AMPS is 337, second day on Lantus

[Sarah and Baby]

I gave my sugar kitty 1u of Lantus last night, had some interesting BS. (See spreadsheet in signature)

She hasn't eaten much for two days and I'm worried about shooting her on an empty stomach. She has a history of ketones in her urine.

I am completely exhausted right now from taking care of Baby and working and everything else in my life. Please help me!

 

[Ann & Tess GA]

Hi and Welcome to LL! Have you read the stickies at the top of the forum? I know it's a lot to take in. Most of us have to read them, re-read them and then read them again, before most of it sinks in. You have found a great resource here though, it is a large and very active group and there is usually someone around to help. We test a lot (also known as the Vampire Club) , but it helps so much to see what is happening with our kitties.

When you first start Lantus it will take several days before you start seeing the full effect of the insulin. This is because a reserve (we call it a shed) builds up in the body, so the entire dose is not immediately available for the cat to make use of. So you will need to be patient for 5 to 7 days. For this same reason we do not adjust the dose frequently, every time we adjust the dose we hold it for 6 cycles so the shed can adjust.

Also, we are basing our doses on the lowest number of the cycle (the nadir) not the highest as with some other insulins. This is why we stress mid cycle checks here.

Things will settle down, but we all have faced the mountain you are staring at. It does get better, there is a life w/ FD.
Welcome to LL again, from a former Minnesotan.

 

[Marje and Gracie]

Sarah....I saw your post on Health. Here is what I said on that condo:

We usually recommend you do not shoot if she isn't eating. You have to have food on board to work with the insulin or she could drop too low. However, the problem with ketones in her urine is worrisome because DKA can occur if there is not enough insulin. Can you syringe feed her? My recommendation is to try and syringe feed her....put extra water in the food that you syringe her with and then give her insulin......but keep syringe feeding her what you normally would give her. Just take it slow so she doesn't get sick. Here is a link to syringe feeding if you have never done it.

[youtube]U6o17wH6ujk[/youtube]

The other option is to try and let her eat on her own....do you have some really smelly foods like Fancy Feast foods?

eta: It DOES get better. Many of us work. Many are doing it totally on their own. You will get more comfortable; you'll get into a routine. And you have us here. We will help you...answer your questions, give you moral support. It's an amazing group. We could not have done all this without this group and maintained our sanity. Sending you HUGS.

 

[Ann & Tess GA]

Here is a link to the Health Post

You said she isn't eating "much." How much? The minimum she should be eating to prevent DKA is 15 kcal a day per pound of ideal body weight. If she is eating less than that you should try the syringe feeding. What foods have you tried? How about baby food? The plain strained meats w/out starches or onions. Or chunks of cooked or raw chicken.

The other problem w/ not eating enough is that there is a chance of hypo once the insulin kicks in. Fortunately w/ Lantus you have a little leeway for getting food onboard. Onset is usually 2 to 3 hours after the shot.

 

[Karrie and Maverick]

Definitely start syringe feeding. This way her liver stays happy while you tackle the diabetes. Marjorie posted a great video. You can get oral feeding syringes from your vet. Mixing it with water helps.

Did you change her food recently? Do you know why she isn't eating as much as normal?

Welcome to Lantus Land. Hugs to you and Baby.

 

[Julia & Bandit (GA)]

What are you feeding Baby? Have you tried some different types of food? Both of my cats have developed food aversions to whatever their current food was when they weren't feeling well, and I had to switch the brand/flavor for a bit until they felt better. Also, canned tuna, turkey, or salmon worked well to mix with the food to get them to eat if they didn't want to eat anything at all. With Gabby's stomach cancer I went through food aversion with her about once a week over a period of 7 months, so if none of that works I have more tricks I'd be happy to share.

If switching flavors doesn't help right away, I second the syringe feeding. If you can, get something high calorie like Wellness kitten formula (or Wellness Chicken or Turkey are good, too). EVO and Merricks are also higher in calories. It's important to get those calories in her if she's at risk for DKA.

 

[Sarah and Baby]

Baby ate about half her can of food after I dosed her and went to bed. I know that wasn't ideal, I'm sorry. She's on Special Kitty right now, that's about all I can afford. She was eating it just great three days ago, 2-3 cans a day. I've tried all the flavors she liked before /sigh. she did this on Fancy feast too, ate just great the first week then didn't want anything to do with it. I can't afford to feed her fancy food. If she doesn't eat again, I will try and force feed her. I am hoping she will just eat!!

