? Binnie AMPS 140

PatinToronto

PatinToronto

Member Since 2021
Hi everyone
I’m new to the forum although I’ve been dropping in and reading your educational material for weeks.

Binnie is an 8 year old 8 kg orange tabby who unfortunately loves to eat. He’s been diabetic for 2 years - responded very well to a switch to low carb wet food and a brief run of Lantus and had a medication free honeymoon of 18 months.
Now back on insulin he is difficult to control. My problem is he just dropped to 7.8 (140?) despite no change in food, or in activity (which is virtually none). He has no signs of hypoglycaemia other than hunger and Binnie is always hungry. My vet says never give insulin if under 10 but I know if I skip insulin now he’ll be 26 this evening. What to do??

Currently he gets 6U Lantus AM and 5U PM.

Any advice appreciated. Thanks
 
Hello and welcome to FDMB! :-)

I presume Binnie is still on a low carb wet food diet? How long has he been back on Lantus and was the dose increased to 6U in multiples of 1U or smaller increments? Do you use a human meter or a pet meter?

The normal range for blood sugar for a cat is 50-100 mg/dl (2.8 - 5.5 mmol/L) on a human meter. So 140 (7.8) is still on the higher side and you need not worry about hypoglycemia at those levels. If you have been home-testing and have data, I would suggest you set up a spreadsheet so we can look at the data and help you with dosing. We are very data dependent here.
How to Create a Spreadsheet
(I can help you with setting up your Spreadsheet and Signature)

We follow 2 dosing protocols and 140 is a shootable number for both protocols provided you have enough data on how your cat behaves on insulin and you can monitor.
Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)

Have you fed Binnie since the last test of 7.8/140? Can you monitor if you give him the shot? That is, get tests during the day?
 
Thanks so much!! Yes everything I read says 140 is OK (and he ran 4-5 (72-90) two years ago when I stopped insulin) but my vet scared me. I have a 2 month record of AM and PM pre-insulin sugars. I’ll get started on a spreadsheet right away.

He is still on wet food but Nulo cat has disappeared from the shelves in Ontario (I see Nulo dog food everywhere). I wonder whether the food switch caused his relapse. He is now on Purina Pro True Nature. We started Lantus at 1U BID and worked up slowly. I settled at 6U/5U as it was the best I could get staying above 10 as per vet advice. Still his PUPD never got better and I wasn’t happy with sugars 13-16 mostly. I use a human monitor - FreeStyle Lite.

Yes I fed him after the 140 this AM but no morning insulin. I know from past experience this will throw him off for 3 days :( I didn’t call vet’s office as they keep asking for fructosamine which is always high anyway.
 
PatinToronto said:
settled at 6U/5U as it was the best I could get staying above 10 as per vet advice.
Click to expand...
Do you give 6u in the morning and 5u at night?

PatinToronto said:
I didn’t call vet’s office as they keep asking for fructosamine which is always high anyway
Click to expand...
You don't need a fructosamine test if you home test enough to know how he is doing. We can help you with dosing once you have the spreadsheet up. Let me know if you need help with that. :)
 
I'm not sure I agree with not worrying about hypoglycemia. The 6.0u dose is a substantial amount of insulin. How did you arrive at that dose? If you've been reading the Lantus information, you're probably aware that we increase the dose in small, 0.25u, increments.

What was Binny's pre-shot blood glucose (BG) reading? It's helpful to know how large the drop in numbers was. (This is assuming that the value you posted -- 7.8/140 -- wasn't the pre-shot test.)

We are a bit at odds with your vet's recommendation regarding what the test value should be and skipping a shot. Once there's sufficient information about how your cat responds to insulin, we encourage shooting much lower numbers. In addition, Lantus dosing needs to be the same at AM and PM. Lantus is a depot-type of insulin. The depot is what gives Lantus it's long duration and gentle action and allows for overlap between doses. If you routinely change the dose, the depot never has a chance to stabilize and the result is wonky numbers.

All of the flavors of the food you're using are low in carbs. It not likely it's the food. Did your vet run labs when your brought Binny in? And most importantly, did you have your cat's teeth checked? One of the most common reasons for a cat falling out of remission is due to dental issues (e.g., gingivitis).
 
