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Amber & Meadow

Amber & Meadow

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I'm new to this, so hopefully I'm doing this right. My cat was diagnosed in Sept 2009. Initially used Vetsilun until recall. Vet switched to Humilin N which didn't work as well. Now taking cat to Internal Medicine specialist. Have been using Lantus for one month. Have went from 2 units twice a day to 5 units twice a day. BG still >500 (won't register). Specialist is stumped. Charged me $1200 last visit and now wants me to bring her back. Has anyone had this problem with Lantus? Just wondering how high a dose can be given to a cat. Thinking about just switching her back to Humilin and increasing the dose. HELP!!!!
 
HI you are in the right place for help. How often are you testing??? ARe you getting a preshot test before you shoot? There are many great people on here to help I am sure someone will come by!
 
Hey, welcome to Lantus. With out knowing much your dose is "probably" too high right now, causing a rebound situation. Are you familiar with rebound? Too much insulin can create high numbers. 5u is a hefty dose -- does your cat eat dry food?
Any ketone issues with your cat?
I wouldn''t go back to Humulin, Lantus is a fantastic insulin but needs to be used properly, we can help you with that.
 
what were your cat's normal doses on Vetsulin and N? And do you test at home at various times of the day? Do you have any numbers we can look at?

High/flat can mean too much insulin, or it can mean too little insulin. It's hard to say which without data, but if you'd like to start testing and posting daily, we can help you figure out your cat.

Welcome to Lantus Land!
 
Welcome!

More questions: are there any current health issues effecting your cat particularly infections? Is your cat prescribed steroids? When was the last dental/teeth cleaning done?
 
Hi and welcome,

I know you must be really worried right now. And kind of poor, too, after that bill. :)

I think this place will amaze you. It amazed me--and still does.

What you need to do if you want people to look at your cat's numbers and think about dosage (and there are people here who can draw on a lot of experience to help yu think this thing through) is to make up a spreadsheet in Google docs using the Lantus template and test your kitty's blood sugar regularly. Click on mine in my signature if you want to see what one looks like. It really is easy to do and makes SUCH a difference.

You were asked some good questions, too, about possible infections or other illnesses and whether your kitty eats dry food or wet food. That makes a bigger difference than you might imagine (and if you already know that I apologize) so if kitty is on dry, I think step 1 is to make a plan to change over to low-carb wet food.

Looking forward to seeing you here!
 
Hi catmom6 and welcome,

This site is wonderful! There are lots of caring people that can help. There is information at the top of this forum about Lantus that is a must read. Will give you a better understanding how lantus works.

Do you hometest? If not, you could post your location and there might be someone in your area that could help you with it. I found someone 20 mins away that helped me. I'm so used to it now that its just like pouring my coffee in the morning. I never thought I could do it so casually. Hometesting really does make a difference. It saves money too.

One thing. Low carb wet food is the best for your cat. But if you don't hometest yet, don't pull all your other food. Low carb food can bring down a cats bg on its own. With the dose that you are currently giving and low carb food that could be dangerous. You don't want a hypo episode on your hands. Thats why hometesting is so important. You know where your cats at.

Good luck and come back with any questions that you have.

jan and sara
 
Wow! Thanks for the replies. I am going to try to figure out the spreadsheet. Meadow is an excessive water drinker (still). Sometimes she just sleeps with her chin in the water bowl. She is urinating excessively still too. She started on Vetsulin (Sept '09 - Jan '10) at 2 units 2x day, then increased to 3 then to 4 units. She was getting low numbers 171, 123, 184, etc. Vet switched to Humilin N (Feb '10 - Mar 18, '10) at 2 units 2x day then 3 then to 4 units. Numbers were in the 200's to 300's, highest at 354. I test myself in the morning before food and in the evening before food. I make my own cat food. It is an extremely low carb diet from Mizzou (U of MO Vet School). No dry food! She is on heart medicine for an enlarged heart, but that is all the medical problems found after the last vet visit. The vet told me not to test everyday on the Lantus, just the weekly curves, so my spreadsheet will be missing days. Hopefully this helps. So... how do I attach the spreadsheet when I get it done?

Thanks,
Amber
 
Hi Amber

welcome to the Lantus forum.

here is a link for spreadsheet help:
viewtopic.php?f=6&t=16

eventually you will want it as part of your signature, all this techie info is in the TECH forum.

