Advice needed - dosage and general trends

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Jaime & Luka

Jaime & Luka

Member Since 2022
Luka's spreadsheet - https://docs.google.com/spreadsheets/d/e/2PACX-1vQ25bdajkIUnRXX-y6lhTVu_2tMf58etnG6U3GlCjLLi1nE0jdh0YhdaFwPZCu8Twu1jRi_PoVng_N4/pubhtml

Hi there,
Luka has been on Lantus for a bit more than 2 weeks now. Because I'm not always at home to test/keep an eye on him, I've not given him insulin on the mornings that he has tested low, but then I come home when I can for spot checks. On the mornings that I've not given him insulin, his numbers have kept very steadily, and then I've been giving him 1 unit of Lantus at night.

I'm very new to this and worried that it might not be the right approach to take - is there anyone that could provide me with some guidance or advice based on the data that I've collected so far?
 
Hi and welcome to the forum. Good job setting up the spreadsheet and starting to populate it with data!

when you don't give any insulin, instead of 0.00 please put NS for No Shot in the column labeled U.

dosing advice here is generally based on the nadir (low point) not the pre-shot number. Like on 3/4 when he went down to 59 on .5u, that is a small dose and yet he was all the way down to a 59, wow. I don't know what to think about that tbh, but I am pretty new at this myself.

Eliminating all dry kibble might and going to a low-carb all canned food diet might help even more.
 
Hi Jamie, you would be better splitting the 1 unit and giving Luka 0.5 units both am and pm dose and see if you can get better numbers that way. Also you need to be getting some tests in during the PM cycle as well if at all possible. Cats often drop lower at night and it is the nadir or lowest point in the cycle that determines the dose. So those numbers are important.
Try and get a before bed test in every night if possible if nothing else. If that test is lower than the preshot test I would set the alarm and get up and test again to see the BG hasn’t dropped too low.

Also if the BG is not high enough to shoot, try stalling, don’t feed and test again in 20 minutes to see if the BG is rising. And post and ask for help . Change the subject line to gain attention.
Are you offering snacks during the cycles as well as the preshot meals?
 
Hendrick's mom and dad said:
Hi and welcome to the forum. Good job setting up the spreadsheet and starting to populate it with data!

when you don't give any insulin, instead of 0.00 please put NS for No Shot in the column labeled U.

dosing advice here is generally based on the nadir (low point) not the pre-shot number. Like on 3/4 when he went down to 59 on .5u, that is a small dose and yet he was all the way down to a 59, wow. I don't know what to think about that tbh, but I am pretty new at this myself.

Eliminating all dry kibble might and going to a low-carb all canned food diet might help even more.
Click to expand...

Thanks about the NS tip - didn't know that!
He is predominantly on wet food now (since about 27 April) and that's made a nice difference. I'm still trying to figure out his Nadir number as I believe it's different for all cats. I guess the more data you get the better, but it's not easy when you work during the day!
 
Bron and Sheba (GA) said:
Hi Jamie, you would be better splitting the 1 unit and giving Luka 0.5 units both am and pm dose and see if you can get better numbers that way. Also you need to be getting some tests in during the PM cycle as well if at all possible. Cats often drop lower at night and it is the nadir or lowest point in the cycle that determines the dose. So those numbers are important.
Try and get a before bed test in every night if possible if nothing else. If that test is lower than the preshot test I would set the alarm and get up and test again to see the BG hasn’t dropped too low.

Also if the BG is not high enough to shoot, try stalling, don’t feed and test again in 20 minutes to see if the BG is rising. And post and ask for help . Change the subject line to gain attention.
Are you offering snacks during the cycles as well as the preshot meals?
Click to expand...

Thanks for the insight Bron! I've switched over to 0.50 from tonight and do a few tests before we go to bed.

In terms of snacks - he has dry food available (barely touches it) and we snack during the day. He eats like a machine so thank heavens we don't struggle with that!
 
Hi Jaime,
A couple of comments. If you get a BG of 79 at +4 like you did last night, I would suggest getting another test in because he could drop further and it’s better to know that he is back on the upward trend. At +4 he could still be dropping.

Also can you have a look at the two dosing methods we have HERE and see which one you want to follow. If you are still feeding any dry food, you will need to choose SLGS. If you are doing SLGS you reduce the dose at 90BG, and you hold the dose for 7 days and then do a curve to see if the dose needs adjusting.
He is actually doing really well for a newly diagnosed cat.
If you choose SLGS and get rid of the dry food, you will need to reduce the dose to 0.25 units twice a day.
But be careful taking away the dry food if you think he is still eating it, as that could drop the BG quite a bit and we don’t want that to happen. If you do take away the dry food make sure there is plenty of low carb there for him to replace it if he snacks on it.
do you leave out snacks at night as well?
Also you will need to monitor more closely for a few days after taking away the dry. Does that make sense?
 
Bron and Sheba (GA) said:
Hi Jaime,
A couple of comments. If you get a BG of 79 at +4 like you did last night, I would suggest getting another test in because he could drop further and it’s better to know that he is back on the upward trend. At +4 he could still be dropping.

