Diabetes & Pancreatitis-feeling defeated

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AmandaBrook

AmandaBrook

Member Since 2021
Brooklyn #'s have been so crazy! For a while, I thought she was going to start needing less insulin. I followed the suggestions of the group when her number was low preshot. I had tried giving her insulin dose in half twice a day but now her numbers are higher than ever. She is behaving normally except her eyes get that sugar high look. I know she's not feeling well. The only change I have made was dividing up the shot but quickly went back to once per day after seeing high numbers. I'm frustrated and sad because I want to help her but not sure what else to do. We went to a new vet but she will not let anyone touch her. She has to be completely knocked out to get blood. This is new behavior but I believe there was an issue at the last vet office. I'm wondering if trying Lantus would make a difference? I thought they are both gargline (sp)? Or do I just tough it out and go back to twice a day for a set amount of days? Not sure how long to give for a change to happen.

https://docs.google.com/spreadsheet...YvVQ0iiIdAa-eUWzGyyHw_qEgI/edit#gid=361360320
 
Would you mind filling out your signature so we can see information about Brooklyn.
HEREis a link with information about the signature in it. Thank you.

I have no experience with Toujeo at all except I know it is more concentrated than Lantus.
If you were to swap over to Lantus, we would be able to help you much more.
If Brooklyn were my cat, I would swap to Lantus.
 
Does she currently have pancreatitis? That will cause glucose to rise. Are you treating the pancreatitis? It can take awhile to get pancreatitis under control. Most vets only give meds a few days, which isn't nearly long enough. Is she eating?
 
Toujeo does not have an appreciably longer duration than Lantus (approx. 14 hrs for Toujeo and 12+ hrs for Lanus in cats). The only difference is in the concentration of the insulin. Lantus is a U100 insulin whereas Toujeo is a U300 insulin. In other words, you still need twice a day dosing regardless of the concentration. The additional problem with once a day dosing is that given the duration, you never have enough insulin in Brooklyn's system for the insulin depot to form. You're starting over every day. It takes roughly 5 - 7 days for the depot to form in order to get the necessary overlap between injections and to get the flatter curves you'd expect to see with any form of glargine.

At a personal level, I managed my cat's diabetes for over 6 years. I would be very apprehensive about using Toujeo. There is very little research on it's use in cats. Just as importantly, but to it's being 3 times more concentrated than Lantus, there is a much greater risk for an overdose. A tiny bit more Lantus can cause a drop in numbers. A tiny bit more Toujeo could cause symptomatic hypoglycemia. It's also got to be much more difficult to measure in a syringe.

I'm also guessing you're using the pens for your dosing. We do not increase doses by 1.0u which is what you need to do with the pens. We use syringes and increase by 0.25 - 0.5u.

Like Bron, I would find out about getting a prescription for Lantus. If you want to stick with Toujeo, you will need to get U300 syringes. The dosing method would be the same as it is for Lantus since they are both glargine. You just need syringes that are calibrated to match the concentration of the insulin (U300 for Toujeo; U00 for Lanus).

If pancreatitis is part of the equation, the pain and inflammation may be influencing Brooklyn's numbers. This primer on pancreatitis may be helpful.

I'm also assuming your feeding Brooklyn a low carb, canned food diet.
 
How is the pancratitis being treated? Typically the treatment is daily sub q's, cerenia for nausea and bupe for pain.

If it were my cat I would try 4 units twice Day for several days. If it proves to not be enough I would then raise it in 0.25-0.5 increments. I'm not familiar with this particular insulin, but I know no insulins last 24 hours in a cat.
 
Olive & Paula said:
Does she currently have pancreatitis? That will cause glucose to rise. Are you treating pancreatitis? It can take a while to get pancreatitis under control. Most vets only give meds a few days, which isn't nearly long enough. Is she eating?
Click to expand...

She had it in April but I think it's coming back. Her weight is holding but I do think she needs SC fluids again. Never was on any meds because she never had any other signs besides the bloodwork.
 
Sienne and Gabby (GA) said:
Toujeo does not have an appreciably longer duration than Lantus (approx. 14 hrs for Toujeo and 12+ hrs for Lanus in cats). The only difference is in the concentration of the insulin. Lantus is a U100 insulin whereas Toujeo is a U300 insulin. In other words, you still need twice a day dosing regardless of the concentration. The additional problem with once a day dosing is that given the duration, you never have enough insulin in Brooklyn's system for the insulin depot to form. You're starting over every day. It takes roughly 5 - 7 days for the depot to form in order to get the necessary overlap between injections and to get the flatter curves you'd expect to see with any form of glargine.

At a personal level, I managed my cat's diabetes for over 6 years. I would be very apprehensive about using Toujeo. There is very little research on it's use in cats. Just as importantly, but to it's being 3 times more concentrated than Lantus, there is a much greater risk for an overdose. A tiny bit more Lantus can cause a drop in numbers. A tiny bit more Toujeo could cause symptomatic hypoglycemia. It's also got to be much more difficult to measure in a syringe.

I'm also guessing you're using the pens for your dosing. We do not increase doses by 1.0u which is what you need to do with the pens. We use syringes and increase by 0.25 - 0.5u.

Like Bron, I would find out about getting a prescription for Lantus. If you want to stick with Toujeo, you will need to get U300 syringes. The dosing method would be the same as it is for Lantus since they are both glargine. You just need syringes that are calibrated to match the concentration of the insulin (U300 for Toujeo; U00 for Lanus).

If pancreatitis is part of the equation, the pain and inflammation may be influencing Brooklyn's numbers. This primer on pancreatitis may be helpful.

I'm also assuming your feeding Brooklyn a low carb, canned food diet.
Click to expand...


I've been reading up on a lot on Toujeo and the thing I like is that there is less likelihood of hypo. As you said that's research on people, not cats. I'm hoping to stick w/ the pen method because I have an elderly mom that will take care of her if I'm out of town- she's the only person Brooklyn lets near her. Brooklyn has been on 5 units awhile-figured out had to add my signature. I scan her libre as often as I can and my son can do it so we have a lot of info on her.

Yes, she has been on mostly FF & Friskies. I give her Young Again Mature Zero but do sprinkle a bit of the Purina DM. If I give her straight YA it gives her gas and diarrhea but she's a kibble addict and barely likes wet food unless she's over 400 BG.
I appreciate all this info as we did switch to a new Vet who seems open to doing what I want.
 
AmandaBrook said:
figured out had to add my signature.
Click to expand...
Might be a good idea to set up your signature, it's at the end of everyone's post in gray
This is what we need for your signature

Click on your name upper right hand corner , a drop down will appear , tap in signature , fill out info
  • On the left, under Settings, Click on Signature. This is where you will put information that helps us give you feedback. There is a limit of two lines which may include two links; you may separate pieces with commas, dashes, | etc. This is where you paste the link for your spreadsheet, once it is set up.
  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.
 
You are still only shooting once a day and that is making it so her numbers aren't coming down because there is no insulin support for half the day.
 
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