Daphne#5 Your new post Lantus user

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Sue and Oliver (GA)

Sue and Oliver (GA)

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Hi All,

Barb posted at the end of Sara's long thread. Here is her post:

Hi Everyone,
I have a newly diagnosed cat named Daphne. Its been about 3 weeks or so, since she's been diagnosed. Since then we started her on 1 u of insulin 2x's daily, then last week we did the 12 hours curve and the numbers were not good…250 low and 484 high. I know I may be a bit confusing because of my own illness, memory is bad, but I'll try to recount things in the best order I can. For some reason I have the 11/24/11- one and a half u 2x's daily. So I guess we started with one u but moved up to 1 1/2 after the first test at home. (I borrowed my brother-in-laws meter for the day and I thought that was the problem, but I see that everyone here also uses human meters too, so we did another 12 hr. curve today (the vet said to give her little ears a brake), so a week later her numbers are a little better I think, TEST 5:40 AM TODAY AND EVERY 2 HOURS SINCE, first number was 340, then at 5:45, 1/2 can food DM, and 2 u of insulin, then test 1/2hr. after this was 378, then 335, 317, 275..then the next dose of insulin 5:45PM, test @ half hour was 266, ending the day with a 258 (just an extra test at 1 AM now) the vet is now closed till Monday and I will only have this board to guide me till then. I know this board does not replace the vet, but this is more for my peace of mind. I watched her all this time, (I know, just like that letter from a cat I read, so true), I follow her around, looked at her eating… I am most concerned about her back legs, if the floor does not have a rug, she slips and will just sit and rest, they are better then they were last week though. I had another cat with diabetes years ago, but she was great, just one u a day and lived a happy long life of 17 years. So far, I have a feeling this time is not going to be that easy. So I read a lot and from what I see, I don't think she is, I think its called, rebounding, (too much insulin?), because there are no low numbers at all. And also, since 4 days ago, we have increased the dose to 2 u 2x's a day. I don't know how long it takes to see improvement after an increase in dose. So if I can ask a question or two here, maybe I can figure things out before I see the vet on Monday. 1. Does anyone know if the numbers I give here are normal for a cat diagnosed 2 weeks ago? 2. Does it take a long time to see an improvement in numbers? The vet said, only feed her 1/2 can DM in Am, and 1/2 can in PM followed by insulin. Already I had to cheat a little, she just seems so hungary, and will sit and look at her dish till the next time to eat, so I give her 1/8 can for snacks throughout the day except when we do the curve. (she was on dry food for most of her life, she's 15) And if I can ask one more question, 3. Does anyone give their cat more then 2 u's a day, it just seems like a lot for a 14 pound cat, since my other cat only got 1 u for years.
Thank you to anyone that has any answers at all for this "overwhelming" process.
Barb
 
Re: Daphne#5 Your new post

Hi Barb,

Well, to start with, you have obviously done a lot of reading and are doing a lot of things right! It is wonderful that you are testing at home and that will really help guide you in dosing. Purina DM is okay with 7% carbs. We think it is too expensive and not any better than the regular low carb supermarket foods. If Daphne will eat it, that is good. If she tires of the constant liver taste, you can certainly switch to a cheaper food: http://binkyspage.tripod.com/CanFoodOld.html You vet will take back the DM - just say she won't eat it.

And we feed unregulated cats more than we might regularly. They are not metabolizing their food well because of their diabetes and really are hungry. So you can certainly feed her more if you want.

The big question we need an answer to is what insulin are you using? That will help us figure out your curve and your dose.

Glad you found us and I know we can help you help Daphne.
 
Re: Daphne#5 Your new post

The back leg issue is neuropathy from the diabetes. As you get that under control, it should improve.

Additionally, methylcobolamin, a form of B-12, has been found helpful in treating the neuropathy. One product is Zobaline which is specifically for cats. There are other brands out there, just be sure it is methylcobolamin and has no added sugar (not good for a diabetic), nor xylitol (not good for any cats - potentially fatal)
 
Re: Daphne#5 Your new post

Hi Barb,

You told us:
TEST 5:40 AM TODAY AND EVERY 2 HOURS SINCE, first number was 340, then at 5:45, 1/2 can food DM, and 2 u of insulin, then test 1/2hr. after this was 378, then 335, 317, 275..then the next dose of insulin 5:45PM, test @ half hour was 266, ending the day with a 258 (just an extra test at 1 AM now) the vet is now closed till Monday and I will only have this board to guide me till then.
Click to expand...

Those are not really bad numbers for a newly diagnosed cat, even 3 weeks out. She is getting a response to the insulin, just not enough response, which does not necessarily mean she's getting too much insulin.

A lot depends on what type of insulin it is, so please let us know in your next post. Yes, some insulins are better than others.

