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Herdo

Member Since 2013
Hello everyone. My name is Andy and I am the owner of a recently diagnosed diabetic cat. His name is Bubba (named after my dad) and he is 6 years old.

Over the past month we have noticed Bubba drinking more water and urinating a bit more, but we attributed that to the weather warming up. We also noticed he "felt" thinner, but we assumed that was him just shedding more due to the increased heat. About a week ago, I picked him up and realized I could feel his ribs which was unusual. I suddenly noticed he was MUCH thinner than normal, almost sickly feeling. I setup an appointment to get him into see a doctor and on Saturday we took him in. His blood was tested and we were told by our amazing veterinarian that she believes he may be diabetic or possibly have thyroid issues. Two days later (Monday) we received a call from her saying his glucose was high, and that we should bring him in to get a urinalysis performed as soon as possible. I setup an appointment for the next day (Today: Tuesday) and after about 15 minutes the doctor came back and said "Well, he is diabetic".

She told us his glucose levels were around 350 or so, which apparently is high, but not extremely high. Unfortunately, the level of Ketones in his blood were quite high apparently, which she explained was due to his body breaking down his muscles. I think both my girlfriend and I immediately felt horrible for not noticing the problem sooner. The doctor was kind enough to tell us these things happen quickly and are sometimes easy to miss. She also pointed out that other than the weight loss and increased thirst and hunger, he seems completely normal, which is true. My girlfriend even made the comment that when cats get sick, it's usually fairly easy to tell, but with Bubba everything seemed normal. There was some good news though. She said usually when there are high levels of Ketones in the urine they like to hospitalize them to monitor them, but because Bubba seemed so fine, she said she wasn't too worried about it. That made us both feel a lot better. She advised we go get the prescription filled and start Bubba on his insulin immediately. She also sold us some Hills prescription food which is the low carb high protein formual (MD), but also told us that plenty of cheaper alternatives exist that are just fine which I really appreciated. She printed off about 15 pages of information about diet, giving insulin, testing, etc.

Now, since Saturday when the doctor suggested diabetes, I had been doing my research ;-) . I actually found this site on Saturday night and I had read tons of info by Sunday night. I already knew about only feeding them wet food with low carbs etc. After returning from the vet tonight, I was looking at the food charts and found that this Hills MD is actually somewhat high in carbs. After doing some research, I found that the reason for that is because you don't want to suddenly drop your cats carb intake extremely low, while supplementing them with insulin as well, which makes perfect sense. I plan on keeping him on this Hills MD canned food for a couple weeks before switching to a lower carb and more affordable food, such as Fancy Feast Classics pate or some of the Friskies pates found on the chart.

Anyways, we went to the pharmacy right after leaving the vets office and dropped off the prescription. We went home, ate some food, and then an hour later were back at the pharmacy to pick it up. "$200!" my girlfriend screamed. $165 for the insulin and another $18 for a box of 100 syringes which are; super thin / 30U / 31gauge / short needle / with half unit measurements. I explained to her that I had read the one month expiration is not necessary if the insulin is cared for properly. She decided to ask the pharmacist who I expected to say "No you need to throw this away every 28 days". To my surprise he said "If you keep it your fridge and don't shake it, it can last 4 or 5 months or more". We took it all home and then I gave Bubba a can of the Hills MD food and watched him practically inhale in. I waited about 15 minutes, then gave him his first insulin injection of 1 unit. He didn't even flinch.

That was at 10:10 PM last night. It is now 4:05 AM and he has hardly moved. Is that normal? He is responsive, and will roll his belly over when I pet him, but he has been in the same spot for the past 6 hours, which is pretty odd for him. His eyes seem really heavy when I can get him to look at me. My thinking is that he may be a bit sluggish until he gets use to a lower blood sugar maybe? He is due for his next injection is about 3 hours and I want to make sure we aren't going to cause hypo or something. My girlfriend and I are taking turns doing injections as of right now. She does the morning and I will do at night, and we are rotating the area of injection so that it goes front right shoulder, front left shoulder, back right shoulder, back left shoulder, etc. We are going tomorrow to purchase some urinary test strips to test his Ketones and glucose. I've also started to look into testing his glucose myself, although I am not sure we have the money right now. With a third appointment setup for Friday now, we are already at about $1000 inside of 1 week. Luckily for us, our vet offers payments plans with zero interest, or I don't know what we would do.