Also can you have a look at the two dosing methods we have HERE and see which one you want to follow. If you are still feeding any dry food, you will need to choose SLGS. If you are doing SLGS you reduce the dose at 90BG, and you hold the dose for 7 days and then do a curve to see if the dose needs adjusting.
He is actually doing really well for a newly diagnosed cat.
If you choose SLGS and get rid of the dry food, you will need to reduce the dose to 0.25 units twice a day.
But be careful taking away the dry food if you think he is still eating it, as that could drop the BG quite a bit and we don’t want that to happen. If you do take away the dry food make sure there is plenty of low carb there for him to replace it if he snacks on it.
do you leave out snacks at night as well?
Also you will need to monitor more closely for a few days after taking away the dry. Does that make sense?
Click to expand...

Hi Bron,
I've been following the SLGS method because of his low numbers.
He currently has access to dry food at all times, but he loves wet food and is eating that about 90% of the time.
I will try to get that 6+ PM shot tonight, but his numbers are so low today that I don't really know what to expect! But it looks like +6 is his Nadir.

Would you recommend that I perhaps rather move to a 0.25 shot? For example this morning when I decided to NS, would you have rather given him a lower dosage?
 
I don't really understand what's going on here, is this kitty even diabetic? Down to the mid-greens today on no shot. Little rise with food then back down. Andi I don't see how it could be the depot at work because most of the past mornings have been no shot.

Has to be the pancreas working, no?

@FrostD @tiffmaxee ?
 
Hendrick's mom and dad said:
I don't really understand what's going on here, is this kitty even diabetic? Down to the mid-greens today on no shot. Little rise with food then back down. Andi I don't see how it could be the depot at work because most of the past mornings have been no shot.

Has to be the pancreas working, no?

@FrostD @tiffmaxee ?
Click to expand...

I would really like him to not be diabetic His poor little bunny ears aren't loving the pricks.

My vet thinks that it was steroid induced as he had a shot once a month for three months, and the diabetic symptoms (massive increase in water intake). I will add that before the diagnosis he was on 90% dry (Hills Prescription for Urinary Stress) and 10% Gravy sachet, and now he is 90% on low carb Jelly pouches and 10% dry food.

The vet did three blood glucoses tests over a period of a 5 days and settled on the initial dosage of 1 unit of Lantus AM + PM, but then I started home testing (vet was against it) and have started to adjust his dose as he hits low numbers most of the day. He has now been on Lantus for 18 days.
 
Pancreas is working but not quite enough (or in the case of steroids, the liver still fighting you).

There is still depot there from the PM shots. See what the others think, but if it were me I'd resume with 0.25U and try to give that consistently AM and PM if over 150.
 
Since he eats some dry food please reduce to .25 as his BG dropped under 90. I think if you can totally eliminate the dry he will become diet controlled since as his pancreas seems to be working and just needs a little more support. I’d get an auto feeder and load it with wet food to open a couple times while you are at work since he loves the wet food. Meanwhile he’s looking good even with the dry. Is he still getting any prednisolone? Going off the steroid and eating mostly wet might just be why he’s mostly in normal BG.

My first cat had acne and was on steroids but never became diabetic but it’s very common. Are there any other treatments for it? Do you feed on plastic bowls? If so switch. It might help.
 
Hendrick's mom and dad said:
'hol up

just shy of 4 months posting here, never seen that before. What's that about? We use only ceramic but that is super interesting to me.
Click to expand...
Feeding on plastic is one way cats get feline acne. That being said it didn’t prevent my cat from getting it once I switched. Glass or stainless steel is best and most be used if feeding raw.
 
As for dosing, I agree with the others, try 0.25 units next. His spreadsheet doesn't quite look like a cat ready to be done with insulin, but close. Fingers crossed.

Plastic bowls can be homes to bacteria and aren't as easily cleaned. Metal, glass, ceramic are better options.

One other thing, it's not "very common" for cats on prednisolone to become diabetic. It does happen, but not what I'd call common. Steroid shots are a different matter. I belong to another group where almost all cats are on prednisolone for treatment of their condition and we don't see many diabetics. I once tested one of my pred kitties, and on 5 mg daily it added about 20 points to his BG's. But still in normal range.
 
Thank you all for the feedback!
We left last night to travel to my parents and I have forgotten his insulin at home It's going to take 2-3 days to get new insulin (remote town) but will be checking is numbers until we have access to it. Not my best cat-mom moment!
 
tiffmaxee said:
Since he eats some dry food please reduce to .25 as his BG dropped under 90. I think if you can totally eliminate the dry he will become diet controlled since as his pancreas seems to be working and just needs a little more support. I’d get an auto feeder and load it with wet food to open a couple times while you are at work since he loves the wet food. Meanwhile he’s looking good even with the dry. Is he still getting any prednisolone? Going off the steroid and eating mostly wet might just be why he’s mostly in normal BG.

My first cat had acne and was on steroids but never became diabetic but it’s very common. Are there any other treatments for it? Do you feed on plastic bowls? If so switch. It might help.
Click to expand...

We are trying to get him completely off dry food and I've ordered a stainless steal auto feeder, but it takes some time to get to South Africa. I need the one with the ice packs as he refuses to touch wet food that's been in his bowl for more than 2 mins...

He only feeds/drinks out of stainless steel bowls, and hasn't received prednisolone since early March.

His numbers are again so low today which is a saving grace as I forgot his insulin at home and have had to order it in as we are in a remote location ‍♀️
 
Removing prednisolone will give him a very good chance at becoming food regulated. His numbers may start to go down very quickly so it’s important to have lots of test strips at all times. So please stock up since it takes time to get them to you. Do you add a little water to his food? That might make it more palatable for longer. But knowing cats it might not help.

How long will it take fir the insulin to arrive? You do keep it refrigerated, right?
 
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