BG testing needs to be done every day - there is no need to "give the ears a break." I tested Gandalf for over 6 1/2 years, including the day he passed because I gave insulin, and even that day you would never have known he had a needle stuck in his ears twice and more per day! Test before each shot and once during the middle of the cycle, if you're able. Then maybe once a week do a curve to see how the insulin works over a whole cycle. The curve is necessary in the beginning, but is not needed as often if we help you find a good dose.

For now, let's get some more info and we can certainly help you help Daphne. And once she gets her BGs better regulated, the neuropathy will heal, but you can still get the Methyl-B in the meantime. It does help.
 
Re: Daphne#5 Your new post

Thank you everyone who responded to my concerns/questions about my sweet Daphne. I tried to find my post and for some reason I could not. I got your email Sue, but still could not find it, so I just got on tonight again, and here it is, with lots of great advice! I will read them again and take some notes. Also, I see I forgot to give the name of her insulin, its called Lantus. OK, so it looks like her numbers are not as bad as I thought, but I'm still worried because she still isn't acting like herself. Everyday is different, today she is just very sleepy. She does love her food (I ordered food and received it today, 3 cases!), oh well, it's ok, if she gets tired of it, I can donate it to a shelter, and I will look over the list of the foods here. My main concern now is, when I last talked with the Vet tech, she said that the smaller meals will raise her BG each time, and since she will not get insulin on the times I give her "snack meals",(I call them that because its just the same food, only a 1/8 can in between her two big ones of 1/2 can twice a day). The poor thing has a little belly and I hate to have to keep putting the dish in front of her to make sure she eats as much as possible to get her on the twice a day schedule, which I see now that its not really necessary to worry so much about the extra amount of food, and she really did seem hungry. Today is the first day I noticed she isn't acting like she is starving, so maybe her sugar is regulating itself or the insulin is working better. But with the numbers I got on Sat. I feel she may still need a little more then 2 u, and my husband said today that maybe they have syringes that are thiner, so it can show smaller amounts of insulin, maybe like 1/4 u, something like that. I can ask the vet I guess. I hope I'm not a bad mother, but I am sick myself, so I did not go to the vet to show her the curve, I want to see if I can fax them to her, so I have a faster response each time. Does anyone here think she would possibly need a bit more insulin to bring her numbers down to around 100 or so?
Again, thank you all for your answers and advice, and I look forward to some other ideas. Thanks Sue for reposting this here also. Now I hope I will be able to find it again. (Don't worry, its not a flaw of this board, its my flaw, my brain just doesn't work like it used to)
Thank you again everyone,
Barb and Daphne
 
Re: Daphne#5 Your new post

Welcome back, Barb! Glad you found your post.

One thing that will really help us help you is a spreadsheet. I have made one for you but was confused about when you got numbers so you will want to edit it.

Daphne's SS

You will need to put it in your signature so it comes up for everyone to see each time. I have explained how we can do this in a new message to you.

The other thing that would be helpful is for you to add Lantus when you start a new post. That way people using your insulin can see it and jump in to advice.

The one thing I think I see (but may not be understanding) is that you don't seem to be testing before each shot? This is very important so that you know that the amount of insulin you are planning on is safe. It is test, feed and shoot. You want a test before you feed so it is not influenced by food.

You have gotten the basics - food, testing and a good mild insulin. Now you need to figure out the dosing. Here is some homework. Most people print it off and read and reread.

Learn how YOUR kitty is responding to insulin:
Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
Peak/Nadir - the lowest point in the cycle
Duration - the length of time insulin continues to lower blood glucose

Example of a typical Lantus curve:
+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.

How to use and store etc: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=151
 
Hi Barb,

Just thought I would bump your thread up a little to make it easier for you to find when you come back on the board.

So how is Ms. Daphne doing?

Mel, Maxwell, Musette & The Fur Gang
 
Hi Daphne,
My 17 year old cat was diagnosed recently and has been on Lantus for two weeks. Her very first injection dropped her BG from 327 down to 59, but after about a week here numbers leveled out and were staying in the 170-270 range. I felt like everything was going great. The vet alo prescribed her 2U twice a day. This week the numbers are all over the place. I'm unable to give her two doses a day because her number drop so low after one dose, and don't come back up after 12 hours (400 pre-test down to 136 at +4 hours, then down more to 85 at +12). I think her body has adjusted and now the insulin needs to be lowered. She is only 8 1/2 pounds. She sleeps nearly all day, but eats and drinks normally. I have given her little 1 ounce canned food snacks as well when I'm worried her BG will drop too low while I'm asleep or at work. I think if the food is low carb, it shouldn't be a problem. I feed her Fancy Fest cat food, although I bought the prescription canned food from the vet. She only sort of likes it and threw it up once, so I said to heck with it. It is extremely nerve-racking trying to figure out all this stuff. I've been obseesed with BG numbers and reading everything I can. I haven't read much from people who are using Lantus, so I don't know how unpredictable it is. Waiting for a call from the vet today. Good luck to you.
 
