Dosing question..sorry a long one.

[George and Bert]

I have two cats on Lantus and both have been on it for three years and doing well. The female ( Matilda ) is easy to test so I can periodically test her and adjust doses with some confidence. The male ( Andre' ) was brutallized by a former Vet and impossible to test unless at the Vets and being held down. They are both former ferals and he is a big strapping boy and tough to hold. Though at home he is a love bug and loves people. For the last three years I have been giving him 2.0 units BID and watching his behavior which is always steady. You would never know either of them were Diabetic. Yesterday, Andre' was not himself and not eating so I rushed him to the Vet. Turned out he had a belly ache because the food compoany changed the food of which I promptly disposed of. The Vet was surprised at how healthy he was and said he saw no problems at all. A blood test revealed that at plus two hours his BG was 120. This was a surprise and a little disconcerting as well. The Vet made no suggestion to adjust the dose seeing that it has never changed in three years the last time he was at the Vets. In fact, the Vet said to keep doing what I was because it was working. In all your considered opinions should I cut the dose back a bit?

 

[rhiannon and shadow (GA)]

I think I would. It's hard to say without data....
but given the situation, I'd err on the side of caution.

 

[tiffmaxee]

Did the vet run a fructosamine? That might be helpful.

 

[Sienne and Gabby (GA)]

While it's not ideal, there are urine test strips where you can test glucose levels. The issue is that they aren't as accurate for low BG and when you test urine, the reading isn't giving you what the glucose is at this second. It takes hours for urine to be processed and collect and your cat to urinate. It will, however, get you in the ballpark.

 

[julie & punkin (ga)]

Hi George! Nice to see you and hear an update of your kitters.

It's really hard to say - i like Elise and Sienne's ideas to get more information to help you know how to proceed. I think there might also be some sort of crystals that you can sprinkle on litter that change color based upon the glucose. I don't know anything about them, however, even if they are accurate or not - i'm just recalling someone mentioning them at some point.

On the one hand, it might be the perfect dose for him to keep his blood sugar in a good range. The thing that would make me a bit nervous is that when cats spend time in normal numbers, which it sounds like Andre is doing, it's possible for their pancreas to heal and begin putting out insulin again. When that happens, people reduce the dose to keep an equilibrium. The dose that was just right before can become too much. We don't know if Andre's pancreas is healing or not - he's been diabetic for long enough that it's less common for that to happen. But it does happen. Amy's Trixie was on insulin for 3 years and is OTJ now. I just wouldn't want to ignore that possibility.

 

[George and Bert]

Hi, Julie and everyone and Happy Easter!

I belive if I could test easily or at all I could put Andre' on canned and he could possibly be diet controlled. But i can't, so I must maintain a prover course as the Vet was amazed at Andre's wonderful condition. Three years ago Andre's became ill with an infection that nearly killed him. He was as close to death as you can get before I found his present Vet who saved him by changing his treatment. The illness I am sure destroyed or badly damaged his pancreas. Thus, the insulin shots. His blood panel numbers looked about perfect and he is robust and noirmal acting. His female counter part is also doing extremly well, but I do test her once every two weeks and adjust as necessary by mostly viewing her behavior. She has been as low as 20 and still did niot act in any abnormal way. They are both on dry with canned twice a day eating as much as they want. The rest of the cats jump in for what's left over. I am down to fourteen.
His morning shot two days ago was the usual 2.0 units. Two hours later he was at the Vets because he was actin lethargic and not eating. It turned out to be a belly ache from new food. The BG was 120 as I stated at that time. Ten hours later I maintained the 2.0 unit shot. The next morning (yesterday 4/3) he again got the usual 2.0 units. Reconsidering, I reduced his dose to 1.75 units just as an act of precaution as you and Rhiannon suggested. I may try the test strips. I used to weigh the litter every day before I found out how to test on this forum. No Fruc test was administered.

Btw, I just got a coupon for Solostar pens that reduced the price of five pens to $306.00. They were not available for a while, but you need to be very specific about what is typed in to the form. I can advise if needed.

I'll update as I can. I appreciate any and all comments and new ideas on how to test reluctant cats as well.

God Bless you all and again, Happy Easter!

 

[BJM]

There are a number of additional observations you may find helpful to make, such as water and food intake and elimination, dehydration checks, and urine glucose/ketone testing. They are described in my signature link Secondary Monitoring Tools. While not as precise as blood testing, using several of them may help track how he is doing in a more systematic manner.