Elise's Max's Number Going Up
- Thread starter tiffmaxee
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MommaOfMuse
Member Since 2010
You need the preshots readings as well as the nadir readings to make any sense of how the Lantus is working for him. Also I'm not seeing what if anything you are giving in the evening.
Mel and The Fur Gang
Mel and The Fur Gang
tiffmaxee
Member Since 2013
My vet says to give him .5 once a day but I have been dividing it into two doses as suggested here. I was told that if his Nadir was not high I did not need to test before his shots. Except for the day after he started insulin, all tests have been done at +6 or 7. I did speak to my vet and he said to keep it the same until I get a few more readings and to call at the end of the week.
hollyall
Member Since 2011
Hi Elise. I have a kitty named Max too! He just started on Lantus in mid-December before that he was diet controlled. Anyway, I would recommend when you're just starting out on the insulin to try and test a little more when you can, like Mel mentioned with pre-shots. On the weekends, when I'm home more, I'll choose a day and do something like +3, +6, +9 to help me get an idea of how the insulin is working. Every cat is different and reacts a little differently to the insulin. My Max tends to nadir a little early, so I try to catch him at +5. In the beginning, it's really helpful to see how the insulin works throughout the 12 hour period and that can help you and vet determine if you've got a good dose or not. You're definitely on the right track by testing and starting a spreadsheet. My vet loves the spreadsheet and I periodically drop it off for her review. This web site and message board have been immensely helpful to me. The members are simply the best and so giving of their time and experience. They've really helped me turn things around for Max.
MommaOfMuse
Member Since 2010
Elise
To be blunt your vet is clueless on how to use Lantus. Lantus is given twice a day in cats so even to suggest once a day already tells me they don't understand Lantus. And to give insulin to any creature without getting a preshot test is DANGEROUS!!! Since without those tests you have no idea if Max is even high enough to give insulin in the first place. Good example my Autumn tested at 51 before her pm shot last night if I had given insulin based only on her past nadirs I would have hypoed her. Those preshots are the MOST important tests to get daily because they are what tell you it's safe to give insulin at all. Nadirs are used to adjust dosage. But need to be taken in correlation with the other tests.
To give you to possible examples:
1) your preshots are in the 300s with nadirs like you've seen...Okay that would tell us the dose isn't high enough and we need to raise it.
but it could also be
2) preshots are in the double digits with the same nadirs as example 1...Well that's an inverse curve telling us the dose is too high and needs to be lowered.
Too much and too little insulin can look alike unless you can see the patterns of how it's working in the body and that can only be done with a meter.
My Casey is a prime example of following a vet's advice to the letter and still having a very sick cat because the vet simply didn't know how to dose a diabetic cat. For over a year his previous owner was not testing at home and giving him 11u bid while feeding him prescription "diabetic " dry food. When I adopted him a month ago he weighed 37lbs on a 15lb cat frame, was peeing bright red blood from a UTI, his coat was dull, full of dandruff and coming out in handfuls. He even had bald patches and clearly felt like sh*t. All he wanted to do was sleep. I adopted him, put him on a canned only diet dialed his insulin back to 1.5u and put him on antibiotics. A month later he's down to 25lbs, his coat is gorgeous and deep red-orange and soft as silk. He's romping through the house playing with toys and my younger cats and well regulated on 1/10 th the dose his vet had him on. Vet's are human and can't be expected to know everything that can and does go wrong with everything from a lizard to an elephant as well as to be able to stay current on all those various treatment advances. Think about human doctors they only have one type of animal to treat...humans yet they don't always have the answers to what is making us sick and vets have hundreds of species to treat.
Mel and The Fur Gang
To be blunt your vet is clueless on how to use Lantus. Lantus is given twice a day in cats so even to suggest once a day already tells me they don't understand Lantus. And to give insulin to any creature without getting a preshot test is DANGEROUS!!! Since without those tests you have no idea if Max is even high enough to give insulin in the first place. Good example my Autumn tested at 51 before her pm shot last night if I had given insulin based only on her past nadirs I would have hypoed her. Those preshots are the MOST important tests to get daily because they are what tell you it's safe to give insulin at all. Nadirs are used to adjust dosage. But need to be taken in correlation with the other tests.
To give you to possible examples:
1) your preshots are in the 300s with nadirs like you've seen...Okay that would tell us the dose isn't high enough and we need to raise it.
but it could also be
2) preshots are in the double digits with the same nadirs as example 1...Well that's an inverse curve telling us the dose is too high and needs to be lowered.
Too much and too little insulin can look alike unless you can see the patterns of how it's working in the body and that can only be done with a meter.
My Casey is a prime example of following a vet's advice to the letter and still having a very sick cat because the vet simply didn't know how to dose a diabetic cat. For over a year his previous owner was not testing at home and giving him 11u bid while feeding him prescription "diabetic " dry food. When I adopted him a month ago he weighed 37lbs on a 15lb cat frame, was peeing bright red blood from a UTI, his coat was dull, full of dandruff and coming out in handfuls. He even had bald patches and clearly felt like sh*t. All he wanted to do was sleep. I adopted him, put him on a canned only diet dialed his insulin back to 1.5u and put him on antibiotics. A month later he's down to 25lbs, his coat is gorgeous and deep red-orange and soft as silk. He's romping through the house playing with toys and my younger cats and well regulated on 1/10 th the dose his vet had him on. Vet's are human and can't be expected to know everything that can and does go wrong with everything from a lizard to an elephant as well as to be able to stay current on all those various treatment advances. Think about human doctors they only have one type of animal to treat...humans yet they don't always have the answers to what is making us sick and vets have hundreds of species to treat.
