I NEED dosing advice for first time on insulin

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skybar22

skybar22

Member Since 2010
ETA: 5:10 PM
I wrote this post early AM. Please read and advise as I am pretty clear that Morgaine is now running up near and above 200.

After reading several comparisons on the Freestyle and the AT, it appears the Freestyle runs low by sometimes 40%. With the borderline nature of my cat's diabetes. this could be quite significant. She is displaying polydipsia and polyuria and her BGs are higher than normal, over 150 and now in the 160 range on the Freestyle which, if off by 30-50 would put her around 200-220. I do not know what to dose her and I would like to go slow. Can someone with experience please help me out? I am going to leave this here and post it at the end of the thread as well. Sorry but i just want to be sure it gets read.

Morgaine has not been on insulin but her numbers are up a bit. she is diet controlled and has had diarrhea for a few days. I finally got it to stop with some slippery elm and probiotics but she is still not quite there. Stools are forming but still soft. she is not having more than one BM a day after having 6-7 for a few days. She is not dehydrated but is showing symptoms of diabetes, drinking and peeing more than normal. She has been to the vet twice in a month, different vets and both think she is borderline and maybe going to hyper levels at times throughout the day. I have been checking her and she is a little elevated in the 150's throughout the day. before the diarrhea she would be 110-150. Now she stays in the 150 range but in reading the info on glucometers, I am wondering if she might be closer to 200. Being a type 1 myself, I have 3 glucometers and i have tested myself with all 3. Both Freestyles give me the same reading and the Precision runs a little higher.

Her Frudtosamine was really high but I have never tested her with results over 200 and mostly she is in that lower range. Things are not right and i am wondering if i need to give her a tiny dose of Lantus or wait a few days, keep an eye on her numbers and let her body fully recover from the diarrhea.

My vet is not helpful. She suggested that she must be much higher than she is due to the fructosamine but her lipids are sky high which effects that test and she also had moderate hemolysis which the lab says gives false fructosamines. So, I am thinking my tests are a truer picture of what is happening. Vet stress caused a spike to 365 2 weeks ago but she did come down from that pretty quickly and was 121 a few days ago. The vet is too anal and condescending. She wants her on a prescription diet for lipidemia with higher carbs. I won't do that. she thought she had to explain the scientific method to me today because i gave Morgaine slippery elm and it worked. She thought it ran its course on its own. i think you all must get the picture. she also said her range for diabetic cats is 150-250. Insulin will not be one of her suggestions at this time.

I am exhausted as I have been up with Morgaine and the diarrhea for days. I can't think straight but I am thinking she may need some insulin. So, what would you folks do or advise? I plan to change her food once her tummy recovers and get the fat down by half without high carb foods.

I have no spreadsheet as I can't access it on google for some reason. I don't give insulin yet so what I have are spot checks at various times throughour the day, before a meal she was 146 and 2 hours pp she was 151 and now she is 159 and ate 4 hours ago.
I feed her several small meals a day since she is diet controlled.

Any clarity and help would be appreciated. I can not afford another vet visit or consult with anyone at this time. but insulin is in the fridge and I have all supplies as well as almost 50 years of life experience as a diabetic. Do I wait or give 1/4 unit or so?
 
Re: Need Some Advice on Possibly Dosing for first time

Just bumping you.
Hang in there, a dose expert will be here soon I'm sure
 
Re: Need Some Advice on Possibly Dosing for first time

Hi Skybar, Here's another bump. I hope that someone more knowledgeable will be along soon.

Ella
 
Re: Need Some Advice on Possibly Dosing for first time

Thanks for bumping me. I am going to go back to sleep. I'm exhausted but will check back later.

A little more info. I use the freestyle Lite for Morgaine and would love to know if anyone has opinions on its variance with other meters and the vet meters. I read that the Freestyle strips can be used with the Alpha Track but that seems so unlikely to me. Abbott has a few meters and none of the strips are interchangeable. Precision X-Tra is also made by Abbott.
 
Re: Need Some Advice on Possibly Dosing for first time

Good morning! Someone should be along soon who can advise you but we wanted to say hello!
 
Re: Need Some Advice on Possibly Dosing for first time

The only thought that I have about starting Lantus is that it takes 5 - 7 days for the insulin depot to form. If you're thinking of giving insulin for a couple of days, you might not get much of a result but this can be unpredictable.

If there's some infection that's clearing, it may be whatever is making Morgaine feel lousy that's elevating numbers. Generally, with a cat already on insulin, the dose may need to be increased to offset the infection/inflammation. Once the infection clears, numbers can drop.