I also have a more serious question. How will this effect his life. I seem to be getting differing opinions about feline diabetes. Some information I have found says diabetes is a horrible awful thing and the cat might as well be put down to save it from the pain and to save the owner the headaches and heartaches of caring for a diabetic cat. Plenty of other sites have literally said, "once you get their insulin and diet regimen down, it's like they are not even sick", also saying that diabetic cats usually live perfectly normal live, they just need help with insulin.

Thanks for taking the time to read this wall of text.
 
For most to answer you, you will need to tell us a few things-

What insulin is he on
What is his dosage
what are your home testing numbers before the insulin shot
are you testing him every few hours after the shot to monitor his BG
can you test him now to see how low he is

I just read you are thinking about home testing- you should home test to see what his numbers are and if its safe to give him a shot. And really to monitor his progress.

Is he exhibiting these behaviors right now----> viewtopic.php?f=28&t=15887

It will take some getting used to at first, but the diet is really important to start to regulate his BG. It is a bit more effort to take care of a sugarcat, but its worth it. Keep checking back at this post and some more people with a lot more experience than me will be posting soon.
 
Please go to Walmart and get a cheap ReliOn meter and steips and 25-27 gauge lancets (ask the pharmacist for alternate site lancets) and a device. Come home, warm his ear with a pill bottle filled with very warm water and poke along the edge. Post his reading. Everything should be under $40

Does he seem dyhrated? Can you pull up his skin and does it stay up?

He could suffering from too much insulin or ketones. Both are very serious. A reading will tell you which. If he seems very ill and is unresponsive, forget the meter - he needs to go to the vet.
 
Hi

i found that filling a sock with some porridge oats and heating it up in the microwave for about 45 seconds to a minute was a better way of heating up the ear - my cat hated the warm bottle near her! Be careful though, I did accidentally set fire to the sock once!

In response to your comment about the effect diabetes will have on his life, my 19/20 year old cat was diagnosed earlier this year. Looking at her now, sure she looks old (but then she is old!) but you couldn't tell she has diabetes, since her BG levels dropped she is her old self again. I think any true cat lover will happily make the adjustments and changes to their routine in order to look after a diabetic cat, I know that my cat is part of my family and it never crossed my mind once to have her put down once she was diagnosed. Once the diabetes is properly managed, there's no reason that Bubba can't live a happy and long life with you.
 
Thank you everyone for your replies.

Bubba is currently prescribed lantus at 1 unit, twice daily about 15 minutes after he eats. We gave him his first injection last night of 1 unit, but this morning he wouldn't eat much food so we only gave him 1/2 a unit. The Dr had mentioned this might happen until he gets use to eating on his new schedule. Soon he should realize what he doesn't eat is gone forever.

As for the symptoms described on that hypoglycemia thread, he isn't really showing any of those. Especially this morning; he is walking around acting pretty normal even after his 1/2 unit injection. I'm thinking he was probably worn out from a long day as well. The symptoms he did have were lethargy. He wasn't very interested in moving or looking at me when I called.

I will go today and look at getting a home testing kit. If we can keep it under $50 or so we can probably get one today after work. Well actually when my girlfriend gets off work. I called out yesterday knowing I would be up all night worrying about my baby. As you may have read, I was up until 4:30 AM hanging out with him.

I am a bit nervous about checking his glucose. It's one thing to quickly poke him and tell him "Good boy!" before he realizes what has happened; it's completely different to hold on to him while poking around his ear. I've watched some videos so hopefully Bubba can get comfortable with it likes those other cats have.
 
My foster cat Wink was a mess when I picked him up from the shelter.

