Hi Barnes,
When I saw you were in UK, I worried that you were stuck on Caninsulin because I know of a couple others who have had a horrible time convincing their vet to let them use Lantus. What a relief.
So, I have not read any of the post postings, so I'll just go with what I see and may repeat others.
Lantus likes consistency so you need to stick to one dose and when you make a change, give the change a good 5 or 6 shots to settle and see if it's working or not...
For testing, I see only half the story on the ss; there are no numbers from tests after the pm shot, so you don't know what's going on at night which makes it tough to understand what you see during the day. There are 3 tests that are the most important every day... the test before the am shot, before the pm shot, and before bedtime. You really don't need to run over every day to test at +6 because you are not sure what it's telling you.
You would be better to test 3 times a day, and then on a weekend day or someday you are free, to test the cat every 2 hours between two shots. Doing a curve will tell you a great deal.
One of my cats had nadir at +5 and the other was around +10 or later, so see if you can get another test here and there, at diff times.
Pancreatitis can be fatal. My cat is currently in the hospital with an extreme bout, with his fPLI test result of 50 and many other health levels affected at the same time.
The usual approach is to give pain meds, Buprenorphine is the best, plus something for upset stomach like Pepcid AC or something like famotidine, and then the 3rd need is to be giving subQ fluids. The fluids are very important, for flushing the system, and pain meds need to be given because it's terribly painful and that's per humans who have suffered from ptitis.
Cats are very clever and hide their pain, so be very sure that your cat IS very well hydrated and eating; if you allow less eating with ptitis, you have to watch for hepatic lipidosis.
What is your concern of a tumor? Are you suspecting acromegaly? If you are, there is a test for it; I think the value positive for you is greater than 1000. Here in North America the test for IGF-1 states 12-92 is negative and over 92 positive.
I hope the others have already addressed the food issue..... feeding any dry food usually results in cats needing much more insulin and when they switch to a low carb wet food, usually a pate type, the need for insulin lowers.
If you can confirm the diet is a wet food, that's good. If not, you will need to test a bit more and switch foods,dropping the dose to go with the lower numbers.
Again, nadir is NOT always at +6; and nadir does not always fall at the same place/time. That's why a curve is the way to go to locate the nadir region.
If anyone is pushing you to test 7+ times a day, ignore them. Maybe if you were at home with the cat, all day, every day, and had nothing to do except test the cat, well OK, but who is in that position? Not many people!
People can usually get the am test and then are away during the day, test before the pm shot, and then maybe 1 or 2 tests in the evening. Then, on the weekend or a day off, they can give the am shot and then test every couple hours during that day until the pm shot, and that gives you lots of data.
Please post where you feel most comfortable and don't let people be too demanding ,,,, do what you can.
Can you explain the need for the steroid for pancreatitis? You would do better to be giving the cat B12 shots weekly at home which will deal with the pancreas inflammation.... it helped both of my cats, and one had pancreatitis flares often before the B12 shots.
Are you giving fluids at home? If not, have the vet show you and you can give them at home. Also, why do you need a biopsy?
Sure you can get an Xray done, and also the ultrasound to confirm the pancreatitis andlook for a tumor, but why the biopsy ... sounds like a money grabbing overkill action which isn't justified. Anytime they go into the body, there is risk, so I'd want to know why before saying OK.
Ask lots more questions.... why the steroids, why the biopsy - on what and also what tumor, what about Xray, what about B12, quiz them and get explanations.
Gayle
