Just tested 95!

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casanovasmom

casanovasmom

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Casanova's normal diet consisted of Purina Healthy weight dry and Fancy Feast wet. His numbers have been high for a while and I'm ashamed to say I really didn't think we could do much better. After going to the vet on Wednesday and realizing my poor baby really needed to lose weight, I went on line and found information on Nature's Variety food. I was able to purchase some of the kibble,some of the wet and some of the raw. He likes the kibble but he has mixed feelings on the wet. It's weird, but last night when I came home from work I set out some of the wet and he actually acted scared of the bowl. I have some of the raw thawing but I doubt he will go for it. This morning I gave him a little bit of the kibble and a can of Fancy Feast. I was getting ready to give him his Lantus but thought I should check his numbers and it read 95! Could the diet change make such a dramatic change so soon? His typical numbers are mid 200s. I decided not to give him the shot and will test again in a few hours. What does anyone think?
 
Absolutely diet can make that difference. 100 points or more almost within hours.

Don't shoot yet. Test in an hour and if over 200 give a smaller than usual dose (what is
his normal dose ?)
 
A wopping 10 units!!!!! After reading about cutting back on his food to help him lose weight, I'm so scared that I'm not going to give him enough :( Losing weight is hard enough but add in diabetes and it makes me very nervous. I don't want to hurt him in any way.
 
I am going to go over to the Lantus forum and see if we can get some Lantus eyes on this. They will be the best people to help you determine the next dose.
 
Wow. HOld that 10u dose!!!

How long has he been on Lantus?
do you have a spread sheet yet?

How was the 10u dose determined?

Yes, food can make a BIG difference.

Going to bump you UP! Get some more of the experienced folks over here! I can't stay with you this morning...I'm out in about 10 minutes ....
 
Hey there!

Can you let us know how you ended up at 10 units? Like, what dose did you start at, how you increased, do you have a spreadsheet, etc?
 
Could you fill in some information about Casanova?

When was he diagnosed?
What was his starting dose of insulin, which I'm presuming was Lantus?
In what size increments were doses raised to get you to 10u?
Are there any health problems, especially a history of ketones or is he on steroids?
Do you have any more blood glucose (BG) test data that you can share?

Just like Karen suggested, a food change to low carb, especially canned food, can drop BG levels dramatically. I suspect what was happening is that with feeding dry, higher carb food, it was like you were giving Casanova cookies. You needed a lot of insulin to offset the high carb (aka "sugar') that was in his diet. You get rid of the carbs, and BG levels drop.

You may want to take a look at some of the sticky notes on the Lantus board. This is the basic information about Lantus:
Tight Regulation Protocol - this is the dosing protocol that we use

The rest of the notes are starred and are at the top of the Lantus Board.
 
I'm going to bump you up on the Lantus forum so that some more experienced Lantus people will help you. They will want to know: How long has Cassanova been diabetic? How long have you been giving insulin? How was 10-unit dose determined? The change in food can definitely change the insulin requirements. I would stall before giving a shot this morning, maybe even skip the shot. Wait for feedback from some of the people knowledgeable about dosing.

Oh, I see that Sienne has just posted. Do whatever she suggests. She is terrific!

Hang in there!

Ella
 
OK first off ... HOLD OFF AND DON'T SHOOT THAT NUMBER.

Are you serious? Your vet has told you to give 10 units of Lantus twice a day?
Unless you have a cat with a known resistance to insulin, that dose is too high.
And if you DO have a high dose cat, you still don't shoot that BG of 95.

I have 2 high dose cats and I would not shoot that number.

The others have given you good info and asked great questions.
I would NOT give any insulin to that number but I would test BG frequently, record the numbers and make notes of what foods were given at what times

The best thing you could have done was what you did: post here with BG and NOT shoot.

I know the others asked you tons of questions, but here are mine:
1. when was cat diagnosed, by whom, and based on what numbers.
2. what was starting dose and first instructions given to you.
3. what insulin, what syringes used, what testing meter.
4. what food was changed and when.
5. what other health issues are present now, were present in the past.


that's a crazy high dose so that's why people are saying WHOA how did you get there!!
there have been cats, many, who are diet controlled, so just by switching from dry to low carb wet can completely eliminate or greatly reduce the need for insulin. Usually when the switch is made, it's important to watch the BG numbers because they will fall and the insulin dose will need to be adjusted as well.