1. Then - severe diabetic neuropathy, walking on his hocks. Stopping every 3-4 steps to rest because it hurt.
Now - waliking normally, on his tip toes, running and jumping everywhere!

2. Then - another round of diarrhea, UTI, sickly
Now - hasn't had a round of diarrhea or a UTI in months

3. Then -severely matted coat, huge flakes of dandruff, lots of bare skin from fur loss, dull looking coat
Now - nice groomed coat, no more dandruff, fur grown back in, shiny silky fur

4.Then - starving. drinking almost 2 cups of water a day. Always hungry. 12-15 ounces of food
Now - normal appetite. normal water intake. Eating 6-8 ounces of food

5. Then - unregulated; BG numbers in the high 300's
Now - regulated, OTJ (off-the-juice) in remission for 2 months now

Happy, preening, purring, playing, chasing my other two cats, peeing normal, pooping good, appetite good. A happy boy.

It will take time, but you can get your cat Bubba feeling and looking better too.
 
Thank you Deb, you and Tia_24 both sound like you have wonderful companions and you both have made me feel better.

I just got off the phone with my girlfriend and she is fully onboard with getting a meter today. She was actually doing some reading on her iPad last night (I think on this site haha), and she kept looking over to talk about knowing their glucose levels before giving insulin. She sounded very relieved that I too was interested in testing them before each meal.

I will report back later this evening with an update. Oh and we will also be picking up some simple sugars in case of an emergency.

Thanks again so much everyone.
 
Glad he is feeling better. You made me nervous. :mrgreen:

Here is a shopping list for hometesting:

A human glucometer. Any one that sips and takes a tiny sample is fine. Some members stay away from any meter with True in the name and the Freestyle meters. Some people think they are unreliable and read lower than other meters. The meters are often free at drug stores; it’s the strips that are expensive. You can, however, buy them on ebay at less than half the price of stores. Lots of people here also like the ReliOn from Walmart. It is an inexpensive meter and its strips are the cheapest around. Try the meter out on yourself or someone else before you try it on your cat. You want to be familiar with it before you poke the cat.

Lancets and a lancet device. Usually, until the ears “learn” to bleed, a 26-28 gauge is good. Any brand will work as long as the lancets match your device.

Ketone strips. (Ketostix) Just like human diabetics use. You will sometimes need to test urine if the numbers are high.

Rice sack. Make this out of thinnish sock, filled with raw rice or oatmeal and then knotted. You heat this in the microwave until very warm but not hot. Then heat the ears before poking. You can also use a prescription bottle filled with very warm water. It provides a good surface to poke against.

Also nice to have. Flashlight: so you can look at the ears and find the little capillaries that come off the vein running down the ear. Vaseline: Put a tiny smear where you want to poke. It will help the blood bead up.

And some lo carb treats to give your kitty, successful test or not Lo carb treats

While you wait, you can get your kitty ready for testing.
First pick a place where you want to test. Some people use the kitchen counter, a blanket on the floor, between your legs while sitting – whatever works for you. Take the kitty there and give him/her lots of praise while you play with his/her ears. Give a treat and release. Next time, add the rice sack (thin sock filled with raw rice, heated in the microwave until very warm but not hot) or a prescription pill bottle filled with very warm water. Lots of praise, treat and release. Finally add the lancet so he/she will get used to the noise. The hope is that when you finally poke, they will be used to the process and know a treat is coming!
 
It's not so much the testing before every meal that you need to do, but testing before every shot of insulin.

We call that test a pre-shot (PS) test. The test in the morning is a AMPS, the test in the evening is the PMPS.

You want to remove food 2 hours before those pre-shot tests. Do not shoot insulin if the BG (blood glucose) number is below 200. Do not feed. Post here and ask for advice first.

If your cat Bubba is used to free feeding, it is ok to still do that. You only want to remove food 2 hours before each pre-shot BG test. All other tests, it is ok to have food available.

Let us know what else we can help with.
 
Ah yes. Testing before insulin makes more sense. I was actually talking with my girlfriend about that last night. I guess it's a balancing act, and it may be beneficial for him to eat a little without getting insulin. I can see why it is very important to be testing him regularly.

