New Member who's struggling :(

[Lulsimb99]

Hello Everyone

I am new to this and I am so happy that I found out about you.. My name is Maike und my baby is called Lulu. We're from Germany and also have three other cats (Simba, Bubbles and Maju). Lulu is the oldest with approx. 13 years. She is a very strong lady and we found her on the street when she was a baby. She does struggle with cat flu every since. But it varies and is not a big deal. Yeah, and now or in August we found out about her having diabetes We first thought it would be hyperthyreoses but apprently it wasn't. (It least we know what it is).
Soo, my vet has been proven not very helpful, most of the things that I learned where through my own research. So all of this in here was very new for me. The vet told me to test BG at home and showed me how it worked. She said it would be useful if I see changes in her or she behaves diffrently that I can check the BG. And about dosage she did not say much. Kind of like just start with 1U und we will see. So I basically gave her 1u for a longer period until i tested BG and so it was still high, so I went to 2. Same goes here. And then at one point I came home later than the shot time and she was not okay. She was wobbly, had circulatory problems and had vomitted. So of course I checked BG and it was too high for the meter.... I was so scared and it gave me a huge wake up call. I literally thought since the vet never said anything about how insulin works, that we would be okay even not having the right dose yet. Wrong thought :'(.. Anyways I was so so worried but after she ate and had her shot she was okay again. I called the vet immediately the next morning and she told me to go up higher but she does not think that it had to do with high BG. We went to the vet, they checked, seemed okay, still too high BG. Okay, I went up with doses then. From 3U to 4U. I saw a that it was better and we only had measures in the 350 areas. A few days later we went up to 5, which was not good, since she went up in BG around 400-500 again. So I went back to 4 and continued for a bit until we were stable in 350 again. So, then I went up 0.5U and no change the past days. Then up to 5U, which u can also see in the spreadsheet. I changed dosage 3 days ago, which also resulted in a weird up, which seems to have stabilized. I am very confused and honestly been struggling to process everything. I since the vet told me so, only tested mainly around 4hours after shots but I will change that now. I feel sad and I am also very sensible with my cat so it's very hard for me to test her so often... (it makes me feel bad). It also took me some time till I figured out how to give the shot properly, but at least that works now. Yeah, so since I am new to this, excuse me not having the right words, numbers and terms, I hope that this is till undertandable. You can ask me anything you want, of course I really want her to get better. She does not use the stair anymore and is very sleepy on some days. It makes me feel so sad for her. And before I forget, since I see that this is important too, I gets MJAMJAM food, it is german so I don't know if it familiar to any of you, but is grain-free with high meat and from Kattovit feline diet dry food. The vet told me to always have some food available so I have the dry food sitting around, which I already heard should not be the best option.

I am sorry for all the details, but I really hope that you guys can help me. I am stressed since I don't see an end in this

Thank you in forward. I am so so happy that I found this page...
Maike & Lulu

 

[CORKY]

Welcome to FDMB
Well hello Maike & Lulu, I love the names of all your cars, Boy you sure have quite a mess with the doses, it looks like how you said, your vet was not a great help. We need to know what insulin you are giving Lulu, the best insulins for cats are ProZinc and Lantus they are a 12-hour insulin, easy on the cat. The dose when first given it takes about 3 cycles, 48 hours to actually see how it would react in Lulu's system, which ever insulin you are giving is way too high, especially for a Newbie, you are setting yourself up for hypoglycemia, which is most likely have been the wobbling and other systems, it is important to test before each shot to avoid this, since the BG remains high, have you tested for Ketones?, with such a high dose this can be one of the reasons, I do not give dosing advice, but I am trying to ease your stress of what might be, also a diabetic cat needs to have a diet of wet can food or raw between 0-10% carbs, as well two main meals and several meals or snacks during the day, cats cannot digest carbs that's the reason for pancreas damage, the food you are feeding can be another very big reason why the BG remains high, we can help you regulate Lulu, what meter are you using? any human meter is good, they are accurate and inexpensive, I will find a member that can send you a Drs approved food list from Germany, we may also have members from there, you might want to find a vet that is well schooled and knowledgeable in Feline diabetes, it does not have to be a specialist. Please let me know what insulin you are using so I can tag the members that can help you with dosing. We are here for you to help you go thru this journey, Feline diabetes in manageable, with home testing, wet can foods or raw between 0-10% carbs, and lots of love, if you want us to assist you please, first we need to know the insulin you are using and meter, we would like you to create your signature and spreadsheet, we are very numbers oriented, and this way we can all be on the same page and advice you correctly, below are two links to do so.
It may all sound overwhelming, but is not, we are here for you every step of the way!

