I need some help here.

[Albert & Ninja]

I bought the Alpha Trak 2 meter and learned how to home test very well. I learned as much as I could about diabetes and still regularly educate myself on diabetes information. I have gone through the entire process of my vet not knowing or not caring too much about carbs, diet, or dry food causing higher numbers than wet and because of this I have taken this into my own hands to an extent. The first step I took on my own accord was completely stopping the dry food.

Ninja has slowly moved his way up to 4 units of Lantus glargine (was at 5 - 6 at one point) and still remains in the 300 to 500 range with very few exceptions. I have stopped all dry food because of the high carb content. He gets a boiled egg for snacking on after his normal meals. He usually doesn't touch much of it unless he is having a bad day, his numbers are high, and he's feeling extra hungry. I first moved him from the wet Hill's C/D to the wet Purina DM. This seemed to help for maybe one day but likely was a coincidence of him just having a good day.

After a week of the DM and no improvement, I have switched him to a pate, Fancy Feast Classic Ocean Whitefish & Tuna after viewing Dr. Lisa's incredible chart for a few hours and deciding it would be a decent pick with low carbs. This hasn't seemed to drop his levels like I assumed the lower level of carbs would. This has prompted me to start my journey here in felinediabetes, because I'm not really sure where to go from here.

Some days he has lower numbers than others. He is almost always fed the same amount yet his numbers vary. I haven't been able to figure out why. I keep reading that 4 units is too high and I agree. He tested below 100 earlier this month and I checked twice because I thought I had a bad test strip and this was after a week of 5 or 6 units every day, dosage varying by how high he was right before administering the injection. I have not tried doses that high consistently because well.. it seems like so much! Also because I am worried that between the new low carb diet and that much insulin it may be too much.

 

[Kris & Teasel]

Here's what I suggest to get you moving forward:

• set up a spreadsheet like the one we use here and enter all the data you have on it
• post on the Lantus forum asking for dosing help - tons of very experienced and knowledgable people over there.

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

 

[JanetNJ]

Your dosing needs help. Go to the lantus forum and read the yellow stickies at the top. Choose a dosing protocols that you feel most comfortable with. I see you've been changing doses in whole units. Sometimes when you do that you skip the ideal dose.... And too much insulin can look like not enough. Post on the lantus forum and they can help you sort it out.

 

[Nan & Amber (GA)]

Hello and welcome! Ninja is adorable!

Great job on the spreadsheet! Here's my two cents after looking it over: you'll get a much better idea of what the insulin is doing (or not doing) for Ninja if you start getting some tests in between shots, when the insulin is actually doing some work. In general, we make dosing decisions with Lantus based on the lowest point during the day (not the pre-shot numbers) so this information is critical. And as JanetNJ says, too much insulin can sometimes look like not enough-- sometimes if the the dose is too high, it causes really low numbers between shots, but by the time the next shot time comes around the cat's body has reacted by dumping glucose from the liver, and BG is high again (we call this "bouncing"). Between-shots tests are one way to figure out whether this is happening, or if Ninja just needs more insulin. Side note: on the one "curve day" I see on the spreadsheet, Ninja was high the whole time, but, that might not have been a representative day. It looks like he went pretty low two days earlier, and he could have still been bouncing on 12/9 (bounces can last up to three days). The only way to sort all of this out is to gather more data on more days.

And, you are very right-- having changed the diet, it's especially important to keep an eye on the blood glucose now! If you can, I'd try to get a couple of tests between shots in the next few days-- try getting some at 3 or 4 hrs post-shot, for example. If you work during the day, sometimes grabbing "before bed" tests in the nighttime cycle can be very helpful.

Let us know if you have any questions!

 

[Albert & Ninja]

Thank you! Everyone here has already been so helpful. I am really liking the spreadsheet as well. Much more organized than what I had made.

Kris & Teasel, thank you for spoon-feeding me. I haven't done the whole forum thing in years.

JanetNJ, I have a Lantus pen that only allows increases in single unit increments. I realize now, after you pointing it out and scouring this forum, that this is not ideal. I will be working on finding a decent priced vial and getting used to classic syringes to help with dosing. I have read that once you hit a green you should hold that dose for 3-5 days. I had hit that with his past few days doses prior to that green being 5 or 6 units so I am going to assume after tonight's tests that he needs a higher dose. I will be posting on the Lantus forum after I gather more data from another few days worth of tests.

Nan & Amber, thank you for proper dosing instruction. I am assuming that he did not bounce as his lowest point was 295 +5 and went right back into his usual 400 range. He has been high the majority of the time. I don't have this on paper for his +5 and +6 areas until recently but I am a good judge of his behavior for when he is low and high. After shots he only has his one or two hours of calm before he seems to go back up. These are usually moments of rest for him as he can let go of the constant anxiousness and desire for food. Only lately has he been only slightly improving due to diet changes and adding water to his meal. In addition to preventing dehydration the added water seems to make him more satisfied with his meal and stay full for longer in comparison to how he was before always hungry so this is wonderful for him.

I will be keeping him at a solid 4 units for a few days to see how he reacts to the new diet and will be gathering numbers. Thank you again everyone for the insight and support.

 

[Critter Mom]

I have a Lantus pen that only allows increases in single unit increments. I realize now, after you pointing it out and scouring this forum, that this is not ideal. I will be working on finding a decent priced vial and getting used to classic syringes to help with dosing.

If you can get hold of the 0.3ml insulin syringes with 1/2 unit markings you can use the pen cartridge as a vial and use the syringe to draw the dose directly from the cartridge. It's usually the most economically effective way to use Lantus (10ml vials usually run out of steam before all of the insulin is used, unless treating a higher-dose kitty).

Many members here buy their boxes of Lantus pen cartridges from the very reliable Marks Marine Pharmacy in Canada at a much cheaper price than the same in the US. Check out the thread about buying insulin from Canada in the main FAQs for further details.


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