New FD pet owner! Please help! Switched to Lantus

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BigHeadTodd

BigHeadTodd

Member Since 2013
Thank you for offering any advice in advance. After many hours of research I seem to be more educated on FD than the two vets that I have been working with so I feel much more comfortable reaching out and receiving advice from fellow FD cat owners. Was sent home $1500 later with Big Head two nights ago at 9pm he was given his first shot of Humulin N at 8pm 2 units 480. We did a curve yesterday feed and injected 2U of Humulin N 8am and 8pm. Still range +2=470 +8=388 +12=486. Today vet upped Humulin to 3units Big head was stressed over getting stuck this morning and was 508. I am picking up Lantus today based on my research. Question 1: Can I give as soon as the 8pm dose? Question 2: Do I still give 3 units? or now that it is Lantus do I start over again with a smaller dosage? And do I have to redo the curve all over again?
 
I'm not an expert at dosing - things have changed a lot in the five years since I've had a diabetic cat! But I do know that you need to start over with Lantus. It works totally different from N. I think you should start at .5 or 1 unit, but I hope others with more experience will be here soon.
 
Thank you for caring enough to respond. I will start over... poor kitty will not be happy about this one bit! But I am determined to do right by him and give him the proper treatment he deserves. Do you have any idea when I should feed Big Head? Before, during or after the Lantus injection?
 
hi
I'm not a dosing expert either but yes, start over at .5 or 1u I think the Humulin is short-lived so you should be ok to start lantus tonight - I'll try to get someone over to confirm and give better dosing advice.

Try to test, feed & shoot at the same time - I know it sounds like you need 6 pair of hands but its not quite that bad :-D
Get everything ready - the testing stuff, the syringe filled and the food.
Test
Put food down and while kitty is chowing down
Shoot.

Lantus usually kicks in 2-3 hours after shot so if kitty doesn't eat much with the shot, you can always give offer the food again an hour later.
My cat used to nibble a bit at shot time and then eat more at +1.

Welcome to the boards!
 
Was the curve at the vets and have you started home testing? Very important for Big Head's safety.

Also, what food is he on?
 
The curve was done here at home every two hours. Big Head also has HIV so I have been double whammied with bad news and big bills this week. He is eating and drinking very regular Purina DM half can 8am and half can 8pm... he acted famished today so I gave him a small spoonful with water around 2pm. He weighs 11 lbs. ANY/ALL recommendations for feeding amounts and time greatly appreciated!!!
 
The initial dose of Lantus can be calculated on a weight based formula: initial dose = .25 x ideal weight in kilograms. If 11 lbs is Big Head's ideal weight, then your starting dose would be approximately 1.0u.

You might want to take a look at this list of canned food choices that is on Lisa Pierson's website on feline nutrition. While DM is ostensibly formulated for diabetic cats, it is composed of primarily animal by-products. It's also expensive. There are lots of other choices that are lower in carbs and far less expensive. You could be feeding a premium, human grade food (e.g., Wellness) for less than what you're paying for DM. We recommend feeding less than 10% carbs although most of us feed in 5% carb range. The list I linked has the carb counts for most of the foods that are available.

Dr. Lisa's site also suggests an approximate amount to feed your cat based on calories.
Required calories per day = [13.6 X optimal lean body weight in pounds] + 7​
Calories are also listed in the table I linked. Most of us feed frequent, small meals -- anywhere from 2 - 4 times every 12 hours. It's best to feed during the first half of the 12-hour cycle since this is when insulin is most effective. If you feed late in the cycle, there's less insulin available to offset the effect of the food. Also, you don't want to feed 2 hours prior to your shot time since the food may inflate your pre-shot number.

You may also want to set up a spreadsheet to keep track of your test data. Having the information all in one place will let you see trends and will also allow us to help you more effectively.

And finally, you may want to read the starred, sticky notes at the top of the Lantus board. This information will help you to understand Lantus and it's dosing.
  • Tight Regulation Protocol: This sticky contains the dosing protocol that we use here. There are also links to the more formal version -- the “Tilly” Protocol developed by the counterpart of this group in Germany, which was also published by Kirsten Roomp & Jacqui Rand, DVM in one of the top vet journals.
  • New to the Group: Everything you wanted to know about this forum and more. Info on our slang, FAQs, links to sites on feline nutrition and to food charts containing carb counts, how to do a curve and the components to look for, important aspects of diabetes such as ketones, DKA, and neuropathy, and most important, info on hypoglycemia.
  • Handling Lantus: how to get the maximum use from your insulin and what to not do with it!
  • Lantus depot: This is an important concept for understanding how Lantus works.
  • Lantus & Levemir: Shooting & Handling Low Numbers: What data you need in order to be able to work toward remission or tight regulation as well as information if you have a low pre-shot number or a drop into low numbers during the cycle.
 