Terwillinger,

Can you start a new topic and copy your text into it? I am afraid you will get lost down here at the end of Daphne's thread.

We can certainly get you the info on Lantus. Add Lantus user to your subject so you catch their eyes.

Welcome! I know we can help you and your kitty.

Oops. You're gone. I will repost for you Terwillinger New Lantus User with a star in the left hand column. Look for it. :-D
 
Thanks again to anyone that gave me advice. Sue is a great help, so take her advice. I know how hard it is, I'm only at 3 weeks now. I never had the lows like someone mentioned, but I just keep having mostly high numbers. I'll be back on tonight when I have more time.
Barb
 
Welcome, Barb!

I see you have your spreadsheet up and running, and that's great! Are you going to be able to get some daily tests? With Lantus, it's good to test at least three times a day--once before each shot, and a test about 5-7 hours after one of the shots.The reason we collect the third test is because Lantus is dosed based of the nadir (the lowest number of the cycle). Before making any dosing adjustments, you would need these tests to see how the insulin is working.

Of course, you can always test more than that if you're able--the more numbers you have to tell you what's going on, the better. :smile: It looks like you did a great job with your first curve! Please make sure you post back if you have any questions about how dose adjustments with Lantus are made.
 
Just a note. No dosing advice. Barb was having trouble making her way around the forum so we explored and got her spreadsheet set up over the phone.
 
No problem, I won't "use dosing advice". It is handy just to see if others are ending up with similar numbers and amounts of insulin. I already know no two cats are alike. My first cat was diagnosed, given an amount of insulin and never tested at home, never changed the amount, and she lived for about 7 years after diagnoses. She was about 17 years old when she died. But this little one here is a different story…numbers all over the place, upping her dose every week so far. I want to put her picture up, but it will take me a year to figure that out, so for now I'll just try the icons above, and also put her numbers in the spreadsheet (thanks again Sue, hope I can do it)!
Barb
 
Welcome!!

I wouldn't get concerned if your cat is having a different response to 2.0u of Lantus than someone else's cat. Every cat is different (ECID) and responds differently to insulin. This is why it's helpful to have a spreadsheet. People with experience can look at your results and help you figure out what's best for your cat.
 
OK, thanks Sienne and Gabby. I am having trouble testing her myself. This morning I tried three times, and didn't catch the blood in time and she shakes her head. I know she feels it and must hurt her I guess, so I can only keep trying and for now test her when my husband is home, which is not a lot. I also am having trouble with the spreadsheet, but I know my husband will figure that out and then I can put all my numbers in. I'm not sure if everybody can put numbers in, or maybe just Sue, who helped me set it up. I will put my numbers here and see if they magically appear on my spreadsheet, LOL. I really just don't want to ask anyone for more help, I feel pathetic enough already. My illness pretty much takes half of my ability to concentrate and you name it, it does something to every part of my body. So anyway, I'm doing the best I can here.
Here are Daphne's numbers from the past and the last two days. Oh, and you see, I didn't even know I tested her at 5:10 am, I was up all night, so I figured I'd let my husband sleep in and I just did it. She was a little sleepy, I guess thats why she was good for me, and of course I didn't have to jab her 3 times, it worked on the first try. This is last Sat. curve, 12/3/11, post reading, 5:40 AM-340, 2u, 7:45 AM- 335, 9:45 AM-317, 11:45 AM-275, 1:45 PM-279, 3:45 PM-296, 5:45 PM 2u, 5:45PM-266, One extra test @1:00 AM-258. (I know we made a mistake at the 5:45 time because we feed/insulin then tested). Then no testing until Thursday 12/8/11, 5:58 AM-385, 10:10-199. Friday, the vet called and told us to give her 2 1/2u, started that at 5:40pm, first test with new dose was @ 10:45PM-235. Sat, 12/10/11, Post- 5:10 AM-382. I assume it takes a while to see the numbers come down after a new, different dose.
Next reading should be at 5:10pm before her food and insulin, hope my husbands gets home on time ( :
Barb
 
Ok, I forgot about that, I'll look back on my emails. I'm so happy right now, we just got her lowest number since the first time, it was 142! The thing that still bugs me is that she is still begging for more food, 1-2 hours after she eats. My husband said, he thinks she just likes the food so much better then the hard food she always ate. I know the fact that they don't metabolize food well, but if the number was 142, I would think she wouldn't be that hungry.
Thanks Sue,
Barb
 
142 is a good number! How long after her last shot was that number taken?

