My kitty is on 6 units of glargine!

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sherry139

sherry139

Member Since 2013
Hi,
I am new to posting and to having cats and especially one with diabetes. Maury was diagnosed in 7/2103 when his glucose levels were in the high 600's. He is presently in the mid to low 300's on 5 units 2x a day, improving but not there yet. He is presently been dosed at 6 units of glargine 2x aday and my vet suggests that I don't glucose monitor due to a change in diet for about 3 weeks. His diet is being changed due to diarrhea. Prior to being diagnosed as a diabetic he did well on a high fiber, carb food WD Science Diet for the diarrhea. Since changing his food to a high protein he has had diarrhea and is taking flaggyl. The vet is reccommending Science Diet DM for both diarrhea, diabetes and weight-loss. I inquired about raw food preparation and she discourages it. Any and all suggestions are wanted.
I think I should change my name to grateful and overwhelmed.

Sherry
 
Hi Sherry

Welcome to you and Maury!

That's a pretty high dose of lantus especially without home testing. We all home test here and support it strongly. It is very easy to get a cat overdosed on lantus and numbers that look high might not mean he needs more insulin.

Are you home testing? If so, are you using a human or pet glucometer?

We rely heavily on Spreadsheets here to help us with dosing. If you could please consider doing one for us and entering any data you have, it would be a great help. If you have any problems doing the Spreadsheet, please send me a private message (click on the "PM" box under my Gracie's photo) and I'll be glad to help you set it up.

We do not recommend feeding DM and so we will suggest that you switch him to a better quality, lower carb food. Most of us use Dr. Lisa's Food Charts to find appropriate foods to feed.

Can you please give us more background info about Maury? Do you know the reason he became FD (e.g. dry food, steroids, etc). Can you also tell us how the dose was determined and raised? His weight and starting dose, etc?

Thank you and welcome!! Bring on your questions :-D
 
Hi Sherry and welcome to you and your sugar boy Maury. There is a lot of reading and learning at first, but coming here is an important step. There is a lot of information on Lantus glargine in the starred sticky notes at the top of this forum. And people here are very willing to answer questions, so keep them coming.

On this board, there are several things that we believe are important in treating feline diabetes (FD). The first is a low carb wet food. If you take a look at the http://www.catinfo.org website, there is a lot of good information on feline nutrition. Dr. Lisa has done a lot of research and posted a food list for most commercial cat foods (including raw). We recommend anything under 10% carbs and most of the people here feed off the shelf commercial canned or raw foods, no need for special veterinary foods. I don't know if you were feeding wet or dry WD, but at 25% carbs, even the WD wet food is way too high for diabetics and not good for weight loss either. DM is better for carbs, but as the main ingredient is liver, often cats will tire of it, and it's pricy. Just moving to wet food only will help Maury's weight. Common wet foods here are the Fancy Feast or Friskies pates, or some of Wellness products are cost comparable if you buy the large cans. My Neko eats raw food - it's between 3-5% carbs. I serve commercial raw food (you could try that first to see if Maury likes it) and there are some people who prepare their own according to the recipe on Dr. Lisa's site.

On the diarrhea, often cats will get diarrhea for a while as their bodies adjust to a wet food diet. Or it could be that Maury is allergic to certain proteins. Beef or fish are common allergens.
ETA: Other proteins like chicken could be an allergen, but are less common.

Second, and equally important for treating diabetes is testing Maury's blood sugar yourself. People don't give themselves or their children insulin without testing, so we believe in testing before giving insulin here. Cats cat get stressed at the vet and that can raise blood sugar over 100 points. There is lots of information here on testing (most test the ears). You can get a people blood glucose meter and use it. For example, Walmart sells the Relion brand which is good. You want a meter where the cost of strips is low.

How was Maury's dose arrived at? We don't go up in dose any more than .25 units at a time, for fear of missing a good dose. 6 units is a large amount of insulin. There are several reasons for a higher dose. Diet can contribute to it - high carb food can require more insulin. And if Maury is going from a higher to a lower carb food, it is especially important to monitor as his needs for insulin can drop. Having an infection or needing a dental can contribute to higher blood sugar and require more insulin. My Neko has what is called a high dose condition, we did get up to 8.75 units before going down again. Or it could be that Maury is getting too much insulin and you need to test his blood sugar at home to know that.

ETA: I see I'm cross posting the same time as Marje. Yes please, do tell us more about Maury and his history.
 
