Have questions and need help

[arnie57]

My 14 yr old cat (Saint) has been diabetic for approximately a year, he is on Lantus, 2 units twice a day I am feeding him a low carb diet, at the moment the Fancy Feast pates but I was giving him the Wellness grain free ones and no dry food.

I am home testing and his reading are consistently in the 300's and 400's but because I am Canadian his meter readings are measured differently but he has been a couple times at high as 600 (33.3). I suspect at that time it is because I forgot to move the dogs food (dry) and he has gotten into it.

My question is what else can I do to get his glucose level down? I have bought new bottles of lantus because I thought maybe there was something wrong with the insulin but that hasn't helped either. He seems fine, he is eating wonderfully, drinking, had neuorpathy but that seems to have disappeared some on its own and some with the help of B12. He just went thru dental surgery approx 3 weeks ago had an abcess drained and three teeth extracted so I thought maybe that was what was keeping it high, but it still isn't coming down.

I have learned a lot from this board but I am still frustrated I can't get his levels lower, and what is a normal level for a cat?

Arlene

 

[terri1962]

Hello Arlene,

You probably need to try to post over in the Lantus forum. It sounds like a dosing adjustment may be needed and they are the most qualified to help you with that. It sounds to me like you have done everything right but it just may be that the dose need adjusted.
You have been feeding the FF, testing and doing what we would tell most people to do.
The people on the Lantus forum have also been using this insulin some of them for many years and are very experienced in all matters Lantus. So pop on over there if you can.
Good luck.

Terri

 

[Julia & Bandit (GA)]

Welcome Arlene! The first thing I would do is set up a spreadsheet for all of the tests you have collected since diagnosis, if you have them still--if not, just fill it in the best you can. Here is how to do it: http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207. It will automatically translate the numbers for you, and it will allow people to give you specific dosing advice. Here is the link to the Lantus forum, once you've got that spreadsheet going: http://www.felinediabetes.com/FDMB/viewforum.php?f=9

How many times a day are you testing? In order to see good results with Lantus, you need to get at least three tests a day--once before each shot to make sure it's safe to give insulin, and a test about 6 hours after either shot that shows you how the insulin is lowering his BG. That third daily test is what dose adjustments are made on.

How did you get to 2u? Most cats on a low carb, canned diet do not need much more than 1u of insulin. If you're not getting daily, mid-cycle checks, it's possible the dose could be too high. Too much insulin can keep blood sugar just as high as too little, as the cat's liver will release glucose into its bloodstream to counter lower numbers. Cat's can be chronically overdosed for some time before they finally have a hypo incident severe enough to show symptoms.

 

[arnie57]

Thanks for the replies. I will check out the Lantus forum and print out the spreadsheet.

My vet is the one who came to the two units twice a day. Based on curves done in his office. I can only home test at the 6 hour mark on the weekends because I work full time Mon - Friday. Now I am wondering if I should lower his insulin to see if that helps but first I will re-post my initial question on the Lantus board.

Arlene

 

[Julia & Bandit (GA)]

I can only home test at the 6 hour mark on the weekends because I work full time Mon - Friday.

I was working a full time job, a part time job, an going to grad school when Bandit was on insulin, so I understand this concern. My M-F full time job was an hour away from my house, so I couldn't run home and test on my lunch break. If you are able to do that, that is one option. What I did was test at his AM shot (7am), work all day, test is PM shot (7pm), test right before bed (10-11pm), and then set an alarm to get up at 1am to get his mid-cycle check (his nadir, about 6 hours after the PM shot). Yes, it was a bit of a pain the first week or two while I adjusted, but after that my body got used to getting up and going right back to bed, and I was fine. Many people do this same thing with newborns. When I was home during the day on the weekend, I slept through the night and did a curve during the day.

Another option (if you can afford it) is hiring someone to come grab that test for you during the day. A local high school or college student would likely do it for cheap, and you just teach them how to test. Or is there a family member or friend that can help you test?

Getting those daily tests are really important--in order to follow the Lantus dosing protocol, you need them, and the high remission rates with Lantus are only associated with the protocol. I speak from personal experience--a cat in remission is way easier on your busy lifestyle than a cat on insulin, and it's the safest and healthiest condition a diabetic cat can be in. It's absolutely 100% worth the added effort to get your cat into remission.

 

[squeem3]

I have learned a lot from this board but I am still frustrated I can't get his levels lower, and what is a normal level for a cat?

IMO, as long as your cat is happy and healthy and getting treatment for diabetes there's nothing wrong :smile: My diabetic was on Lantus and then later Levemir, ate low carb canned food, and I got the advice of other Lantus users here yet blood glucose levels stayed in the 200+ range with the occasional lower numbers. He had dentals done and testing for insulin antibodies and other things which all came back negative. I tested blood glucose levels several times daily. I was doing all the "right things" but we could never get blood glucose levels to stay in a good range. Don't just focus on the numbers. The whole cat is important, too.

Normal non-diabetic cat blood glucose levels are about 60 to 150 mg/dl (3 to 11 mmol). Ideally a diabetic cat should be in this range with insulin and diet, and maybe one day, on diet alone.

Do take a look over on the Lantus board and ask for help from the more experienced Lantus users. Having a spreadsheet of all your cat's numbers would be really helpful. You set the srpeadsheet up on Google.com and put a link to it in your signature. That way anyone here on FDMB or even your vet can look at the spreadsheet at any time and see how your cat is doing.