Carl
 
Hi Barb,

I know when I first switched my gang (all 13 of them) over to wet food after adopting my first diabetic Maxwell, they tried to eat me out of house and home until they figured out that the wet food wasn't a special treat and was now the standard menu. It took them a couple of weeks to figure that out, and now there is somedays that they actually leave food between feedings.

Also since I have 2 diabetics now, adopted my second Musette in June of this year, I feed mine 4 times a day, so they basically get breakfast, lunch, dinner and a before bed snack. Now I feed 5.5oz. cans of Friskies, since I'm too lazy to open that many 3oz cans to feed my herd. :lol: But I feed about a 1/4 of a can per cat per meal, now some of my guys do get more than that per meal as they are bigger cats. (I've got three 16 pounders). But on average my normal size cats get that 1/4 of a can per meal, as well as lots of treats that are cooked chicken or turkey. I just buy chickens and turkeys on sale, boil the chicken or bake the turkeys, take the meat off the bone, cut into bite-size pieces and package up in tubs that will last me about a day at a time and freeze the others.

Mel, Maxwell, Musette & The Fur Gang
 
okay, so as near as I can tell, shot time was around 5-5:30 but not sure what the BG was at that point. The 142 was somewhere around +4? and the dose was 2.5u lantus?

Carl
 
a .5 unit increase from 2.0 to 2.5 units seems a little much to me given that the cat was seeing response to the lantus....
Not sure i'm getting the whole picture, but it looks to me like maybe increases of .25 unit would be better indicated.

And WELCOME, barb and daphne!

celi & binks
 
OH, hi everyone, how nice to meet so many cat lovers. I'll see if I can answer some of the questions, and I will take advice. Carl the 5:10pm BG # was 382, so that BG # of 142 @10:00 was a shocker. I hear you Celi&Binks, if her numbers are lower tomorrow, I will call the Vet on Monday and ask if she needs that insulin level adjusted again. I just was happy to see the number today to be almost normal, which I thought it would translate to not wanting to eat all day. But I think, maybe MommaOfMuse with all 13 cats (wow, I wish I had the energy to do what you do), I love cats, I always had about 4 or 5 at a time, but now that I'm also sick, I have to keep the numbers down. But I think you said, your cats thought it was a treat to have all those extra meals. I think thats whats going on here, its hard to figure out if she's hungry or just loving the food, but that makes sense, if she eats just plain chicken, then maybe she's hungry, but if she turns her nose up, then it means she just loves her new caned food.
I'm exhausted, but it's paying off now that she is getting better. I found one problem with the spreadsheet, I think since I have a mac, it's not working, so I will try my husbands HP tomorrow.
Thanks everyone for all your input.
Barb
 
Oh, well, I guess I spoke too soon. Today Daphne's numbers are all over the place. I can't seem to get the SS to work. I haven't had the time to work with it, just been testing and writing numbers down with notes…food, times… So I guess until I can work out the SS, no one can help me. I read the Doc. (Roomp_Rand…) and that explained some things, but I'm still not sure of many things, including the fact that Daphne really needs snacks and its hard to test and figure out if its the snack that gives her the high readings or not. One GREAT thing is, I can test myself! Thank G for that, my husband still doesn't test in the AM, long story, but I test her at 2 or 3AM…pretty long after her last dose at around 6:00pm. So I'm really doing the best I can with the testing. It seems like from what I read in the doc. "Roomp", that I should be increasing by .05 or more. For the last 2 days she's been hovering around 142 to 317. She only had one low at 78 one time a day ago. So for now, I'm going to rest and figure this out tomorrow I guess.
 
Hey Barb,

Until you can figure out the spreadsheet you can just give us her numbers like this:

AMPS (morning preshot number)
+1
+2
+3 (the plus numbers represent how many hours past her shot time)
+4
+5
+6
+7
+8
+9
+10
+11
PMPS (evening preshot number)

That way we can at least see the trends you are seeing and maybe be able to help you figure this all out.

Mel, Maxwell, Musette & The Fur Gang
 
Well, I know there will be one problem, my husband does not test her in the morning, he's rushed and its very early. Instead I've been testing more during the day and as late as I stay up at night, which is pretty late, most times till 2 or 3AM. My illness kind of messes with my sleep patterns, so anyway, I'm doing the best I can. Eventually I am going to work with my husband to get him to do the AM reading, but its just a zoo here at our house now…. I also have someone helping me to get that spreadsheet working, so you may see that soon, I hope.
Thanks!!
 
Hi
I really hope this works. I finally have the spreadsheet done, (I HOPE). I know some of the times and numbers aren't there, but we've only been doing this for about 2 months now. Until I came on this board, I had no idea I was not supposed to raise insulin so fast, but that was under the Vet's instructions. I haven't adjusted, or I should say, she hasn't adjusted the insulin amount since 12/8/11. I hope the full SS appears when I click submit, fingers crossed, and thanks to Sue.
 
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