New here and still okay on diet only but will use Lantus if

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skybar22

skybar22

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Hi Lantus users,

I have not had to give insulin injections yet and maybe I will not have to but if I do I have a fresh bottle of Lantus in my frig and I just ordered 1/2 unit syringes for Morgaine. I'm type I and wear a pump but Lantus is my back up and I only have 1 unit syringes so I am just getting prepared. I have no fear of giving injections and have done it to myself since 1964.

I am just not sure when to give it and how long to wait to see if diet will do the job alone.

Morgaine was dx'd last Wed. 5/3. I immediately changed her diet to FF only and got rid of the Hill's r/d she had been on for a few years. Morgaine now weighs 15 pounds but she is a big cat. She lost 5 pounds on Hill's and developed Diabetes.

Last Mon. her BS was 292, taken by the vet and sent to a lab. Her urine was +3 with no keytones and a trace of protein. On Wed. I was given the dx, changed her food and on Friday morning her BS was 162 on my Precision Xtra meter. This meter also tests for keytones so I will buy some of those strips as I don't get keytones and am under excellent control. I am a fanatic so bear with me as I have multiple complications myself after 45 years and know how damaging this disease can be to organs. I am saddened and a little overwhelmed to have my dear kitty develop this insidious disease and I will do all i can to monitor her and care for her so she can be in a normal range and hopefully go into remission.

By Fri. evening Morgaine was at 155 and her next BS was 123, Sun afternoon. Yesterday, Mon. she was 125 3 hours after her feeding but today, 4 hours after her feeding she was 153. I just checked her again 2 hours after her last feeding and she was 129. I have been giving her amoxy and it has a little sucrose listed as the last ingredient. The only test I ran post dosing the amoxy was the one 4 hours after her dose and she was 153. I am wondering if it is the amoxy raising her a bit.

I realize these numbers are very good and we are less than a week out from her diet change. My question to all you Lantus users is when would you start to dose a cat with Lantus instead of doing only diet? I am going to stop the amoxy as there was no indication of any infection and she has been on it for over a week.

I am pretty anal about all of this as I deal with it myself. Advice, support, ideas are all welcome. I am hoping for remission!
 
hi, it looks like you gave more info in this post, but i wanted to let you know i replied last night to your post in health
 
Hi welcome.
It looks like you have everything covered and are already very knowledgeable about diabetes.
How was Morgaine diagnosed? It sounds like he may have had a fructosomine test.
The diet seems to really have helped the numbers.

I am not sure about starting Lantus yet. Since the numbers seem to be pretty good you may want to wait a little bit longer but I will let some other experienced people chime in to see what they think.
 
Welcome!
it looks like you have a good handle on the situation and need just a bit more info to sort things out.
I am not familiar with how to handle newly diagnosed who also seem to be improving form diet change. I do know that several kitties do NOT need insulin at all or maybe just for a very short time, because they become diet controlled!

So often, people don't look to the ingredients of their kittie's foods or believe the mfgr's misrepresentations of their products. It's tough when even the vets' offices are pushing poor food choices and even sell dry foods! Ah well.

The numbers changing from 292 down to around 120 sure looks nice; the experienced people around here will be able to tell you so much more about these numbers and what would be good for you to do. I don't know much but my first thoughts were that the diet changes are making a big improvement so give it time to see if just diet alone will work! Also, I was not moved too much by that 292 as numbers taken at the vet office are often higher cuz what kitty likes being at the vets! The numbers you are getting in the comfort of Morgaine's own surroundings are going to be more believable to me.

But that is just my thoughts and I don't know near enough, so hang around for the smart guys to come along. It's good that you have the 1/2unit markings because you could even start at .5u or even .25u if Morgaine needs only a wee spot of insulin.

I hope you and Morgaine have a great day and get some useful info today from the others here.
 
Wow her numbers look super without insulin! The food change is certainly helping. Did I read you giving antibiotics? I don't know for sure which ones in particular but some medications can raise BG. As for stopping it early I don't know if that's a good idea, the rule is to always take an antibiotic as prescribed and as long as prescribed. Stopping early can lead to a violent return of of an infection and increase the chances of antibiotic resistance. A lack of signs and symptoms for an infection while taking an antibiotic is typical and by no means proves thier isn't one. The high BG could have been caused by an infection and the fact that it is returning to normal supports that the antibiotic may have cleared up the infection. I don't like throwing antibiotics at every sniffle or giving them without any solid reason, but once you have begun with one it is always wise to see it through.