Hi Sherry. Welcome to the FDMD. I'm new here myself and I will assure you there is a lot of good information and advice to be found here. I'll assume you meant Hill's Prescription Diet DM cat food. Is that their wet food or their dry food? Most of the people here would recommend wet food as cat's tend to be low thirst animals and do better when they get some water as part of their meals. I am guessing your vet is worried that new food will cause the blood glucose levels to very in an unrealistic fashion and throw you off. Perhaps but give some consideration to starting to keep track of Maury's blood glucose levels just before you give him his shots in the morning and evening and also about half way between each shot, about six hours after each shot. Hill's DM is a step in the right direction but there are many commercial cat foods with even lower carbohydrates as a percentage of their calories. For now though, whatever gets that diarrhea under control and is low carb, go with that. Probably the best place to start is reading about cat nutrition and diabetes on Dr. Lisa Pierson's website. The internet link is below. Also in the Lantus glargine forum there are several posts with sticky's on them at the top of the list of postings that have a wealth of information. Best of luck to you and Maury.

http://www.catinfo.org/
 
Welcome to Lantus Land!

At least in one major way, we take a different position than your vet. We strongly recommend home testing. There is just no way to know where Maury's blood glucose (BG) level is when you're giving a shot. This is critical since WD is much higher in carbs than DM. You have so much more information and control if you are monitoring your kitty's BG. Frankly, unless your vet is planning on moving in with you, the vet isn't going to know if you're testing. Home testing is the single best way to keep your cat safe. This is especially the case because Maury's dose is quite high.

Did the vet suggest you give Maury a probiotic to help with the diarrhea? FortiFlora is available on-line and is formulated for cats. Given that the diarrhea has persisted, you may want to try a stronger probiotic. ReNew Ultimate is available at Whole Foods, GNC, and probably other places, as well. You would use approx. 1/4 to 1/3 of a capsule in food twice a day.

Most of us do not feed prescription foods. There are other foods that are just as good as DM and are made with better ingredients and are lower in carbs. (DM is very heavy on animal by-products vs. muscle meat.)

Please let us know how we can help. The people here are very generous with their knowledge and time. We're here to help.
 
:?: So Maury's BG was down last week to 78 and the vet insisted I put him on DM and not Weruva. I am utterly confused. How much protein and calories and carbs should he be eating? I am feeding no more than 4 oz. of food a day spread out over 3 meals. I used the probiotic foti flora and it made the transition easier.
 
Hi, Sherry

Welcome to LantusLand! :-D

Unless there's an unlying reason medically why your vet would want you to feed the DM, I wouldn't recommend feeding it as a low carb food as more often than not it'll raise the BG's (I think it's a high carb food, but can't be 100% certain). Been there, done that with my own. Here's a couple of links for the canned cat foods available:

http://binkyspage.tripod.com/CanFoodOld.html

http://binkyspage.tripod.com/CanFoodNew.html

The Fortiflora certainly helps to get the kitty to eat, that's for sure.

Also, please get a spread sheet set up for your kitty, and if you haven't already started doing so, please begin the home testing, too. It'll help to cut down on the vet visit costs (been there, done that too), and also if you're home all the time, you'll be able to monitor your kitty, and take care of him/her should anything come up.

I think there's a sticky at the top that has information for setting up the spread sheet. Stickys are marked with a star. Hope that helps, and good luck!
 
There is no formula for the content of protein, fat, and carbs. Because carbs raise blood glucose (BG) levels, we suggest that carbs are kept below 10%. Most of us feed under 5%. The links that others provided to Lisa Pierson, DVM's site on feline nutrition will give you a solid start on understanding your cat's nutritional needs. Her food charts will also give you all of the information you need for selecting a food. I had the same issue with my vet around food. I finally pointed out that both Fancy Feast and Wellness were lower in carb than DM, were a better quality food (i.e., more muscle meat which is a high quality protein vs. animal by-products), and cost less than prescription food. She didn't push the prescription stuff after that.

As for the diarrhea, you might want to try a more potent probiotic. ReNew Ultimate is stronger. You can find it at Whole Foods, GNC and other places. You add about 1/3 of a capsule to food twice a day.
 
Hi Sherry, and a somewhat belated welcome to you and Maury.

I think that the people here need more information in order to help you and Maury. For example, you say that his blood glucose was 78 last week, but without saying at what point in his cycle the 78 was registered (I assume that the 78 was on the vet's meter, since I don't see that you have begun yet to home test). Also you haven't given any recent information about what Maury's dose is now. Have you got your spreadsheet set up? If so, please link it to your signature so that others can see what is happening with Maury. (Follow the instructions that Marje gave you earlier this month, or check the "Tech Forum" to learn how to set up a spreadsheet in Google docs. )

I'm sorry that he still has diarrhea and hope that the probiotic Sienne recommends will help.