Let me see if there are some others who can help you think this through.
 
Re: Need Some Advice on Possibly Dosing for first time

Thanks! I got some sleep and am clearer now.

Lantus certainly does act differently in cats and I am not sure how it will act in my cat which makes me hesitant.

She seems much perkier today and no poop at all so far so I am hoping things have resolved on that front.

I have not checked her BG yet. She sometimes runs and hides from me but I will get a reading soon.

Any other advice is so welcome.
 
Re: Need Some Advice on Possibly Dosing for first time

So, 2 hrs pp she is at 162. Still higher than she was before the diarrhea. I know that her bowels have settled down as she has not had a movement since yesterday AM. Would still love some input as to how long to wait to see if she comes down and as I said, I am concerned that her actual numbers are higher.
 
Please advise as I am pretty clear that Morgaine is now running up near and above 200.

After reading several comparisons on the Freestyle and the AT, it appears the Freestyle runs low by sometimes 40%. With the borderline nature of my cat's diabetes. this could be quite significant. She is displaying polydipsia and polyuria and her BGs are higher than normal, over 150 and now in the 160 range on the Freestyle which, if off by 30-50 would put her around 200-220. I do not know what to dose her and I would like to go slow. Can someone with experience please help me out? I am going to leave this here and post it at the end of the thread as well. Sorry but i just want to be sure it gets read.
 
bump

is 162 your +10?
are you at about 2 hours before possible shot time ?
edit to add: sorry, im trying to catch up still - you are not sure if to start lantus.
hang on ok?
 
Morgaine has been diet controlled and has not been given any insulin ever. but she had diarrhea for several days and is now running higher. I thinks she needs some insulin but where do I start?
 
One way to approach Lantus dosing is based on a cat's ideal weight: dose = ideal weight in kilograms x .25. For the average cat, this comes out to somewhere around 1.0u. You can always start lower and work your way up. The effect of Lantus may not be immediate. It may take 5 - 7 days for an insulin depot (aka "shed") to form.

(To convert pounds to kilograms, divide your cat's ideal weight by 2.2)
 
Hi again, Skybar,
I don't feel competent to advise you whether or not to begin Lantus (or any other insulin), but I can set your mind at ease about the FreeStyle glucose meter. Most of us here use human meters, like the FreeStyle. (The Alpha Track animal meter is much more expensive, as are its strips.) The blood-glucose numbers you see on our spreadsheets and in our subject lines are almost always those of human meters (those of us who use the Alpha Track will say so either in the subject line or in their signatures). The protocol we use is calibrated for the human meter (with a separate section for those using the Alpha Track). So 162 on the FreeStyle is not particularly high. Please hang on a bit longer for someone with dosing experience to help you (Sienne, Libby, Jill, Laurie, are all very experienced, and I may have left out some others).

Ella & Rusty
 
Lipidemia....isn't that Feline Hepatic Lipidosis?

I am concerned that you are starting insulin and not under a supporting vet. Here are my concerns...

You cat has had diarrhea for several days. This means the intestinal tract has been irritated and inflamed. And while it may appear to be coming under control there may still be hidden issues with the infection in the gut. ALL of that will affect your cats Blood Glucose for several days unrelated to being diabetic.

Has your cat been overweight and recently lost a lot of weight not attributable to the diarrhea?

If caught early enough FHL can be reversed by diet.

In some patients, switching the patient to a low-fat diet may be the only therapy needed. It is generally recommended that diets should contain less than 25% fat on a metabolizable energy basis for cats However, obtaining a good diet history to estimate the level of consumed fat is important before deciding the degree of fat restriction. The patient should be fed a diet with a fat level lower than the previous diet.http://veterinarymedicine.dvm360.com/vetmed/article/articleDetail.jsp?id=456193&sk=&date=&pageID=5

Edit:

I would add that many times we have seen cats on this forum begin using a high protein low carb diet for their cats...and the simple diet change was all that was truly needed. You can find some food suggestions by visiting this link, Diet for cat with diabetes

Since it will take a few days to see an affect from either the insulin or a diet change, wouldn't it be great to find out you don't need the insulin first?
 
Thanks! My concern is that she is symptomatic at these numbers and having diabetes myself, type 1, I am not symptomic until I reach my renal threshold. She has been spilling sugar intermittently in her urine. I will check that later after I clean her box so i can get a clean sample. I use the Feline Pine sifting box so I can dip the stick easily when the bottom of the box is cleaned out.