Mel and The Fur Gang
RobinCot
Member Since 2013
I agree with Mel - only I couldn't say it as well. We all want to love and trust our vets and for many things we do BUT many are not versed on the proper care of Feline Diabetes. Luckily many are open to learning from those who are doing this sugar dance day in and day out and even all night long. Lantus needs to be administered every 12 hours and pre-shots keep our kitties safe more than any other tests. The information that Mel provides is backed by examples such as Casey's and many more years of FD cats who have come here and gone OTJ or have reached regulation. There is a whole lot more detailed exposure to this disease here than a vet, who is handling a myriad of animal issues in a single day, might have. I was lucky enough to have a vet practice who allowed us to teach them about this disease and now they look at our spreadsheets and recommend cats off dry food and support bg testing.
Mel has a lot of experience and great advice.
Mel has a lot of experience and great advice.
nckitties3
Member Since 2013
Again, agree with Mel.
Most vets haven't a clue. Had I listened to my vet when I got Lucian home and done what was prescribed, he wouldn't have survived a week. Instead I researched and found FDMB and people that actually KNOW something about Feline Diabetes thru time and experience, not just basics from a classroom.
I did not contact my vet for 7 months because I was so angry about it. But took a chance and she has been wonderful, checks his SS and does anything and everything I ask because she knows I know my cat better than she does.
Listen to the experience on these boards, no vet has that.
Most vets haven't a clue. Had I listened to my vet when I got Lucian home and done what was prescribed, he wouldn't have survived a week. Instead I researched and found FDMB and people that actually KNOW something about Feline Diabetes thru time and experience, not just basics from a classroom.
I did not contact my vet for 7 months because I was so angry about it. But took a chance and she has been wonderful, checks his SS and does anything and everything I ask because she knows I know my cat better than she does.
Listen to the experience on these boards, no vet has that.
tiffmaxee
Member Since 2013
Today's +6 was 217. Are you saying that even though his +6 is there he could still drop in 6 hours? I thought once it reached its lowest level it would go up again. For the record I don't believe my vet is clueless. He started Max back on the smallest of doses so he won't go hypo. He is well aware that Lantus is supposed to be a 12 hour drug but also that not all cats fit the mold.He felt it would be too hard to give a dose of .25 accurately. I actually wonder if that might be why the fluctuation. Maybe I'm not as exact as I think I am. From now on I will draw .5 and then get rid of some outside of the vial to make sure of what is happening. I practiced a lot with water but it is still only as exact as I can do it. My vet is a Diplomat Internist and well respected in the community. He has been in practice for many years and treated more animals than most as he is a workaholic but still finds time to return my calls even at 8:30 on a Friday night . He has worked with me on many other issues and doesn't get big headed or upset if I ask questions or want to do things differently. When I called yesterday wanting to up the dose like someone on the FDMB suggested, he said no way based on a couple of high readings. I will test tonight before I shoot to see where Max is at. My cat is very sensitive and I can't test as much as you do because I can't risk him withdrawing completely. He hides under my bed to avoid his medication gel cap. If testing too often I risk that he will not trust me at all. Thanks for caring.
hollyall
Member Since 2011
Every cat is different with how Lantus works on them. On some, it can last longer and you can get some overlap, which is great for keeping #'s down. You'll start to learn how Lantus works on your Max.
On your vet, if he's a good vet and you are happy with him and he's willing to work with you, that's great, really. I have a great vet that I've been seeing for years and years. I've stuck with him. He's not as knowledgeable on feline diabetes, but he's still a great vet and willing to work with and listen to me... most important. In fact, he recently added a vet to his practice more versed in diabetes and recommended I see her too. You want to use all the tools and knowledge at your disposal, and you're doing that by finding this site, starting a spreadsheet, and working closely with your vet. That really is a great start.
On testing, I totally and completely sympathize. My Max, especially at first, was a bear to test, a real bear. He's terrible to give any kind of medication to. For the longest time, I couldn't test him on my own. I needed someone to help hold him still, so I could have my hands free to test. He just would not sit still. For me, treats have been key. My Max loves, loves the low carb treats (freeze dried chicken). I am now finally able to test him on my own, which, in the beginning I really, really did not think I would ever be able to do. It took a lot of time and patience. Now, if I shake the treat container and show Max the test tools (don't want to trick him on what is up), he will always still come even knowing what's involved. He'll still be wiggly sometimes but doable most of the time. Just do what you can do and be patient. I specifically joined the "relaxed" group because I'm not able to test as much as some. You do what you can.
On your vet, if he's a good vet and you are happy with him and he's willing to work with you, that's great, really. I have a great vet that I've been seeing for years and years. I've stuck with him. He's not as knowledgeable on feline diabetes, but he's still a great vet and willing to work with and listen to me... most important. In fact, he recently added a vet to his practice more versed in diabetes and recommended I see her too. You want to use all the tools and knowledge at your disposal, and you're doing that by finding this site, starting a spreadsheet, and working closely with your vet. That really is a great start.
On testing, I totally and completely sympathize. My Max, especially at first, was a bear to test, a real bear. He's terrible to give any kind of medication to. For the longest time, I couldn't test him on my own. I needed someone to help hold him still, so I could have my hands free to test. He just would not sit still. For me, treats have been key. My Max loves, loves the low carb treats (freeze dried chicken). I am now finally able to test him on my own, which, in the beginning I really, really did not think I would ever be able to do. It took a lot of time and patience. Now, if I shake the treat container and show Max the test tools (don't want to trick him on what is up), he will always still come even knowing what's involved. He'll still be wiggly sometimes but doable most of the time. Just do what you can do and be patient. I specifically joined the "relaxed" group because I'm not able to test as much as some. You do what you can.
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