 

[Karrie and Maverick]

Maverick was on special kitty and two of the three shelter cats (two adopted, one foster) are eating fancy feast. Any food a cat eats is the best food. Maverick liked it more than Fancy Feast and the FF spiked his blood glucose too. Just wanted to know if the lack of appetite was due to a change in food. Maverick had to be syringe fed when we got him off kibble. It was a long transition

 

[Julia & Bandit (GA)]

Baby ate about half her can of food after I dosed her and went to bed. I know that wasn't ideal, I'm sorry. She's on Special Kitty right now, that's about all I can afford. She was eating it just great three days ago, 2-3 cans a day. I've tried all the flavors she liked before /sigh. she did this on Fancy feast too, ate just great the first week then didn't want anything to do with it. I can't afford to feed her fancy food. If she doesn't eat again, I will try and force feed her. I am hoping she will just eat!!

I've suggested this for a few people today that were having trouble with foods today--EVO 95% is cheaper than Fancy Feast if you get it in the big 13 oz cans. Wellness also sells the Chicken and Turkey formulas in big cans that makes it more affordable. All of those are high in calories, lower in carbs, and cheaper than the prescription high-cal food the vet would prescribe. Plus, because of the high calories once Baby is maintaining her weight again, you don't need to feed as much of it as you do for SK or FF.

I wouldn't recommend buying the big cans until you've tried a few different flavors in the smaller cans to make sure she likes it and will eat it. So you don't end up wasting most of a big can.

And once she's eating again, you might be able to go back to Friskies or Special Kitty. Bandit developed a food aversion recently to his EVO and Merricks when an incredibly stressful dental left him feeling awful, so I switched him back to Fancy Feast because that's what he wanted to eat. Now that he's feeling better I'm re-introducing the EVO and Merricks, and he's gobbling it up just like he used to. Gabby used to do the same thing--I could rotate some foods she developed an aversion for back in after a month or two without it.

But even just temporarily, I would try it to see if food/liver aversion is the problem, or if something more serious is going on.

 

[Sienne and Gabby (GA)]

Sarah --

Are you testing for ketones? I know money is tight right now but Ketostix are not terribly expensive. I'd check to see if Walmart has their own brand -- they probably cost less than other options (which run around $15). This is a small investment that will prevent a huge vet bill. Also, add water to Baby's food. The better the hydration, the more you will keep flushing Baby's system.

There are a couple of tricks that may entice Baby to eat. Sprinkling food with freeze dried chicken (or beef, salmon, etc.) treats is one thing that most cats really like. A pack of the treats goes a long way. Likewise, sprinkling canned food with some dry food that's been pulverized into dust may also work. The bottom line is that your cat needs to eat. If it means switching between different foods every day, that's fine. I alternate between two different flavors of the same brand of cat food each day.

Other than being picky, is there any other change in Baby's behavior?

 

[Jill & Alex (GA)]

here's some ideas on how to get kitty to eat from cheryl/winnie:

Remember -- getting to the bottom of why he is not eating is most important. That way you can treat the underlying cause ( or symptoms of underlying cause) . It is always very important to get cats to eat, as they can quickly develop hepatic lipidosis from lack of food.

Here are some things you can do do entice your cat to eat:

-sometimes in order to get a cat to eat you even have to resort to dry it is more important that they eat. there are a couple low carb / grain free brands -- EVO and wellness core.

-making a buffet to give him choices
- heating food

sprinkle food with :
- forta flora -- a probiotic you can get at vets or online. is very smelly and cats love the taste of it.
- parm. cheese
- smashed crumbles of dry food
- bonito tuna flakes
- halo chicken treats -- crumble into dust over food -- my Wolfie loves this stuff.
- poor a little water from tuna in water over food ( I use low sodium/no sodium added as other kinds in water has veg. broth in it and I assume that means onions, which are toxic to cats-- check labels)
-powdered oregano. yep sounds weird . but some cats like it and it will entice them to eat.

other ideas of foods to offer your kitty to stim appy:
- trader joe tuna for cats
-baby food -- beechnut turkey and broth or chicken and broth. they have no onions or other additives. some babyfoods have onions . please read labels if you can't find beechnut.
- kentucky fried chicken
- deli turkey /chicken
- plain cooked ( boiled or baked ) chicken breast
-canned chicken for people (watch the label that their are no onions)
- chicken broth -- low sodium

If enticements don't work, you should consider:
-assist feeding ( syringe or make little meatballs and place in mouth)
-and/or talking to your vet about appetite stimulents ( mirtazapine or cyproheptidine)
http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=26965#p273790



you've already been given some very good advice. in order to prevent ketones from developing again you'll have to get food, water and adequate insulin into baby as well as treat any infection or underlying health condition. the dose may have to be increased sooner than later, but first things first. you'll want to get baby's normal amount of calories into her everyday. i hope some of the ideas listed above will help.

also, as mentioned... please pick up some ketostix or ketodiatix to test baby's urine for ketones. follow the directions on the label carefully. if baby is throwing even a small trace amount of ketones, please let us and your vet know right away.

i know all this information is overwhelming especially when you're trying to balance everything else in your life (we've all been there), but in no time at all this will all become routine. you can do this. we'll be here to help.
hope to see you posting often...