Need Lantus help

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George&Bert

George&Bert

Member Since 2009
I made an appt with the vet office that diagnosed Andre' as I am unable to hold him still enough to get blood at this time.

I was reluctant to go because the "partner" and senior member was on. He is a "I give the orders around here and not you" type. He is the brains and I am an intolerable dummy.

The techs took the sample from his paw with me assisting. Andre is fed up with over two months of pokes, prods, meds and handling plus being extremely ill for seven weeks. It was questionable if we was going to pull out of the URI or whatever else he had.

He is feeling good now and looks bright. Around me he is happy and purring, but forget about the vets handling or taking blood. I suspected his numbers would be good because he seems so normal ( I have noticed increased urine in the box though ) :(

I should remind you I have twenty cats and I cannot separate them before I move to this next segment.

After he was diagnosed I gradually pulled all the hi carbed dry and replaced it with EVO 6% dry kept increasing the low carb canned to several small meals a day. I have been worried that all that cut back would hypo him,

His number at + 6.5 was a whopping 440. I nearly fell off the chair. I can't believe between the insulin and food cutback he is getting higher than when he was not on insulin.

The doc said to increase the dose from one (1.0) unit BID to two (2.0) units BID. Isn't that too big a jump? And what do I do about that? Do I not follow his instructions?

He wants me to bring him back Thursday morning and afternoon.
 
I took Ruby to the vet for a curve once. Just once. If you look at her spreadsheet, check out Jan 10th. She was thru the roof the entire time she was at the vet. She gets so stressed out that her BG skyrockets. She's had her blips of red here and there, but nothing like that day. Once my Dr. K saw the difference between the curve they did and the testing I do at home, she agreed that its best for Ruby to not go in unless its absolutely necessary.

Its entirely possible his test was that high because of the stress of being there.
 
I forgot to add that the numbers she scored on that curve caused Dr. K to increase her dose, which we immediately dropped again because it was too much. At the time Ruby was on PZI, not Lantus, but knowing my girl the way I do, I don't think the type of insulin had anything to do with it.
 
I agree the high number you saw at the Vet's is because of the stress of being there. I bet if you were to let Andre' relax and take a reading at home you would see he went from 440 at the Vet's to whatever much lower number you get at home.

As far as increasing the insulin from 1.0 units BID to 2.0 units BID that's a 100% increase! I wouldn't go more than 0.25 units at a time, especially since his BG readings at home may be much lower.
 
You take the cat to the vet. He's really pissed off, feeling like crap, and does NOT like being poked.
Two vet techs hold him down and the 3 of you are able to get a test.
There is NO WAY that number is going to be true! And then to use that number as the basis of DOUBLING THE DOSE?

No, I would not double the dose under any circumstances.
Give him 1.5u dose and get some tests at home to see how he is doing.

It's not a good idea to be raising the dose at the same time as you are adjusting diet which will need less insulin.
 
I am not a dosing pro by any means. But I do have a lot of experience w/Lantus & I have 16 cats & 2 diabetic kitties.

I would definitely attribute the 440 to vet stress. Even transport stress. Tinkerbell HATES riding in the car and just a short drive will spike her sky high. Tawny on the other hand doesn't even have to be confined in a vehicle, she just lays on the seat and rarely moves and it doesn't phase her one bit to be in transport.

As far as the dose increase goes, I do not support a full unit increase at any one time. The TR protocol recommends either .25u or .5u at a time depending on nadir and then recommends holding that new dose for between 6-10 consistent cycles (3-5 days). Most of us here I think try to hold to the 6-cycle rule when possible.

& of course we don't increase a dose if we are waiting for a bounce to clear.

Was there a food spike in the 440 as well? If Andre' had eaten anything at all w/in 3 hrs of that # that could have also caused a higher #.

Have you tried making a "burrito" out of him when you test? Wrapping him up tight in a towel? This worked well for me once when I was treating an abcessed wound on one of my kitty's faces right near his eye.

& have you tried testing his ear instead of his paw? If you "burrito" him & test his ear that might be easier.

Personally, if it were my cat, I would not increase more than .25u and at the very most .5u, and I would not raise that dose under any circumstances for at least 3 days, 6 consistent cycles.
 
