Belle- new diagnosis

[AmandaL&Belles]

Hi everyone. We are in uncharted territory with my Belles, 8 y/o. We are recently diagnosed on Friday May 28. Among a new diagnosis, we are also fighting a UTI and ear infection. My girl has been on RC Urinary S/O for the last year as she is prone to crystals. She now (whether due to UTI or just feeling yuck from highsugars), will barely eat anything. I understand the concept of a proper diet with diabetes, but right now we are trying to get her to eat anything. She will not eat her regular food, and we have tried pates and morsels with gravy (which she tends to like a little, but barely eats any of the meat, mostly licks gravy even when I mash it up). We just started at home testing 3 days ago, so that in itself is a feat when we are able to accomplish it. I only have three readings so far (PLEASE DONT BE HARSH, I see it often when people aren't doing the exact right thing with their bubs, but we are trying and learning!). And yes I will start using the spreadsheet when we are more comfortable with testing.

We have been prescribed Lantus, 4u twice a day (which seems like an extremely high starting dose to me, soI've been using my nursing judgment based off how much she eats). I know, start low and go slow. I alsounderstand the importance of regular interval testing and not as I have done it so far. Like I said, it's alearning curve for all of us here. The first 2 days, I did give the 4u as told but we were not testing at that point, and she ate basically the same as she is eating now,very little. I'm obviously terrified of the lows.

Readings:
May 31, 2021 at 1700- 26.9 mmol (484.2 mg/dl) [1unit after eating]
June 1, 2021 at 1645- 20.7 mmol (272.6 mg/dl) [1unit after eating]
June 2, 2021 at 0600- 10.8 mmol (194.4 mg/dl) [no insulin yet]
I hope I have provided sufficient information for someones input and hope that someone can advise. What should we do in a situation like we have currently, with a BS of only 10.8 and eaten a small amount? Should I withhold, should I give a very small amount of Lantus? TIA

 

[Wendy&Neko]

Hello and welcome to you and sweet Belles from the Canadian west coast. As you probably know, that UTI and ear infection can also raise your girl's numbers. The RC Urinary S/O (hopefully just the wet food) is high carb and would be the time of food we'd bring out if our cats were going into low numbers. For when you have time, some reading from a vet specializing in feline nutrition for proper diet for urinary issues is HERE. The catinfo website has all sort of good info. Anyway, all of those combined probably mean's your girl tested higher in the vet than normal. Some cats also get an increase from stress at the vet.

All that to say, 4 units is a HUGE starting dose. It's much better to start lower and work your way up to that dose if you need to. A typical starting dose here is 1.0 units. We find that giving the same dose each time is better for our dosing methods and the depot nature of Lantus. And as you can see, that one unit you've been giving so far is lowering her numbers.

For your specific situation, we tell brand new people not to shoot if under 200 at shot time. Although the guidance can change if there are ketones or recent DKA. If your cat is just under 200, you can wait 20-30 minutes and retest to see if she's coming up over 200. Or give half a dose. Are you using 1/2 unit marked syringes? (BD Ultrafine II).

I am worried that Belles has gone off her food. Are you testing her for ketones? I'm worried about the potential of DKA. The three pieces of that formula are infection, not enough insulin (likely at this point), and not enough calories. You can get Ketostix at most pharmacies and just put in the urine stream. Tips to catch and test a urine sample

By the way, the fact that you've started home testing is great! I did a lot of crying to start, we all had difficulties learning how to do it. If you have questions about it or are looking for tips, let us know and we can help.