New member, ? About starting dose

[Sherri & Moondance]

Sherri (human) and Moondance (cat) here .

Moondance is 15 y.o. with a history of IBD, dental problems, and anxiety issues. Last Fall he started drinking & peeing much more than usual. I really expected a Dx of diabetes at his annual exam in November, due to the PU/PD and longterm use of Prednisolone for IBD, but bloodwork was good (except high WBC). A few weeks later he was acting weird so I took him back in. His teeth were a mess and they had to pull them all (half in early Dec, half in mid-Jan). Somewhere in there he started refusing to walk up the steps or walking up in slow motion. I wrote it off as being due to pain, cone of shame, pain meds, etc. He did not heal well from the extractions and had to have a surgical repair done in Feb. In March we found a recurrence if infections in his mouth, so more antibiotics. Every time I took him in, I mentioned the PU/PD and strange behavior with the stairs.

Finally in April I realized he wasn’t just walking in slow motion, he was really struggling to get up the steps. Back to the vet in early May who ran bloodwork and found BG at 268. We weaned him off the Prednisolone and hoped that would due the trick. It didn’t, so here we are! His numbers have never been terribly high 230-380. Vet recommended Rx food (Purina DM canned), but Moondance has been on homemade raw for years. I did’t see how switching could possibly help.

So, now he gets methyl b12 for the (suspected) neuropathy. I’ve started testing at home (which is going pretty well) with a Relion meter, placed an order for Lantus from Mark’s Pharmacy in Canada, and ordered u100 syringes with 1/2 unit markings from Amazon. My goal is remission (of course), but I am a bit intimidated by the TR testing requirements and nervous about hypos. Luckily, I work from home so frequent monitoring shouldn’t be a problem. I picked up some MC and HC canned food and corn syrup today to be prepared for lows. Tomorrow, I will start feeding and testing according to the schedule I plan when we start the insulin.

Vet said starting dose of 1 unit 2x/day, which is in line with the recommended .25u/kg. Moondance weighs about 10.5 lbs. But since his BG has never been terribly high, should I start w/ .5 u instead?

This board is a godsend! I welcome any words of wisdom or advice.

 

[Ann & Sister]

Sherri (human) and Moondance (cat) here .

So, now he gets methyl b12 for the (suspected) neuropathy. I’ve started testing at home (which is going pretty well) with a Relion meter, placed an order for Lantus from Mark’s Pharmacy in Canada, and ordered u100 syringes with 1/2 unit markings from Amazon. My goal is remission (of course), but I am a bit intimidated by the TR testing requirements and nervous about hypos. Luckily, I work from home so frequent monitoring shouldn’t be a problem. I picked up some MC and HC canned food and corn syrup today to be prepared for lows. Tomorrow, I will start feeding and testing according to the schedule I plan when we start the insulin.
Vet said starting dose of 1 unit 2x/day, which is in line with the recommended .25u/kg. Moondance weighs about 10.5 lbs. But since his BG has never been terribly high, should I start w/ .5 u instead?
This board is a godsend! I welcome any words of wisdom or advice.

Wow, you are doing everything right. Have the right syringes, Lantus is on the way, you can do BG testing, already giving B12 Methyl. Good for you! I also agree that feeding a DM wet food when Moondance already eats raw makes little sense. The DM foods do not contain any magic ingredients that I am aware of. I was sort of oblivious when Sister was walking low to the ground like a bear. I think we always hope it is something temporary. My first diabetic kitty never got neuropathy and was in remission within 5-6 weeks on Lantus.
I think that as soon as you begin testing, you will see how the Lantus works on his BG and may be able to reduce the dose based on those numbers. Vets seem to start with 1 unit and I think it is considered safe. I can't do TR because Sister is still on dry food, but I understand how the method might intimidate you. That said, there is plenty of help on this MB.

