I AM AT A LOSE WITH THIS DIABETES THING

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sylvester

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MY 9 YEAR OLD CAT SYLVESTER HAS BEEN ON LANTUS NOW FOR THE PAST 4 MONTHS. I GET SO DISCOURAGED WITH HIS NUMBERS. THEY CONTINUE TO FLUCUATE ALL OVER THE PLACE. NOT SURE IF IT'S NOT ENOUGH INSULIN. HE GETS LANTUS TWICE A DAY. I WAS TOLD TO GIVE 1/2 UNIT IF NUMBERS ARE 400 OR BELOW AND 1 UNIT IF ABOVE 400. I FEED HIM 1/3 CUP OF WELLNESS (WET) AT 9 AM AND AGAIN ANYWHERE'S BETWEEN 4:30 AND 6:00 PM. OF COURSE HE WANTS TO EAT MORE. HE GETS HIS LANTUS SHOT AT 9:00 AM. AND AGAIN 9:00 PM.

BECAUSE OF HIS HIGH NUMBERS I CHECK HIS URINE FOR GLUCOSE AND KEYTONES. HE WAS HOSPITALIZED FOR 4 DAYS BECAUSE HE WAS DK. HIS HIGHEST NUMBER WAS IN THE MID 400'S AND HIS LOWEST 154. HIS NUMBERS ARE ALL OVER THE PLACE. HE JUST HAD BLOOD WORK AND URINE DONE FOR DIABETIC PANEL AND IT CAME BACK OF COURSE HIS DIABETES IS NOT CONTROLLED.

OF COURSE HE ALWAYS HAS GLUCOSE IN THE URINE DIP STICK TEST....MAJORITY OF THE TIME 2000+. i JUST DON'T THINK HE IS GETTING ENOUGH INSULIN FOR THE BG LEVELS HE IS HAVING.

HE CAN START OUT LOW IN THE MORNING 215 AND THEN BY 9 HE IS AT 350 OR HIGHER OR ON THE REVERSE SIDE HE CAN HAVE 413 IN THE MORNING AND 147 AT NIGHT. ITS DRIVING ME CRAZY.

AND DOES ANYONE KNOW FOR A FACT IF YOU DO OR DO NOT ROLL THE INSULIN BOTTLE BEFORE DRAWING OUT ANY. I HAVE SEARCHED AND GET MIXED ANSWERS. I SHOULD JUST CALL THE MANUFACTUER AND SETTLE IT ONCE AND FOR ALL.

I DON'T WANT TO PLAY DR. BUT I THINK HE SHOULD GET 1 UNIT IF HIS NUMBER IS 300 OR HIGHER. BUT THEN AGAIN I GET NERVOUS WHAT IF THAT'S TOO MUCH AND HE GOES HYPO. THAT HAS HAPPENED 2 TIMES SINCE HE'S BEEN A DIABETIC. SEE BELOW CURVE I DID: THIS OF COURSE WAS DONE WHEN HE FIRST CAME HOME FROM THE DOCTORS AFTER BEING HOSPITALIZED.

2:54 AM #474
5:01 AM #442
7:10 AM #431
9:08 AM #439
FED @ 9:10 AM 1/3 CUP WELLNESS WET FOOD
(I UNIT INSULIN @ 9:11 AM)
11:23 AM #379
1:07 PM #304
3:27 PM #324
FED @ 5:15 PM 1/3 CUP WELLNESS WET FOOD
5:32PM #403
7:29PM #441
8:57 PM #450
(1 UNIT INSULIN @ 9:00 PM)

NOW NUMBERS LOOK LIKE THIS: 8:24 AM #233
FED 1/3 CUP
1/2 UNIT LANTUS @ 8:48 AM
5:05 PM #280
FED 1/2 CUP @5:08PM
8:41PM #351
1/2 UNIT LANTUS @8:50 PM
11:10 PM NEG KEYTONES 2000+ GLUCOSE

P.S I HAVE ALSO READ THE CAT BG # ARE OK IN THE RANGE OF 100-300...IS THAT TRUE?..I WASN'T TOLD THAT, SO I AM CURIOUS.

ANY COMMENTS WOULD BE GREAT.... LOOKING FOR SOME FEEDBACK...THANKS...
 
I'm a newbie here as well...

But what my vet told me is a little bit different: BG# > 200, IU; <150, .5 U

IMHO, 0.5U for 300+ BG is a little low
 
hi there and welcome.

first, can i ask a favor? can you turn off the caps lock? it's considered yelling on the web but for me it's hard on the eyes. thank you :-)

next, i would suggest reading thru this info about lantus as it will help you understand how lantus works hopefully.

viewtopic.php?f=9&t=151
viewtopic.php?f=9&t=150

that's enough to start with as far as reading goes i think.

some important things though to pick out of your post, lantus likes consistent dosing so that 1/2 unit under 400 and 1 unit at 400 is a problem. the dose needs to be consistent.

also, yes, if one dose isn't working after a week or so, it's time to change the dose. after you read thru the above info, formulate some questions, etc.....you could check out the lantus insulin support group here and they'll help you understand the dosing, etc.... when you feel up to that. viewforum.php?f=9
 
Normal BG for a cat is any where from 50 to 110. If the lowest your cat has ever been is 154, then you are not even near the danger zone for being hypo. Hypo for most cats would be 40 to 60. I agree that you need to stay with one dose consistently. Considering how high your cats current BG numbers are, 1 unit BID would not be considered an unreasonable dose. Once your cat is stabilzed, the numbers should be under 200.