I cross posted with Sienne ;-) but here's what I wrote:

I'm glad you're home testing. That is a big start and will help you to keep your cat safe. With Lantus we recommend that besides testing before every shot, that you also test somewhere around his nadir (lowest point in his cycle) as often as you can. Lantus doses are decided by the lowest numbers in the cycle, and those numbers usually happen around 5 or 6 hours after the dose is given.

Please read the Stickys found at the top of the page in the Lantus forum. Copy and print out the hypo instructions and tape them to your refrigerator or to the inside of the cabinet where you keep your karo syrup, honey, and a small supply of high carb cat food.

The onset of Lantus is around +2 (2 hours after the shot is given). We recommend that you do not feed from 2 hours before shot time up until shot time, so that the Pre Shot test is not influenced by a rise in numbers from the food spike.
At shot time, you would want to test his numbers, and if the numbers are high enough, then give the insulin and feed him. You can also give him some more food in mini meals up until about +8 or when you see that the affect of the insulin is starting to wain or wear off and he is starting to rise. Eventually, you will probably find that feeding him at shot time, and a couple mini meals before nadir, each cycle, is all he needs.

The Purina DM is not the best food. You can get a lot better food from the grocery store for less money and better quality ingredients. Check out this chart http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf and look for foods and flavors that are below 10% carbs.

Right now, I'm not sure what to tell you about dosing. Lets see what others have to say. I am thinking you may want to start over again at 1 unit of Lantus and see how it goes, by testing as frequently as you can.
Please start a spreadsheet as soon as you get a chance. Someone will provide you with the link on how to set one up.
Again, I defer to other's opinions on the starting dose of Lantus for your cat.

Sorry, for rambling a little, but I am an early morning person and it's getting late for me, now and am tired.


Ask questions about anything you don't understand. Keep posting and let us know how Big Head is doing, we're here to help you help your cat.
 
And I cross posted with Dyana - guess everyone is eager to help ;-)

Its a lot to take in but the fact that you are already home testing and Big Head (love the name :-D ) is already on wet food (although, I'd go for one of the brands Sienne listed) are great steps forward.

Again, frequent meals are best - keeping in mind test and shot times - but most newly diagnosed cats are famished and need extra food to put weight back on.
Mine has gone from 9.5lb to 12lb in 3.5 mths - now I have to watch she doesn't put too much on!
 
Thanks guys for all of your support... Big Head Todd is very upset with us :evil: and shredded both my and my boyfriend's arms trying to get a test reading... he barely let me administer the 1unit of Lantus. Up until tonight I was able to administer while he eats but he is just too upset and wants nothing to do with any of this... I think II was able to inject the 1u but have no idea what his level is... this morning he was at 508 and don't doubt with all the stress tonight that he is just as elevated... we have hit a wall and never thought I would come to tears over the stress but I have been consumed with FD for the past 3 days and feel defeated by all of the misdirection we originally received from our vet... is it possible to just administer the 1u of lantus twice a day for a couple of days in order to let Big Head calm down? and then try to do another curve?! I honestly think it is our fault because the vet did not give us the proper instructions to test the blood and we have stuck him way too many times for him to tolerate us near his ears... ugh :cry: I will keep reading to see how we can all get through this without bloodshed and tears.

thank you all again for your support... I am so mad at my vet for all of the unnecessary costs and mistreatment to our Mr. Bigs
 
There are a couple of things to consider. First and foremost, ALWAYS give a treat when you test. Even if the test is unsuccessful, your kitty gets a treat. If you need suggestions for low carb treats let us know. (Freeze dried chicken is a big favorite in these parts!) Bring your kitty to his testing spot and just give him a treat and tell him what a good boy he is. Let him make the association between the test spot and something good, not just with being poked.

If his ears are bleeding relatively easily, use a thinner lancet. Once a cat's ears get used to being poked, a 30 or 31 gauge lancet will be less painful.

If you need to wrap Big Head Todd in a towel to make him a kitty burrito until he adjusts to the testing, that may be the way to go. It will save your arms.
 
I'm a newbie here also. Just started posting maybe a week or two ago. I place a thick bath towel, folded in half, on top of my Rocky (yes, he's a fighter). If he starts trying to get a way, I just cover up his front paws and only his head is out. I'm also straddled him but not putting any weight on him. The majority of the time just the towel will keep him still. I also wear long thick sleeves every time I test him and a glove on my left hand. The first time or two I tried to test him, he turned on his back and wrapped front legs and back legs around my left arm and starting kicking me with his back legs, like upper cuts, and was gently biting at my left hand. So since I'm new, I'm going with better safe than sorry for my arms. You can search my posts and see all the frustration that I went through. One day I was in tears because I couldn't draw blood on the tests.
 