Glad to see you here, hope to see you posting often and that we get to see pics of Meadow too!
 
Hi Amber -- thanks for including your "real" name and Meadow's.

Here's the info on linking the SS to your signature. It should also be covered in the instructions in the Tech Center. If you have some additional time, there is also information there on how to complete a Profile. If you could complete the template and attach that to your signature, we won't have to keep plaguing you with questions.

Linking a info to your signature: Go to your "User Control Panel" under the FDMB logo located at the top left of page. Click the "Profile " tab, fill in the "edit profile" info then click "edit signature"sub-tab, type in what general info you want there, then add the URL for your spreadsheet. That way it will be at the bottom of every post and people don't need to go searching for it. Remember to make sure your SS is set to "share" with us.

I think if you look at our SSs, not only do we test every day, we test multiple times per day. At the minimum, we test at AM and PM pre-shot times (AMPS, PMPS) and at least once during each the day and evening cycles. The pre-shot tests are to make sure that Meadow's numbers are in a safe range for giving insulin. The spot checks are to aid in changing dose since Lantus dosing is based on the lowest point, or nadir of the cycle which is usually somewhere in the middle of the 12-hour period. Many vets do not advocate testing as much as we do but we've found it effective for helping you to know how Lantus is effecting your cat.

I'd encourage you to read the sticky notes at the top of the board. There is a huge amount of information there. You should definitely look at the note on the dosing protocols. There is a modified version in the note as well as links to the formal protocols that are based on research. The other notes discuss the care of Lantus, how to do a curve, a link to our slang dictionary, conventions for posting, etc.

When you have a chance, can you describe how Meadow's dose was changed your initial dose to 5.0u? Based on the dosing protocols, we change doses in small amounts -- 0.25 to 0.50u. The small increments insure that we don't miss what could be an optimal dose. Meadow's numbers be as high as they are because she may be rebounding -- there are lower numbers during the middle of the cycle and a bounce into higher numbers at shot time. If you can put the numbers into your SS, it will give us the opportunity to take a look and see what may be going on.
 
Welcome Amber and Meadow! This is a fantastic place. There is a tremendous amount of cumulative experience and wonderful compassion here. Meadow will be on the right track if you follow the suggestions given above by terrific people who really know what they are doing. They can advise, and we who are not so experienced can give support. Glad you found your way to Lantus Land.

Ella & Stu
 
I'm sorry, can anyone open my spreadsheet? The vet had me switch to Humulin (which I purchased the Novolin with her approval). Yesterday before I bought the Novolin, Meadow's a.m. BG was >500. Gave her 4 units of Humulin N. Tested at 6 hr mark and still over 500. Vet said increase to 5 units. This morning BG over 500, gave 5 units of Novolin N and tested at 6 hr mark. Still over 500. What is going on???? I spoke the vet about your suspicions of rebound, but she said based on the curves, that's not happening, since she is over 500 the whole 12 hours. Does anyone have any thoughts???

Amber & Meadow
 
ugh. i'm sorry but it sounds like your vet doesn't really know what they are doing. not only do they not have you testing enough but they are dosing incorrectly, with all insulin's you've tried so far, and now they've had you go backwards 10 steps to one of the worst insulins for a cat in my opinion. yes, i'm very blunt :)

i can't open your spreadsheet right now but i suspect it is because of the computer i'm on at the moment but i'm gonna try another one 'cause i'd love to see it
 
I opened your spreadsheet.

I would encourage you to post this question on the Health forum, because most of us in the Lantus forum are not very familiar with N. I think you need a different set of eyes. Here is the link to Health: viewforum.php?f=3 and a link to the Vetsulin/N group: viewforum.php?f=19 Your dose seems very high to me, and it seems like the dose was not reached in a safe way. Most start on 1 unit of N and hold that for a little while to see what happens before increasing. Meadow had a couple of 100's on 2 units, then when you increased from there everything got worse. I would try to get some numbers earlier in the cycle, like after 3 or 4 hours instead of 6. That's when you're likely to catch any lower numbers on N. Then post your numbers on Health or in the Vetsulin/N group for help in interpreting them.