I totally agree; the number is most likely inflated by stress and therefore pretty much worthless. Neither the tight regulation protocol nor the Start Low Go Slow protocol ever calls for an increase as big as your vet is suggesting; even tight regulation, the more aggressive of the two, would only call for a .25-.5 increase at a time when the starting point is only 1 unit. Remember that the dose is based on the nadir point, and if you aren't testing, that number isn't known. so if i were you, I would not increase to more than 1.25, especially since you are not able to get spot checks at home. Raising the dose without testing is a pretty big gamble, IMO.

Believe me, ALL of our cats are probably sick of being poked and prodded several times a day, and some people have had to find some pretty creative ways to test. Have you tried wrapping Andre in a towel like a burrito so that only his head is out? Another method of making a kitty burrito is to use a large sweatshirt with soft elastic (but not TOO stretchy) sleeve cuff; pull the sleeve over the kitty's head and pop his head out the end, then push the cat up the sleeve so the sleeve is around his legs and only his head is out the end. I found this to work really well for a kitty I had who needed eye medication but was a genius at escaping the towel burrito. I found that putting Mikey on the counter and holding him against my side with my elbow works better for me than the kneeling option. If he's being especially feisty, I'll take some freeze-dried chicken or turkey and crumble it up into a fine powder and spread it on the counter, which distracts him long enough cleaning it up to get the test.
 
Hi George:

I think you've gotten some good info as to whether that could be a stress induced number or not.

If you would like us to help with some dosing suggestions, we'd need to see a spreadsheet, please. It's much easier for us to pick out patterns that way. Here is the link to create a SS: Spreadsheet

I know this was scary for you to see this number, but we only use the "911" in case of an emergency. Since we have eyes on your condo, we'd really appreciate it if you'd edit and take it down now. Thank you so much. :-D
 
i would want to know how low he is going before i increased his dose, george.

what about the possibility of a bounce? if he's behaving like he feels well, his blood sugar may be lower and if he's hit a number lower than he's used to, he may very well bounce from it. if you'd like to click on punkin's ss in my sig line, you can see how he's been bouncing this past couple of weeks. he's on a very good dose and he's hitting very healthy numbers - greens and blues - but they are causing his liver to let loose sugar and hormones and you can see 400's in there as well.

i understand the difficulty of your situation, but if you increase without knowing how low the current dose is taking him, you could be giving him too much lantus and when the bounce clears, he will be over-dosed.

that's my 2 cents on it, at least. i would not increase without seeing the mid-cycle lows.
 
George....

Julie and I are on the same page. I wouldn't increase at this point. Again, we can be alot more help to you if you have a spreadsheet.

Thanks for taking down the 911.

Also....one condo per day per cat so any questions you have about dosing, food, etc. should all be in the same condo; I just saw you have a second one. Please read this info: Making the Most of Your Lantus ISG Experience

I know it seems like we have a lot of "rules" in this forum. We have alot of kitties needing help, as you can see. So we have to have some organization otherwise we wouldn't be able to help everyone that needs it. We're happy to help. Thanks so much!!
 
Outside of his after vets exhaustion period he is bright active, happy, hungry, friendly with the other cats and runs for the door when I come in to see if I have any canned food for him. Then he eats like a truck driver on cheap diner food.

He does not linger over the water bowl and yet I am seeing more urine..but,,, they are all getting wet food now sooo more pee...right?
 
thinking more - if you feel like he isn't getting enough insulin - ie, he's drinking a lot, peeing a lot, his hair looks icky - at any point, you only want to adjust lantus by .25u. that's 1/4 of one unit. that's enough to make a difference. doubling his lantus is a terrible idea and even if he does need more insulin, there are doses of 1.25u, 1.5u, 1.75u and slightly more or less than each of those in between 1 and 2units.

cats are very responsive to insulin and a drop can make a difference in some cats. literally 1 drop - we've got several cats who get their dose adjusted by just a drop.
 
one drop..amazing...I am posting about registration shortly on health.

I don't trust what the vet says..I am so sorry to say. He was too fast to make a decision.
 
it is amazing. we've had 2 cats almost off of insulin entirely with the dose being 1 drop for a period of time. you get one drop by pushing the plunger in hard before putting it in your insulin, then releasing the plunger. the amount sucked back in becomes the dose. it's crazy.

in all fairness to vets, they have to treat so many animals and most people seem to put their diabetic cats to sleep. in my old vet's 3 vet practice - they had 2 diabetic cats: mine and one other. i just don't think it's common enough for many of them to gain experience in it.
 
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