Lantus. Fancy Feast trying to lower numbers

Deborah Jordan

Deborah Jordan

Member Since 2021
0615 Debbie
AMPS 15.6
I switched to Fancy Feast pate as the vet wants me to give 10U Lantus (she was on 8U) and have her tested for Hyperthyroidism as other tests are negative. After 4 cans of FF she was down from the high 20s (and a 30) to 3s and 4s. Unfortunately the PS was 3.4 and I panicked and instead of 8U gave her 5. After a day on the phone to other members she was stabilising and on her way back. However that was Monday and her figures are going up again and she's drinking loads if water again. Tomorrow I see the vet and part with more money as her current numbers don't support me dropping her insulin or believe that FF does anything (at her climbing numbers im losing faith) so he'll want me to switch to 10U and get the Hyperthyroidism test.
She's 7.5kg so could she be hungry and need more to eat? Why is she going up instead oh down? I bought 3 months supply of FF lol!!
Please can someone help.
"Bonnie's Spreadsheet" has her numbers that I did.
 
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Hi Debbie, welcome to the LBL forum.

When was Bonnie switched to FF Classics? And is that all she eats now? No other dry food or higher carb canned food?
I don't see any numbers for the PM of 14/6. How much insulin did she get? Were you able to get any tests? Did she get 3U this morning?

We do not recommend increasing insulin dosage by whole units. We increase by 0.25-0.5U at a time. It looks like Bonnie needs much less insulin when switched a low carb food.

Link to previous post on Main/Health:
https://www.felinediabetes.com/FDMB/threads/dosage-help.278452/
 
Deborah, I live in Sydney.
I can't see your Spreadsheet. Am I missing something?

I read back on your last thread and this is what Karen said...did you see it?
Karen's response in the previous thread:
It's important to remember that once she went on the Fancy Feast, the sugars dropped dramatically, so you had to reduce the insulin dose. So instead of giving the 8u, you reduced to 5u and even then the sugars dropped below 5, so there's been more reduction. Today you gave 3u on a pre shot of 8.2, and it's gone up quite a bit, but that may be a bounce from yesterday's low numbers. You certainly can't go to 10 units from what you're giving now. You honestly need to be patient, let the low carb food do the job and let her body adjust to those lower numbers. I know how hard that is, especially when you see those high numbers, but the overall trend has been her blood sugars coming down with the change in food and the decrease in dosage.

I agree with what Karen has said. After changing to low carb food, your kitty is needing less insulin. Don't go back to the 10 units. It is unsafe to do so.
A cat frequently bounces after a drop into low numbers. We really need to see your Spreadsheet. I am wondering if @Bandit's Mom can help you with it.
Here is information about bouncing:
  • Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast. The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
 
Looking at the SS I would stay with the 3 units for now and see how she goes with that. The higher numbers you are seeing are from bouncing, as explained in the above post. Bonnie is not used to the lower numbers any more and her body is reacting to them by bouncing. Try not to get distressed by these bounces. Lots of cats have them.
Keep feeding the low carb food, and posting each day so we can help you.
 
Bandit's Mom said:
Hi Debbie, welcome to the LBL forum.

When was Bonnie switched to FF Classics? And is that all she eats now? No other dry food or higher carb canned food?
I don't see any numbers for the PM of 14/6. How much insulin did she get? Were you able to get any tests? Did she get 3U this morning?

We do not recommend increasing insulin dosage by whole units. We increase by 0.25-0.5U at a time. It looks like Bonnie needs much less insulin when switched a low carb food.

Link to previous post on Main/Health:
https://www.felinediabetes.com/FDMB/threads/dosage-help.278452/
Click to expand...
The needles I have an entire but unopened box of won't allow me to draw 0.25. My vet is wonderful but he admits he's not an expert and takes on board anything I pass on to him from learning in here or FB b
group. Could you please tell me why type of needles I need to buy. Australia only stocks these items in the big cities so I have to order a lot of things on line or my pharmacist will buy them for me when he goes to the city every week to get stock.
Thank you
Debbie
 
