New member- question on starting insulin dose

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Crystal Martinez

Crystal Martinez

Member Since 2023
Hi all,
Im grateful to have found this forum. I’ve had a cat with diabetes 8/9 years ago, and this time I’m a bit more nervous for some reason. My current cat, O’Malley is 13 lbs and he got diagnosed today with diabetes. They gave me the Hills m/d food and said to start him tonight in 3 units of insulin twice a day. Everything I’m reading says 3U is a lot. I checked with the vet again and they’re saying for his weight that’s a low dose but my previous cat was quite big too and I think I started him on 1u so I’m wondering if it’s safe to start on 3 and if I should just make the executive decision to start him at 1 or 2. Any advice would be helpful.
 
3u of Lantus is a big starting dose! There are 2 dosing methods that we use with Lantus -- the Tight Regulation Protocol (TR) and Start Low Go Slow (SLGS). With Tight Regulation, the starting dose is calculated using a weight based formula (initial dose = 0.25 x ideal weight in kilograms). If O'Malley's ideal weight is close to 13lbs, based on the formula, his starting dose would be around 1.25 - 1.5u. With SLGS, the starting dose would be 0.5u if your cat is eating a low carbohydrate, canned food diet. If on dry food, the starting dose is 1.0u. Also, in order to use TR, your cat must be eating a low carb, canned or raw food diet.

Also, if the vet gave you M/D in the dry version, it's very high in carbs. The canned version is 13% carbs. We consider that a medium carb food. Low carb would be less than 10% carbs and most members feed their cat foods that are in the 5 - 7% range or lower. To be honest, there is nothing special in the M/D that makes it a good choice for a diabetic cat. The pet food manufacturers were subjects of a class action suit that they lost for misleading the public by calling their food "prescription." There is nothing prescriptive in the food. Further, they charge as much or more than most of the premium cat foods and the ingredients are less than ideal. This is a link to a food chart that contains information about the carb content of most of the canned foods available in the U.S. You have lots of choices! Most people here feed their cat either Fancy Feast or Friskies pate style food. It's low in carbs and priced reasonably.
 
Sienne and Gabby (GA) said:
3u of Lantus is a big starting dose! There are 2 dosing methods that we use with Lantus -- the Tight Regulation Protocol (TR) and Start Low Go Slow (SLGS). With Tight Regulation, the starting dose is calculated using a weight based formula (initial dose = 0.25 x ideal weight in kilograms). If O'Malley's ideal weight is close to 13lbs, based on the formula, his starting dose would be around 1.25 - 1.5u. With SLGS, the starting dose would be 0.5u if your cat is eating a low carbohydrate, canned food diet. If on dry food, the starting dose is 1.0u. Also, in order to use TR, your cat must be eating a low carb, canned or raw food diet.

Also, if the vet gave you M/D in the dry version, it's very high in carbs. The canned version is 13% carbs. We consider that a medium carb food. Low carb would be less than 10% carbs and most members feed their cat foods that are in the 5 - 7% range or lower. To be honest, there is nothing special in the M/D that makes it a good choice for a diabetic cat. The pet food manufacturers were subjects of a class action suit that they lost for misleading the public by calling their food "prescription." There is nothing prescriptive in the food. Further, they charge as much or more than most of the premium cat foods and the ingredients are less than ideal. This is a link to a food chart that contains information about the carb content of most of the canned foods available in the U.S. You have lots of choices! Most people here feed their cat either Fancy Feast or Friskies pate style food. It's low in carbs and priced reasonably.
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Thank you so much for those links and the input! Very helpful
 
Zhigulin said:
3U is way to much by any standards and it is downright dangerous if no home testing is taking place. I'm not sure how the vet can say it's low, usually if BG at diagnosis is under 400 it should be 0.25U/kg and over it should be 0.5U/kg. O'Malley is 5.8 kg.
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They of course didn’t leave me with the paperwork showing the levels and closed for the weekend, but based on everything I’m reading in these forums I’m definitely not comfortable with 3U. I appreciate the input!
 
