I'm back with Sugarkitty #2

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Jacquie & Lizzie

Jacquie & Lizzie

Member Since 2012
It's been awhile since I've visited the FDMB, I used to be known as Jacquie & O'Malley. Alot has changed since 2007. That's when we lost O'Malley from complications due to diabetes. We lost another kitty this past December to bone cancer and we are left with our sweet, beautiful Lizzie and her sister, the ever jealous Lily :) Lily is our only dog & is the baby of the family in every sense. She's very much a momma's girl!

Lizzie was diagnosed with Diabetes yesterday. She is 9 years old & has been pretty healthy her whole life. I started noticing symptoms that mimicked O'Malley and got her in as soon as I could. She has been peeing ALOT, drinking alot, losing weight, walking like she's sore, her eyes have lost their blue color and her third eyelids were starting to come into the corner of her eyes, and she's just being way more affectionate than usual. (all in a matter of a couple of weeks, weird how fast you can hone in on it when you know what to look for) Her blood glucose level taken Monday afternoon was 472! While I'm not surprised she is diabetic, I was unsettled by such a high number. The rest of her blood work actually looked very good. Good kidney & liver levels, but slightly anemic. Her teeth & gums are in very bad shape which we'll address in a couple of weeks once we get her blood sugar down.

Last night our vet, Christa, & I decided to start her on Lantus at 2 units twice a day. This morning, I got a glucose meter, test strips, lancets, rice sock, you know all the essentials...I took a very active role in managing O'Malley's diabetes and plan on doing the same with Lizzie. Here's our plan:

Feed 1.5 oz Fancy Feast in the morning & evening, test, & shoot. We are switching her from Iams dry pet food to Purina DM, free feeding about 1/2 cup during the day as needed. (We may switch to a different wet food but I wanted to change the dry first) We are going to have to put up the dog food during the day because she prefers it to the cat food. I am off work until the middle of August so I will be spot checking her at 3, 6, & 9 hours and keeping a spreadsheet. I meet with Christa in two weeks to discuss her progress.

I didn't get a preshot number this morning but +3 was 388 & +6 was 298. Not even close to where it needs to be, but it's the first day. Patience grasshopper ;)

I feel pretty good about our course of action & I think our vet will be receptive to me testing and being very involved. I'll know more as I talk to her about Lizzie's progress.

Now some questions & remarks...HOLY MOLY is Lantus expensive or what?????? I was completely shocked when the pharmacist gave me the total. Christa said the bottle should last about 3 months so I guess it works out, but whoa I don't remember spending that much on PZI with O'Malley. Christa said she gets very good results with it so we'll cross our fingers. But...you can't put a price tag on a life & I will do whatever it takes to help her. I always felt I failed O'Malley in the end by not noticing his signs & I'm determined to not make the same mistake with Lizzie.

Anyway, about syringes & lancets, how many times can I reuse them? Do I need to roll or shake the insulin before filling the syringe? I haven't looked at google yet, but I need to get one of the insulin bottle protectors, it sucks when you break a brand new bottle, not that I've ever done that, ha ha! Gosh what else do I need to know? I'm sure I'll have questions as we go along, I just wanted to say hi & thanks for having us back. FDMB is such a great support, tool, & provider of information & it's nice to connect with others who are going through a similar experience. Thanks for being there for us with O'Malley & being here for us now with Lizzie.

Jacquie & Lizzie & O'Malley (GA '07)
 
1 vial of lantus is 10 mL with 100 units per mL = 1,000 mL
If you continue at 2 units 2 times a day, you'll get 250 days of insulin out of it.

We suggest getting the Lantus insulin pen, then using a syringe to withdraw the insulin as you need it, treating it like a smaller type of vial. That way, it is less likely to go bad before you finish with it. Placed in the refrigerator on a shelf, never shaken nor rolled, some folks have used it to the last drop.

If you drop the dry food, you may be able to reduce your insulin use and possibly get diet-controlled.

Never re-use syringes nor lancets; they become duller and hurt more, plus become contaminated with bacteria.
 
Anyway, about syringes & lancets, how many times can I reuse them? Do I need to roll or shake the insulin before filling the syringe? I haven't looked at google yet, but I need to get one of the insulin bottle protectors, it sucks when you break a brand new bottle, not that I've ever done that, ha ha! Gosh what else do I need to know? I'm sure I'll have questions as we go along, I just wanted to say hi & thanks for having us back. FDMB is such a great support, tool, & provider of information & it's nice to connect with others who are going through a similar experience. Thanks for being there for us with O'Malley & being here for us now with Lizzie.
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You shouldn't ever reuse the syringes. They get dull, plus the lubricant inside can contaminate the insulin. With Lantus, you don't want to shake rattle or roll it at all. I like to tell people to treat it like it is nitroglycerine but it's not quite that delicate. I've seen advice that you should keep in stored in the fridge but NOT on the door, as that might shake it up if someone slams the door.
The lancets are best not reused too, as each time you use them, they'll dull.

Christa said the bottle should last about 3 months so I guess it works out, but whoa I don't remember spending that much on PZI with O'Malley.
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The "old" PZI isn't around anymore, but today's version (Prozinc) costs over $100 a vial too. The best way to buy Lantus is the solostar pens, I think they come in a 5 pack? You'd get more shelf life out of those than out of a vial.

And if you are used to the way PZI works, Lantus is a "different world", so you want to make sure and visit the Lantus TR forum under the Insulin Support Groups and read up on all the stickied threads. It works differently, the curves are not quite the same, the dose is based on the nadir number rather than on the preshots. You'll do great with it, but it'll take some "getting used to".

Carl
 
Jacquie,
I'm just wondering how the vet determined the starting dose of 2u twice a day... How much does Lizzie weigh, and is she underweight or overweight at this point?

It takes several cycles for the Lantus "depot" to be established, so don't stress too much over the numbers for the first couple of days. Gathering data like you've done today is a big plus, however.

I'm going to see if I can get some "lantus eyes" to chime in here.

Carl
 
Carl,

Thanks for responding. I'm not sure how she based the dosage. Lizzie weighs about 13.5 lbs & has lost at least one pound in the last few months. I think she's within the normal weight limits for her size but the weight that she's lost is noticeable. Christa mentioned something about how high her glucose level was & that's what she wanted to start it at. I thought it was a higher than normal dose, that's why I'm watching her numbers carefully. I don't want to send her to far the other way. :)

That's good to know that it takes a few cycles to start getting in the range we want. I don't know that I'll check her as often tomorrow. She really hated it today but hung in there for me.

I'll keep a close eye on her & maybe start posting on the Lantus board.

Jacquie
 
These are the AAHA guidelines for dosing, and what we usually do is go with .25u/kg of lean body weight. In her case that would be roughly 1.5u bid.
Posting lantus specific questions, especially related to dosing, on the Lantus TR forum would be a fantastic idea!
http://www.aahanet.org/PublicDocuments/AAHADiabetesGuidelines.pdf
I think the dosing info is on page 218.

Carl
 
And don't forget that vet stress could have raised her numbers at the vet, plus the dry food...

And I am not sure how much her numbers will decrease if she needs dental. Usually any kind of infection actually raises BG levels. Many cats have had their BG's decrease greatly after a cleaning/pulling.
 
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