Cheekyface - post-vacation and lower numbers on Lantus

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Lesley & Cheekyface

Lesley & Cheekyface

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Hi all, just checking in and looking for some opinions/advice on dealing with much lower numbers than I've been used to since we were diagnosed end of May.

I got back from holiday on Wednesday evening and collected my girl from the cattery Thursday lunchtime. She'd been well during her stay with no problems and received 2u Lantus bid, which means she'd been on that dose for 18 days. As it was a vet-run cattery and she was housed in the hospital section, I wasn't worried about not having BG readings for that time--they would have charged me $15 a pop for it and since she was never alone, she was safe.

Once she came home, I recommenced testing, using a new OneTouch Verio meter which needs less blood, and gave skinny 2u on an AMPS of 11.3 (203). BOY has she dropped!! I had to run a lot of errands most of Friday, hence no spot tests during the day. She was bright and active when I did the +11, purring fit to bust as usual, so I ran side-by-sides on those late-cycle 5s (90s) readings and the difference with my AccuChek is 0.6 at the most so I have to believe them. I chose not to shoot, especially since she only picked at her dinner, and cut the Saturday AM dose by 0.5u. Lots of 6s (100s) and no real rise to PMPS, but she ate all her dinner so I gave a skinny 2u and stayed up to test nadir.

That was 3.8 (68) and way too near the danger mark for me since I understand that 5 (90) is lowest desirable for a FD; so, coupled with another lowish AMPS reading and her mild lack of interest in food, I halved this morning's dose (she then ate all but 2 tsp of her 1/2 can bf by +2 and has nibbled at tuna). It's turned raining and cold here so I think her arthritis is bothering her as well and I'm trying not to be paranoid about her sleeping so much--Bodie is too, after all :smile: and my bad hip is killing me, so I'm not moving much either :lol:

But as of tomorrow, I'm back to work and can't get home during the day to test and so am VERY wary of continuing on 2u. My plan is to reduce to 1.5u, talk to the vet, and reassess in a week once we've really settled into the home routine again. Does anyone have any thoughts?

Lesley
 
Re: Cheekyface - new dance steps, lower numbers!

I am not all that familiar with Lantus (use PZI) but I think your gut instinct is right. If you have to go to work and nobody is going to be around at nadir, then I'd go with the reduced dose of 1.5 in the mornings. I have a really screwed up work schedule. Some weeks I'm working during the day and not around for the drop in BG and other weeks it's the opposite - not around for the night drop in BG. A huge advantage for me is that I work and live on an island, and I'm never more than 5 or 10 minutes from home while I'm working. So I can swing by the house and at least check on Bob if I feel the need.

You're dosing 2u (or 1.5) 2x per day, right? I mean, the same dose each shot? What I did with Bob was once I started to reduce his dosage, I would for instance give him 1.5 in the morning and then 2 at night. I continued that, where if one was lower than the other, it was always the morning dose that I'd shoot the lower amount of insulin. That worked best for me with my schedule, and removed the worry about a hypo incident when Bob was home alone. You might find that going with 1.5 am and 2 pm will work out for you, providing his BG numbers continue to be within an acceptable range.

That seemed to work great with PZI, but I am not sure how or if it works with lantus. I'll let an experienced lantus user chime in...

Carl in SC
 
Re: Cheekyface - new dance steps, lower numbers!

Thanks for the input, Carl, I feel better about my decision now. These things seem to happen at weekends and my vet isn't 24/7.

Yes, her set dose has been 2u 12 hourly. Different dose amounts am/pm may well be the answer and I'll be sure to ask my vet about it.

It's lovely to see her with such steady numbers but the fact she's not significantly rising to the PMPS is making me nervous... :?
 
Well, and it gets more interesting by the minute.

Today Monday 25 July:
7.02am AMPS 4 (72)
7.25am retest 3.3 (59.4)

Fed and withheld shot.

9.31am 5.8 (104)

I put a call into the vet at 8am, and am about to follow up. I need to know what to do this evening because I know she should have regular insulin since she was DKA at diagnosis.