Hi and welcome
I agree that 3 units is way too high dose to start on.
I would start on 1/2 to 1 unit...no more than that.
And I would really recommend you think about home testing the blood glucose to keep your kitty safe.
We are happy to answer any questions
 
If I had to venture a guess, the vet thinks 3.0u is a "low" dose if they are selling their clients high carb food. The higher the carbohydrates, the more insulin you need to offset the carbs.

I'm echoing the encouragement to home test. It's critically important for keeping your cat safe and it's also a way for your to know how your cat is responding to insulin. In the long range, it will save you a good deal of money since you won't need to take your cat to the vet's office for a curve or for fructosamine tests.
 
Sienne and Gabby (GA) said:
If I had to venture a guess, the vet thinks 3.0u is a "low" dose if they are selling their clients high carb food. The higher the carbohydrates, the more insulin you need to offset the carbs.

I'm echoing the encouragement to home test. It's critically important for keeping your cat safe and it's also a way for your to know how your cat is responding to insulin. In the long range, it will save you a good deal of money since you won't need to take your cat to the vet's office for a curve or for fructosamine tests.
Click to expand...
Is there a good test y’all recommend?
 
With home testing, we're suggesting that you prick your cat's ear (or paw pad) to get a drop of blood and test the blood with a glucometer. This will tell you how low the insulin dose is taking your cat's blood glucose (BG). If the dose is too high, the numbers may go low which could be dangerous and also signals that the dose needs to be reduced. This is a link to a post on home testing. There are instructions, videos, etc. If you look in our signatures, you'll see a link to a spreadsheet that contains our testing information. We strongly encourage members to learn to home test. It's the most effective way for you to manage your cat's diabetes. Most people here use human meters. The Walmart Relion meter has the most inexpensive strips available.
 
Sienne and Gabby (GA) said:
With home testing, we're suggesting that you prick your cat's ear (or paw pad) to get a drop of blood and test the blood with a glucometer. This will tell you how low the insulin dose is taking your cat's blood glucose (BG). If the dose is too high, the numbers may go low which could be dangerous and also signals that the dose needs to be reduced. This is a link to a post on home testing. There are instructions, videos, etc. If you look in our signatures, you'll see a link to a spreadsheet that contains our testing information. We strongly encourage members to learn to home test. It's the most effective way for you to manage your cat's diabetes. Most people here use human meters. The Walmart Relion meter has the most inexpensive strips available.
Click to expand...
Appreciate this so much!!
 
So I stuck with a 2U dose to start on Saturday night, Sunday morning and night. By this morning he was throwing up and wouldn’t eat so I couldn’t give him his dose this am. His eyes were also glossed over when I gave him his other doses. The doc suggested I do raise it to the 3U but I’m still nervous since his eyes were like that and he threw up. But also his blood sugar count was at 410 on Wednesday and today it was higher ag 490. However, I don’t know if it was just higher due to not eating and getting his shot this morning.
 
If you could set up a spreadsheet (or we can help you with that) it would be much easier to help you with the dosing.
Here is a link to setting up the spreadsheet
https://www.felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/
Why does the vet want to raise the dose to 3 units because the cat is vomiting…doesn’t make sense!
Have you tested for ketones in the urine? To do this you need a bottle of Ketostix from Walmart or a pharmacy.
there should be no ketones in the urine.
Has he stopped vomiting? It’s important that diabetic cats eat and that they get their insulin.
If he’s still vomiting he may need an antinausea medication such as cerenia or ondansetron.
Please keep us posted
 
Bron and Sheba (GA) said:
If you could set up a spreadsheet (or we can help you with that) it would be much easier to help you with the dosing.
Here is a link to setting up the spreadsheet
https://www.felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/
Why does the vet want to raise the dose to 3 units because the cat is vomiting…doesn’t make sense!
Have you tested for ketones in the urine? To do this you need a bottle of Ketostix from Walmart or a pharmacy.
there should be no ketones in the urine.
Has he stopped vomiting? It’s important that diabetic cats eat and that they get their insulin.
If he’s still vomiting he may need an antinausea medication such as cerenia or ondansetron.
Please keep us posted
Click to expand...
They did test for ketones and it was negative. from my understanding they want to raise it to 3 bc the levels increased to the 490. luckily he started eating again and hasn’t vomited again. And they did give him anti nausea meds in case
 
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