Needing reassurance

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KittyMom777

Member Since 2014
Okay, I've been reading and posting and getting so confused as people give different advice and my vet gives different advice again. I am going round and round in circles trying to figure out what to do and my own instincts.

I've read the "start low, go slow" regime and it makes sense, however I think I messed that up in the beginning.

My vet told me to start at 1 unit once per day. (I am using U-100 syringe, Lantus insulin and the syringes don't have half units, in fact I found it really hard to get only one unit without any air bubbles but I think I am better that now).

After a week, probably I should not have, I upped him to two units in the morning as his levels were still consistently high at 23 mml/L (I did not at this point know that insulin should be given twice a day and my vet had not mentioned it yet..she did later when I asked and she said we were building up to that). Perhaps I should have at that point, gone to one in am and one in pm. Anyways, after 2 weeks at 2 units a day vet did first glucose curve. The lowest point was two hours after the 2 units insulin given. He went from 23 (obviously I now know that was high because he had not had evening dose so a good 24 hours since last dose). 2 hours after the dose he dropped to 6.1 and hovered between 6 and 8 for the next 6 hours, 8 hours later he was up to 13 and 12 hours later back up to 23.

Therefore my vet said to give him 2 units at night as well. I have had someone post on here to say that that is too much to double the dose and told me about depot, carryover whatever. So I thought I would give just one unit in the evening then test to see what that did - if it dropped right to 6 again or stayed the same. He stayed the same at one unit before. Or, do I split the dose he is currently getting and give one morning and evening - however, on only one unit his levels didn't change in that first week at all. I cant give half units so its either one or two.

I do not know what to do for the best. Vet says 2 and 2, I am not sure.

Please help.
 
Okay lets start with what a shed is:

Think of a funnel that you are trying to fill to the top and keep level without putting a cork in the bottom. So as you pour water in it's running out the bottom. If you pour too much or too fast the water at the top overflows, that is the same as hypo. But on the flip side if you pour too slowly or not enough the water at the top of the funnel gets lower, that's not enough insulin. But if you find an amount that you can pour and a speed to pour that amount in that holds the top level even with the top of the funnel that is your ideal dose. The water that is in the funnel is your shed. The water running out the bottom is what is in the shed that is being used to lower the BGs, it isn't the water that you are currently pouring in the top, it is what was already there, and what you are pouring in is what is being added to replace what is being used. Make sense so far?

When you change a dose with Lantus the shot you give in the morning may not even come into play until the evening cycle or even the next day or two. You have to fill the funnel up first before it starts working like it should. That can take anywhere from 3-5 days in the beginning. PATIENCE is the keyword when working with a depot insulin like Lantus because it builds up crystals under the skin that have to dissolve first before they can lower his BGs. That doesn't happen immediately.

If he was one of mine I would start by giving 1u morning and night, hold that dose while monitoring by testing for a full week and then run a curve at home to check where his nadir is (the lowest point in between the two shots). If at anytime during that first week he drops below 50 (2.7) you will need to get syringes with 1/2 unit marks because the dose is too high.

You are probably going to want to get syringes with 1/2 unit marks anyhow as you'll eventually need them, doses are adjusted off the nadir with Lantus and are changed by .25 to .5 at a time.

Once your ready we would love to have you over in Relaxed Lantus which is the forum I moderate, and is specifically for the Start Low and Go Slow Protocol for both Lantus and Levemir

Mel and The Fur Gang
 
Thanks for that. Didn't quite get the shed analogy but I will split his two units in the morning to one in evening and one in morning for a week then do a glucose curve next weekend. His evening levels and pre-shot levels are very high though so I am still unsure. Part of me wants to leave the two units in the morning as that has been working for him and give him one unit at night. I guess I will go with my instinct on Saturday.

I cant get half dose syringes where I am in Canada, I have already asked and I cant get them. He is a big cat so if he's currently on two units in the morning and I am only splitting that dose, not increasing in any way, I think its unlikely he will drop low as low as you suggest (2.7), I have never ever seen it less than 23 and the vet is the one who had him at 6.2 during his curve. I can only test morning or evening unless on a Saturday when I am home all day.
 
You can get them, but you might have to order them from ADW. I know where I am in the states Walmart will tell me that they don't carry them, but they do. What I get is Relion 3/10cc 31 gauge with a short needle right now, although my preference is these If you go through the link at the top of the forum to order them the board gets a small kickback that helps fund the running of the board.

BTW my Cassanova was 37lbs when adopted and yes he was a walking watermelon with feet, he is still a big guy at a healthy weight of 17lbs, but he never went over 1u twice a day, and 8 months later is in remission.

My Maxwell is also a large guy at 16 lbs healthy weight he also never went over 1u twice a day, yet my little petite female Autumn was at one point up to 1.5u twice a day and is now down to .3u and dropping in dose. Weight while it does play some role in this, doesn't play a huge part, it is more diet and insulin and testing that will find the correct dose.

Mel and The Fur Gang
 
MommaOfMuse said:
You can get them, but you might have to order them from ADW. I know where I am in the states Walmart will tell me that they don't carry them, but they do. What I get is Relion 3/10cc 31 gauge with a short needle right now, although my preference is these If you go through the link at the top of the forum to order them the board gets a small kickback that helps fund the running of the board.

BTW my Cassanova was 37lbs when adopted and yes he was a walking watermelon with feet, he is still a big guy at a healthy weight of 17lbs, but he never went over 1u twice a day, and 8 months later is in remission.

