Need advise on when/if to give insulin

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Alexander's Mom

Alexander's Mom

Member Since 2015
Hello everyone
Alexander was diagnosed almost 2 weeks ago. The vet wanted me to change both is diet and administer insulin (Lantus). After finding this discussion board, I realized how dangerous that could be, so I started testing his blood glucose level (OneStep Ultra 2) and using that to decide whether to give him insulin. Sometimes, that decision is clear, other times, I worry a shot would be too much (he is supposed to get 2units 2x/day). I often end up taking the BG level an hour or more after he eats something, because he frequently starts with a few bites and then comes back later for more. Alexander's BG-insulin log should be part of my signature below so you can see his ranges, when I've dosed and not, as well as my notes. Any advise on the threshold I should use to decide whether to use insulin is much appreciated! Right now, he is at 113mg, so I'm holding off on the shot because earlier this week he had been at 130mg and the shot brought him down to 59mg 6 hours later, yesterday he was at 123mg and the insulin brought him down to 66mg 6hrs later.

I also have a question about food. My cats used to be on a dry-food only diet (indoor weight control combined with prescription dental formula). They did not like the Purina DM that the vet suggested. I have him on Fancy Feast (trying the different low carb versions to see which ones my cats like most). I push for the turkey and chicken pate types, but my boys definitely prefer having something to chomp on and having more liquid. I've added warm water to create more gravy, even once added a tablespoon of warmed chicken brother. Right now, their strongest preferences is for the Fish and Shrimp Flaked, which is low in carb. Are there issues with giving them fish every day?

While I'm not freaking out as much as I was a week ago, I'm still a bit overwhelmed and am not getting much support from my vet (sometimes takes almost 2 days to call me back). It has been incredible finding this discussion board because I learned how to do BG testing as well as good tips for administering Lantus (the vet tech's instructions contradicted so much of what I've seen on-line, and she couldn't answer most of my questions). Thank you all for your wisdom and support!

Take care,
KS
 
Stall 30 minutes without feeding and re-test, then post.

The dose is somewhat high for a diabetic on low carb food; 1.0 units may be a better starting place - how much does he weigh, and is he underweight?

If you can't be home to check on him, I wouldn't shoot.

Notes:
For cats off insulin, normal ranges are 40-120 mg/dL.
For cats on insulin, we'd like to keep them between 50-130 mg/dL if using a tight control protocol.
Testing in the +5 to +7 hours post shot can find the lowest glucose or nadir.
 
BJM,
I was just reading in your Glucometer Notes that the human and animal specific glucometers give different readings. The numbers I've been recording are from the OneTouch…. does that affect your advice?
He is now 84mg (about 2.5-3hrs post feeding), so I don't plan on giving him insulin.
Alexander is 15lbs. He was 16lbs in mid-February. He is a large/long framed cat, but the vet had definitely not wanted his weight to go over 16lbs. I had their caloric intake tightly controlled, yet they wouldn't lose weight. On the FF, I'm feeding them at about the same level of calories (200kcal/cat/day), though I think my 4yr old, Jack, is taking more than his share :)
Initially, I took up the food after an hour or so, but Alexander was not eating enough. Now, I'm leaving it out, and it is usually gone within 3 hours of the feeding time.
Thank you!
KS
 
Nope. The reference ranges for human glucometers, including the One touch, are in the document.
As a pre-shot number, 84 mg/dL is too low to shoot unless and until you have mid-cycle data showing it would be safe. you've got some, but you've been skipping shots because he's been too low.

Ideally, you want to be able to give insulin twice a day. When you get a pre-shot that is too low to give insulin, that suggests a lower dose may be needed. You've been skipping a lot because he has had low numbers; I'd drop to 1 unit the next time he is over 200 mg/dL and you're able to give insulin.

 
BJM,
Would you then suggest I only give him insulin if his numbers go above 200mg for now? The only time his numbers went above 200 was when I was still transitioning food. Since the vet had me switch diet and given insulin at once, I'm wondering if the diet change is sufficient.
On the note of food, my boy has a sensitive system with any diet variation, so of course his stools have been loose to liquid. Is there a point where I should be concerned and try a different food?
Thank you!
KS
 
Yes. And only give 0.5-1.0 units at that. If you have to skip when you give 2 units, 2 units is too much.

Giving a probiotic such as Forti Flora (least expensive on Amazon, more expensive from your vet) to see if that helps stabilize the loose stools.
 
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