UPDATE: I called my vet to ask about his lethargy and she was concerned. I told her when I wave my hand in front on his face there is a slight delay in him following it, and that he is a bit more alert than yesterday but still not quite himself. She told me to set down food immediately and see if he would eat. I put down some of his old high carb hard food, and he ran over and started gobbling it up. Amazingly after about 30 minutes he seems to be back to normal. Running around and playing with his sister, etc.

I mentioned to the Dr. we would like to start testing his BG, and she said that is a good idea if we are comfortable with it. She also said, his glucose levels were not THAT high, and that with a proper diet he may not even need insulin! :-D She said she hasn't mentioned that yet because he needs to stay on the insulin to lower the amount of ketones in his urine. She said from now until his next appointment on Friday we need to lower his dose to 1/2 a unit (although we will be able to confirm that tonight after we check his glucose levels).

I think we may just need to leave out a bit of higher carb food for him to snack on throughout the day. Again, I guess we will know a lot more once we start testing him tonight.

Thanks again for the help everyone. I will update this thread later tonight after we have tested him.
 
Sue and Oliver (GA) said:
Glad he is feeling better. You made me nervous. :mrgreen:

Here is a shopping list for hometesting:

A human glucometer. Any one that sips and takes a tiny sample is fine. Some members stay away from any meter with True in the name and the Freestyle meters. Some people think they are unreliable and read lower than other meters. The meters are often free at drug stores; it’s the strips that are expensive. You can, however, buy them on ebay at less than half the price of stores. Lots of people here also like the ReliOn from Walmart. It is an inexpensive meter and its strips are the cheapest around. Try the meter out on yourself or someone else before you try it on your cat. You want to be familiar with it before you poke the cat.

Lancets and a lancet device. Usually, until the ears “learn” to bleed, a 26-28 gauge is good. Any brand will work as long as the lancets match your device.

Ketone strips. (Ketostix) Just like human diabetics use. You will sometimes need to test urine if the numbers are high.

Rice sack. Make this out of thinnish sock, filled with raw rice or oatmeal and then knotted. You heat this in the microwave until very warm but not hot. Then heat the ears before poking. You can also use a prescription bottle filled with very warm water. It provides a good surface to poke against.

Also nice to have. Flashlight: so you can look at the ears and find the little capillaries that come off the vein running down the ear. Vaseline: Put a tiny smear where you want to poke. It will help the blood bead up.

And some lo carb treats to give your kitty, successful test or not Lo carb treats

While you wait, you can get your kitty ready for testing.
First pick a place where you want to test. Some people use the kitchen counter, a blanket on the floor, between your legs while sitting – whatever works for you. Take the kitty there and give him/her lots of praise while you play with his/her ears. Give a treat and release. Next time, add the rice sack (thin sock filled with raw rice, heated in the microwave until very warm but not hot) or a prescription pill bottle filled with very warm water. Lots of praise, treat and release. Finally add the lancet so he/she will get used to the noise. The hope is that when you finally poke, they will be used to the process and know a treat is coming!

Thank you so much! Sorry, I somehow missed your comment. I have written these things down and I will be going with my girlfriend later this evening to pick it all up.

Luckily, he is very use to people "messing" with him. My girlfriend loves to pull his knots out instead of cutting them (usually found around the base of his ear). She is gentle but stern with him so he is already use to people poking and tugging his ears. He is also an extremely laid-back cat. We haven't even had to hold him down or anything for his first two injections; he just lays there and looks up at you.

God forbid my other baby Luna ever needs regular testing, because she is not as docile. :roll:
 
Welcome Andy and Bubba! It's great that you found us!

You've already gotten some fantastic advice, but I did want to inquire about how he was before the diagnosis. 6 years is a very young age for diagnosis cats and there's usually an underlying cause in cats that young. Don't stress because this might be a good thing since it does lead to a higher chance at remission (where the kitty is diet-controlled and doesn't require insulin shots). The fact that he has ketones makes me think he has (or had) an infection of some sort that might be a contributing factor. Was he ever on any steroids? What food were you feeding him before?