Two concerns about dosing her according to weight. she is a very large cat, almost 15 pounds and should be 13-14 pounds. Since I do not know how she will react to Lantus and it builds up in their body and since she is just recovering from 5 days of diarrhea, I fear putting her into a hypo. I do not want to do any harm and what if this is all due to the diarrhea which is now not happening. I was thinking more like giving her a tiny does like .25 or .50 and see if it brings her down from the 160 range she is holding in now. I guess I need to wait for someone with some more experience with all of this and I appreciate all of the help and support you are offering here.

I am a stickler with my own diabetes and have tight control with a pump. I know how to do insulin for myself but have no clue about the cat and her tiny little pancreas and I know that if I get ill my BGs go up some but not too high. This seems a little tricky since she is clearly not up there in the 300s but still on the borderline. Even the vet isn't clear but she keeps diabetic cats in the 150-250 range so Morgaine would not be a candidate for her protocol and she is not an adfvocate for BG tests at home except for spot checks twice a week.
 
Edit:

I would add that many times we have seen cats on this forum begin using a high protein low carb diet for their cats...and the simple diet change was all that was truly needed. You can find some food suggestions by visiting this link, Diet

Since it will take a few days to see an affect from either the insulin or a diet change, wouldn't it be great to find out you don't need the insulin first?
 
Lipidemia....isn't that Feline Hepatic Lipidosis?
Click to expand...

No, she doesn't have FHL. Lipidemia is high fat in blood. Her triglycerides were sky high but her liver and other organs were fine. Vet attributes this to diabetes.
I am concerned that you are starting insulin and not under a supporting vet. Here are my concerns...

You cat has had diarrhea for several days. This means the intestinal tract has been irritated and inflamed. And while it may appear to be coming under control there may still be hidden issues with the infection in the gut. ALL of that will affect your cats Blood Glucose for several days unrelated to being diabetic.
Click to expand...
These are also my concerns. Thank you! I need to have someone to discuss this with.

Has your cat been overweight and recently lost a lot of weight not attributable to the diarrhea?
Click to expand...
No. Morgaine had been 20 several years ago, went on a Hill's R/D diet for quite a while and lost 5 pounds slowly, then she developed diabetes from the carbs in Hill's, IMO. That was last May. I put her on high protein, low carb wet food and she went into remission until this spring when I noticed some symptoms. She remained under 150 but is now creeping up. I do think it might just be recovery from diarrhea.

If caught early enough FHL can be reversed by diet.

In some patients, switching the patient to a low-fat diet may be the only therapy needed. It is generally recommended that diets should contain less than 25% fat on a metabolizable energy basis for cats However, obtaining a good diet history to estimate the level of consumed fat is important before deciding the degree of fat restriction. The patient should be fed a diet with a fat level lower than the previous diet.http://veterinarymedicine.dvm360.com/vetmed/article/articleDetail.jsp?id=456193&sk=&date=&pageID=5
Click to expand...

I am going to transition to a low fat diet but the diarrhea prevented me from changing her diet. We are working on that and I am slowly adding a little of the new food to the old.
 
The only food I could get her to eat, after literally 50 or more different flavors or brands including the primo to the least expensive , is Pro Plan chicken and liver. I am transitioning to Pro Plan Turkey and Giblets as it has 1/2 the fat of the chicken and liver. I am also goin gto cooke for her and attempt to transition to raw. I have been in touch with Felice at Instincts and she has advised me to start with the cooked and use the Instincts mix and cook the food less and less while she gets used to it. I have no idea if that will work. she refused raw food last yr.
 
Just a side note to answer one of your earlier questions.

Lipids can mess with a fructosamine test and give false results. That may be why your numbers are not corresponding with the vet.

Well, there's part of it....

ProPlan Chicken and liver according to our information is high fat.
Adult Chicken & Liver 43P 55F 2C
Adult Turkey & Giblets 55P 39F 6C

So if the link from earlier in dealing with lipids is correct, you still need to look to get down below 25%.
 
Be aware the Nature's Variety Canned is all high fat content. I just received updated information from them on their canned foods. I bring this to your attention as they do a whole line of Instinct and the frozen/freeze dried raw is not the same as what is in the cans.
 
Sorry. The Instincts I was referring to is the Feline Instincts mix for raw feeding. I determine the fat content on that.

I do know about the lipids and the fructosamine being off as well as the hemolysis which was ++ , moderate, caused by the tech who drew the blood. Her method was very poor and she had to poke her in two veins to get the blood she needed so those blood cells were messed up for fructosamine. The lab warns of that as well.

