Insulin not lasting long enough?

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SugarFreeLucy

SugarFreeLucy

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Hi again everyone,

I'm not sure if my subject line is the best, but it is the best way I can describe what my sugar kitty is doing! ohmygod_smile

For the last three days, Lucy has only had one shot of insulin per day?!?! Her other numbers have been too low to shoot (yay!) I can't seem to figure out what is going on, so I am hoping someone may be able to shed some light onto it. I have spoken to the vet, and she is stumped too!

Lucy has not had any dry food since April 7th. I am feeding her about 1 can of wet food, plus 1/4 can of FF as a snack....too much? too little? She is about 8lbs and a little on the skinny side.

She has been on Clavamox since the evening of April 5th...she has a tooth that we think is infected and were hoping it would come out on it's own - not yet, but we want her to be a bit more stable (sugar wise) before we attempt any dental procedures!

I have been giving her 2.5u of Lantus (when her numbers dictate) but she rockets from 3.1 in the morning, stays low all day, then by the time i test her again, she is back up to 17! It seems like the insulin from the previous night lasts 18ish hours, but within the 17th or 18th hour her bg shoots up super quickly.

I'm hoping someone can offer some advice, the vet suggests we try and shoot 2u BID and see if that balances her out...I am not prepared to give her that high of a dose when her numbers are below 10!

Any thoughts would be appreciated!
Val (Sugar Free Lucy's mom)
 
Looking at her spreadsheet I would say her dose is too high. Lantus and all insulins for that matter when it comes to cats needs to be given TWICE a day because of their very high metabolism rate. Personally, if she was my cat I would back her dose off to 1u twice a day 12 hours apart and keep testing her to see where she goes on that and see if she doesn't get more consistent readings.

Especially with her diet change it if very possible that she needs much less insulin, and since you are home testing you can track her progess and using the protocol for how Lantus works adjust her dose when she needs it. If you are unsure how Lantus is adjusted according to the numbers you see on curves please read the stickies over in the Lantus TR forum.

Mel, Maxwell, Musette & The Fur Gang
 
As already said, cats need insulin at least twice a day and some cats get insulin 3 times a day!
Once a day is not enough.

think about going on a trip 10miles away, so you put in enough gas to drive 10miles... well, how do you plan to get home? Before you leave for home, what do you have to do? stop at a gas station and get enough gas to drive 10miles home.

What are you doing? You are making your cat push the car home.
Give him a hand and fill the gas tank.
 
Thank you both for your replies. My 'gut' feeling is that the dosing is too high as well! And I'm not thrilled with the one injection a day either, but now I feel a bit more comfortable having others agree with me!

Is it ok to still give her insulin when she is in the low (green) numbers? I ask because I am away all day, and would hate to inject her and have to leave her unattended.

Sorry for all the questions, it seems like we are getting somewhere with her and I want to make sure that this trend continues!

What about thoughts on the amount of food she is getting?

I will check out the Lantus stickies, and have more questions I'm sure lol

Thanks again everyone!
Val and Lucy
 
Since you're just starting out, we generally recommend you not shoot below 200.

Once you have a fair amount of data, you'll know better how your cat responds to insulin - how low, how fast it drops, etc. - and will be able to lower that no shoot number based on those experiences. there are some folks with lots of data who will shoot in the green and they have data to support doing so safely.
 
OK first thing, apologies for asking questions is not accepted.... you must ask every question you have! OK?
With cats having faster metabolism, they use insulin different from dogs and humans.
Shots are needed 12 hours apart or as close as you can to the 12hrs.

About the food, until regulated, in better numbers and your cat's feeling better, you will see an appetite quite large as the cat's body is not able to extract all that is needed for the cat to function, so alot of food is in and out with nothing pulled from it... I know many people limit the amount of food, and within reason is good, but they DO need more food. My two cats were up to 24oz and 30oz a day but dropped way down to closer to 6oz and 10oz once they were regulated.

it's good to leave a bit of food out when you are away because if a cat goes low, the cat will look for food to self regulate. Many people use an autofeeder so that the food is more evenly spaced out during the day.
some food links for you:

Binky’s Food Lists
Feeding Your Cat: Know The Basics of Feline Nutrition
Petsafe 5-meal Auto Feeder

You asked about shooting low numbers; there's some info on that topic:
Lantus & Levemir – Data Ready to Shoot Low Numbers

If you are ever in doubt, just post on here and someone can help you with the decision if too low to shoot or maybe you can delay the shot.

For your shot times, pick times that are most fitting to your life, and see if you can be giving shots when you have time to wait a bit after the shots. Say you have to leave for work, out the door, at 8am. Well, be sure you don't pick 8am/pm for the shot times.... try for maybe 7am/pm and then you have time to maybe delay the morning shot if needed with a low number. Me, I picked 5am/pm because I had plenty of time to play with if needed in the morning and I would also be able to get a test or two done at nite before bed.