Herdo said:
I also have a more serious question. How will this effect his life. I seem to be getting differing opinions about feline diabetes. Some information I have found says diabetes is a horrible awful thing and the cat might as well be put down to save it from the pain and to save the owner the headaches and heartaches of caring for a diabetic cat. Plenty of other sites have literally said, "once you get their insulin and diet regimen down, it's like they are not even sick", also saying that diabetic cats usually live perfectly normal live, they just need help with insulin.

I have a kitten diabetic that was diagnosed at 6 months. He's now a year and a month old and has had diabetes longer than not. Even still, you'd never know he had diabetes. I also have an 8 month old non-diabetic and am expecting them both to live long, healthy, happy lives. The only difference in their care is that I give Mikey shots twice a day and Henry doesn't get them. As for testing, Henry decided a couple of months ago that he wanted in on the treat action too and started waiting for his own "test" so he could get some treats.

Horrible, awful? Not at all. They're happy, frolicking kittens. Headaches and heartaches? At first, yes, because it's a really steep learning curve, but now it's easier to manage Michelangelo's diabetes than it is for me to feed them! Don't get me wrong, there are definitely times of frustration and aggravation, like when I'm already late for work and Mikey decides it's "playtime" instead of "test and shot time." :roll: But then again, Henry frustrates and aggravates me when he leaves my cupboard doors open because he's looking for treats or jumps on my kitchen counters that he knows he's not allowed on. ohmygod_smile That's part of what being a cat owner is all about! :lol:
 
KPassa said:
Welcome Andy and Bubba! It's great that you found us!

You've already gotten some fantastic advice, but I did want to inquire about how he was before the diagnosis. 6 years is a very young age for diagnosis cats and there's usually an underlying cause in cats that young. Don't stress because this might be a good thing since it does lead to a higher chance at remission (where the kitty is diet-controlled and doesn't require insulin shots). The fact that he has ketones makes me think he has (or had) an infection of some sort that might be a contributing factor. Was he ever on any steroids? What food were you feeding him before?

Thanks KPassa for the reply! It's funny you should mention an infection, because the first thing the Dr mentioned was an abnormally high white blood cell count. She called me on Sunday to tell me this (the day after his initial visit), but we had to wait until Monday for the full test results to come back. Once he was diagnosed with diabetes, the Dr made no further mention of it. After some quick searching, I see what you are talking about. It could be possible that he may just have an infection which would cause his glucose levels to be elevated, as well as the ketones in his urine. He had a huge blood panel done something like a "Not feeling well" or "Not feeling right" blood panel or something, but I don't know if that would identify some sort of infection. Everything came back looking great, which is one of the reasons she said he was fine to come home. She said his kidneys and liver looked "beautiful". How can we look into this more, because I would like to rule that out as quickly as possible. I have another appointment scheduled for Friday, so is there anything I can ask to have checked?

Thank you for telling me about your cats. That made me feel a lot better about this whole process. :smile: I'm hoping we can get Bubba to the point where he is well regulated and is back to normal and feeling good.
 
UPDATE: BG is at 357. So maybe his lethargy is all in my head. We are going to give him 1 unit tonight about 15 minutes after eating and then retest his BG. How long should I wait before testing his BG after giving him the Lantus? Should I be testing before giving the insulin? For the record his BG was at 376 when he was tested on Saturday.

We tried to test him a bit earlier, but couldn't get a decent blood sample. This second time I used a flashlight and went directly for the vein and he screamed. :sad:
 
I don't think the lethargy is in your head, I think it is very possible that he was lethargic - you mentioned that he tested positive for ketones at the vet and the vet wasn't concerned. well the vet should have been concerned and should have either treated the ketones or sent you home with instructions for treating it.