The fact that Morgaine is able to lower her BG without insulin (especially 3 hours after eating) is a clear sign that she does have a working pancreas. You have helped protect it and allowed it to heal by changing her food to a lower carb "lower stress" diet, and treating a possible infection may also have contributed to the improvement. As you are probabably aware another helpful move would be to feed small amounts more often so as to keep the pancreas busy but not overwehlmed with a large amount of glucose all at once to deal with, this will also keep the numbers from swinging as much.

So I don't have type it all again I will go look for what I wrote to someone a few days ago about a working pancreas and copy it here later.

With the numbers you are seeing right now (mostly under 150) there is little or no organ damage happening and you definately can afford (no risk) to wait a little bit before deciding to use insulin. Should the need arise then likely it will be a small dose (.5U or less) and likely a short time.

Keep testing at periodic times (before meals, directly after, in between) mix it up and keep track, also make a note about when, what, and how much was eaten. You know all about that I'm sure, you are looking for patterns etc.
 
Welcome to Lantus Land!

I just have a question for you -- you said you ordered "half unit" syringes. Just want to be sure you are using the right specifications. You can read about it here: viewtopic.php?f=9&t=151: The U100 syringes, 3/10 Ml, 30 gauge.

Good luck -- I hope the diet does it for your kitty!
 
Thanks you all for your comments and advice.

I will finish the amoxy and maybe her numbers will go down a bit more. She had no sign of infection in her urine or blood work but because he thought she might have a UTI he put her on amoxy and he gave her a sm. amount of steroid. I KNOW how bad that is for diabetes and I actually need to be on Lantus and my pump if I get any steroids. That is basically double duty for humans. She will not be getting anymore steroids. He wanted to calm down her bladder.

Morgaine was not taken to the vet so her stress level was not as high. I use a home vet. She did not have anything but a straight BS and CBC. I was unawate of any other tests to determine diabetes in cats and the vet didn't mention it. He also said NPH was the insulin he used and later said he read some things about glargine but I got the impression he was not up to date at all. I did consult with Dr. Lisa by phone twice and she guided me here and gave me some basic information after looking at the lab work.

This is a vet I never used before and because I am homebound and no longer drive I have to rely on home vets which are limited to just a few. I am so grateful to this board and Dr. Lisa.

I did order the 3/10 syringes with 1/2 unit at 30g. I have plenty of 1/2cc syringes but they are not marked for 1/2 units. Hoping not to need to shoot insulin. With these numbers I think I may be okay for another week to see what happens after the amoxy is out of her system.

At what number would any of you start using a tiny bit of Lantus? I have read 150 and above but others are saying above 120.
 
I'm sorry I didn't think to ask this before. The BG numbers you've been getting -- did the vet obtain them using a veterinary meter, or did you obtain them using a human meter? There is a variation of about 30 points between the meters, with the veterinary meter being higher. That 150 would be equivalent to a human meter's reading -- approximately -- of 120 points, which is a good score.

The steroids do complicate things, so it would be great if you could hometest and keep track of your kitty's BG. There are others on the board who have dealt with this personally. You might try putting "steroids and newly diagnosed kitty" in your subject header next time.

It's wonderful that you have a home-visiting vet, but that person might easily not have in-depth knowledge of feline diabetes. People here have so much knowledge, having treated so many kitties. I know you'll get the input you need!
 
I'm sorry I didn't think to ask this before. The BG numbers you've been getting -- did the vet obtain them using a veterinary meter, or did you obtain them using a human meter? There is a variation of about 30 points between the meters, with the veterinary meter being higher. That 150 would be equivalent to a human meter's reading -- approximately -- of 120 points, which is a good score.
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Those are home tested numbers. No fear here with doing that. I test myself 8 times a day or more. Kitty seems okay with it as long as she is in her kitty tower and curled up. She purrs when I put the warm rice sock on her ear and she loves a little protein treat after we test. It is almost as if she knows I need to do this and she has seen me do it to myself so often. I wonder what they "know"?

Question:If the vets numbers are 30% higher does that mean the meter he uses is more accurate or that the cat is stressed? My vet never used his meter on her but he did say he had a meter calibrated for cats. I know that ALL meters have a variance and some are greater than others. In checking with Abbott labs about the Precision Xtra, they told me the variance was about 10% unless we were in the hi or lo range. But I still don't know what that means for a cat. Can anyone clarify?
 
I'm glad Hillary stepped into the conversation -- she knows her stuff! :-D

It's just a matter of calibration. But some vets freak out when they see the numbers obtained using human meters; they think the cat is too low, when it's really just what's normal for the meter.
 