I would encourage you to go to the lantus subforum and read some of the info. It is good that you are testing for ketones and BG at home. Your cat is on one of the better insulin for cats. You or your vet probably just got over cautious because you had a hypo incident in the past. It sounds like you just need some help with the insulin dosing.

I would suggest you start another topic or change the title of this to 4omething like "need help with insulin dosing". Good luck to you and your kitty!
 
Please read the links that Cindy + Mousie posted. You'll find great information there about Lantus.

Do not roll your insulin, but you'll see that information in of those stickies that she posted.

Also suggest not to change your dose, 1/2 to 1 Unit is not good. Lantus needs consistency to work at it's best.

Thank you for the great information you posted about Sylvester, it really helps us to help you. Going forward could you not type in all caps, it's harder to read and might keep some folks from being help and it's also on the internet and emails sometimes considered yelling or making a very strong point. If I wanted to give a big hug to everyone for helping me, I might write "I wanted to give a HUGE HUG to all of you." That way huge hug stand out :mrgreen:

Very much looking forward to hearing more about you and sweet Sylvester.

Edited for spelling.
 
If you are using the 10 ml bottle of Lantus and you have been using it for more than a month, it's likely no longer effective it may have lost some potency thus possibly one reason why your cat's bgs are not responding. Buy new Lantus, and instead of the 10 ml bottle, ask the vet to specify either the SoloStar pens or OptiClick cartridges. Both come in a box of 5 so that's at least a 5 month supply you'll have on hand. The initial cost is much more than a 10 ml bottle (maybe $150 or so) but it's more cost effective. You use insulin syringes with either the SoloStar pens or OptiClick cartridges. You do not need an insulin pen or pen needles like a Human diabetic would.

1 unit twice a day doesn't seem enough to work for your cat. You'll likely need to increase it but very slowly. With Lantus, you stick with a dose for at least a week before doing a curve and then determining from the curve if you need to adjust the dose. Read the Lantus info links others have posted. Constant dose hopping just makes it harder for the insulin to work.
 
squeem3 said:
If you are using the 10 ml bottle of Lantus and you have been using it for more than a month, it's likely no longer effective ...
Click to expand...

Um .. not exactly.

If you have kept the Lantus refrigerated and not rolled it, or left it out accidentally, it actually is good for much longer than 1 month and may last up to 3-6 months.
 
BJM said:
squeem3 said:
If you are using the 10 ml bottle of Lantus and you have been using it for more than a month, it's likely no longer effective ...
Click to expand...

Um .. not exactly.

If you have kept the Lantus refrigerated and not rolled it, or left it out accidentally, it actually is good for much longer than 1 month and may last up to 3-6 months.
Click to expand...
When used for felines, Lantus remains effective for more than the advertised 28 days (assuming it has been refrigerated). The "28-day rule" is for human consumption.

My experience has been that vials of Lantus contain so much insulin that, unless you have multiple cats or a high dose kitty, you will end up throwing out some insulin. I agree that, while the upfront cost is more, SoloStar pens are the way to go. They are basically smaller vials of Lantus and you can still use your U-100 syringes. In my case, I can use the entire amount of insulin in the SoloStar pen and not have to throw away any.
 
BJM said:
squeem3 said:
If you are using the 10 ml bottle of Lantus and you have been using it for more than a month, it's likely no longer effective ...
Click to expand...

Um .. not exactly.

If you have kept the Lantus refrigerated and not rolled it, or left it out accidentally, it actually is good for much longer than 1 month and may last up to 3-6 months.
Click to expand...

I wrote that to rule out possible pooped out Lantus. OP did not say if he/she has been using the same Lantus for the past 4 months. Edited post to say the insulin may have lost some potency if it has been in used for awhile.

The only way to know if Lantus has lost effectiveness is by hometesting. Some people can only get a month, maybe a little more, out of a 10 ml bottle even with careful handling. Other can get a few months use out of the bottle.

I have used Lantus and have never gotten more than a month out of a 10 ml bottle. I was always throwing away a still nearly full bottle and then spending $100+ for a new one. The pens are so much more cost effective.
 
I bought the full vial one time...and even with two cats getting 2U BID, I had to throw about half of it out. SoloStar pens is the way to go, IMO. It does cost more up front, but I don't throw any insulin away...so, in the long run, it is more economical.
 
In brief:

Never roll Lantus. The Insulin is a very long-chain molecule and rolling the vial can break it and make it ineffective.

Lantus is only "guaranteed" good for 1 month. It may break down after that time and be ineffective. ("pooped out")

Many kitties need more than 1 unit of insulin twice per day.

Read all you can -- ask questions here -- learn to test blood sugar at home

((((hugs)))) You've come to the right place for help
 
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