New member looking for advice

Pattheteacher25

Pattheteacher25

Member
Hello everyone. My cat Garcia was diagnosed with diabetes last December . He was put on Lantus by his vet that admitted in January he didn’t know so much about this disease to treat him . I value his honesty and I am still seeing him as he is willing to learn and has been very kind to Garcia and my dog too. Said that, Garcia was in remission for some time in April until he got an ear infection . His numbers are very high and I haven’t been able to lower them . Any advice is welcomed .
 

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Hi Patricia

Dropping his dose back to 1u is what we call doing a “rebound check”. Based on the other SS you had, that is hallmark advice from a FB group who still hasn’t learned rebound checks never work and put kitty at risk with high numbers.

But with Lantus, it is not a good idea to change the dose as much as you have been. Lantus is a depot insulin so it takes time to fill the depot and have it start working better.

Were you doing any specific method of regulation like Tight Regulation or Start Low Go Slow? My suggestion is to do TR and we should consider increasing his dose by 0.5u after every four cycles for a few cycles, then give him a break, then do it again until we start seeing better BGs.
 
I have been trying to read all the information . I have been testing him pre shot or sometimes looking for nadir numbers . I have never tested ketones . He has been on 1 dose of Lantus fur more than 7 days so I increased it to 1,50. Should I start testing him on Ketones ? He is on a home cooked diet prescribed by a nutritionist vet. He can’t tolerate raw food .
 
Pattheteacher25 said:
I have been trying to read all the information . I have been testing him pre shot or sometimes looking for nadir numbers . I have never tested ketones . He has been on 1 dose of Lantus fur more than 7 days so I increased it to 1,50. Should I start testing him on Ketones ? He is on a home cooked diet prescribed by a nutritionist vet. He can’t tolerate raw food .
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You should always check the preshot (PS) and at least 2-3 other times during the cycle. Of course, at night when he’s high, if you just get the PS, +2, and before bed, that should be ok when he’s high.

Yes, you should be checking ketones every day while he is this high.

It looks like you shot 1.25u this morning and 1.5u this evening. I would continue with the 1.5u for three more cycles unless he drops below 50 which I doubt he will do. After a total of four cycles at 1.5u, we should reassess and talk about the next plan. I’m almost certain you will need to increase to 2u at that time but let’s see.

Perhaps if you can tag me after three more cycles, just to be sure I remember to come back here. You would just type in @Marje and Gracie and that will tag me to check in with you.

How does that sound? In the meantime, please keep reading and ask any questions you have.
 
A cycle is 12-hours so there is an AM and a PM cycle every day.

You can either get a ketone meter or use urine test strips. Both are good it's just a matter of your preference.
 
Pattheteacher25 said:
@Marje and Gracie
https://docs.google.com/spreadsheet...5nqgugPq1wqx8xeENXA9Dltkuis/edit?usp=drivesdk
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Patricia….you don’t need to link the spreadsheet in a post. It’s already in your signature.

I’d suggest increasing to 2u every 12 hours for four cycles. It’s best if you can try and always get a +2 both cycles. During the day, any other midcycle test in addition to the +2 is helpful. In the evenings, a +2 and a before bed also works.

Thanks for tagging me as I’m following several members so it’s helpful to know when the four cycles is done. Tagging me again after the fourth dose, or any time you have a question, is appreciated and we will see where he is.
 
@Marje and Gracie sorry to bother you, his numbers are horrible . He has had dhiarrea since yesterday , talked to his vet . García is active ( in his own way , never been an active boy) eating and sociable . He tends to hid if he is not feeling well and that is not happening
 
Pattheteacher25 said:
@Marje and Gracie sorry to bother you, his numbers are horrible . He has had dhiarrea since yesterday , talked to his vet . García is active ( in his own way , never been an active boy) eating and sociable . He tends to hid if he is not feeling well and that is not happening
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I was looking in Friday and his SS wasn’t updated. I didn’t want you to do more than 4 cycles at 2u. Also…if we are going to fast track him, you must have data. We can’t do it without knowing how low he is going. I’ve seen cats, including my own, who have gone from 300 to 30 to 300 in one cycle and without the mid-cycle data, it just looks like the cat is high. Our philosophy here is you always need to k ie how low the current dose is taking a kitty before you increase.