Once you can answer some of the gazillion questions thrown at you, people will be able to give you some suitable guidance, but in the meantime, do NOT give that dose and no shot now till you know what's going on.

Oh yeah welcome!
 
First off, thanks for all the support! This forum is great. He is a 12 year old male and he's had diabetes for about 5 years. Way back at the beginning he started out on about 5 units and over the years he has gone up in increments of about a unit at a time. I've never really had his diabetes under great control but he was doing okay with numbers in the mid to low 200s-which is really NOT so okay. He has always been a bit of a finicky eater but just recently he's been more accepting of wet food. I'm ashamed that I didn't switch foods up sooner:( A little over a week ago I noticed he was drinking and urinating more than usual so took him to the vet. He had a full blood panel done and there were no ketones and his liver, kidney and thyroid functions were good. That was my main worry. His fructosamine level was high at 413. I don't have a spread sheet but his numbers are consistantly in the mid to low 200s.

Just saw the newer post. He's on Lantus and I use the U-100 insulin syringes. I use a One Touch Ultra tester. He has no other health issues except being fat.

Was eating Purina Healthy Weight Management Dry and Fancy Feast Wet. In the last couple of days introduced Nature's Variety canned and kibble.
 
It will help if you can give any recent numbers.

Do it like this:

amps (means morning before shot) # units of Lantus shot
+6 (6 hours after am shot- or any mid cycle number you have)
pmps (evening number before shot) # units of Lantus shot

So today would be

amps 95 No shot given

The more data, the better the help.
 
You said he's a finicky eater, but that he's fat. Do you think he might have an insulin-resistant condition? Most cats with uncontrolled diabetes lose weight; acrocats can gain weight. With him being diabetic for 5 years but consistently in the 200s now, I think I would check into it. 200s isn't great for a normal diabetic; it's pretty good for a cat with acromegaly.

You might read the information here and see if anything jumps out: viewtopic.php?f=12&t=375
What does he look like?
How often do you test?
Is his curve rather flat (no matter how much insulin he gets), or are his numbers high and low?

Acromegaly is more common that people think - depending on how you read the studies, 1/3 of diabetic cats may have acromegaly OR 1/3 or hard to regulate diabetic cats may have acromegaly (I think this second statement is more likely). I agree that you should skip this shot, but given the time you've dealt with this, I think you should explore reasons for the high dose rather than starting over (which some people might advise).
 
I haven't done a curve on him in forever. This past week when I was concerned that things weren't right I did test and him to see if his numbers were off the charts. The high one morning was 326 and the lowest was 247. This morning I tested before shooting since I was curious to see what the food was doing if anything and got the 95. When I got up I fed him a can of Fancy Feast and about an 1/8 of a cup of the Nature's Variety Kibble. I tested him about 3 hours after that and got the 95. It's been about 2 hours since that and just got the 113 reading. Sorry I don't have more numbers. I've honestly gotten a little apathetic because it just seemed hopeless. I'm kicking myself since all along it maybe was the food.
 
What matters is today. And his numbers look fantastic today. :mrgreen:

I would suggest you start a spreadsheet and put in any numbers you have: Setting up a spreadsheet If you need help, ask. I have helped lots of newbies get their sheets up.

Then you can start posting on the Lantus forum and get specific advice for your insulin.

This is assuming the acromegaly information does not seem to fit. The part I wonder about is that you started at 5 units. The recommended starting dose is .5 to 1 unit, so you may have had a problem from the beginning.

I would not consider shooting under 200, and I would ask for specific advice then on the dose.
 
OK that's some good info, no other health issues, not recently diagnosed, but man, that is one huge high starting dose of 5u BID. When was the last increase done? Does your vet do curves or something to determine the increases?

As has been suggested, there's a protocol that most follow around here, and it's worked quite well with many many cats getting off insulin, or getting very regulated.
Here are some links with the info for you - the last one is about shooting lower numbers:
Tight Regulation Protocol
Lantus & Levemir – Insulin Depot –AKA- Storage Shed
Lantus & Levemir – Data Ready to Shoot Low Numbers

If you were able to remove ALL the dry foods, including any treats, you may see a great deal of movement in his dose needed, in the downward direction. That dry food is not referred to as kitty krack for nothing! If one of mine gets just a small mouthful of dry, her numbers will be in the 400s.