Untreated ketones can develop into DKA diabetic ketoacidosis. Here are a couple links that explain all this and why it is important to test and treat.

http://www.felinediabetes.com/ketones.htm

http://www.cat-world.com.au/ketoacidosis-in-cats

what you need to do is flush the ketones out of the body and if you are not giving subq or intravenous fluids, then you can add extra water to the canned food (which is good to do anyway) to help ensure he gets plenty of water and can start flushing out the ketones.

so not to scare you or anything, but this is serious and needs to be taken seriously.
 
Hillary & Maui said:
I don't think the lethargy is in your head, I think it is very possible that he was lethargic - you mentioned that he tested positive for ketones at the vet and the vet wasn't concerned. well the vet should have been concerned and should have either treated the ketones or sent you home with instructions for treating it.

Untreated ketones can develop into DKA diabetic ketoacidosis. Here are a couple links that explain all this and why it is important to test and treat.

http://www.felinediabetes.com/ketones.htm

http://www.cat-world.com.au/ketoacidosis-in-cats

what you need to do is flush the ketones out of the body and if you are not giving subq or intravenous fluids, then you can add extra water to the canned food (which is good to do anyway) to help ensure he gets plenty of water and can start flushing out the ketones.

so not to scare you or anything, but this is serious and needs to be taken seriously.

The vet confirmed ketoacidosis. She said they almost always hospitalize them when that is the case, but with him he was active enough and has been eating just fine so she said he could go home, but to come back in 3 days for another check. We are going to get some ketone strips tomorrow to check and see how he is doing so far. Then we will get an official update on Friday.

The reason I said the lethargy is probably in my head, is because his BG was at 357 before eating for the night. Could 1 unit of Lantus really drop it from 357 down to hypo levels? We just have him 1 unit and we will be checking his BG again in 2 hours to see where he sits.
 
Herdo said:
The reason I said the lethargy is probably in my head, is because his BG was at 357 before eating for the night. Could 1 unit of Lantus really drop it from 357 down to hypo levels? We just have him 1 unit and we will be checking his BG again in 2 hours to see where he sits.

Yes, it's very possible, especially with a diet change occurring. In the same breath, he might not be dropping into hypo numbers but he might be dropping into numbers his body isn't used to (I.e. 100s) and his liver is panicking and spilling extra glucagon to counteract what it thinks is too much insulin. Only way to know for sure is to test him when you can, especially if he's acting lethargic.

As to infections, it might be anything and it might already be gone from his system. Common culprits are UTIs, dental issues, and possibly pancreatitis (but I think you would have seen more symptoms by now if it were pancreatitis, which is very painful for cats).

And welcome to the Vampire Club! :-D
 
KPassa said:
Herdo said:
The reason I said the lethargy is probably in my head, is because his BG was at 357 before eating for the night. Could 1 unit of Lantus really drop it from 357 down to hypo levels? We just have him 1 unit and we will be checking his BG again in 2 hours to see where he sits.

Yes, it's very possible, especially with a diet change occurring. In the same breath, he might not be dropping into hypo numbers but he might be dropping into numbers his body isn't used to (I.e. 100s) and his liver is panicking and spilling extra glucagon to counteract what it thinks is too much insulin. Only way to know for sure is to test him when you can, especially if he's acting lethargic.

As to infections, it might be anything and it might already be gone from his system. Common culprits are UTIs, dental issues, and possibly pancreatitis (but I think you would have seen more symptoms by now if it were pancreatitis, which is very painful for cats).

And welcome to the Vampire Club! :-D


That is something my girlfriend and I have both discussed. Mixing insulin with a low carb diet may be a massive change for him. Like you said, I guess we will know soon after we test him. I will report back with an update. Thanks again everyone.
 
UPDATE: 277 two hours an fifteen minutes after giving the 1 unit of Lantus. He seems fine and I think we will continue with the 1 unit twice daily until Friday and see what the vet says. It's not a great number, but I am happy to see he isn't too low. Assuming he doesn't get any lower I am sure the Dr will bump up his dose by another unit or so, but like I said we will wait and see. As I have been, I will keep this thread updated.

Thank you again to everyone who has been amazingly helpful and uplifting.
 
