New diagnosed Lantus side effects *PLEASE HELP*

leslibbbya

leslibbbya

Member
Hello everyone,

My 10 year old kitty june has recently been diagnosed with feline diabetes. She has been to the vet about 3 days ago, which is when she was prescribed 2 units of Lantus twice a day. I have been reading up on the forum since, and we have begun the treatment this morning. She had around 2oz of DM canned cat food, mixed with tiki cat shredded chicken at around 8am. It is now 6pm, and she barely wants to eat. I have noticed some diarrhea, but I am not sure if it is a response to the Lantus. Her blood sugar was 190ml/dg before feeding her this morning, but i am unable to test right now as it seems the glucometer is broken. She doesnt appear to have any symptoms of hypoglycemia, aside from that she prefers laying down, even though shes gotten up and walked around a few times since. Thank you so much.

-Leslie
 
Hi Leslie and welcome to the forum. 2 units as an initial starting dose is higher than what we would usually suggest. Can you share some details on how June was diagnosed as diabetic? Did the vet run a fructosamine test and other lab work, including a urinalysis, and did they tell you what the results were that confirmed the diagnosis? What was her BG value at the vet’s?

If you have recently changed food, which it sounds like you may have done, since you noted DM canned food, I would say it’s likely the diarrhea is due to the food change, not because of Lantus. Also, if you changed from dry food I’d be a little concerned about 2 units starting dose, especially since you’ve tested today for the first time and got 190.

Are you using a pet meter or a human meter? Depending on the meter you are using it may be that you aren’t getting enough of a drop blood.

We have some more information for new members that we can share, usually that happens when newly joined members start in the main forum, but I wanted to try and offer some help now to your original questions.
 
Christie & Maverick said:
Hi Leslie and welcome to the forum. 2 units as an initial starting dose is higher than what we would usually suggest. Can you share some details on how June was diagnosed as diabetic? Did the vet run a fructosamine test and other lab work, including a urinalysis, and did they tell you what the results were that confirmed the diagnosis? What was her BG value at the vet’s?

If you have recently changed food, which it sounds like you may have done, since you noted DM canned food, I would say it’s likely the diarrhea is due to the food change, not because of Lantus. Also, if you changed from dry food I’d be a little concerned about 2 units starting dose, especially since you’ve tested today for the first time and got 190.

Are you using a pet meter or a human meter? Depending on the meter you are using it may be that you aren’t getting enough of a drop blood.

We have some more information for new members that we can share, usually that happens when newly joined members start in the main forum, but I wanted to try and offer some help now to your original questions.
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Thank you so much for your reply,

June was diagnosed after 3 weeks of constant meowing at night, increased thirst/ urine, and accidents when using the litterbox. She has also lost some of her energy. We first thought it’d be a UTI, but the vet ran a fructosamine as well as a urinalysis test. Her glucose levels were in the 500s. I am unfortunately not sure what her BG value was at the vet (according to a glucometer). I am currently using a human meter. I am also concerned that 2 units is a large dose, especially after reading further on this forum. I have emailed her vet, but I am not sure he will be answering for the next couple of days. I have administered her second dose this evening after she ate her evening meal, but I am still slightly nervous that her blood sugar levels may drop. Her old dry food is very carb dense, and she doesn’t seem to be very interested in her new food, as she needs to be encouraged to eat.

Thank you everyone so much for your advice, please let me know if there is any more info i can provide to help out my girl :)
 
Thanks for providing some more clarification. So if I understand correctly, June is still eating dry food? Were you able to get another blood glucose test before this evening’s shot? And did you give 2 units? Ideally you want to be able to get some tests during the cycle, since with Lantus the insulin usually starts to take effect about 2 hours after the shot, and will continue to drop the blood glucose levels until about 6 hours after insulin. Depends on the cat, but that’s a good starting point.

Did the vet mention anything about ketones in the urinalysis? You mentioned that June isn’t all that interested in eating, is that new? What did she eat at pm at shot time? I’d try and see about giving her some small snacks of food around +2 (2 hours after shot) and +4 (4 hours after shot) and see if you can get some tests with the human meter. We find here that feeding small amounts spread out during the day and evening works better than just feeding just 2 meals a day.

Sorry for all the questions, just trying to get a picture of things.
 