Another few links of info you should have handy and even print out if needed is relating to hypo situations. With the change in foods and drop in his insulin needs, you may run into a time when he drops REALLY low:
List of Hypo symptoms
How to treat HYPOS-They can kill! Print this out!
Jojo’s HYPO TOOLKIT

I for sure don't know what others would have to say about his shot for tonite, but I think I'd wait to see where his BG ends up. Did I miss it? What time are his shots? It may be a good idea to post his BG just before his shot time and see what sort of feedback you get.

One thing about food is that most people remove all foods for 2hrs prior to the shot time because food influences the numbers and you want to see a clean number and is not higher because of some food eaten just an hour before.

As for fat, I can totally relate to that! I am trying to figure out how to get my chunky monkey down a few lbs!

I know the others have mentioned insulin resistance, and 10units is what that says to me, but first you need to be sure that food is not the culprit in alot of that dose. For sure the food is important, so let's sort out the food and then see where you are. If he's still up with the higher number, but on all low carb wet food, you may be looking at insulin resistance and can have him tested for those conditions.

That's no problem, so don't worry about that part for now. It is worth mentioning though and keeping in mind.

Here's how we measure the times when we fill out the spreadsheet or even just post the numbers in here.
I'll use one of mine as an example.
6am - tested Oliver and he was 212. I gave him his morning shot of 22units. That's his amps am pre shot BG.
9am - tested him again and he was 206. That's what we call the +3 number or 3 hours after his shot.

If I were to post in here, I'd put the following:
212 - amps
206 -+3
I'll test him again around noon and that will be his +6 BG number

That 113 you got means he's coming up slowly.
His amps (or +12) was ? I am guess you give shots every 12hrs, so this time is his +12 or amps.
His +3 (+15) was 95 (this number is 15hours after his last shot)
His +5 (+17) was 113 (this number is 17hours after his last shot)

I know all the numbers can be confusing, but it sure looks like the food change is making a difference and he has been looking funny because he was likely going too low.

Now that you are here, you are going to be just fine and casanova's going to be even finer.
Keep testing through the day, and then closer to his shot time, you can post and see what is thought about what his shot should be tonite.
 
Just got home and tested him and his number was back up. Got a reading of 282 then used a new pack of strips just wondering if my strips were bad and got a reading of 338. His last shot was given last night at about 9:30 so it's been about 19 hours. This is such a rollercoaster!
 
casanovasmom said:
Just got home and tested him and his number was back up. Got a reading of 282 then used a new pack of strips just wondering if my strips were bad and got a reading of 338. His last shot was given last night at about 9:30 so it's been about 19 hours. This is such a rollercoaster!
Click to expand...


Actually, that's not too bad for a bounce from normal numbers. Normally we talk about reducing the dose or dose changes with verified numbers below 40-50? And then we talk in 0.25u units, but that may be different for your case.

You have a few hours to go until shot time. Just keep monitoring...he may go above 500. Don't be startled to see that kind of number. His liver my be doing a glucose dump from going to numbers he is not used too. It is called a bounce/rebound and is sort of normal and should clear in a few hours to a few days.

As far as dose would be concerned I think advice from Sienna or someone from the HighDose group would be helpful.
 
how many hours until you want to shoot?

And I don't think this question has been asked yet (sorry if it has, I'm trying to scan the thread quickly), how long has Cassanova been on the 10 unit dose? I see that he started at 5 and worked up. Has he ever had a hypo, that you know of? Or ketones? Are there any other health issues that we should be aware of?

Also, I think a fructosamine of 413 is actually pretty good. This chart actually lists it as "good control."

Can you get another test about an hour before you plan to shoot? We're looking for the rate of rise, or to see if maybe he is already turning back downward.
 
From the sounds of things, Casanova was given his usual 10units of Lantus last nite at 930pm.
When he was tested this morn, he was 95. He was not given a shot.
That means his number of 338 when next tested is not bad at all considering it had been 19hours since the last shot of insulin.

Casanova is likely surfing nice on that big shed of his. Combine that with the food change and he is not likely going to need a 10u shot tonite.