 

[BellaBlue82]

Hi Sherri and Moondance!
I'm fairly new myself, and my buddy Nico actually had a severe reaction to Vetsulin that caused horrible bouncing and neuropathy. He wasn't walking on his back hocks but he would refuse to walk, if he had to go upstairs to pee he would take one step at a time (literally stop on each one.) He acted really weak, wouldn't jump, anything but lay. Once I changed his insulin, added methyl B12, he got a few weeks of stability and he started walking better. So far so good, fingers crossed with time Moondance starts to feel more like himself.
Bella and Nico

 

[Bron and Sheba (GA)]

Hi Sherry and Moondance and welcome!
Looks like you are pretty organised. Well done on hometesting and setting up the SS, signature and hypo kit!
Have a look at the two dosing methods which are at the top of the Lantus page in one of the yellow stickies. If you are concerned about TR, you can start off with the SLGS method and change over when you gain some confidence. When you decide, pop the decision into the signature please.
As you are feeding a low carb raw diet, I would start off with 0.5 units. Hold the dose for a week to let the depot fill and the do a curve.
If you are doing lots of testing during the cycles, a curve may not be necessary. After the week we can see if the dose needs to be increased.
One thing I would do now, because you have not started the insulin, is go out and buy a bottle of Ketostix from Walmart or a pharmacy and test the urine for ketones. Ketones can appear in diabetic cats, especially if they are not on insulin or are not getting enough insulin. Test daily until you start insulin and then a couple of times a week ongoing while the BGs are higher than normal.
Keep asking questions. We are happy to help.
Bron

 

[Sherri & Moondance]

I think we always hope it is something temporary.

This! My vet suggested insulin in May, but I was sure everything would turn around when we took him off the steroid. But she didn’t tell me the quicker we start treatment the better the chance of remission. Luckily I am a research junky, which is how I found my way here.

Once I changed his insulin, added methyl B12, he got a few weeks of stability and he started walking better. So far so good, fingers crossed with time Moondance starts to feel more like himself.

That is good to hear! Moondance has been taking the methyl B12 for about a month, but without controlling his sugar, it’s not doing much good.

One thing I would do now, because you have not started the insulin, is go out and buy a bottle of Ketostix from Walmart or a pharmacy and test the urine for ketones. Ketones can appear in diabetic cats, especially if they are not on insulin or are not getting enough insulin. Test daily until you start insulin and then a couple of times a week ongoing while the BGs are higher than normal.

Will do! He was tested for ketones at the vets (negative), but that was a few weeks ago. I’m not sure how to get a urine sample. With his hind leg weakness, he pretty much pees sitting down. Any tips?

 

[Bron and Sheba (GA)]

I’m not sure how to get a urine sample. With his hind leg weakness, he pretty much pees sitting down. Any tips?

You don’t need much urine.
Can you slide a ladle or large spoon under his butt?
Or partly bury a plastic container in his favourite spot in the LB?
Or out some plastic in the LB?
Some people get some marine stones, I’ve never used them.
Good luck!

 

[Sherri & Moondance]

You don’t need much urine.
Can you slide a ladle or large spoon under his butt?
Or partly bury a plastic container in his favourite spot in the LB?
Or out some plastic in the LB?
Some people get some marine stones, I’ve never used them.
Good luck!

Thanks! I’ll give it a go.

 

[Sienne and Gabby (GA)]

You are impressively organized!

You may want to post on the Lantus board or at the very least, get familiar with the sticky notes at the top of the board. You may also want to take a look at some of the Lantus user's spreadsheets.

 

[Sherri & Moondance]

You are impressively organized!

You may want to post on the Lantus board or at the very least, get familiar with the sticky notes at the top of the board. You may also want to take a look at some of the Lantus user's spreadsheets.

Only because of these forums! There is so much good information here. Having to wait for the insulin coming from Canada is giving me a chance to get all of my ducks in a row. I have been poking around on the Lantus board and peeking at other’s spreadsheets. Just following along as other members learn to deal with the highs and lows is both educational and reassuring.

Today’s testing was a bust. Lots of pokes, but never enough blood to test. I’m giving us both the day off tomorrow. Moondance has been a trooper, but his little ears are bruised. I will try again on Sunday by warming the ear first.