Kathy and Kitty said:
I'm glad Hillary stepped into the conversation -- she knows her stuff! :-D

It's just a matter of calibration. But some vets freak out when they see the numbers obtained using human meters; they think the cat is too low, when it's really just what's normal for the meter.
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I still don't understand. If my meter reads 150 does that mean the vet's meter will read 180 and that she is really higher than I think or is it just for the lower range? If so, then should we be considering some insulin if things don't go down a bit more? Sorry to be so dense but I just can't seem to get this one. OR...is Morgaine okay to be in the 120-180 range on diet alone for a while longer. That table was helpful but I am seeing some great numbers on your charts and I want to try for remission. Is there a consensus here about safe range befoe giving insulin? I'm convinced that the vet I am using doesn't know the current research on treatment.
 
I think (maybe?) this will help to explain or at least illustrate the difference in measurement. The Rand Protocol gives a set of dosing guidelines based on the use of a human meter or the Abbott AlphaTrack that is calibrated for cats. There's an explanation of the difference in meter readings.

I'm not a big proponent of giving ABs if there's not a good clinical reason for the med. I suspect that from what I've seen Dr. Lisa write, she would have encouraged a cytocentesis (needle inserted into the bladder for a sterile draw of urine) and a Culture & Sensitivity (C & S) to diagnose a UTI so the appropriate antibiotic could be given. You might want to wait until the amoxy is done before deciding whether to start Lantus. Some cats are exceptionally sensitive to carbs and even a tiny bit may be elevating Morgaine's BG levels above 12,0 which is what we use (as a rule of thumb) as the top of the normal BG range.
 
skybar22 said:
I still don't understand. If my meter reads 150 does that mean the vet's meter will read 180 and that she is really higher than I think or is it just for the lower range? If so, then should we be considering some insulin if things don't go down a bit more? Sorry to be so dense but I just can't seem to get this one. OR...is Morgaine okay to be in the 120-180 range on diet alone for a while longer. That table was helpful but I am seeing some great numbers on your charts and I want to try for remission. Is there a consensus here about safe range befoe giving insulin? I'm convinced that the vet I am using doesn't know the current research on treatment.
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a human meter may read 30%-40% lower than one calibrated for feline use in the low end of the range.
120 -180 are diabetic numbers, but you've already seen quite an improvement by changing diet alone. in your shoes, i would probably hold off on insulin for the moment. a diet change alone has worked for more than one kitty! :-D

unfortunately, the chart hillary posted contains guidelines which are not followed by those of us using tight regulation as a means to remission. we do aim for numbers in the 50 - 120 range. "if" insulin is started, eventually you'll be shooting insulin on numbers in the 50 - 100 range. however, we do not encourage this practice until enough data has been collected to support your decisions.
 
Sienne and Gabby said:
I think (maybe?) this will help to explain or at least illustrate the difference in measurement. The Rand Protocol gives a set of dosing guidelines based on the use of a human meter or the Abbott AlphaTrack that is calibrated for cats. There's an explanation of the difference in meter readings.

I'm not a big proponent of giving ABs if there's not a good clinical reason for the med. I suspect that from what I've seen Dr. Lisa write, she would have encouraged a cytocentesis (needle inserted into the bladder for a sterile draw of urine) and a Culture & Sensitivity (C & S) to diagnose a UTI so the appropriate antibiotic could be given. You might want to wait until the amoxy is done before deciding whether to start Lantus. Some cats are exceptionally sensitive to carbs and even a tiny bit may be elevating Morgaine's BG levels above 12,0 which is what we use (as a rule of thumb) as the top of the normal BG range.
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He did a sterile draw of her urine and Dr. Lisa had the results and said the urine was clean. She did advise exactly what you suggested she would but it was too late. He had already given her a shot of AB and a bit of steroids so there was no way to check for sensitivity at that point. I am going to follow her advice and finish the 10 days and not continue for 20. That was her advice after we discussed it all. He gave her enough for 20 days with NO evidience of any infection whatsoever, just based on her polyuria which is associated with diabetes, as we know. He doubted she had Diabetes and thenhe got the labs back and diagnosed it!


Jill and Alex, thank you for your clarity. I am going to keep going on diet, check her as often as I can get her to allow me to without too much stress and see where we go once the amoxy is out of her system.

If anyone disagrees please advise with reasons why you might do it differently. I am still waiting for the 1/2 unit syringes which I had to order online. Morgaine seems very content and happy right now with no symptoms.

I am so grateful to all of you and I think you know how much it means to have a support group like this to help deal with this whole thing. My heart says thanks!!!

Rosalie and Morgaine
 
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