NEED ADVICE asap!

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KarenAmelia

Member Since 2012
My cat had a dramatic drop in BG this last 12 hours: from in the 300 and 400s yesterday to today: 378 preinjection, 114 at +6, and 133 at next preinjection. My vet says to continue with the 2 units of Lantus as before, but with such a low reading I'm concerned she'll become hypoglycemic in the next 12 hours. I did change the cat's diet from dry, high carb, to low carb canned just in the past two days. Should I listen to my vet (which I'm skeptical about) or should I give a lower dose, such as 1 unit? He doesn't know about the change in diet, because he told me not to change the cat from her dry high carb food until regulation occurred.

Should I err on the side of caution or stick with the higher dose?
 
I don't use Lantus, but until someone who does comes along: Do Not give the 2 units. Wait 20 minutes without feeding and retest. By then we should have someone who can advise on possible dose.
 
Hi Karen, welcome to FDMB! I'm sorry you need to be here :smile: but you're in a good place to get advice about your kitty. First off, don't feed! I'll post more in a bit.
Liz
 
The change in diet seems to be having the desired effect! (And thank goodness you're home testing.)

How long has your cat been on insulin? Is 2.0u the starting dose? And finally, how much does your cat weigh and is this a good weight or is she over/under weight?
 
I would not shoot the insulin. You don't have any data to know what could happen and you're already seeing the dramatic and wonderful difference that food change can make. If it were my cat and being so new to insulin I'd skip the shot and start over at 1 unit BID tomorrow.

Get some tests tonight if you want to see how she's doing, but if shoot later tonight you'd have to delay tomorrow's dose and if you need to be on a set schedule, for me, if it were my cat, it would be easier to skip tonight and start over.

I'm assuming she has no history of ketones since you're new to this. If she had a history of ketones then perhaps a reduced dose, but I have a feeling you haven't experienced that, lots of kitties don't.
 
Wow, you switched to wet food in 2 days? It took us several months. Good job! Sienne is very knowledgeable and gives excellent advice.
Liz
 
Hi Karen, Welcome! :-D :-D Changing the food can cause a dramatic drop in the amount of insulin needed. One of the first things you want to do is just what you did, get the cat on a low carb diet. I don't know why you vet said not to???!!!!

How long have you been giving Lantus? For someone who is new and still getting to understand how their cat react we often recommend not shooting below 200.
Alternatively you can shoot a reduced dose . Another test without feeding is a really good idea. We can see if his BG is going up or down uninfluenced by food. If he is going up it is much safer to shoot. let us know right away what hte next test is.
 
I will test in a few minutes, to make it a half hour from the previous test. My cat has been on Lantus only since Dec 31. She started on 1.5 units. I changed her to canned food two days ago. She is not and has never been overweight. I don't know about ketones, as I haven't tested. She has lost a LOT of body weight and muscle tissue. I've been letting her eat at will, just small amounts, about every hour or two today.


Yesterday I misread the syringe and gave her only about .5 unit, two times, and her BG was in the 300-400 range all day. So today is quite a dramatic change. She started 12 hours ago with a BG of 378. I hate to seesaw back to high BG, so maybe a lower dose, like 1 unit, might be safe. I did three tests today, with feeding. They were on my earlier post.

Thanks for the help. Please stay tuned and I'll post her next reading in a short while.
 
Hi, Karen.

I just went back to see if I could find more info on your kitty. Generally, with a new Lantus user, we suggest that if you have a pre-shot of less than 150, you have 3 options. (Also, many people here on Health will use below 200 as a "no shoot" number.)
  • You can skip the shot. This has a big effect on the insulin depot but in some cases, this is your best alternative.
  • You can stall. You don't feed when stalling. You also want to re-test in about 30 min. If the numbers are coming up, it's usually OK to shoot. If they are still lower than what you're comfortable with, you can continue to stall. The big negative is that this can put you off schedule for your AM shot which needs to be 12-hours from whenever you shoot tonight.
  • You can shoot a reduced dose. (However, the not shooting below 150 still applies.)
Each of these options has it's pros and cons. If you stall or shoot a reduced dose, you will need to be around to keep an eye on your cat's numbers. If you're unable to do this, then skipping may be your best option.

Here's more info on handling low pre-shot numbers.
 
On second thought, my cat is getting really pissed at me for doing this pricking and testing. I hate to do another test so soon. She had three readings today: preinject this a.m. (after she ate some canned food) 378, then inject plus 6 hours: 114, and then inject plus 12 (next preinjection reading) was 133. It clearly is on the way up, but somewhat slowly.
 
I hope you're giving your kitty treats every time you test!

Unfortunately, when you run into low numbers, whether it's at pre-shot or during the cycle, you do need to test more in order to make sure your cat is safe.
 