Mid-300s to high 200s in 2 hours is not bad. Lantus nadirs at 6 hours after a shot and he's probably also still building up the Lantus depot so you'll start seeing lower numbers soon. If you're able, it'd be a good idea to grab another test in 3 to 4 hours to see how low he's going. Since we don't have any prior data we don't how much lower he might go or when he might reach his nadir and there's still ~9 hours left in the cycle. If he's below 200 tomorrow before his next shot, don't feed, don't shoot, but post here first for advice.
 
Welcome!

Nadir = lowest point between shots.

ReliOn is the brand name at WalMart. Specific meters such as the Confirm, Confirm Micro, and Prime seem to work fairly well. The Confirm and Confirm Micro are actually made by ArkRay USA and sold at our shopping partner ADW (link at top of page).

I know its another expense, but ask the vet about some subcutaneous fluids to help flush the ketones from his body.

And its OK to leave the food down from shot time until 2 hours before shot time. Allowing him to graze will reduce increases due to spikes from large amounts of food. If he tends to scarf and barf, freezing some of it to thaw and be nibbled helps with that, as will smearing it across the plate or putting an upside down heavy cup in the middle of the plate. If finances permit, an automatic feeder may help, too.
 
Assuming he doesn't get any lower I am sure the Dr will bump up his dose by another unit or so

One unit is a lot to increase the insulin dose in one step. A slow and steady approach, would increase by 0.25 units at a time. If you increase too quickly, you may bypass the appropriate dose that will work for your kitty.

Too much insulin as well as too little insulin can make the BG numbers be too high.
 
Hello there

This
UPDATE: I called my vet to ask about his lethargy and she was concerned. I told her when I wave my hand in front on his face there is a slight delay in him following it, and that he is a bit more alert than yesterday but still not quite himself. She told me to set down food immediately and see if he would eat. I put down some of his old high carb hard food, and he ran over and started gobbling it up. Amazingly after about 30 minutes he seems to be back to normal. Running around and playing with his sister, etc.
makes me, and your vet I suspect, think that the lethargy wasn't in your head. Since he perked up after the food had gotten into his system it could have been low blood sugar so it's good you reduced the dose.

As kpassa said, lantus acts in a curve, it kicks in about two hours, reaches maximum action around 5-7 hours from the shot and then wears off usually in time for the next shot. This is why it is important to test midcycle if you can, to see what the lowest point is. The lowest point of the day (or night) is what we base dose changes on. And lantus takes a few days to build up in the system, so you don't want to make dose changes too quickly. Also generally dose changes are made 1/4 unit at a time so as not to miss the good dose or cause a hypo by going too high.

In terms of feeding, many of us free feed or give mini meals through the day to keep the blood sugar stable. We then remove food two hours before shot time. At shot time we test first , then feed/shoot.
Reason for that is sometimes you get a low test result before the shot and you want to wait and see what the blood is doing naturally and not influenced by food before you shoot. For example say you measured a 101 at shot time, you would not shoot or feedm and wait 30minutes. Test again. If he has gone up over 200 you would feed/shoot . If he has gone down you would continue to wait until either its going up, or you skip because your schedule is too messed up.

Wendy
 
Ok UPDATE: We only tested him once today, but his BG was at 250, five and a half hours after eating and 1 unit of Lantus. Tomorrow we are going to the Dr to have him checked out again for Ketones and to review with the Dr.

Thanks everyone!
 
You should really test before every shot to keep him safe. Reason is that if he is low, the worst thing you can do is shoot and give him a hypo. Also you can assume he was higher at preshot than he was 5.5hours later. Cats dont always follow the typical lantus curve, especially if they went low in the last 48hours as the liver tends to overreact and shoot out sugar for a day or two after a perceived "low".

So we recommend test before every shot and then if possible, a mid cycle test and one before bed. Gives us and you a real good picture of what is going on so you know if you need to increase or decrease dose.

Can you set up a spreadsheet? It will help you see what is going on better, as well as us and your vet: http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207
 
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