Christie & Maverick said:
Thanks for providing some more clarification. So if I understand correctly, June is still eating dry food? Were you able to get another blood glucose test before this evening’s shot? And did you give 2 units? Ideally you want to be able to get some tests during the cycle, since with Lantus the insulin usually starts to take effect about 2 hours after the shot, and will continue to drop the blood glucose levels until about 6 hours after insulin. Depends on the cat, but that’s a good starting point.

Did the vet mention anything about ketones in the urinalysis? You mentioned that June isn’t all that interested in eating, is that new? What did she eat at pm at shot time? I’d try and see about giving her some small snacks of food around +2 (2 hours after shot) and +4 (4 hours after shot) and see if you can get some tests with the human meter. We find here that feeding small amounts spread out during the day and evening works better than just feeding just 2 meals a day.

Sorry for all the questions, just trying to get a picture of things.
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I really appreciate the questions, thanks so much for responding.

As of yesterday morning, prior to beginning her insulin shots this morning, I have not been feeding june any dry food. Starting yesterday morning she had been on a strict wet food only diet, and i still let her graze throughout the day. The being less interested in her food aspect is new, I had noticed a few hours after her very first shot this morning, she seemed less interested in eating but would still drink heavily when encouraged.
Pm at shot time, I fed her some tiki cat chicken in consomme ( which she didnt have much of) and much rather preferred a gravy-style canned food, which she also enjoyed during her previous diet. I understand feeding her the diabetic prescribed food is optimal for now, but I did not want her to go hungry/ not be able to get her pm shot.
The vet didnt bring up ketones, I believe her test came back negative for those. I unfortunately was not able to get a sample before the pm shot, as my meter is presenting me with an e-2 error, which it didnt this morning. I have tried testing around 5 times with 5 different strips this evening but the error still comes up. I am monitoring June now, and she seems fine after her pm shot. She is now laying down and resting, I will be checking on her every 45 mins- to an hour. I forgot to mention earlier i did administer 2 units at pm after she had eaten some more of the gravy- style canned food. I’m hoping that my glucometer works by tomorrow morning so I can get a reading before her next am shot.

Once again, thanks so much for your reply.
 
Well…actually feeding a canned food that is less than 10% carb is beneficial, it actually doesn’t have to be a vet-prescribed food :). Glad to hear no ketones at diagnosis.

I believe the e-2 error is not enough blood. Some meters need quite a bit of a blood drop, which is problematic especially with newly diagnosed cats, since it takes a bit of time to get the ears used to bleeding. You want to aim for the sweet spot, outer edge of the ear, and perhaps try a larger gauge lancet, like a 28g or 29g. It would be good to get those BG tests before giving insulin, to be sure it is safe to do so. If it is not a matter of enough blood, I’d consider getting a new meter, or replace the battery in the current meter.

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Here is a good information page if you haven’t seen it yet: New? How You Can Help Us Help You
 

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I’d also add, hopefully when you get the meter working, if it were me, I’d be more comfortable starting out with 1u, since at the moment, you’ve been able to get a BG test this morning before insulin of 190, so I would err on the side of caution and start with a lower dose.
 
How much does June weigh? One of our dosing methods uses a weight based formula for starting dose. I do agree with Christie that you should lower the dose and 1 unit sounds like a good place to start.

If you read that post for new people that Christie linked, you'll see that we are very dependent on data here. The signature will contain answers to many of the questions already asked, and will be viewable by others easily - so we don't have to keep asking the same questions. The spreadsheet is key to us being able to help you with dosing. If setting up a spreadsheet is a challenge for you, we have people who can help you do it.
 
Wendy&Neko said:
How much does June weigh? One of our dosing methods uses a weight based formula for starting dose. I do agree with Christie that you should lower the dose and 1 unit sounds like a good place to start.

If you read that post for new people that Christie linked, you'll see that we are very dependent on data here. The signature will contain answers to many of the questions already asked, and will be viewable by others easily - so we don't have to keep asking the same questions. The spreadsheet is key to us being able to help you with dosing. If setting up a spreadsheet is a challenge for you, we have people who can help you do it.
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Hello there!

