? Bacardi’s pattern - going from black to green/blue twice a day. Is he bouncing?

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MrWorfMen's Mom said:
Without any symptoms now or previously of pancreatitis, that does seem a long shot explanation for Bacardi's BGs. My bet is that his numbers will flatten out with insulin withheld resulting in lower pre-shot BGs (non food influenced readings even without insulin) but be higher mid cycle telling you he still needs insulin. This still leaves the question of how much insulin he needs up in the air. I think it's the action of Caninsulin and not the dose of insulin that is causing those significant highs and lows and a switch to Lantus would be a good next step.
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Yes, that is exactly what my vet said - and is probably waiting for - a flatter curve. She was more worried about switching him to Lantus right away, because she was unsure about the initial Lantus dose (she said that with his nadir numbers so low she was afraid of sending him to hypo with the switch) - so, it will either be as you said (lower preshot numbers but higher nadir) and then he'll get Lantus, or the unlikely case of him going into remission.
 
AlysonE said:
Sorry I got so emotional. It was one of two worst experiences of my life, I would not wish it on anyone. Thank you for your kind thoughts. <3

Back to the issue at hand, I am so glad you decided to wait. If the solid real issue is "having a hard time controlling a diabetic cat" then it seems very counterproductive to put that cat on a high carb diet based on a vague suspicion and no relevant symptoms. Best of luck to you and handsome Bacardi The Great. :)[/user]
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Thank you! I'd love you to hang around if you want, I am going to update this thread from time to time :)
 
So, we are in the middle of Bacardi's insulin withdrawal test and it's going terribly. Instead of "higher nadir and lower preshots" situation we have just "high all over the place" one. The vet told me that we need at least 3 days to see the real effects, but I am afraid I am already hurting him. He begs me for food all the time, so I think he's uncomfortably hungry. I am considering calling it off...I don't know. The vet is in later today, so I'll give her a call.
 
I hope your vet tells you to call off this no insulin trial. There's really no need to have any sort of wash out period when switching insulin. It's obvious he doesn't feel well in those high numbers and they put him at risk for ketone development.
 
We have 14.8 now! I was expecting HI to be honest. Well, at least a partial relief. Will call her anyway, she wanted to make sure that he still does need insulin (no surprise he does). I can’t wait for our Wednesday appointment, where I will finally (hopefully) get Lantus for the little rascal.
 
How stressful that must have been. I get upset and emotional when my pets act like they are suffering. You were brave, but I am glad for you both that Lantus is coming soon. :)
 
Hi again guys. So, more bad news today. I went to the vet to finally get my Lantus prescription. I was told that there was a shortage of Lantus in pharmacies and walked out with two prescribed insulins: Lantus Solostar (a prefered one) and Toujeo Solostar (which my vet told me is what I most likely would be able to get). All good. BUT!

1) I was told to start him at 1 unit, but just in one shot per day. (from what I've read I think it would be better to give him 0.5 in the morning and 0.5 in the evening, right?)
2) a huuuuge problem! They ONLY sell prefilled pens of Lantus in my country (and Toujeo as well). Those pens only do 1 unit increments, which I don't want as we are talking about 0.25 u increments in the SLGS protocol. I asked the pharmacist about other insulins that they do sell in vials, so that I can ask you about the best alternative for Bacardi, but she refused to answer and told me to tell the vet to do the research. But my vet did not even know that they only make Lantus pens, because she told me to get 100u injections. So, as much as I respect my vet, I am sure that she is not as educated about feline diabetes as the collective brain here ;)

So, we're back on caninsulin until I figure out what to do now. The question is: should I get those pen cartridges and draw from them? Is that even possible? Would they be airtight once I "damage" them? Or do you know about some insulin, that I might be alble to get in vials (this is a hard ones as I believe every country is different). Whyyyyyyy does it have to be so complicated? I was really hoping that we would start Lantus tomorrow morning!
 
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MrWorfMen's Mom said:
WHOA on the TOUJEO! DON"T USE IT! It is highly concentrated Glargine triple the dose per ml that Lantus is.
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She told me only to get it if I can get 100U.I/mol - warned me about the 300. But I am not going to get it, as they do have Lantus in the pharmacy. The problem is - they only have pens..no vials :(
 
Sorry I didn't mean to leave you hanging .....I'm monitoring another low kitty and just wanted to be sure you didn't end up with a major catastrophe.

As for the pens, you can buy syringes and use the pen like a vial but you don't need to inject air into it. You need 3/10ml 31 gauge, 8mm syringes with half unit markings. There is a picture somewhere of how to use the pen in this way but I'll have to look for it. The pens are a far better value for our cats anyway because with a vial you often end up with a pile of waste due to the small doses we use. If you need further help with the syringes, just holler. :)
 
As for dosing, Lantus works better when given in a consistent dose twice daily so you would start Bacardi off with 0.5u twice daily every 12 hours. There has been the odd cat only getting one dose per day but they are generally already regulated and it's still rare.

Other insulin options for Bacardi would be Basaglar (glargine under a different brand name) which I believe is a bit cheaper than Lantus and Levemir which is a different but somewhat similar long acting insulin. Someone here is trying out Tresiba but there is little experience with it in cats at this point in time.

Don't be concerned that your vet may not have all the details about the different insulins. They are human insulins and they just don't have the experience with them yet. My vet had to research when I wanted to switch from Lantus to Levemir due to my cat's high dose condition (different PH for comfortable shots). TA this point in time, they are coming out with all sorts of different human insulins but vets just don't have any reason to keep up with those new human drugs under most circumstances.
 
Do watch the excellent video on that page. It makes very clear the differences between drawing from a vial and using a pen. I found it a huge help when I recently switched to a pen.
 
Merry Christmas to you all from Bacardi & me ;)
 

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