Max Off Lantus Day 10 Days Remission?

[tiffmaxee]

So Max was on insulin for a month and has now been off for 10 days. His BG at the vet's office was 202. My vet said there is a 50/50 chance he will go into remission. He doesn't want me to give him insulin and come back in 10 days- 2 weeks. At this level he feels he might go hypo on insulin. Since he has had chronic pancreatitis for 4 years now I wonder if that is the cause. He said the most important thing I can do is make sure he doesn't gain any weight. He was 14 lbs 9 oz. today and my vet would be happy to get him to be 14 lbs through slow weight loss. Wish us luck. Oh, for those of you following Max I am pleased to say that my mom is out of the hospital. It's still going to be a juggling act for both of them.

 

[KPassa]

Are you still testing Max daily? We consider a cat OTJ if their numbers are between 40-130 with the majority of the time in double-digits for 14 days. The 202 seems a little high, but that could have been caused by vet stress. What was the amount of the last dose he was on? Many people wean down the dose, even giving just a drop for a little while before stopping insulin altogether. This usually helps make the remission "stronger" (less likely they fall out of remission or fail their OTJ Trial).

 

[BJM]

That number is still a bit high from our perspective, especially with a background of chronic pancreatitis.

What dose were you giving and how often?

Here are some glucose reference ranges used for decision making using glucometers. Human glucometer numbers are given first. Numbers in parentheses are for non-US meters. Numbers in curly braces are estimates for an AlphaTrak.

[Glucose reference ranges are unsubstantiated and have been removed by Moderator]

 

[tiffmaxee]

Max had been getting 1/2 unit of Lantus. The 202 was with an Aloha. I didn't test on Friday with my Relion Micro but the previous week it was 130 on it and 230 with the Alpha. The Relion has been reading about 100 points lower each time. I thought that was too big a difference and called the company. I received a new meter today so will see what happens with it. He seems to be feeling better. He was having a pancreatitis episode when the glucose became high. He isn't drinking water nor is he urinating excessively.

 

[BJM]

When we have cats going off Lantus, we like to go down to a quarter unit, and then even use the drop method.

To do dosing with drops:
Use some colored water for practice.
Fill 0.5 units.
Gently squeeze out equal sized drops.
- Hint: turning the plunger as you press seems to work well.
Count the number of drops.
Repeat until you can consistently produce the same number of equal sized drops.

If he pops over 200 mg/dL, you might consider using just a drop of Lantus.

 

[Deb & Wink]

The pain and inflammation from the pancreatitis can often cause the BG (blood glucose) numbers to rise. I'm not surprised this rise happened with Max.

Hope your mom is still doing well since she has been released from the hospital.

 

[tiffmaxee]

I do think his high glucose is due to his pancreatitis as well. That is interesting about the drop dose. I will practice it tonight. So you would suggest giving him a drop if his BG is over 200 on the Relion Micro?? That hasn't happened since he has been off insulin. It was over on the vet's meter. Interestingly, I asked my vet about going to a quarter unit first when Max registered 235 on his meter and 130 on mine and he felt it would be too hard to measure. Since we stopped the insulin I think the drop method might work if necessary. Do you agree? Thanks again.

My mom is home and very weak. I'm heading over there now. The break from insulin at least means I don't have to fear coming home to a hypo cat. Maybe we will get lucky and with the fancy feast classics I won't need to address this again. One can always hope.

 

[Deb & Wink]

Since we stopped the insulin I think the drop method might work if necessary. Do you agree?

Yes, I think the drop method would help your Max.

There have been several kitties that only need really tiny doses of insulin to help them out. That is why we suggest the drop method of measuring. Practice with a used syringe, trying to draw up some colored liquid like grape juice. Practice twisting the end of the plunger and see how many drops you can squeeze out. Practice til you get the same size drops and count how many you get. Once you get consistent at squeezing out a consistent number of drops, then try this with the insulin.

Alternatively, this picture shows some of the microdoses of insulin some of us have given. Basically, it's getting the plunger lined up with that first, or zero line on the syringe. Some insulin is just below the line, 0.1u is just on the line. There will still be some insulin in the syringe when you depress the plunger firmly. I did this with Wink for a bit, when he was on 0.1u of insulin as he was tapering off and getting ready to go OTJ (off-the juice). Here is the picture of 0.1U

You can click on the picture to get a larger view.

Hope these help.

 

[tiffmaxee]

Max went to the vet today and his BG was 310 on his meter and 249 on my new one. So after three weeks off he is back on Lantus. He wants me to give him 1/2 unit once a day. I asked if he has done this with many cats and he said he has. When I got home I tried measuring .25 and tried to see how many drops were in it but it didn't work for me. I know that Lantus is a 12 hour drug but what am I to do? 1/2 unit twice a day is too dangerous as he might go hypo based upon previous readings. So i gave him 1/2 unit at 2:30 and will give him 1/2 unit each morning for now. Max is not going to make this easy but then again he never does. I was so sure we would get good results today based on his not drinking or peeing a lot. I even questioned stress so he checked his urine and there was glucose in it. So much for my being able to read him. Nervous time again.