All of these values are confusing to me. The vet said she wanted me to put her on a diet with no more than 20% fat on a dry matter basis. She uses tables from Purina to determine that. Dr. Lisa has info on how to approximate that on her website, catinfo.org. She initially wanted me to put her on Purina prescription OM and then she suggested Royal Canine high protein but they all have much higher carbs, and fat was still in the 30's. I have so many lists of foods but my cat is extremely picky, as mentioned upthread. I am hoping to begin cooking lean chicken breast and mixing it with the Feline Instincts mix which contains all the nutrients she needs and slowly transitioning her by mixing it with her current diet and eventually going to raw. I have the best laid plans but she has to cooperate.

Vet wants me to consult with a veteranarian nutritionist to the tune of $250. They come up with a few suggestions and some home cooked recipes but there is no guarantee Morgaine will eat any of it. I don't have $250 to spend like that without a guarantee. She also wants me to get an Alpha Trak ($200 with strips) and she wants me to have her get an ultra sound ($450). I am retired and on a fixed income so these amounts are beyond my means at this time.

Right now I have a Precison X Tra and 3 Freestyle Lite meters since these are what my insurance pays for. i get hundreds of free strips each month because I wear a pump so I have a nice amount of supplies. I can't imagine paying for the pet only meter and strips.

Question: Do some of these vets really believe most people have this kind of money? I have spent well over $1,500 dollars in the last month on blood work and consults and I am still searching for what to do. Just venting a little. I told her my situation and about my own medical problems and she still suggests I get these things done.

Just a note on the diarrhea: I gave her some L Carnitine , 250 mg. Started out at a lower dose but she tolerated it and so I increased it to the suggested dose for cats. That is when the diarrhea started so i am pretty sure it caused it. I can't say enough about the slippery elm I gave her. I bought the powder and mixed 1 tsp in a cup of water so it is very diluted. I boiled the water and then simmered for 3 minutes, let it cool and it made a thick mix. I added 1/4 -1/2 tsp. to her food 4x a day with probiotics and the diarrhea began to immediately clear up. She had been going 5-7 times a day and had 1 movement yesterday after 1 day of slippery elm mixure. Today she had no movements and i think that is a good thing. I will add a tiny bit of pumkin to her food tonight for some healthy fiber. I am sharing this for anyone who needs a fix for diarrhea. I was truly amazed at how fast it worked. It is also my understanding that slippery elm is good for constipation, as is pumkin. PM me if any of you want the articles I used to research all of this. It was suggested to me by Felice at Feline Instincts and a holistic vet she knows.

I guess, from the discussion here, I am going to hold off on insulin and give my girl some time to heal her digestive tract. If her numbers continue to rise I will ask for more advice and if anyone has other ideas about all of this, please post them here.

Thanks again for all the helpful info and support.

I tend to get very caught up in trying to find solutions and do the right thing for Morgaine because I love her so. I know the people here are all diligent in caring for your kitties and it is a very encouraging place to hang my hat. The love for our felines is palpable. :YMHUG:

Rosalie and Morgaine
 
I don't have a ton in dose support to give, but agree that you have a lot of reasons to be concerned! I apologize if I already mentioned this in health, but have you tried offering the Merrick Before Grain (BG) Turkey variety? I ask because that particular variety has a very favorable protein/fat ratio for Morgaine's issues.

Fingers and paws crossed that you have more answers soon!
 
Christie & Willie said:
I don't have a ton in dose support to give, but agree that you have a lot of reasons to be concerned! I apologize if I already mentioned this in health, but have you tried offering the Merrick Before Grain (BG) Turkey variety? I ask because that particular variety has a very favorable protein/fat ratio for Morgaine's issues.

Fingers and paws crossed that you have more answers soon!
Click to expand...

I am so full of complaints right now but I am also unable to drive around town to find the Merrick Before Grain Turkey. I know they sell it at Petco but I no longer drive due to disability and my friends are so burnt out on all of this and I live in Tucson where the temps are well over 100so no one is eager to drive me around. I would have to order it by the case and the chances are she will not eat it anyway. She hated all of the Merrick foods I tried last year and I was stuck with a case of Cowboy Cookout. Learned my lesson. If you know of any retailers on line that will send me a couple of cans to try I could do that.

ETA: It looks to me like the Turkey has the same fat content as what she eats now. Do you have the numbers on this product and can you post them?
 
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