Now, I don't think you are going to be getting low green numbers once you cut the dose down and start giving shots twice a day.... the numbers will level out.

ETA:
What dose are you planning to give? It may be an idea to go back down to 2u am and pm, but see if you can do some curves when you can, maybe a weekend cycle or two, and maybe a test just before bed as cats often go lower at nite.
The numbers that are most important are the lowest numbers, usually around mid cycle and you base your dose changes on the low numbers.
if you are looking for any info just ask and someone can dig it up for you.
 
Gayle Shadoe & Oliver said:
OK first thing, apologies for asking questions is not accepted.... you must ask every question you have! OK?
With cats having faster metabolism, they use insulin different from dogs and humans.
Shots are needed 12 hours apart or as close as you can to the 12hrs.
Click to expand...

No problem! I will ask all of my questions....I was always told 'the only 'stupid' question is the one that you don't ask!'

Lucy always seems to be hungry, I will figure out how to leave out wet food without the ever curious dog finding it! Perhaps the frozen method will work....that timed feeder is awesome!! Will have to start saving my pennies now, as I will need 2! One for Lucy and one for her sis Ethel!

it's good to leave a bit of food out when you are away because if a cat goes low, the cat will look for food to self regulate. Many people use an autofeeder so that the food is more evenly spaced out during the day.
Click to expand...

Currently I am shooting at 7am and 7pm and that seems to work well...I have to be out of the house by 8am and hubby works shifts so he is either out way before me, or fast asleep as he has only been home a short time. I am able to test a couple times at night, about 2hrs after shot and then again at bedtime (usually 4 or 5 hours after shot)

ETA:
What dose are you planning to give? It may be an idea to go back down to 2u am and pm, but see if you can do some curves when you can, maybe a weekend cycle or two, and maybe a test just before bed as cats often go lower at nite.
The numbers that are most important are the lowest numbers, usually around mid cycle and you base your dose changes on the low numbers.
if you are looking for any info just ask and someone can dig it up for you.
Click to expand...

I am going to try 2u in the am and pm as of tomorrow....will be able to get a mini curve at night time, a full curve hopefully this weekend. I am still terrified of giving 2u with her numbers in the low green! I am going to check out the Lantus TR link you gave me!

Thanks again for all the help! This forum is great! I can't wait until I can be the one giving advice :mrgreen:
 
I'm hoping someone can offer some advice, the vet suggests we try and shoot 2u BID and see if that balances her out...I am not prepared to give her that high of a dose when her numbers are below 10!
Click to expand...

Whether you realize it or not, by asking YOUR questions and getting answers, you are helping all those who are reading posts, and may have the same questions but are scared to post and ask!

So there you go; you are already helping others!

I think by going back to the 2u and getting in some more tests where you can, you will find out if more of a dose is needed or not.... it could turn out that her 'good dose' is 2.25u! Let her shed drain a bit and her numbers level off some, and then you guys will be ready to decide if she needs to go up in dose or stay put.
 
SugarFreeLucy said:
I have been giving her 2.5u of Lantus (when her numbers dictate) but she rockets from 3.1 in the morning, stays low all day, then by the time i test her again, she is back up to 17! It seems like the insulin from the previous night lasts 18ish hours, but within the 17th or 18th hour her bg shoots up super quickly.
Click to expand...


Hi Val

What you want to find is a dose you can give twice a day without skipping any. When you have a high, then a low and have to skip the shot repeatedly, this suggests the dose is TOO HIGH. So the corrective action is to LOWER the next shot you give.

Also, you just changed completely to all canned food - this really dropped the insulin requirements. It may be prudent to drop back down to 1 unit twice a day for 3-5 days, with some mid-cycle tests, so you can see how low she's going and possibly doing a curve around day 5 if you've not had to skip any doses.

Have you had a chance to read over the Lantus sticky posts? That'll explain a lot about how Lantus works and how best to use it with your cat.

Also - is there a table or chest or fridge on which you can put the food where the dog can't get to it but Lucy can? Or maybe pick up some baby gates and block off a room where the cat food can be placed.
 
Hi again,

Here is my update! I have pulled back, and reduced Lucy's insulin to 1u BID and guess what?!?!? Today is day 2 of 'normal' numbers! No crazy spikes!!!! :o I am able to get nightly nadir values and they are great too! 90 - 100 **happy dance**

I am hoping this is a turn in the right direction!

As for the food situation, I have figured out a place for it to go that is out of reach of the dog, and Lucy's slighly overweight sister! The first time I left it out, Lucy promptly marched over and ate it all! ohmygod_smile oh well, will try the frozen FF and see if that works well!

Val
 
It is great to hear the changes you made are working out; I am sure you are so relieved.
 
What a wonderful update....crossing fingers that those beautiful numbers continue and soon you have a diet controlled kitty! :thumbup

Mel, Maxwell, Musette & The Fur Gang
 
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