Just as well I have a very understanding boss and we're not busy at work right now...

EDIT: only one vet on today--mine, TG--so I'm in the reply-needed queue :YMSIGH:
 
Hi from Melbourne, Can we send our kitty to your cattery? Those numbers are fantastic. I think you hold at 1.5 for a few days and when the weekend rolls around do a curve. Also study the Qld protocol and you can't go too wrong. I think I read that your kitty weighs 5.8kilo's? I can reassure you that our kitty has occasionally dropped very low on Lantus. One time the meter said Lo. Then I tried again and it was 1.9 Our kitty has never had a hypo event. He's had a few 2's too. But someone in our neighbourhood insists on giving her kitty once daily insulin. (once a day) Her friend works in diabetes in a hospital and told her that Lantus can be given once a day. (which is true for humans - cat's absorb it twice as fast) This little kitty has survived 6 units given at 7am for about 2 months now. It had a weird event last week where she thought her girl may have been hypo so she put syrup on her tongue. Now she's dropped the dose to 5 units once a day. OMG, she won't take advice unless she hears what she wants to hear. But my point is that Lantus is pretty gentle. My vet is always saying so. I don't think you need to worry too much about a hypo on 1.5units - if there is food around during the day for cheekyface to nibble on. Btw I leave food sitting on an icepack in the warm weather.

Marilyn
 
Anyname said:
Hi from Melbourne, Can we send our kitty to your cattery? Those numbers are fantastic.
Click to expand...

Hi Marilyn, nice to see another Aussie on board :-D I know, aren't they lovely?? and I wasn't even here to record the process dammit, she'd only been on 2u for three days before I went away so it was a big thrill to see her so 'normal' when I got back.

Trouble is, because I haven't seen it happening "live" and getting used to the idea, I'm leery of seeing so many gorgeous greens all at once :mrgreen: let alone first thing in the morning when I was supposed to go to work!!

Anyname said:
I think I read that your kitty weighs 5.8kilo's? I can reassure you that our kitty has occasionally dropped very low on Lantus. One time the meter said Lo. Then I tried again and it was 1.9 Our kitty has never had a hypo event. He's had a few 2's too.
Click to expand...
.

She's 5.3kg on my scales so likely a bit less.

I AM reassured by your experience with such low numbers with your boy and thank you for sharing. My vet thinks I overdo the testing--I have to admit, I was a bit crazy when I first started, as are we all I'm sure--but unless it's the weekend when I can get a daytime nadir and a couple of bedtime tests, I only do preshots and I don't think that's overdoing it at all. If it was ME with the diabetes, I'd be doing that much myself!

My terror is that she'll hypo when I'm at work, when no-one's there to notice...but looking at those 5s at the end of Friday's cycle I'm damn sure she got down a lot lower than the 3.8 I caught on the Saturday PM+6. Or last night even. She's a good solid cat and still a bit over her target weight, which is what she's being dosed for so really, she should be okay as long as she eats. Which is a bit dodgy right now for other reasons...

I'm positive her post-Saturday behaviour re eating/sleeping/standoffishness etc has nothing to do with the diabetes; her arthritis is quite advanced and I had to stop giving glucosamine when she was diagnosed (must revisit that with the vet the next checkup actually), plus I have to be cautious with the Metacam. We have an animal acupuncturist here in Adelaide, who successfully treated my friend's (now deceased) elderly VERY arthritic cat for 6 months or so, and I might have to investigate that further.

But meanwhile, I'll carry on with the "if she doesn't eat give half dose" until her numbers start climbing and then we'll crank it up again.