My Maxwell is also a large guy at 16 lbs healthy weight he also never went over 1u twice a day, yet my little petite female Autumn was at one point up to 1.5u twice a day and is now down to .3u and dropping in dose. Weight while it does play some role in this, doesn't play a huge part, it is more diet and insulin and testing that will find the correct dose.

Mel and The Fur Gang

ADW? Canada and US is obviously very different. I am to get U-100 needles only. 17 lb seems very heavy for a cat. My other cat is 16 lb and huge. I am trying to bring her weight down.
 
ADW American Diabetic Wholesale and they are U100 syringes as I use a U100 insulin.

The markings on the syringes have nothing to do with the strength of the insulin except that you need U100 syringes for U100 strength insulin. All that means is that there are 100 units in a cc/ml. Insulin syringes themselves come in several different volumes and markings. A 3/10cc syringe only means that there is the max volume of 30 units that that syringe can hold, so the lines are farther apart to make dosing in smaller amounts easier to see when you are drawing up the dose.

The smaller marked syringes are designed for giving insulin to a human child that also may take a very small dose. So they are probably available in Canada, since I know we have a bunch of Canadian members that use them, you may just have to order them online or request that they be ordered in for you at your pharmacy. Because if they don't have a child that is on insulin that regularly uses them for their syringes they may not just carry them in stock.

Mel and The Fur Gang
 
If you go through our SHOP link above, then locate and click ADW, you'll be taken to their web site.

From our SHOP link, you could also try searching for 3/10 ml, 30 to 31 gauge, short OR long needle, U-100 syinges on Amazon in Canada.
 
For most breeds of cats 17 lbs is huge, but not for all cats. Cassanova is a big long and tall cat, Maxwell is a Maine Coon mix also extremely tall and long. On my Siamese they would be huge at 17 lbs, as they aren't a large breed of cat, while on the Maine Coon or other larger breeds that is just about right for them.

You want an overweight cat to take off the weight slowly, because losing too fast can cause serious, life threatening illnesses. Their livers can't process their own body fat like we humans can, and it can clog up the bile ducts if they lose too fast. But just like in humans to lose weight you feed less, to gain you feed more than what a normal weight person/cat would require to maintain that healthy weight.

Mel and The Fur Gang
 
Re my cat's weight loss - I used to feed both my cats one small tin of Whiskas - 100g, plus half a cup of dry food (Whiskas)each, split into two meals a day. However, six weeks ago I changed this when my cat was diagnosed with diabetes.

I fell for the vet's suggestion of buying their expensive food so I bought a case of Purina DM and a huge bag of the dry. I gave my diabetic, a quarter tin of the DM plus half a cup of the DM dry and my other cat, one tin Fancy Feast (reducing wet food to the 85 g tin that FF is), and reduced the dry to almost nothing - 1 teaspoon - purely because she is an addict.

However, after reading posts here, I have now moved them both to Fancy Feast only.

She is not dropping ANY weight though - and is only getting 85 g tin a day. no treats.

Any suggestions? Maybe she is sick too? But I cant afford to take her to vet for check up right now until my diabetic is stabilised. I have already spent over $1,500 on him and I am out of funds. Even to buy new needles - I bought enough for three months so I will look for the ones you suggested in January when I need more.
 
She maybe losing the weight you just aren't seeing it yet, cats lose slowly very slowly. as in grams and tenths of a gram not pounds. She's a cat not a person so the weight comes off slowly. She didn't get obese overnight and she isn't going to be slim and trim either overnight, any more than she became diabetic overnight or will go into remission overnight either. All of it is a marathon not a sprint.

Hopefully before January she isn't going to need a dose smaller than 1u, because eyeballing it can be hard. Just saying it can be tricky at best with 1/2 unit marks if you have to reduce to .75u or even .25u

Mel and The Fur Gang
 
Sorry, I think I confused you. Its not my diabetic cat that is overweight but the other one. I have been weighing her every month since June as she has only gained the weight in the last 6 months that's why I am thinking something is wrong. Its how I discovered my diabetic cat was losing weight as I weighed them both and saw he was losing for no reason.
 
The diabetic is losing weight because he is diabetic and unregulated. Insulin is the hormone that allows the cells in their body to use the nutrients from the food they are eating as fuel. It is sort of like buying groceries but the house is locked and you don't have a key. You can keep buying groceries but until you have the key to unlock the door and get into the kitchen they aren't doing you any good.

With a diabetic they're eating (buy groceries) but their house is locked and they need the key (insulin) so they can use the food they just ate. So in short they are literally starving to death while consuming huge amounts of food.

Mel and The Fur Gang
 
MommaOfMuse said:
The diabetic is losing weight because he is diabetic and unregulated. Insulin is the hormone that allows the cells in their body to use the nutrients from the food they are eating as fuel. It is sort of like buying groceries but the house is locked and you don't have a key. You can keep buying groceries but until you have the key to unlock the door and get into the kitchen they aren't doing you any good.

With a diabetic they're eating (buy groceries) but their house is locked and they need the key (insulin) so they can use the food they just ate. So in short they are literally starving to death while consuming huge amounts of food.

Mel and The Fur Gang

Thanks. I realised that after the vet gave me the diagnosis.

Will have to take my other cat soon to make sure there is no underactive thyroid thing going on to prevent her losing.
 
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