Nelson on Lantus-New Sugar "Mom"

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CatMomWendy

Member Since 2012
Hi,
We adopted Nelson in Sept. 2012 so I am a new sugar mom and fairly new to the group. I have been reading and printing material posted here. Nelson is 13 and he came from a rescue. We were told he has been diabetic since age 9 and the previous owner was traveling more for a job and couldn't treat the diabetes anymore. We specialize in special needs kitties but this is our first diabetic.

Nelson came to us on Lantus at 2 units twice per day. First round of blood tests within the first week showed his BG numbers still in 300's so we increased to 3 units twice per day per the vet. I found this site and started learning about tight regulation and feeding wet so we are in the process of converting off of dry. I feed Fancy Feast and now starting this weekend, a small amount of raw. I also a received a blood meter from the group and we have learned how to home test. A second round of blood work showed his numbers still in the high 200's and we then did a blood curve about 1 month ago. His lowest reading was 195 3 hours after insulin and as high as 387 9.5 hours after insulin. The vet recommended to go to 4 units twice per day and we started that 3 weeks ago. Did a partial curve yesterday and found a PM insulin dose time (before food and before insulin) at 154 (checked twice). 3.5 hours later the value was at 48. We checked this am and got 66. We did not give insulin this AM. I wrote it all out and faxed to the vet but haven't heard back yet.

My question is dose related. I am not good at navigating this board yet and I haven't been able to figure out how to adjust a dose (if I should be). I assume I should be going back down on Lantus since I am trying to phase off dry food (still feeding about 3/8 of a cup of dry and about 4 oz of wet per day...just bought a digital scale to better track the wet amount). He was at 1/2 cup of dry per day but as I start to introduce the raw slowly I am taking the dry down. I have not heard back from the vet yet today. Obviously, we will test at the PM dose tonight to see what numbers we are at but I really don't know how much to insulin to be giving now that we are hovering around the right numbers.

His weight as of 11/18 was 17.6 lbs. (husband weighed himself and then added Nelson....not the best but only way to measure at this point). Past blood work is good except a slightly high pancreas value. We are currently giving Denamarin once per day.

Thanks for any guidance,
Wendy Panaro (CatMomWendy)
 
Your objective is a Lantus dose which may be safely given every 12 hours.
This means the pre-tests shots (for now, until you have a fair bit of data about how Nelson handles Lantus) should be at or over 200 before giving insulin AND the nadir values (lowest point, about 6 hours post shot) should be above 50.

When you have a pre-shot as low as you did, it means the Lantus is too high or some other problem may have occurred such as vomiting - so 4 units is too much. I'd go back to the 2 units while you are in the process of removing the dry. Once change at a time helps you determine what the result of a specific change is.

And it will really help to get as many mid-cycle tests as you can manage, even if it means setting the clock for the middle of the night. Some cats drop as much as 100 points when dry food is removed and some cats tend to go low overnight, so this mid-night tests may help keep him safe.
 
Thanks BJM - I am still waiting to hear back from the vet today. He hasn't been vomiting. In fact I don't think he has ever vomited since we got him. Yes, I will decrease tonight even if I don't hear back from the vet. But I will test first to see what the result of no insulin this AM did during the day. Nelson does like his soft and raw food and I also give one freeze dried duck heart per day so other than him being conditioned to eat dry food, I don't think it will be too hard to get him off it eventually.

I hear what you are saying with testing at 6 hours but it will be VERY difficult to do during the work week. We have other cats, some special needs, and as it is, I am lucky to get 6 hours sleep per night (I work full time during the day). I can't test myself (Nelson just isn't sitting still for that yet). We can probably swing a night test on a weekend. I am not very good at home testing yet and need to get better at it so I can do it alone. I know it all comes with time and I have to much to learn and so little time to study it to make myself knowledgeable.
 
Might see if you could recruit a high school student interested in becoming a Vet Tech or Veterinarian. Might be able to set up a work experience or community service hours with the school.

Other than that, do your best.
 
We set the alarm and got up last night. When I tested him before his PM shot, Nelson was 231 (he did not have an AM shot yesterday). We gave only 2 units. At 12:30 AM (6 hours post shot) he was 255 and at the AM shot time, he was 283. I gave 3 units this AM. Talked with the vet this AM. We love him but I am getting the sense that he is kind of blind on tight regulation management as discussed on this board. He didn't agree with the over 200 number before a dose is given. We agreed on 3 units (he suggested 3.5 units) but we will still do adjustments as needed and I think I might already know more about this than he does so will adjust as I feel is right for Nelson based on what I learn here.

We are leaving Friday AM for the weekend so I am hoping to find a "happy medium" dose as our sitter does not know how to test and with all the other cats to care for, I don't want to ask her to take that on too. It is hard to find a sitter that can deal with our clan. If we are unsure, Nelson will go with us (inherited a home farm about 2.5 hours away and I have family in the area).
 
If you're preparing for a vacation, for safety, go for stability - keep the food the same, stabilize on the 3 units, and feed the same way and times. If something is in the process of changing while your sitter is responsible, he or she may not be able to handle it.

We have a few folks who do take their diabetic cats with them on holidays. It helps to get the cat accustomed to a harness with leash (to prevent bolting away) ahead of time. Obtain a refrigerator pack for the insulin during transport. Leave the carrier out with a comfy towel or blanket, spritzed with Feliway or catnip to make it a friendly place, thus reducing stress during transport.
 
Thanks. Nelson does very well traveling. I adopted him from a shelter in VA. I live in WI. I sent a soft sided carrier with towels a few days ahead of time with a shirt that smelled like me and some Feliway. I flew to Washington DC and a volunteer with the shelter (2+ hours away) had transported him to her office in DC. He got to hang out all day with her in her office. I flew in and was in town walking around all day until it was time to go get him. Within an hour of meeting him, we were going through security at the airport where they made me take his leash and collar completely off before I could go through the scanner. He was very good and didn't even try to get away. He was in cabin with me on the way home. I was completely in love with him by this time as it couldn't have gone better. Each day I am more in love with the guy.

Yes, we want to stabilize on a dose so we don't have problems while we were gone. We held off on moving to 4 units because that timed out exactly right before my husband and I left for the Best Friends No More Homeless Pets conference last month. We waited until we got back to make the move up for the same reasons.
 
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