw has 0 carbs) and he loved it so I think we will switch him back to that. Also good to know that there are carb-free treats because our little guy LOVES treats and we love giving them to him :)

We will implement some of the changes that have been recommended, do some curves and keep you all posted.

Thanks again!
 
Re: Advice from fellow Lantus users on regulating diabetic c

Just one more question...Carolyn, you mentioned that it's not good to skip shots, which I completely agree but I was following the vet's instructions. Every time I skipped a shot, I just knew that his level was going to shoot right back up and we'd be starting from square one again...very frustrating! So my question is, what do I do if his pre-shot level is normal or low? Do I give the shot and just be ready in case he goes hypo? What if I have to go out and can't be around to monitor him? Thanks again!
 
Re: Advice from fellow Lantus users on regulating diabetic c

I posted this on your other thread

Ry & Scooter said:
Even though we know normal is 2.8 - 6.7ish, when a cat's body is used to being in higher numbers, bouncing numbers happen when the blood glucose drops outside of the "normal" range... the body panics and thinks the cat is hypo when we know they really aren't... it dumps a bunch of hormonal hypoglycemia countermeasures into the bloodstream and causes elevated BG for up to 3 days afterwards. I figure a combination of feeding dry food (a big nono) and perhaps too much insulin is causing these rapid swings in BG levels. I would cut all the dry food completely and be extra diligent about testing to prevent a hypo situation. I applaud your vet for using Lantus and teaching you how to home test, but their diet recommendations are poor.
Click to expand...
 
Re: Advice from fellow Lantus users on regulating diabetic c

Marvin said:
Just one more question...Carolyn, you mentioned that it's not good to skip shots, which I completely agree but I was following the vet's instructions. Every time I skipped a shot, I just knew that his level was going to shoot right back up and we'd be starting from square one again...very frustrating! So my question is, what do I do if his pre-shot level is normal or low? Do I give the shot and just be ready in case he goes hypo? What if I have to go out and can't be around to monitor him? Thanks again!
Click to expand...

Good question!!!
First and foremost is your cat's safety. If you cannot stay home and monitor (this may mean testing every 15-30 minutes, and having a full hypo kit ready) then it is NOT a good idea to shoot a number that is 'normal' or 'low'. Even when you are prepared, there are times when it is best to just skip the shot. As you gather more data on a spreadsheet, you may be better able to determine when it is ok to shoot a lower number (because you know how your cat will respond). You are not there yet (at no fault of your own). You are doing the wise thing by skipping the shots.

That said, if you are having to skip shots frequently because the preshots are low, than it is probably in both yours and your cats best interest to lower the dose.
 
Re: Advice from fellow Lantus users on regulating diabetic c

I agree with the others about the dry food--there is no dry food that is appropriate for a diabetic cat, including the prescription foods. Purina DM canned is a good food to feed a diabetic (3% carbs), but Hills M/D is not (14% carbs). The goal with whatever food you feed is to stay under 10% carbs. That said, while Purina DM canned is fine to feed, it's also really overpriced and there are cheaper grocery store options that are the same or better quality food. For example, there are several low carb Fancy Feast flavors that are pretty much the same thing as Purina DM. You just want to limit fish flavors to once or twice a week, because of the mercury content and its addictive and allergenic properties.

I also agree that your current dose is likely too high, and causing that bouncing up and down in Mavin's numbers that you're seeing. Here is the dosing protocol for Lantus, which gives guidance on what to do with those lower numbers, and when and how the dose should be increased: http://www.uq.edu.au/ccah/docs/diabetesinfo/link4.pdf. With Lantus, dose adjustments are made based of the nadir, or, the lowest number of the cycle, which is typically about 6 hours after each shot. It's very important to collect daily mid-cycle tests with Lantus, as well as the preshots. You'll find more information about the protocol here: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581, and some information about shooting and dealing with lower numbers here: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=147.
 
Re: Advice from fellow Lantus users on regulating diabetic c

Hi again,

Sorry for all of the questions...still new to this :)

I just downloaded the spreadsheet and have some questions about it.

1. What does AMPS refer to?
2. I assume the U column stands for dosage unit?
3. What do the +1, +2, +3, etc... stand for?
4. What does PMPS stand for?

Basically I need the entire spreadsheet explained to me! haha

Thanks!
Carolyn
 
Re: Advice from fellow Lantus users on regulating diabetic c

Marvin said:
Hi again,

Sorry for all of the questions...still new to this :)

I just downloaded the spreadsheet and have some questions about it.

1. What does AMPS refer to?
2. I assume the U column stands for dosage unit?
3. What do the +1, +2, +3, etc... stand for?
4. What does PMPS stand for?

Basically I need the entire spreadsheet explained to me! haha

Thanks!
Carolyn
Click to expand...

1. AM Preshot. The test you take before you give insulin (and before you feed) in the morning.
2. Yep
3. Those are where you put your test results, in hour increments after the shot. 1 hr after the shot, 2 hrs after the shot, 3 hrs after the shot and so on.
4. PM Preshot, same thing as AM but in the evening.
 
Re: Advice from fellow Lantus users on regulating diabetic c

Please disregard my questions about the SS. I found a thread with the answers. Thanks!
 
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