My autumn's numbers are still high on 2 units twice insulin daily

[Autumnsmom]

Hi, this is my first post. My calico Autumn, 6, has pancreatitis , IBD possibly SIBO, on metronidazole to keep blood out of poos, prednisolone 1.25 gm, 8 mg cerenia and half tab pepcid a c to keep the vomiting away[ between once every two weeks to every three days ] and keep her appetite up. The pred was much higher, and this is what the specialist said caused the diabetes [diagnosed in April]. The insulin [lantus] has gone from 1 unit once a day to two units twice daily now. Her blood glucose levels are usually the lowest 300 to high 430 anytime I do a curve [ usually every two weeks]. She is overweight, free eats purina diabetic dry [ about 2/3 daily] and about 1/2 can of purina or hills science diet diabetic/metabolic]. The specialist and cat vet do not want to change her diet- let her free eat, and don't want to discontinue the pred yet. I'm worried- is this a high dose of lantus? Right now she is only getting Vit. b 12 once a month, and is getting tested for Vit. B 12 deficiency in a week. The blood test [fructosamine] has been done twice, with theydose increasing everytime. She is happy, alert, very loving etc. right now trying to break the screen on the window to go and chase birds. She is my first diabetic cat- any help would be appreciated.

 

[Nan & Amber (GA)]

No, it's not too high a dose. While many cats need less, it sounds like Autumn has some other factors (the pred, the dry food, maybe even the pancreatitis itself) that would be expected to push the dose higher. When there are other issues like that, it's best to just dose around them-- kitty needs however much insulin she needs.

Do you test before shooting, and/or between shots, or just do the curves? Most folks here would not be comfortable giving more specific dosing advice without seeing that kind of info, although it does sound like she probably needs more insulin right now. We generally try to increase doses in small increments-- 0.25U-- in order to not miss the perfect does.

I'm glad she's in good spirits, with all she has going on-- that's a great sign!

 

[Autumnsmom]

Thank you so much, we have an amazing specialist [ I think the best in Canada, and anyone who has her as a specialist agrees] and an amazing vet. Right now I just do a curve when they tell me, which is about every two weeks. And they say with all her other issues to just stay the course- no changes right now. if she vomits before a dose, then I do the curve, but with the two units twice a day she still has numbers in at least 32o to 380. I lost two soul kitties in three years before falling in love with this one,so her being sick is so scary.

This is a picture of her about 2 lbs lighter

 

[Nan & Amber (GA)]

Awwww, what a cutie! And so composed, sitting up in the chair with her tail folded neatly over her feet-- what a little lady!

If you could start getting some a few checks in between shots (any time, but between 2hrs and 6 or 7hrs post-shot would be especially useful), that would also help to figure out what is going on with Autumn. Lantus is usually dosed by the nadir (lowest BG), which is why curves are so good to do. Problem is that you never know if "curve day" is a typical day-- so spot checks on non-curve days can fill in the blanks and verify that she isn't going much lower on other days.

Like I said, there are tons of factors going on here that make the 2U a perfectly reasonable (possibly even low) dose, but it's always good to check, especially if you're worried.