Might visit Diabetes SA shop for some of those syringes with 1/2 unit markings on the barrel... :-D

Lesley, Cheeks and the Bodemeister

EDIT: yes I leave catsickles/freezies out morning and night--trouble is, it can only be tuna or boiled chicken for the sake of my CRF geriatric boy, and godalone knows who actually EATS it @-)
 
Hi again Lesley, It might be worth asking your cattery what their exact routine was while CF was there. I'm my cat's own worst enemy - he knows I'm a soft touch and can always get me to get up and feed him when he looks all starving and pathetic. He never bothers to hang around my husband for food. This tells me he could eat less if I wasn't around. We are away for nearly 4 weeks next month so I guess he's going to learn what it's like to be fed to a regime!!! My cat is on 4 units twice daily - it's making me nervous that if they don't feed him as much as I do then he too will have lower numbers than I get out of him. nailbite_smile This is his first cattery stay since dx 14 months ago.


::::Trouble is, because I haven't seen it happening "live" and getting used to the idea, I'm leery of seeing so many gorgeous greens all at once let alone first thing in the morning when I was supposed to go to work!!

I can understand how you feel. We are used to anything with out little guy. He was all green's and blues last November/December but then the wheels fell off. I don't test as much as I used to as I'm not trying to get him into remission. I test at least once a day - some times three times. Our vet thought it was strange at first but our cat doesn't take much notice of being tested.


:::: My vet thinks I overdo the testing--I have to admit, I was a bit crazy when I first started, as are we all I'm sure--but unless it's the weekend when I can get a daytime nadir and a couple of bedtime tests, I only do preshots and I don't think that's overdoing it at all.

Naaa, don't worry about what the vet says. It's good to get a sense of how CF is doing - the numbers eventually form a pattern that tells you where he is at. I don't even mention it to the vet unless it's relevant. He knows we test and says we are doing all his work for him.

:::::My terror is that she'll hypo when I'm at work, when no-one's there to notice...but looking at those 5s at the end of Friday's cycle I'm damn sure she got down a lot lower than the 3.8 I caught on the Saturday PM+6. Or last night even. She's a good solid cat and still a bit over her target weight, which is what she's being dosed for so really, she should be okay as long as she eats. Which is a bit dodgy right now for other reasons...

Is there a neigbhour who could pop in to check if she's eaten something during the day (in this early stage of getting her sorted)? I guess it's better to go less lantus if you can't be sure CF will get a mid-day snack. Do you live a long way from work?

::::I'm positive her post-Saturday behaviour re eating/sleeping/standoffishness etc has nothing to do with the diabetes; her arthritis is quite advanced and I had to stop giving glucosamine when she was diagnosed (must revisit that with the vet the next checkup actually), plus I have to be cautious with the Metacam.

Have you read about Metacam? I didn't give it to LB after what I read about it on this forum. But I don't know that LB had a condition that required it. Our vet can't work out what is wrong with LB. Could be his allergies or another condition. I'm trying not to fuss too much and just get him over his off patches without running to the vet every time.


:::We have an animal acupuncturist here in Adelaide, who successfully treated my friend's (now deceased) elderly VERY arthritic cat for 6 months or so, and I might have to investigate that further.

How did you find out CF had arthritis? BTW I made a lovely friend from SA on this forum. They came to dinner a few weeks ago. They on a sheep station near Yunta. Lovely couple. Her kitty is now deceased from CHD but before he diagnosed with that he came good very quickly on Lantus. Look up and read Joan and Oscar. Joan posted very recently explaining that Oscar had passed away. Her experience with Oscar on Lantus was quite unbelievable.

::::But meanwhile, I'll carry on with the "if she doesn't eat give half dose" until her numbers start climbing and then we'll crank it up again.

How old is he? What does CRF stand for? LB is nearly 12. He has allergies to beef and god knows what. I have trouble finding food that is ok for him - been on ground rabbits but he's sooo bored with them now. I have to let him have a few biccies on top to coax him to eat up!

Are you giving essential oils? I'm wondering if fish oil or flaxseed oil might help her arthritis. Vet told us to put LB on evening primrose oil for his allergies. I've recently started using Dermoscent - Essential 6, which is aborbed thru their skin. You put it on the back of their necks like flea treatment.

enough from me. Try not to worry ! If you are too worried move her to 1.25 units ... She's not very big. LB weighs over 9 kilo's. He's a Maine Coon. They big big cats.

Marilyn
 
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