I don't know why your vet is so insistent on feeding DM. Have you looked at Dr. Lisa Pierson's site on nutrition? http://www.catinfo.org/.
I see that you say you are feeding Maury "
sherry139 said:
no more than 4 oz. of food a day spread out over 3 meals.
Click to expand...
. This does not sound like it is enough food. That's only a little more than a small can a day. I hope others will pick up on this and comment. Is Maury overweight? Dr. Pierson's site (see citation above) has a chapter on feline obesity. It contains a formula, based on the cat's optimal weight, for how many calories a cat should get a day:
"Required calories per day = [13.6 X optimal lean body weight in pounds] + 70".
Click to expand...
This may help you figure out how many calories Maury should be consuming, regardless of whether he is normal weight or overweight.

Good luck with learning how to home test Maury's blood glucose. You will find lots of help here on the FDMB.

Ella & Rusty
 
just want to add my welcome. others have given you lots of good advice already. if you have other questions, just let us know. you can expect answers here fairly quickly.

we understand how overwhelming all the info can be and will hold your hand and teach you what you need to know to take care of Maury.

hang in there. ask lots of questions. it gets infinitely easier once you understand things a little more. cat_pet_icon
 
Hi Sherry & Maury and welcome to FDMB & LL :-D I see you have a lot of homework to read over, so I will just tell you that I am very happy you found your way here! You are going to get a ton of great info now in helping you to help Maury with his diabetes and a couple things can not be stressed enough:
1) Home Testing-Very important
2) Low carb diet-introduced slowly once home testing has begun

Look forward to hearing more about you two :-D
 
I just spoke with Sherry and Maury's update is:

she has been shooting 3 units, is now able to test and he tested pmps 121 using Alphatrac.

so she did not shoot last nite.....

amps.... 147, again using Alphatrac.

I am advising not to shoot any as she will not be home to test....

needed additional advice

thanks!
 
Sherry, would it be possible to start another posting today? You posted on someone else's condo and included a link to your SS
https://docs.google.com/spreadsheet...c0a2V3MnpCQml6UllFa3l3cXc&usp=drive_web#gid=0. It would be best if that link is in your signature too. If you are using the Alphatrack as your main meter, also include that note in your signature as the protocol uses different numbers for Alphatrack readings vs. those from human meters.

I notice from the SS that you are not getting tests before giving shots. Those are the most important tests of the day - without that, we don't know if we should be giving insulin or not. On this board, we suggest 150 (human meter) as the number at which you post and ask for help before shooting, that would be 180 on the Alphatrack. I recommend getting tests before each shot, and then at least one other test each cycle. It's very important that you try to get at least one test at the night time cycle. Some cats (like mine) go much lower at night than during the day. Without that data, it's hard for us to give any suggestions on correct dose.

However, it is good to see Maury is responding better to the insulin and is on a lower dosage now.

@Ohbell - Is there anyway you can help Sherry with the technical issues of getting her SS in her signature? The SS also needs to list the data with the oldest data at the top of the SS and adding new days to the bottom. It's upside down to what we are used to looking at. I'm not sure she's putting data in the correct cells. It looks like a lot of +1 tests, but no PS tests during the day.

ETA: If Sherry was not home to monitor today, skipping was the correct action this morning.
 
Sherry,
I sent you a pm.

sure would like you to post today.
Saw your wish for help in Marje's condo.... but she might not be on today at all after losing her sweet Gus.

Let the rest of us help you, please?
 
:-D Hi Sherry:

I'm not a member that gives advice - I'm usually asking for it. One thing I do know is that the people on this board that do give advice know what they're talking about. They literally saved my kitty's life. If I had listened to my vet, who is otherwise perfectly capable, Cinco wouldn't be here now. I know how overwhelming this all is, but the wonderful friends you've found here will help you to sort through it. I printed out the main stickies for beginners and read them over several times when I started out. I keep them in a file and refer to them often for reinforcement.

When you have a new question, or it's a different day, start a new topic. That moves you to the top of the board. You can always reference your previous posts. Play around with posting a little to learn how to do it.

Hang in there - you've come to the right place. Good luck with your sugar cat. :-D
 
Sudden food changes can provoke diarrhea, so that could be part of the problem. Its usually preferred to make the changes about 20-25% different food at a time, slowing down the rate of food change if/when symptoms develop, to allow the GI tract to adjust.

Adding a small amount (1/8 to 1/4 teaspoon per meal) of unflavored, powdered psyllium (ex unflavored Metamucil) to the canned food may help firm the stools a bit while he's getting used to the food. Then, you may be able to phase it out.

My cats eat roughly 1 oz per pound of weight, divided into 2 feedings. For example, a 10 pound cat might get 5 oz of food per feeding, which I actually leave out for nibbling until gone. With 15 cats, its a bit tough to monitor exact food intake. When you're dealing with just 1, you can observe the cat's condition and weight, then tweak the food amounts up or down as needed.
 
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