Casanova's mom,
Can you test him an hour before his shot time to nite - I am guessing that will be 830pm your time local - and then post in this thread with his BG number. I would then test him at his shot time, at 930pm, then post here again but do not give him his shot yet. Someone will be here to help you decide what dose to give him and I don't think you should be shooting 10u now.

If you can read the earlier posts from others and me, and answer any of the questions still not answered.
We know you changed the food about a week ago, now we need to know how long has he been getting the 10u dose, and when did you increase from the 9u dose - I think you said you did full unit increases.

When you reply, we can help you keep Casanova safe.
 
casanovasmom said:
Was eating Purina Healthy Weight Management Dry and Fancy Feast Wet.
Click to expand...

I have not read this entire thread but this did catch my eye.

I find it so sad that my colleagues continue to ignore the impact of a proper diet on the health of our cats - both diabetic and non-diabetic. If your vet knew that you were feeding the above dry food...shame on him or her for not being more proactive about getting their patient on a 100% low-carb CANNED food diet.

Please note what I write about pouring gasoline on a fire on my Diabetes webpage linked below.

Don't be too hard on yourself for feeding the dry food. Now you know better but your vet certainly should not have endorsed the feeding of a high carb dry food...or ANY dry food, for that matter since we also worry about urinary tract heath and the feeding of a water-depleted diet. Remember...carbs are not the only thing that we need to worry about. (Please see the Feeding Your Cat article linked below.)

Please also be sure to read the STOP sign section on the Diabetes page below. That is a critical section to fully understand.
 
He has been on 10 units since April. When I went to the vet this week, she recommended bumping it up to 11 units. I haven't done that yet because I was hoping to try a new diet and see if that worked. We have been to almost every vet in our town as well as an internest a few years ago trying to find a vet that had a clue about the disease. Unfortunately, none have them have been much help. This board has been much more informative.
BG numbers from today 9:15 95 11:42 113 4:34 338 8:49 361.
No other health issues and he has never had ketones.
 
We know Cassanova's name. What's yours?

it would be good for you to post over on the Lantus board. You can include this thread so you won't get asked all those questions again. Just paste this URL into your post. viewtopic.php?f=28&t=31394, tell them you are new and need help.

They will want a spreadsheet so they can see how the insulin is working. I can set one up for you if you want tonight. Just send me a pm or private message. use the button on the lower left hand bottom of my post.
 
I actually went to google and set up an account to start a spreadsheet. I just have to put in some numbers. I'll try to put this in the Lantus forum. And my name is Laura :)
 
That's great Laura. Is it the template we use? If so, you can choose Share and put it in your signature so it comes up every time you post.
 
Hi Laura,
Do NOT increase the dose to 11u. I am sorry that you have gone through all the vets in your area (where are you located) but sadly there are not that many vets who are that knowledgeable on feline diabetes.

The vets at my vet office know next to nothing, but they are good with other issues. They give me no input on treating my cats' diabetes because they have no knowledge on the subject.

Once you have your spreadsheet filled in and attached to your signature here, the guys over in the Lantus group can give you a hand in deciding what dose to shoot. I don't think you have said but I guessed your shot times are 930am and 930pm? If it's a different time, what is it?

With the food change, Casanova's likely going to need a dose decrease.
 
It's the one from google that a previous poster suggested. Now setting it up is done but getting the link to show up in my signature line may be tricky. I'm not very computer savvy.
 
Thanks so much for all the support today. It has been a trying day. I really hope the new diet works but the BG numbers fluctuating is maddening. It is so hard not to second guess all the decisions that need to be made about when to shoot and how much to shoot. To answer a previous question, my shot times are usually 8:30am and 8:30pm unless life gets in the way :)
 
The ss looks great! It looks like you have not given a shot tonite. One test that's very good to get is a before-bed test because many cats go lower at nite, so it's best to see Casanova's numbers just before going to sleep. There have been quite a few people surprised with low numbers and they needed to stay up a bit to bring the numbers up.

Whatever dose you give tonite, it may be a good idea to get a couple tests before going to sleep, just to be sure he's not going too low.
 
you've got the best of the best helping you here, laura...so i'll just say...you've found the right place for help.

and also ask...have you rested and eaten?
sometimes it's overwhelming...
 
I have. I have had two great meals today and have also been able to go to a fabulous event in Colonial Williamsburg, the Grand Illumination to kick off the holiday season. Off to bed shortly. Thanks for the concern and support!
 
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