I'm still here ... could use some Words of advice?

Status
Not open for further replies.
Cindy Lou & George

Cindy Lou & George

Member Since 2015
I have some concerns maybe someone could give me some love? GB has been all over the page. I thought we were hitting some good numbers in the yellow zone :) then we're back in the 400's and now the 500's. sleeping and wants to drink water,,, he usually jumps up on the bathroom vanity and has a drink while we're in the bathroom. tonight he couldn't make the jump ... I noticed he is favoring a hind leg too. should I try the other insulin that Alan sent me?
 
What kind of insulin did Alan send you?

Sure looks like the Novolin isn't working very well for him, but without a few more tests in here and there, it's hard to say.

Novolin isn't usually a very good insulin for cats, so depending on what other insulin you have, it might be worth a try
 
cindy lou said:
he usually jumps up on the bathroom vanity and has a drink while we're in the bathroom. tonight he couldn't make the jump ... I noticed he is favoring a hind leg too.
Click to expand...

Does it look like this video?

If it's diabetic neuropathy, we've had some good results from Zobaline for Cats....it takes time to work, but we've seen some really great comebacks! But the most helpful thing you can do for George is to get that blood glucose under better control
 
Hi Cindy, I can't really help you with dosing advice as I don't use Lantus. You'll probably get more responses if you post your question on the Lantus board, I'm sure there are lots of folks over there who can give you the advice you need. :)
 
I would recommend that you start the Lantus at 1 unit twice a day. Since it will last longer than the Novalin you want to start at a lower dose. Keep it at 1 unit for at least a week before determining if you need to increase the dose. If you do, only increase it by 1/2 unit and wait another week before increasing it again. This way you reduce the chance of hypoglycemia and can find your optimal dose.
 
Starting from Scratch, For a week I'm just to give George 1 unit of the Lantus twice a day. His attitude has changed already, he is eating a full meal. and is starting to drink less. I tested his Gb just for fun today. my meter said "HI" i don't think it was greeting me... Lol . but at least I know were going in the right direction.
 
Hi Cindy!!

First, I'd like to invite you over to the Lantus Forum ....you'll get the most experienced eyes watching for you there since everyone uses Lantus or Levemir there

Each day we start a new post with the date/cats name and the AMPS number in the subject line....as the day goes on, you "edit" the subject line and add new test results (You'll see what I mean when you go look at the other posts there)

In the body of the post you'd first put the link to your prior day's post...that makes it easy for people to quickly go back and see what's been said, and then you'd give the WCR (Whole Cat Report)...How George is doing generally....appetite good? Are the 5 "P's" in place? (purring, preening, playing, peeing, pooping) and any questions you may have that day

It's also helpful to read other posts...you may see something that you don't understand now but is explained another way and all the sudden it'll click with you, as well as possible thinking of questions you didn't even know you should ask!

Second...and most important....I think your vet is starting George at too low a dose which could lead to glucose toxicity setting in (where he'd need even higher doses to break through the resistance) as well as leaving him at risk for ketones from having a dose that's too low for him. Usually we start new cats at .5 to 1U doses, but George has already been on 4 and 4.5 units of a much harsher insulin.

The other problem is you don't have many tests in between the Pre-shot tests and those are going to be VERY important. Lantus dosing is based on how LOW it takes them, so without getting tests in between the shots, you're not going to know how low he's going (which is the problem with what's going on now too) We've seen cats go from 400 to 40 and back to 400 in one 12 hour cycle...if the only numbers you see are the 400's, you might think he needs more insulin, when in fact, he needs less!

If at all possible, we'd like to see at least 1 test somewhere between +5 and +7 on the AM cycle and always a "before bed" test on the PM cycle

Let's see if I can get some other opinions here, but I'd probably try 2.5 units and make sure to get those tests in between the shots in if at all possible..it's especially important on the PM cycle since most cats go lower at night.

@julie & punkin (ga) @Wendy&Neko @Jill & Alex (GA) @Sienne and Gabby
 
I knew there was something else I was forgetting!!

It'll help if you'll do something "extra" special with your spreadsheet to show that you've started Lantus....like go across a whole line and manually color code each cell something "bright" and put letters in the cells that spell out "Started Lantus"
 
Hooray for good blood work. I see George has been on Lantus a couple of days now. Do you have any blood tests other than the one tonight? I too suspect you started on too low a dose, but getting some Lantus data will really help us help you.
 
The best thing you could do right now to help figure out if this dose is ok or not would be to get at least one test in between the shots. Lantus takes a few days to build the depot, so you don't necessarily see how well it works immediately. Here is a good link that describes how Lantus works - understanding this can help you understand a little more about dosing with Lantus. As Chris described, the low point is typically somewhere in between about 3-8 hours after each shot, so getting some spot checks in those hours will really help us see what the dose is doing.

Just getting one test in between each shot is going to make a world of difference in helping us help you.

Also, can you test his urine for ketones? That's really important until a cat is regulated. When switching to a depot insulin, or significantly decreasing the dose, the possibility increases that ketones can develop. It's good to prevent that. Here's more info on the subject.

What was the new vet's reasoning for starting over with the dose? If you can't answer that question, I'd give the vet a call and ask them to explain that to you. When switching from one insulin to another, typically the cat's blood sugar response to the last insulin is taken into account - and it looks like George was needing 4ish units to get into the 200's. That would suggest that he might need a similar dose of Lantus as well. Significantly dropping his dose and starting over can put him in high numbers unnecessarily. If I'd looked at the spreadsheet first, I'd have been thinking you could start at about 3.5-4units per shot. There are common conditions that can cause a cat to need more than the average amount of insulin. Sometimes vets haven't seen those and think they are rare, but we see them often here. Both Wendy and I have cats that have needed larger doses of insulin.

You'd be welcomed on the Lantus/Lev group - we have new people all the time and posting there will help keep experienced people's eyes on George. I hope you'll post there. If he doesn't surprise us by getting into some lower numbers on this dose, he may need dose adjustments fairly quickly.

Ask a zillion questions, too. No one minds.
 
thanks for the Invite... At first she (the vet ) was shocked that I was using such a large dose and not getting a response from the insulin, Also she wants to rule out a urinary track infection as she put him on antibiotics for 14days . I have to admit I was lyre at first.... but I'm starting to get my George back.. :) numbers this morning Gb 384 so maybe he's starting to come around.

Happy Friday
 
Last edited:
I would say he has been getting a response from the 4+ units. It was moving him closer to normal range.

The latest research is that 1 in 4 diabetic cats has acromegaly - a condition that causes a need for larger than typical doses of insulin. Punkin got up to 15.5u of insulin PER SHOT before we had his acromegaly treated. That's a pretty typical dose, although I know of a couple of cats that have gotten over 100u per shot. My only point is that a cat needs as much insulin as it needs - it's unhelpful for a vet to think that a certain amount is going to be the "right" amount. For those who are hometesting, we can track insulin needs by the tests.

Acromegaly is not uncommon at all - 25% of all diabetic cats would make it fairly common - but many vets know little about it and have the idea it's rare. 25% is not rare - we see it all the time here. We've been told that vets get about 1/2 hour total of education in vet school on feline diabetes. Within that, perhaps there is a mention of the high dose conditions (there are 2 others as well as acromegaly, but it is the most common) but perhaps not. Most vets don't treat many diabetic cats because most people euthanize their cats upon diagnosis. They don't realize that it is very treatable.

And of course, I have no way to know if your sweet George has acromegaly or not - my only point is to say it's common, and that diabetic cats need the amount of insulin they need.

Let us know how we can help you.
 
Status
Not open for further replies.
Back
Top