In Australia we can’t buy the 1/2 unit syringes like they can in the US and the UK. But I managed with using the following syringes and drawing up 1/4 unit amounts. I used a magnifying glass and a good light.
So the syringes you need are U100, 3/10ml, 30 or 31 gauge, 6 or 8 mm insulin syringes. The best ones to get are the BD ultra fine ones. I’ll give you a link to show the pharmacist. You can buy them at other places apart from the following place but I am just showing you what to buy.
https://www.pharmacydirect.com.au/b...MImKriofbE_wIVPdBMAh3EYQ-qEAQYASABEgIQGfD_BwE

It is wonderful the vet wants to learn about diabetes. I think that shows what a good vet he is. Please tell the vet with Lantus you need to increase the dose in 1/4 unit doses and that the increases are based on how low the dose is taking the cat. We don’t increase on the Preshot BG..
You might like to print off and show him the 2 dosing methods we use here.
DOSING METHODS
 
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Bron and Sheba (GA) said:
Deborah, I live in Sydney.
I can't see your Spreadsheet. Am I missing something?

I read back on your last thread and this is what Karen said...did you see it?
Karen's response in the previous thread:
It's important to remember that once she went on the Fancy Feast, the sugars dropped dramatically, so you had to reduce the insulin dose. So instead of giving the 8u, you reduced to 5u and even then the sugars dropped below 5, so there's been more reduction. Today you gave 3u on a pre shot of 8.2, and it's gone up quite a bit, but that may be a bounce from yesterday's low numbers. You certainly can't go to 10 units from what you're giving now. You honestly need to be patient, let the low carb food do the job and let her body adjust to those lower numbers. I know how hard that is, especially when you see those high numbers, but the overall trend has been her blood sugars coming down with the change in food and the decrease in dosage.

I agree with what Karen has said. After changing to low carb food, your kitty is needing less insulin. Don't go back to the 10 units. It is unsafe to do so.
A cat frequently bounces after a drop into low numbers. We really need to see your Spreadsheet. I am wondering if @Bandit's Mom can help you with it.
Here is information about bouncing:
  • Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast. The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
Click to expand...

I should never have given 5U at a 3. anything. I knew I'd killed her and it was a public holiday and the emergency vet an hour away. I honestly thought she was going to die. Luckily help was on hand from a FB group and I calculated her old dry food to be 27% carb and had honey on hand! After a few handfuls of that so the insulin was needed I felt better. I had fed her FF pate over a year ago but during the pandemic we couldn't get it in Australia. She started it Saturday night and by Monday was LOW so she'd had 30.9 on the Wednesday or Thursday abd the vet wanted her on 1OU. Not only did I think that was crazy I couldn't afford it. So I was up til 2am and found the FF pate was back and drove there the next day and bought i3 months supply.
Now I'm praying it works!!


Bandit's Mom said:
Hi Debbie, welcome to the LBL forum.

When was Bonnie switched to FF Classics? And is that all she eats now? No other dry food or higher carb canned food?
I don't see any numbers for the PM of 14/6. How much insulin did she get? Were you able to get any tests? Did she get 3U this morning?

We do not recommend increasing insulin dosage by whole units. We increase by 0.25-0.5U at a time. It looks like Bonnie needs much less insulin when switched a low carb food.

Link to previous post on Main/Health:
https://www.felinediabetes.com/FDMB/threads/dosage-help.278452/
Click to expand...
 
Yes I remember when Fancy Feast disappeared from the shelves in the supermarket.
I’m glad the fb page was able to help you.
Do you have a hypo kit set up? If not I would get one set up asap.
Her is a link to HYPO BOX
And HOW TO TREAT HYPOS
It looks as if you only test the BGs every so often. I would strongly recommend you test before every dose and again during the cycles if at all possible.
 
Bron and Sheba (GA) said:
Yes I remember when Fancy Feast disappeared from the shelves in the supermarket.
I’m glad the fb page was able to help you.
Do you have a hypo kit set up? If not I would get one set up asap.
Her is a link to HYPO BOX
And HOW TO TREAT HYPOS
It looks as if you only test the BGs every so often. I would strongly recommend you test before every dose and again during the cycles if at all possible.
Click to expand...

