Need Refresher course on glargine

[Sara and Buttercup]

my cat has been on steroids and it has reaised her bg to the low to mid 200's and it's hoving there for about a month. i guess i'll be starting her back on glargine. vet says start with 1/2 unit once a day. i have given my cat insulin for over 5 years but it's been quite awhile since she's been on it, maybe i year. i forgot alot of stuff.

so i know i am supposed to do glargine 2 times per day but i don't know if i can handle it with my schedule.

i guess my main questions are, once i start the insulin (prob tomorrow night because i can't afford it until i get paid) when and how do i do the glucose curve? i remember glargine not having a specific low point(i used it on her for about two month previously) and then i did it twice a day. i was shooting into anything over 150. iknow alot of you guys shoot alot lower but a "fat 0" was dropping her like 80 to 100 points if i remember correctly.

i am planning on testing first to get her preshot number and then injecting the insulin maybe around 5 pm or so.
do i start testing right away or do i give it a day or two or three before staring to test after the shot?

her bg is ranging from about 200 to 250 and not going much higher, sometimes she is under 200 and this is without insulin but i know the longer i wait to start, the more her pancreas will be damaged. she's been on two remissions, this being her second but the budesonide raised it back up to this level.

i am alos going to be lowering the budesonide dose at the same time.
i guess i could wait a few days after lowering the busonide dose to see if that bring it down before staring the insulin. what do you think about that?

what a damn pain.
doing 2 to three sub q's a day for different kidney cats and literaly about 10 meds/other procedues a day on the cats and working more than full time outside in blazing hot weather.
cat ranging in age from about 11 to 16.
so tired. anyway, thanks for the heelp.
my diabetic is doing ok. but i could use the help of people here again like i have in the past once she goes back on the insulin.
yesterday she was at 237.
internal med specialist gave me ok to go to every other day with her budesonide dose which is at .375 mg per day and i'm going to every other day. i guess i'll start the skip tonight and test bg tomorrow night just in case it starts to come down right away.
maybe, maybe it will start coming down with lowering the dose. i'll wait at least another 24 hours before starting the insulin.
thanks very much for your help and support.

 

[Patty & Champ]

Wow, it sounds like you have a lot on your plate!! I really do feel for you!!

I wish I could give you some advice on this, but I just don't have the experience to feel qualified. Your thread has been cross-posted in the Lantus forum so hopefully one of the experienced people there will pop over to help you out.

I do have a question, and please forgive my ignorance because I have no knowledge of the steroid your kitty is on. Have you asked your vet if there is a substitute for the steroid she's taking since steroids aren't the best thing for diabetics? You probably already knew to ask, but I thought I'd put it out there.

I hope someone is able to help you soon.

 

[Beth & Atlas]

when and how do i do the glucose curve?

i am planning on testing first to get her preshot number and then injecting the insulin maybe around 5 pm or so.
do i start testing right away or do i give it a day or two or three before staring to test after the shot?

i am alos going to be lowering the budesonide dose at the same time.
i guess i could wait a few days after lowering the busonide dose to see if that bring it down before staring the insulin. what do you think about that?

I am glad to see your vet recommending such a low starting dose. Good for him/her. I would start testing right away as a mini-curve for the data. That would be a Pre-shot test before food and insulin, a +3, +6,+9, and an AM Pre Shot and maybe snag a test before you leave for work in the morning after the second dose.

I cannot address the budesonide issue, but that every cat is different. But let me see if I can find someone who can...

 

[Sienne and Gabby (GA)]

Hi Sarah!

The easiest way to get back into the swing of Lantus is to take a refresher course on the starred sticky notes on the top of the Board. In particular, I'd look at the Tight Regulation sticky. Like Blue (Beth) suggested, getting tests in sooner, rather than later, will be very helpful and will allow you to make sure your cat's numbers stay in a safe range.

Do you have access to your old SS? That may also help to remind you of the routine.

One thought regarding cost -- if you call around to hospitals or university medical centers, you may find that the pharmacy will sell a single Lantus pen. Often the hospitals are breaking up the packs to send insulin to the hospital floors and as a result, the pharmacy will sell individual pens. It's much less expensive to buy one pen than a pack of 5.

 

[Sara and Buttercup]

thank you thank you thank you guys! you are always such a big help and so nice. i will be checking in here soon.

and yes, i did tlak to the vet (s) about doing something other than steroid for her chronic diarrhea. believe me, we tried pretty much everything over a course of 2 years... metronidazole, vit b shots, probiotics, diet, canned pumpkin,... she had bad bad diarheaa and i do believe in her case the steroid was called for at the time, but i am going to start tapering it tonight so we'll see it that helps with the sugar. thank god she is acting pretty healthy now and recent blood work was normal so i hope i have a little time to figure this all out.

it would be great not to have to add insulin and subsequent bg checks to my daily grind of pet chores but if i have to, i definitely will.