If you can get some tests in today, we can look at an increase for tonight.

If you were in the US, I could give you options for how to treat the diarrhea but I don’t know what you can get there. Have you made any diet changes or could he have gotten into anything?

And it’s absolutely no bother. It’s why we are here .☺️
 
No changes in his diet . I gave him some catnip because he was munching my plants in the balcony . Couldn’t upload before . I was testing as much as I could , crazy load of work . I’ll test him more frequently today . Thanks again
 
Pattheteacher25 said:
No changes in his diet . I gave him some catnip because he was munching my plants in the balcony . Couldn’t upload before . I was testing as much as I could , crazy load of work . I’ll test him more frequently today . Thanks again
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If he doesn’t come down any today, I’d shoot 2.5u tonight. Since you gave him a break by shooting 2u six times, let’s just do 2.5u four cycles and check back in. Please tag me at the beginning of his fourth cycle on 2.5u.

thank you. Paws crossed for some better BGs. I hope the diarrhea gets resolved. If he’s not on a good probiotic, he should be. If you can get hold of Saccharomyces boulardi with MOS there, it’s a good one for diarrhea. You can give 1/4 capsule every two hours while he has diarrhea. When it stops, you can give him 1/16 tsp twice a day for maintenance.
 
Pattheteacher25 said:
4th cycle @Marje and Gracie
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Thank you. How did the vet visit go? Does he still have diarrhea?

While his BG looks high and flat, without more data, I can’t recommend we fast-track him to a better dose. Fast-tracking is an aggressive tool and it requires we absolutely have some idea of what his BG is doing during the cycles. Without that data, I am not willing to be unsafe with him by pushing the increases.

These high numbers put him at risk for DKA which can be deadly very quickly so I hope you are testing his urine ketones every day. He is also at risk for glucose toxicity which can result, among other things, in him needing higher doses of insulin to break through.

Fast-tracking helps us get him to better numbers faster. But as I’ve said before, you have to have data and if you aren’t willing to test him as I’ve recommended before, especially at night, I won’t take any risks that he might be dropping somewhere that we can’t see.

It is your decision how you want to proceed and I don’t mean to sound blunt. But if you want to get him into better numbers faster, you absolutely must get data every cycle. During the day, the pre shot, a +2, and any other test close to nadir helps. At night, a pre shot, a +2, and a before bed. It’s essential.

Thank you and please let me know if you have questions.
 
Pattheteacher25 said:
Hi, the vet gave me a probiotic. He thinks the diarrhea was because he was eating the catnip.
So I should test him 6 times a day ? That’s the schedule?
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He would have to eat a lot of catnip to give him diarrhea unless it was in a garden and had something sprayed on it.

Yes, at a minimum, six times a day to fast-track. More is better if he allows it (e.g. a +7 or +8 during the day). Right now, there is no need to get up at night unless the tests before you go to bed indicate he’s dropping. Remember every meter has a 20% variance between tests so any number within 20% of a previous one is essentially the same.
 
Pattheteacher25 said:
@Marje and Gracie . Numbers are crazy . I was thinking about getting another Lantus pen .. could it be that it’s isn’t in good condition ? I don’t know what to think . I’ll take him to the vet again tomorrow
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How old is the pen? Do you keep it refrigerated?

The problem is he wasn’t at a good dose before but then you dropped it ton1u. The glucose toxicity builds and it takes more insulin to breakthrough it.

I have to be out of town and I’m going to find another experienced member to help you until I get back.
 
Patricia

Christie (Christie & Maverick) will be monitoring all this and letting you know when and how much to increase. You can trust her…. She’s been around very long time and gives excellent advice.

I think if he’s not sick and it’s just the BGs you are worried about, I am not sure a vet could do much. They will likely want you to increase by more but that’s not a good idea. We have a tried and true protocol. Garcia’s are not the highest I’ve fast-tracked. It just takes patience.

If, however, he is not eating or drinking, is lethargic, or shows any other signs of illness, that’s different and he might need to see the vet. Please just stay on top of ketone testing.
 
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