Diet controlled kitty going back on insulin - advice please

[hollyall]

Hello. My name is Holly and my cat is Max. Not sure if I'm in the right place or if I should posting over on health to start. I previously used this forum when Max was first diagnosed 1/8/2011. Through the amazing advice and help of the caring members of this forum, I was able to get Max OTJ about 2/17/2011 through diet change and insulin. I've continued to monitor him and he's been in great numbers until recently. I've been working with my vet, and we've tried several different things in case an underlying illness was causing raised BG #'s (ear infection, dental, UTI, various tests). Nothing has come back as the culprit, so today the vet advised putting Max back on insulin and recommended Lantus. When Max was first diagnosed, he was on PZI. I had been interested in Lantus then, but the vet was not familiar with it. Since then, he's added a partner to his practice that is way more up to date on feline diabetes (yay!). I'm going to call around to pharmacies when I get off work and see if I can get some Lantus to start Max on hopefully tonight, tomorrow at the latest. The vet recommended to start at 1 unit. I've read everything I could find on this forum about Lantus (so appreciate those that took the time to share their knowledge). At this point, I was wondering if I could get some general advice on if the 1u is a good place to start based on Max's BG #'s and what to expect/be aware of. Max's spreadsheet in my signature is current with the testing I've been doing (scroll down to bottom). I definitely see better #'s 1-2 hours after he has eaten. He eats Fancy Feast classic varieties, mainly Chicken and a little seafood on "Fish Fridays." As many newbies, I'm feeling a little overwhelmed and sad to be going back on insulin.

 

[MommaOfMuse]

Re: Diet controlled kitty going back on insulin - advice ple

Welcome Holly and Max

Yes Lantus we usually like to see a starting dose of either .5 or 1u so either would be a great starting point.

Lantus does work totally different than the insulin you are use to. PZI is an "in and out" whereas Lantus is a depot insulin. So in the beginning you are going to need to get a few more tests in. I usually like to see at least 3 tests a day. Preshots and a lights out test but where it looks like Max still has a somewhat sputtering pancreas you may want to get a couple spot checks in around nadir which is normally around +6-ish.

With Lantus you will be basing dosing off that nadir and not his preshots plus because it is a depot insulin its going to take 3-5 days for his shed to fill before you will see the full effects of the dose. So whether you start him at 1 or .5 you will want to hold that dose for at least a week.

If you haven't already when you have a moment pop over to the Tight Regulation forum and read the stickies on Lantus that will give you a great idea on what a Lantus curve looks like and how to know when to raise and lower the dose.

Btw I also have a sugarcat whose OTJ named Max actually Maxwell...lol

Mel and The Fur Gang

 

[hollyall]

Re: Diet controlled kitty going back on insulin - advice ple

Thanks so much Mel! Very helpful info! I'm a chicken so may start with the .5u. Just concerned that I'm at work during the day and the sputtering pancreas. Sounds like I may have some interrupted sleep at night to catch that nadir #.

Maximilian was almost Maxwell. I can't remember why we went with Maximilian, but the decision was between that and Maxwell. My mom was voting Maxwell. I'd say Max's in all their variations are the sweetest!

 

[MommaOfMuse]

Re: Diet controlled kitty going back on insulin - advice ple

And they are both orange..lol

This is Maxwell



Mel and The Fur Gang

 

[hollyall]

Re: Diet controlled kitty going back on insulin - advice ple

What a handsome guy Maxwell is and he looks like such a sweetie too! I always tell my Max that he's my big fluff.

Mix up with vet and pharmacy on prescription means I have to wait until tomorrow to pick up the Lantus. I wanted to try the SoloSTAR pens and the vet phoned in for a vial. :-/

 

[KPassa]

Re: Diet controlled kitty going back on insulin - advice ple

Welcome back, Holly and Max!

Lantus is a great insulin. Were you able to get the pens?

As Mel mentioned, in the Tight Regulation Lantus Forum there are "Stickies" at the top to help guide you through the process, which I've summarized for you below:

• New to the Group?: General Info on Lantus, glucometers, syringes, dosing, what a typical Lantus curve might look like, food lists, etc....
• Tight Regulation Protocol: dosing information.
• Info, Proper handling, & Storage: syringes, pens vs. vials, etc....
• Insulin Depot: explaining how the depot works and how Lantus and Levemir differ significantly in dosing from all the other insulins available (i.e. PZI/ProZinc).
• Shooting and Handling Low Numbers: What to do when you see numbers under 200 when first starting out or 150 after you've been doing it for a while. Specifically for introducing the "shoot low to stay low" method of the Tight Regulation protocol.

As for testing, I always try to get at least 4 tests minimum each day:

• AM Pre-shot test to know if it's safe to give a shot
• AM mid-cycle test, if possible (this one I sometimes skip because of work). It lets me know how the dose is working and how low Mikey might go
• PM Pre-shot test to know if it's safe to give a shot
• Before-bed test to see how low he might go overnight while I'm sleeping

All other tests, I consider them as more data points on how Michelangelo reacts to the insulin in that particular cycle, how food and/or activity affects his numbers, if he needs an increase or decrease in dose, how he might be handling a new dose, etc.... I basically play fill-in-the blank across the week and try to grab tests at different times across different days with a few repeats thrown in.

Please let us know how else we can help you!

 

[hollyall]

Re: Diet controlled kitty going back on insulin - advice ple

Thanks so much for the added info KPassa! I'm trying to read up on all the info I can find. Your Mikey looks like he is a heart-breaker. Loved the pic of him on the stairs. Sounds like he is so lucky to have you for his Mamma.