I chose new wet food from Dr Lisa’s chart, based on very limited availability of American brands in my home town. It’s full name is Purina Pro Plan True Nature and the chicken n liver which Binnie likes is, acc to her table, 36% prot 62% fat 1% carbs and 107 cal/3oz.
 
Sienne and Gabby (GA) said:
I'm not sure I agree with not worrying about hypoglycemia. The 6.0u dose is a substantial amount of insulin. How did you arrive at that dose? If you've been reading the Lantus information, you're probably aware that we increase the dose in small, 0.25u, increments.

What was Binny's pre-shot blood glucose (BG) reading? It's helpful to know how large the drop in numbers was. (This is assuming that the value you posted -- 7.8/140 -- wasn't the pre-shot test.)

We are a bit at odds with your vet's recommendation regarding what the test value should be and skipping a shot. Once there's sufficient information about how your cat responds to insulin, we encourage shooting much lower numbers. In addition, Lantus dosing needs to be the same at AM and PM. Lantus is a depot-type of insulin. The depot is what gives Lantus it's long duration and gentle action and allows for overlap between doses. If you routinely change the dose, the depot never has a chance to stabilize and the result is wonky numbers.

All of the flavors of the food you're using are low in carbs. It not likely it's the food. Did your vet run labs when your brought Binny in? And most importantly, did you have your cat's teeth checked? One of the most common reasons for a cat falling out of remission is due to dental issues (e.g., gingivitis).
Click to expand...
 
Yes the 7.8 (140) was the pre-shot number. He had last eaten 12 hours ago and his last Lantus was at that time, 5 units. After the 7.8 this AM he ate but no insulin.
I got up to 5 one unit at a time. I’ll post spreadsheet and you’ll see. I didn’t really see a response till 5. The 6/5 was my bright idea as I’ve been feeling kind of on my own here. I increased the AM insulin as his evenings run high. I’ll go back to 5 BID. Tnx!
 
In regards to the food list I posted above, I need to find out from Wendy who compiled it as it has been pointed out to me that the PC contains glucose as an ingredient! So check the labels for ingredients before ordering any new food. It must be a recent change or else was used as hc perhaps.
 
OK I've posted Binnie's spreadsheet (I hope) although I'm not really sure where/how other members access the file. I'm keeping him at 5u BID for now until people have had a chance to look at it and comment.
Thanks all! Any help appreciated.
 
Glad to see the spreadsheet. In order to help with dosing you need to find out how low his current dose is taking him because that is how lantus is dosed. When will you be home so you can test every two hours fir 12 hours or every 3 hours for 18} Are you home at all between +5-7? Are you able to get a +2?

Would you add more information to your signature please? What he’s eating, meter used, date diagnosed, any other issues or medication, etc. Once you do that we won’t bug you with the same questions over and over.
 
Yes OK sorry. I'll figure out how to post that in a sec.
I'm still off work tmw and can do the testing every 2 hours in theory, but it doesn't always work out. First, sometimes I get it on 1st or 2nd try, sometimes I stab him 7-8 times and give up in tears. Second, although Binnie is a sweet placid cat, I've always done his sugars while he is eating, and Binnie hardly notices as he's very single minded when he eats. I'm not sure he'll let me do the sugars if he's not otherwise occupied. But, I'll try.
Thanks!
 
Couldn't write everything in signature as too many characters and too many lines. Unable to add that he has lymphoma x 2 years, stable. Reg vet checks and reg chemistry, all normal except BG and fructosamine. Also that he was in remission for 15-16 mos and only relapsed 2 mos ago, I think related to a change of diet. I was no longer able to buy Nulo, and switched to Purina Pro Plan True Nature which is 1% carbs on Dr. Lisa's list, but his PU/PD started shortly after the switch.
 
Welcome to FDMB. I’m sorry Binnie is back from remission but it’s unlikely it’s the switch to a 1% calories from carbs food. We’ve found that many diabetic cats do best on foods that are in the range of 6-10% calories from carbs so a 1% food won’t have an effect. If you weren’t feeding dry but added that in the mix, that would do it :)

I’m glad Bhooma linked the Start Low Go Slow method for you. Be sure to ask any questions you have on how to use it.
 
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