 

[Kelly & Oscar]

My guess is if the steroids are helping the runny poo's is that your kitty has what is called IBD. Sometimes there is just no other alternative to steroids and you adjust the insulin accordingly. This sounds like one of those situations! 0.5u sounds like a great starting dose for a previously otj kitty needing insulin again. I know with your schedule, curves may not be possible until the weekends. During the work week you will need to test before each shot, but what someone else suggested for curves when you can get them in sounds great. Either every 3 hours or every 2 hours until you find the pattern your kitty will give you. After that you can adjust to just testing around the time they are usually the lowest.

 

[Beth & Atlas]

Good Morning Sarah!

Atlas had the runny-poo's for nearly 9 months. We tried everything...

Finally the vet suggested a raw food diet. Of course he wanted to give me the recipe to make my own, but well...not my cup of tea...

So we tried Nature's Variety Raw Instinct(frozen patties, canned, freeze dried). The trick with a food trial is to give it a month and it must be a unique protein source. So, that means Venison, Rabbit, and even Bison. Unfortunately it is not inexpensive to go this route of the pre-made stuff. I believe Dr. Pierson's website has the recipe for the make your own raw too.

Raw Instinct also comes in cans for cat and dogs. You can usually find the dog food in the can. The duck and the venison are 7% carb. all the others are 13% carb, but like the steroid issue you would need to adjust the insulin. Psssttt....I spoke with their rep a while back and the dog fuds...same as the cat fuds. Actually the way she phrased it...it is originally formulated for cats. ;-)

The Raw actually cleared Atlas up within a few days. Yes, a few days, after months of A/bs, probiotics, etc. WE did top the raw rabbit with fortiflora the first month to help re-establish the good bacteria in his gut.

 

[Larry and Kitties]

I have had four kitties on budesonide. Two Civis and two diabetics. For the diabetics, the budesonide did not seem to effect the BGs. For my first Civi, I did not notice any change but did not look either. My Civi Lightening started budesonide about a month ago. Prior to that he started loosing weight and had a poor appetite but seemed to be hungry. The vet found a mass by his abdomen and blood work showed hyperthyroidism. He also had very soft feces. The mass was removed and was nonmalignant. an old hernia was also repaired. A little after a week after surgery, started METHIMAZOLE and budesonide. His blood work done Tuesday showed his T4 is where it is wanted but his GB was 200. I measured it yesterday evening and it was 190. As of now, I will just wait and see if the BG goes up. He is gaining weight and the feces are a lot better.

 

[Vicky & Gandalf (GA) & Murrlin]

Good Morning Sarah!

Atlas had the runny-poo's for nearly 9 months. We tried everything...

Finally the vet suggested a raw food diet. Of course he wanted to give me the recipe to make my own, but well...not my cup of tea...

So we tried Nature's Variety Raw Instinct(frozen patties, canned, freeze dried). The trick with a food trial is to give it a month and it must be a unique protein source. So, that means Venison, Rabbit, and even Bison. Unfortunately it is not inexpensive to go this route of the pre-made stuff. I believe Dr. Pierson's website has the recipe for the make your own raw too.

Raw Instinct also comes in cans for cat and dogs. You can usually find the dog food in the can. The duck and the venison are 7% carb. all the others are 13% carb, but like the steroid issue you would need to adjust the insulin. Psssttt....I spoke with their rep a while back and the dog fuds...same as the cat fuds. Actually the way she phrased it...it is originally formulated for cats. ;-)

The Raw actually cleared Atlas up within a few days. Yes, a few days, after months of A/bs, probiotics, etc. WE did top the raw rabbit with fortiflora the first month to help re-establish the good bacteria in his gut.

I just want to add that Blue's experience with the raw food for an IBD kitty is not unusual. There are testimonials on the site of Feline's Pride which basically echo the same experience for IBD kitties.

I understand you mentioned you've tried everything, including diet, but I don't know if you've tried or considered raw. You do not have to make your own! http://www.felinespride.com sells a premade, premixed, balanced raw food for cats in different meats such as turkey and chicken which most cats love! My own experience with it was with pancreatitis and severe diarrhea probably brought on from the Hill's food the vet had me feed. The very day I syringe fed the Feline's Pride to him the diarrhea ended right then and there. And within 2 days Gandalf was eating on his own.

Raw food is controversial, but it requires the same common sense handling we use for meat we prepare for ourselves - clean counters, wash hands, don't re-use utensils involved until they are washed in hot and soapy water, etc etc. Feline's pride is sold frozen in 2.5 lb. containers, so you do have to transfer it to ziploc bags or small freezable containers to thaw and feed later. It will stay fresh in fridge for at least 3 days once thawed, so you can make batches large enough for 3 days.

It may be worth a try. Please at least read the testimonials on their site. If the raw would help this kitty you may not have to start her back on insulin. You're doing a great job helping your over-the-hill crew!