June weighs in at 9.19 pounds. I will be adjusting june’s dose to 1 unit as per yours and christie’s advice, and seeing how things go from there. I do apologize for the lack of information with the spreadsheets, I am a bit new to this site and have some trouble setting it up. I will make sure to do some more research and read the post Christie linked. Thank you everyone for the overwhelming support, I was having a bit of trouble managing as this is my first time taking care of a diabetic kitty :)
 
Christie & Maverick said:
I’d also add, hopefully when you get the meter working, if it were me, I’d be more comfortable starting out with 1u, since at the moment, you’ve been able to get a BG test this morning before insulin of 190, so I would err on the side of caution and start with a lower dose.
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Hello Christie,

Thank you so much for the attachment, I will be trying the edge of her ear tomorrow morning, and also adjusting her to one unit. I’m also glad to hear the food she is eating now is okay for her as she is still adjusting. I will also hopefully get a proper measurement of her BG tomorrow morning. I’ll be making sure to update my signature as to provide everyone with more information. I once again want to thank you for the advice and support, it has made managing my girl’s day a lot easier :)
 
leslibbbya said:
Hello there!

June weighs in at 9.19 pounds. I will be adjusting june’s dose to 1 unit as per yours and christie’s advice, and seeing how things go from there. I do apologize for the lack of information with the spreadsheets, I am a bit new to this site and have some trouble setting it up. I will make sure to do some more research and read the post Christie linked. Thank you everyone for the overwhelming support, I was having a bit of trouble managing as this is my first time taking care of a diabetic kitty :)
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It gets easier! I’m roughly two weeks ahead of the position you’re in now. The folks here offer great advice. You got this!
 
You’re welcome :). I use the FSL too, so the good news is that it only needs a small amount of blood. Have you tried the meter on yourself to see if it is functioning?
 
leslibbbya said:
I fed her some tiki cat chicken in consomme ( which she didnt have much of) and much rather preferred a gravy-style canned food
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Are you familiar with the food list? Not all canned food is low carb. Often times when it mentions gravy it tends to be higher in carbs. As Christine mentioned, ideally you want less than 10% carb. Most likely you will have to buy several small cans of pate type food until you find one she likes. I believe most of us also mix a little water into the food to make it a little more soupy but it's all trial and error.
 
leslibbbya said:
She had around 2oz of DM canned cat food,
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You've received some great advice. I will only add that when Cleo was first diagnosed and we followed only vet advice we used DM also. Cleo has no problem with the savory select but when we have her the DM pate, she has some diarrhea and waa withdrawn :(. It was strange because she was always able to eat just about anything without stomach upset her whole life until that food. Don't know if that helps any.
 
Heather82372 said:
Are you familiar with the food list? Not all canned food is low carb. Often times when it mentions gravy it tends to be higher in carbs. As Christine mentioned, ideally you want less than 10% carb. Most likely you will have to buy several small cans of pate type food until you find one she likes. I believe most of us also mix a little water into the food to make it a little more soupy but it's all trial and error.
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Hello! I’ll be taking a look at the food list and trying out different ones to see what she likes. Thankfully she is feeling more active and hungry this morning.

Thanks so much!
 
Angela & Cleo said:
You've received some great advice. I will only add that when Cleo was first diagnosed and we followed only vet advice we used DM also. Cleo has no problem with the savory select but when we have her the DM pate, she has some diarrhea and waa withdrawn :(. It was strange because she was always able to eat just about anything without stomach upset her whole life until that food. Don't know if that helps any.
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Hi Angela! I believe the same thing is happening with my kitty, I’ll be making sure to switch her food rotation.
Thanks so much for your advice! :)
 
Christie & Maverick said:
You’re welcome :). I use the FSL too, so the good news is that it only needs a small amount of blood. Have you tried the meter on yourself to see if it is functioning?
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Hi Christie,

I have tried the meter this morning on myself and it is giving me the same error, I will instead try to buy a new meter and pricking her ear according to the chart you provided. Thanks so much for your advice :)
 
Morning Leslie, well at least now we know it’s not your testing skills ;). It’s either the meter or the strips, although I’ve never heard of a full batch of tests strips that are wonky, usually you expect a few but in those cases, you just get a reading that doesn’t seem to jive with other readings. How is Miss June feeling? Diarrhea better today?
 
Christie & Maverick said:
Morning Leslie, well at least now we know it’s not your testing skills ;). It’s either the meter or the strips, although I’ve never heard of a full batch of tests strips that are wonky, usually you expect a few but in those cases, you just get a reading that doesn’t seem to jive with other readings. How is Miss June feeling? Diarrhea better today?
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Glad it wasn’t my testing doing the job wrong, I wasn’t too sure either about the strips not working but i’ll be trying a new reader soon. Seems June is feeling better this morning! She had quite a bit of an appetite and I administered one unit after breakfast as advised. I havent noticed any diarrhea so far, but i’ll be monitoring that as well. Hopefully I’ll have some good news to share later throughout the day!
 
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