? Changing insulin

[Nada]

Hello, everyone!
I haven't posted in a while, but I've been having problems regulating my kittie. I went to 4 units of lantus gradually with no change in readings. Good thing was that he kept gaining the weight he lost and he was looking better and better. No signs of the dehydration that was constant.

As it turns out he has a UTI and started an antibiotic last sunday (amoxiclav). The readings started coming down a little but still not the target. He stopped drinking tons of water and only drinks small amounts since the antibiotic.

I only have a couple of doses in the lantus pen and as I only buy it individually, I was asking wether I should change into Levimir or stay on lantus for a while longer.

Regarding The missing readings between the 3 and 4 units. I was getting one every once in a while and not recording it. I saw no point in wasting the test strips when his readings are always high. And I could always predict it since he never stopped drinking.

 

[Wendy&Neko]

We typically suggest trying one insulin for at least six months. He did get to green on Lantus a couple weeks ago. The UTI can make a difference and his numbers should come down with treatment. I think I would try at least one more pen of Lantus,

 

[Nada]

How longer do you suggest I stay on 4 units before I increase? As I said he's already gaining weight so I don't think It's a matter of the insulin not being enough.

 

[Wendy&Neko]

You can tell it's enough insulin when his blood sugar numbers come down. Right now the numbers are mostly too high. I would increase to 4.25 now. I wouldn't hold doses longer than 7 days, unless his nadirs are where you want them to be, please make sure to gets tests before every shot. The data may be high and not important to you, but we need that data to give dosing suggestions,

 

[Sienne and Gabby (GA)]

I honestly don't think you can accurately evaluate the effect of the insulin if your kitty had an infection. There's a good chance the UTI was inflating his numbers.

I don't think this is a matter of the insulin not lasting long enough. I think Farafero needs more insulin. (I'm writing just as Wendy posted.) Whichever dosing method you're using -- Tight Regulation or Start Low Go Slow -- I would follow the method closely. You don't want to hold doses overly long if the numbers aren't in the range where you want them. Most of us aim for normal range (50 - 120) numbers. While fewer symptoms and weight gain are important, the BG numbers are really what you're looking to lower.

Also, how long is your kitty supposed to be on the antibiotic? Did your vet get a sterile urine sample (use a needle into the bladder to get the urine) and run a culture and sensitivity? The latter will allow you to know what bacteria is growing and then the vet can select an antibiotic that's specific to the bacteria. If Farafero's numbers start to go up again even with your increasing the dose, I wouldn't be surprised if the infection isn't gone.

 

[Nada]

I honestly don't think you can accurately evaluate the effect of the insulin if your kitty had an infection. There's a good chance the UTI was inflating his numbers.

I don't think this is a matter of the insulin not lasting long enough. I think Farafero needs more insulin. (I'm writing just as Wendy posted.) Whichever dosing method you're using -- Tight Regulation or Start Low Go Slow -- I would follow the method closely. You don't want to hold doses overly long if the numbers aren't in the range where you want them. Most of us aim for normal range (50 - 120) numbers. While fewer symptoms and weight gain are important, the BG numbers are really what you're looking to lower.

Also, how long is your kitty supposed to be on the antibiotic? Did your vet get a sterile urine sample (use a needle into the bladder to get the urine) and run a culture and sensitivity? The latter will allow you to know what bacteria is growing and then the vet can select an antibiotic that's specific to the bacteria. If Farafero's numbers start to go up again even with your increasing the dose, I wouldn't be surprised if the infection isn't gone.

I'm sorry I just read your reply, we haven't done a culture yet and went to empirical therapy instead, I'm supposed to give him his antibiotic for three weeks and if there is no improvement, we'll do the culture. I'm trying to reduce the expences as much as I could because these things are really expensive here and my parents are the ones paying, so I can't push it too far.

I've read the protocol for increasing the dose and I know it should be by 0.25 units, but that's not possible for me because I could only find the 50 units syringes, so I go by half units. Also the reason I held the dose that long was to give the antibiotic a time space to start working in case the infection was the reason for the high numbers. But I just increased it now. Thank you for helping me understand more about it.

 

[Sienne and Gabby (GA)]

It's not that you can't "find" syringes in 0.25 units -- they don't exist. We approximate the dose. As long as you can be reasonably consistent with measuring a dose that's less than 0.5u, you're doing fine. In the sticky note on syringe and insulin information, there are pictures of micro-doses.