Also here is the Humulin N Primer: viewtopic.php?f=19&t=303&view=unread#unread

The curves in this spreadsheet are from Lantus, is that right? I tried to copy the numbers here for you, I have no idea what the format will look like once I hit "submit" so apologies if it is hard to read.

Meadow's Lantus Spreadsheet
Date AM BG Units 6th Hour PM BG Units 6th Hour Remarks
3/18/2010 371 At Vet office BG >600. Vet gave 1st dose of Lantus - I tested 6 hours later.
3/19/2010 314 2 169 2 303 Confusion on testing at night. Vet said to test only on 6th hr (?)
3/20/2010 387 2 405 2
3/21/2010 191 2 343 2 343
3/22/2010 294 2
3/27/2010 403 2 Go to remarks
Curve every 2 hrs for 12 hrs: 403, 449, 408, 392, 380, 344, 401
4/3/2010 452 3 See remarks Insulin increased / curve: 452, 500+, 500+, 500+, 500+, 463, 500+, 500+
4/4/2010 500+ 4 500+
4/5/2010 491 4 476 2
4/10/2010 418 4 See remarks Insulin increased / curve: 418, 500+, 500+, 500+, 500+, 500+, 454
4/18/2010 461 5 See remarks Insulin increased / curve: 461, 500+, 500+, 500+, 500+, 500+, 500+
4/19/2010 476 5 490 5
 
Cindy + Mousie said:
i can't open your spreadsheet right now but i suspect it is because of the computer i'm on at the moment but i'm gonna try another one 'cause i'd love to see it
Click to expand...

It's a Microsoft Excel spreadsheet. You need that program to open the file.

Here it is copied and pasted into here:

Meadow's Lantus Spreadsheet
Date AM BG Units 6th Hour PM BG Units 6th Hour Remarks
3/18/2010 371 At Vet office BG >600. Vet gave 1st dose of Lantus - I tested 6 hours later.
3/19/2010 314 2 169 2 303 Confusion on testing at night. Vet said to test only on 6th hr (?)
3/20/2010 387 2 405 2
3/21/2010 191 2 343 2 343
3/22/2010 294 2
3/27/2010 403 2 Go to remarks Curve every 2 hrs for 12 hrs: 403, 449, 408, 392, 380, 344, 401
4/3/2010 452 3 See remarks Insulin increased / curve: 452, 500+, 500+, 500+, 500+, 463, 500+, 500+
4/4/2010 500+ 4 500+
4/5/2010 491 4 476 2
4/10/2010 418 4 See remarks Insulin increased / curve: 418, 500+, 500+, 500+, 500+, 500+, 454
4/18/2010 461 5 See remarks Insulin increased / curve: 461, 500+, 500+, 500+, 500+, 500+, 500+
4/19/2010 476 5 490 5

Amber, when you get a chance, please set up an online spreadsheet to track your cat's blood glucose numbers. It will be much easier for FDMB members to access. Most people use a Google spreadsheet. See the instructions here on how to set one up: viewtopic.php?f=6&t=16
 
Looking at your spreadsheet.. you simply aren't testing enough for anyone to know what's going on for sure.. it's great that you are testing some... but I see many day gaps with no tests at all.. and that only test the 6th hour thing is not true.. the peak or nadir (lowest point of the cycle) can be anywhere in the cycle, and it can move around.

You are at the point many of us were at when we found this place.. following the vets advice and just not feeling quite right about it.. you need to decide whether you want to continue with your vet's advice.. and if not, decide which insulin you want to try to tackle this with.. and jump in wholeheartedly into the recommended protocol for it..

I don't doubt that your vet has the best intentions.. they even seem to be aware of a bunch of the lingo and such.. but bounces can last up to a full 3 days.. and there wasn't enough testing anywhere along the way to rule that out.

The people here (myself included) have decided that we wanted to use one of the L insulins (lantus or levemir).. and follow the protocol used here..so that's obviously going to be my advice to you :).

It isn't the only way.. but it's one of the easier and safer methods in my opinion.
 
It has been brought to my attention that I may not have been clear. My entire "Looking at your spreadsheet.. " paragraph is in reference to your Lantus spreadsheet and the remarks on it.

I hope you get Meadow figured out, it's obvious you love her very much.
 