We've all been upset and frustrated at first - I remember thinking I could never do it and now, its easy.

Things will get better, just keep plugging away :YMHUG:
 
Good morning, we wrapped Bigs into a blanket and tested his back paw this morning... he is still reading 508!!!! UGH!!!! Was hoping the 1u of the Lantus last night would help lower it somewhat... I will test this afternoon and again this evening... HEADING BACK TO THE VET TO RETURN THE $210 glucose meter they insisted I had to buy along with the DM food that no one on this site seems to have anything positive to share. I will put him back on the Friskies Pate and wet food only. He does seem hungry even after he eats. He is 11lbs... Is a half a can in the morning and the other half in the evening enough?!
 
That's probably not enough food. I'd use this formula to calculate how many calories per day your kitty needs.
Required calories per day = [13.6 X optimal lean body weight in pounds] + 70​

So, if your cat's optimal weight is 11 lbs, he should be getting approximately 220 calories per day.
 
Are you going to pick up a different meter? The relion brand at Walmart is a good price and is failry accurate and the micro doesn't need much blood..
 
Bought the ReliOn Prime from Walmart $14 and 50 test strips for $10!!! That's the only good news... Bigs 8pm reading was the highest ever 548 :sad: I increased his Lantus to 2u... I hope that was the right thing to do... This is the highest reading ever :cry:
 
Thanks Wendy! I will get the +2 and get back to you! I also have been keeping a log. We didn't do a new curve today because he was just too upset with us sticking him so many times... we were not properly sticking him and I am so grateful for this site and the help and instructions that you have all offered! We struggled but were able to get readings from his back paw. Will do a +2... hope something gives soon. He is very social and looks great and is eating great... he acts hungry... very hungry...

AHHH!!! Have to share something very important that may be due to this reading... I gave him a small spoonful of friskies as a snack at 4pm he was acting so ravished!!! I was hoping to try to get him on a 4x cycle as someone suggested Main meals 8am and 8pm with a afternoon and late time snack. Is that wrong? Is there a preferred feeding cycle that I should be following as a new FD?
 
Can you do a spreadsheet and plug in your log so we can see? I am not sure what caused the reading - could be the new meter, could be bouncing from a low earlier in the day.. for example he could have gone morning 508, midday 100, and then reacted to that low and bounced to 548. ( i can explain this process later)

So thats another reason to get more tests in, we need to get a better idea of what he is doing. I recommend to people to always test before every shot and then regularly in the middle of the day (5-7hours from the shot) and just before bed. Occasional spot checks every few days at different times depending on whats going on with his BG. Curves arent really necessary that way.

ECID.. some people feed twice a day, some free feed (like me), some people feed every few hours... Although we recommend no food for two hours before the shot to ensure it doesnt spike the preshot test values. And then you test, shoot and feed.
 
Working on it now!!! trying to figure out the spreadsheet! Will hopefully have it to you shortly. Thank you for helping!

-Jenny and Big Head
 
Sometimes you need to save it or convert it to a google sheet. Then it allows you to publish it to the web and use that link. Then you would update the google sheet instead..
 
Hope this works... the url in my signature should be Big's SS... keeping fingers crossed and getting ready to get +2 reading
 
can not get a read... both my boyfriend and I are shaking we tried sticking Big Head's back foot pad 5 different times and not enough blood... this process is so upsetting for us all... all of my cats are freaked out with this poor guys screams of anger as we wrap him up in a blanket.... we can't do this anymore tonight :{

Thanks for trying to help.
 
Give the poor boy a treat (and big head too lol). Make sure you apply some neosporin on it. You can try again tomorrow morning, he probably won't drop too low overnight since he is so high already. Also you may want to give the ears another try... Many people have problems at first but you can overcome it.

Have you been testing for ketones?
 
Just wanted to reach out and let all of our new friends know that Bigs is doing well at the moment. He has been diagnosed with congenital heart failure and in the emergency room 3 times over the past two weeks so his diabetes has become the secondary focus at the moment. I am increasing his Lantus to 3 units tonight his BG is still in the 500's... once we get a few days on the increased units I will begin building a new curve.

Thank you all for your advice and caring efforts to help Bigs.

I am keeping updates on his BG sheet and the url is in our signature. So please do not think that we have forgotten you all. We just have to get his heart regulated first and then focus on the BG. Good news is that he is showing no signs of Ketones so at least we have that going for us while we take the time to get him strong enough to work on getting him OTJ!!! I just can't wait for the day to enter a number that is in the green on our chart!!

Hugs out to all!!!

-Jen and BIgs
 
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