Looks like a food change is going to be a very big help in regulating your kitty (is Amelia your kitty's name?)

I see Sienne has covered the dosing quite well while I was typing so I'm just leaving the lecture to TELL your vet you switched foods. How do you expect him to be able to give you sound medical advice without something so important as a major diet change?

Oh, and some encouragement, she'll get used to the pricking, treats help :-D
 
Just did a +13 test and the number was 150. It came up from 133 the previous hour, so I felt a bit safer in injecting. I gave the cat 1.5 units instead of 2. I will keep an eye on her. Now...since it's nighttime, does itmake a diff - should I feed as if it were daytime? Should I go ahead an make food available to her in the next few hours before I go to bed?

Thanks for all the help. I was panicking, and it helped to be reminded that I could wait a bit and no disaster would befall.

I read the post about low-BG reading response and could make no sense of the numbers. When they say 40 or 50, does that mean 140 or 150?
 
What does this paragraph mean (from low reading post):

The short answer is that most kitties can be shot at +12, almost regardless of the number, once you are data ready to do so. The exception is that shooting 30s or 40s is not recommended for most cats, so if the cat is less than 50 then usually the best option is to wait until they are above 50 to shoot. While you’re waiting, the shed is draining, so you want to get the insulin in as soon as it makes sense to shoot.

Please translate. Thanks!!
 
Re: NEED ADVICE asap! for Melanie and Smokey

Sorry for the flood of messages but I want to reply to some earlier posts.

Melanie, I didn't tell the vet about the food change because I did it against his recommendation and since he doesn't think there's a value to changing food, I assume he won't know much about how to handle that. Otherwise he would've talked to me about it as an option. I don't feel ready to put my complete trust in the vet, and am supplementing his advice with what I get from this forum.
 
Since you decide to shoot and you have already stalled , you must shoot 12 hours from the time you finally gave the shot. Try to keep on a 12 hour schedule if at all possible. Any more than 15 minutes early acts as an increase, because of the overlap. Shooting late acts as a decrease , because the shed gets used a little.

Definitely feed your cat now. What food are you giving? and what is his/her name? You will need to test several times tonight to make sure, he/she isn't going too low again. Do you know how long it takes for your cat to reach the lowest point (nadir) of the cycle?

There is a lot to learn about Lantus that is different from other insulins. It builds up a reserve in the body which will continue to be released over several days. We call it the shed or depot. It take several cycles to build up so you see the true effect of the dose. Conversely, it will continue to act after the dose is reduced and the shed balances out. Because of this it is very important to hold doses for several day. Lantus is not adjusted on a daily basis like other insulins and it is the lowest point in the cycle that is used to determine how the dose is working.

Yes. always give you cat a treat when testing, even if it didn't work. Tess sits and purrs because she know she is getting her favorite treat, freeze dried chicken! The perfect treat for a FD kitty, it has no carbs!
 
Lot's if posts are fine. I'll try to catch up. When that post says
most kitties can be shot at +12, almost regardless of the number, once you are data ready to do so.
Click to expand...
Means that you understand your cat's cycles well enough to predict how he/she will react to a shot. if you shoot low you must be prepared to test often and have higher carb food on hand to boost numbers up if they fall too low. Normal BG for cats is about 60 to 100. Below 50 and we work to get numbers up to keep them from dropping into the hypoglycemic range.

You don't have enough data yet to shoot those lower numbers and are still a little shaky with getting tests frequently. That's why we suggest newly dx cats not get insulin below 150, to keep them well away from the hypo range. Gradually you will get to feeling confident shooting lower numbers.
 
Of course no cat does things the way we expect, but here is what we notmally look for in a Lantus cycle:
Example of a typical Lantus curve:
+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number
Click to expand...
 
Thanks to those who responded so quickly yesterday. It was a lifesaver. I was so stressed out! Yesterday the BG numbers got into the normal range - 100s, and today, back up into the 300s, even at nadir. But the cat is looking and acting better. She even played a bit today. She seems less bony, even after only 5 days - perhaps she was dehydrated as well . The insulin must be allowing her to get some real fuel in her, thus the better disposition. She doesn't act as if she were on death's door, as before. Surprising to see that, even with the numbers still being over 300.

I was so discombobulated last night that I left the insulin out all night. It was in a room that was 55-60 degrees F. How can I tell if the insulin has been degraded? Should I just keep using it until I don't see any response in the BG numbers? It's unfortunate that it happened so early on, before we've reached any stability in the process and in the sugar regulation, so I won't really know, will I, if the insulin is faulty? Any advice appreciated.
 
I also answered your post about the insulin elsewhere...after doing a google search I found insulin may be stored at room temperature but will only last a month. We keep in refrigerated to last longer. Good to know! :smile:
 
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