Hi Amber & Meadow..Welcome to lantus land, and may I say it's a good thing you ARE HERE!!
There is much to learn, and much to do to get Meadow back to good health..My Moonie was on Humilin N in the beginning--She responded badly to it , and after the vet had me go from 1U bid to 3U, and the suggested go to 4 units 2 x per day--I said NO because I was already on the board here!!- The people here helped me and Went to a vet specialist & she was put on lantus. Then she began to get well, to get her head out of the water bowl & food.. The worry, not sleeping, vet visits, we all understand here!!
I so understand how you feel.. I still remember, but Moonie is in a good place now & we are thankful that you are also now here...
Again, welcome to lantus land.. :-D
 
So does anyone have any suggestions about Lantus? I still have 3/4 of a bottle left. Should I start all over with Lantus? And if so, what dosage should I start with and how often should I test? I'm in nursing school, so this weekend would be a perfect time to test. Please let me know asap. Also, am I understanding everyone correctly? Are you saying that too high a dose of insulin will keep the BG level high? When I had Meadow on Humilin N, she was getting 4 units bid and her AMPS & PMPS were in the hi 200's to lo 300's. When I switched to Lantus at 2 units bid, she was in the 300-400's, and when I increased it went over 500. I'm totally confused. The vet & I discussed that maybe the Novolin N would bring her back down enough to figure out Lantus. HELP!!!

Sincerely,
Amber & Meadow
 
CatMom6 said:
So does anyone have any suggestions about Lantus? I still have 3/4 of a bottle left. Should I start all over with Lantus? And if so, what dosage should I start with and how often should I test? I'm in nursing school, so this weekend would be a perfect time to test. Please let me know asap. Also, am I understanding everyone correctly? Are you saying that too high a dose of insulin will keep the BG level high? When I had Meadow on Humilin N, she was getting 4 units bid and her AMPS & PMPS were in the hi 200's to lo 300's. When I switched to Lantus at 2 units bid, she was in the 300-400's, and when I increased it went over 500. I'm totally confused. The vet & I discussed that maybe the Novolin N would bring her back down enough to figure out Lantus. HELP!!!

Sincerely,
Amber & Meadow
Click to expand...


Hi Amber,

when are u do for PMPS tonight? How many hours from now
 
oh by the way, when u have a chance
you might want to start a new thread soon, this one is from tuesday. As you can see the threads here begin with the date 04/23 kitty name AMPS #

if u have urgent questions/concerns just edit your main subject line DOSE HELP, for example, and add that to your subject line.
 
It would be exceptionally helpful if you could set up a Google spreadsheet so everyone here can view it. From what you've indicated above, you were giving Lantus from 3/18 to 4/19 and then switched to Humulin N for the last few days with a dose of 5.0u. Your starting dose of Lantus was 2.0u and that dose jumped to 5.0u with no other increases in between. Is this correct?

I think if you ask on this forum whether to begin again with Lantus, since we all use Lantus, the answer you are more than likely to get is a "yes." If you are struggling with whether to stick with N vs. switch back to Lantus, you would probably do better posting on Health to get a more balanced response.

If you meant that you wanted to re-start Lantus and didn't know what dose to start with, it will help to know your cat's ideal weight. There is a formula in the dosing protocol that bases starting dose on weight. Looking at your previous Lantus dosing, most cats, unless they have a history of being on another insulin prior to Lantus, are not started on 2.0u unless this is a particularly large cat. Also, doses are raised in increments of 0.25 - 0.50u so the jump from 2.0u to 5.0u may mean that a more effective dose was missed.

If a dose is too high, it can cause numbers to bounce. I don't know if this was the case with Meadow. Typically, what you would see is a high pre-shot number an a drop at nadir. The low number causes the liver to release glucose as a self-protective measure and the result is that it drives numbers up. I suspect that is what people were suggesting might be happening.
 
I tested 1.5 hrs ago and it was over 500. The Humilin Primer forum said to wait 1 hour after feeding before injecting. Is this right? So I haven't given her a shot yet, just waiting for the hour to be up. She finished eating 30 minutes ago. She currently weighs 10.2 lbs. She was 12 lbs when diagnosed. So with Lantus, do you inject before or after meals. I guess I'll post on the Health forum to see if anyone has any suggestions about staying on Humilin.

Thanks,
Amber & Meadow
 
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