Little boy blue!

[Rusty/Jen & Ernie]

So here we are with Ernie not really getting insulin since 8/9. Over that span he has only had a total of less than 1 unit, spread over 3 doses.

As you can see by his chart, he has settled into being a Blue Boy here lately, with only a couple of green dips & a couple of yellow highs. On 8/22, he sat up in the yellow, but we believe he got into his sisters food bowl!

After that day, we quit leaving wet food out to free feed. We have since started picking up the food before leaving in the morning and replacing it with a wet food, frozen puck. In the evening, at bedtime, we leave a tiny amount for them to finish.

We have also ordered a couple of auto feeders to feed smaller meals every 2-3 hours. (This is a pain with a 3 cat house, and 1 of the civies being a skittish eater! We have also ordered an infant scale to keep an eye on all 3 of their weights. I am scared about the skittish one not getting enough food & we all know that is bad!)

My question is, with his color of choice being blue & usually in the lower blues, is there enough room to be dosing Lantus? We have decided we are likely done with Vetsulin. It is just too hard on him & crashes his #'s. I just don't know if we should look towards Lantus, or wait for the feeders and see if a balanced meal schedule will help keep him around 100. Or should we aim to keep him below 100?

For reference, he has put on 1.2 lbs since his DX a little over a month ago.

 

[Rusty/Jen & Ernie]

His appetite has been a little elevated. He is scarfing a tad. But that could also be his realizing that the food doesn't sit out all day! Or it could be that hunger sensation fueled by the brain of a sugar baby!

 

[Critter Mom]

Hi Rusty and Jennifer.

Great to get a progress update on Ernie. He has done well to hold in the blues with little or no insulin.

I've used both Caninsulin and Lantus. Saoirse was in a similar boat to Ernie; not quite in remission but not far away when it came to the stage where I refused to give her more Caninsulin on safety grounds. Looking at Ernie's numbers Lantus or a similar with a gentler lowering action profile than Caninsulin would be a valid treatment choice to let his pancreas rest longer and possibly recover more function.

With regard to trying to manage Ernie's blood glucose levels with food, you could do some mini curves to assess the strength of response from his pancreas to incoming dietary carbs (it produces pulses of insulin when the cat eats) :

1. Test after a 2 hour fast, then feed.
2. Test at +1, +2, and +3 to assess any rise after the food and then whether the BG level drops lower in the ensuing hours.

You could repeat these tests to try to work out an optimum feeding schedule (times and amounts).

Have a look at Saoirse's spreadsheet for 2014. The fourth tab has US mg/dL values. It might give you an idea of what's possible. I use an Alphatrak 2 as well, so you've no need to do mental gymnastics to compare Ernie's current range to how Saoirse responded to Lantus at similar numbers (but remember that each cat has an individual response to any particular insulin.) Note that I eventually moved Saoirse onto SID dosing of Lantus. This is not common practice. I elected to do this because due to my own health problems I could not monitor at night, and also Saoirse tended very much to run lower in the PM cycle so I took advantage of that to keep her in tightly regulated numbers with just one dose a day until she became diet-controlled.



Mogs
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[Rusty/Jen & Ernie]

Thank you Mogs, I will digest your chart & then respond back. Thank you as ALWAYS for the encouragement & advice.