I live on NSW south coast and everyone hates cats because of wild life death so I think vets don't have the experience. We were both pouring over his text books last week bcoz I can't stop her numbers from going up. We checked acromegaly and ruled it out but Hyperthyroidism was top of the list. I'm seeing him tomorrow as he's been on the farm for a week. He told me to increase to 10U but I had NO intention of doing it and sat up til 2am until discovering FF was available and found where I could buy 2 months supply!! I tested after 48 hours on a public holiday and thought I'd killed her. She hadn't been that low since FF and it took longer to get results. The vet wants a nice curve but she always had zigzag ones!!
He said I didn't need to test pre shot as the Curves determined everything. It's lack of experience and I was lucky I decided to run a curve to check how it had affected her - thank god I did.
I bought some food incase of a hypo and I always have honey (I've never seen corn syrup in Australia but it could be here)
I have never run tests after her last shot with food bcoz the vet didn't ask for one. I was only doing it to make sure she didn't crash. After 4 days she is now running if I walk to her as she is so over me stabbing her in the ear lol!!
I'll look at the hypo kit and set one up - thx.
 
You don’t need corn syrup. Use honey. It does the same thing.
Please always test before every dose to see it is safe to give the dose.
It is better to get 4 tests a day (the 2 pre shot tests and a test during each cycle) than getting a curve every so often. If the cat is bouncing during the curve you will think the dose is not high enough when in fact it is probably too high.
 
Bron and Sheba (GA) said:
You don’t need corn syrup. Use honey. It does the same thing.
Please always test before every dose to see it is safe to give the dose.
It is better to get 4 tests a day (the 2 pre shot tests and a test during each cycle) than getting a curve every so often. If the cat is bouncing during the curve you will think the dose is not high enough when in fact it is probably too high.
Click to expand...
 
Looking at her figures I know why the vet says not to test every day! At the beginning I had really perfect curves (he did them in a graph but I can look at the numbers and see the "curve" and pretty soon it was all zigzags. I feed her at 8pm bcoz I get up at 8 feed and shoot and go back to bed (I'm on disability after falling 6ft off a ladder at work 20years ago) and needed a knee replacement so couldn't bend to do her numbers. However i finally got in om Jan 24.(it was another 2 year wait where I am) 4 months later I can bend and get up so it's sooo much easier. The test strips cosy ne $50 for 50 and I've finished the container in these last few days..$1 a strip is ridiculous so I'm going to buy the human meter as even buying the meter is less than 50 strips!!! The meter was $200 but came with 50 strips. I've read about the difference but if this board recommends the human ones I'll be saving money!!
Obviously I will now be testing PS bcoz apart from the freaking out a vet trip is stupidly expensive in emergencies.
I don't know whether to bother with the Hyperthyroidism test as her water consumption is related to her BG readings. That's been obvious as I watched her for 4 days!!
 
A human meter is much cheaper to run. I bought my test strips on eBay after the first time.
You might like to wait and see if we can help you to bring down the numbers before doing any more tests.
 
Bron and Sheba (GA) said:
A human meter is much cheaper to run. I bought my test strips on eBay after the first time.
You might like to wait and see if we can help you to bring down the numbers before doing any more tests.
Click to expand...
That's exactly my thoughts. But suddenly after her water consumption totally dropped she has drunk 500mls in 24 - 36 hours. I'm so confused as it doesn't make any sense to me. The FF has a high water content and she's not eating dry food. I only have until the next prescription is due. I won't let him run curves bcoz he sticks her in a cage with a Libra on. Well that's high stress so her readings are totally meaningless!
Is him wanting the perfect curve aiming too high? Even if her readings are high he expects a curve. I can't get a regular nadir time any more - it used to be at +8 but I don't know any more.
 
Nadirs move around so it won’t always be at +8 or + 6
When the BGs are higher the water intake will rise. Let her drink all she wants. That’s ok. The higher the BG, the more she will pee and she will need to drink more then.
If you are hometesting there is no need do for any curves at the vet.
Just keep getting a Preshot every time you give insulin and a couple of tests during each cycle. More if BG drops lower if possible. That is enough for us to see what is happening.
You won’t get a perfect curve until she is well regulated so aiming for one now is unrealistic.
 
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