Sticky - New? How You Can Help Us Help You!
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

 

[Lulsimb99]

Hello Corky,
Thank you so much for the fast reply!!
Yeah, it’s all a bit messy that‘s what makes me so frustrated. I am having Caninsulin, and I am using a pet meter I got from the vet. I will send a photo of it. We have not tested for Ketones as far as I know (as I said, the Vet is not a great help), so I guess no. Finding a member for the food list would be great. I hope that the other three cats can also eat that food then, because I do struggle with that as well. Since we are four and one only eats dry food and another one is quite heavy we need to have a look at that as well. And I was already having a look at new vets and wanted to call some tomorrow, see if I can get an appointment maybe after the holidays. I did talk to the vet and also already thought that this dosage might be too much but she always said that if the numbers are still so high then I need to go higher in dosage. And yeah idk, we never had any number lower than 260. I don’t understand. But we will figure it out, I am positive
I have already done my signature and spreadsheet, can’t you see it?

Thank you again for helping me!!! This really gives me a huge boost again. <3

 

[Lulsimb99]

A big thank you from us

 

[CORKY]

There is your answer Caninsulin is a dog insulin it works hard and fast in a cat tge word says it CANINsulin, that is your main issue, you need to speak to this vet and tell her you are not comfortable with this insulin that you want to switch to ProZinc or Lantus and a reduction in dose, you are in control, now I am more positive about searching for another vet, WOW ! I’m impressed! Girl, you got this!!I will tag a member that can give you a larger prospective and knowledge on how to handle Caninsulin until you get the right insulin, don’t worry we will get it right

@Sienne and Gabby (GA)

 

[Sienne and Gabby (GA)]

Maike -

I'm guessing that you may not have come across the German counterpart of this group. A few years after FDMB was started, there was a group in Germany that was involved in providing research on feline diabetes. The originator of the German website, Kirsten Roomp, PhD worked with a vet from University of Queensland to publish the Tight Regulation Protocol for Lantus and Levemir. They have a great deal of information on their website. The website is available in both English and German.

Where it may be helpful for you is if you need recommendations for a vet or for food or other items that are available locally. Most of our membership is in the US and Canada.

Please don't think I'm trying to chase you away. We're happy to lend a hand.

A couple of thoughts...
We increase doses in smaller amounts -- dose changes are in 0.25u increments. 5.0u is a large dose especially of Caninsulin. Are you feeding Lulu about 20 - 30 min prior to giving her insulin? Caninsulin works quickly and you need to have fed your cat prior to giving a shot.

Are you giving insulin twice a day? From the spreadsheet it doesn't look like you're giving a shot in the evening. Cats have a fast metabolism and need insulin twice a day. I

Please get at least one test during the evening cycle. Testing before you go to sleep is helpful so you know your cat is in safe numbers while you're asleep.

 

[Lulsimb99]

Omg, thank you for telling me. I did not know this! I will call another vet and will ask for different insulin and get her in for a Ketones test. If someone could help me with the Caninsulin do now, would be great. And of course I will need help with how to properly switch and dose with the new one. Cause I do not trust the vet anymore. My poor little baby.
Thank you so so much!!! You have no idea how much this already helps me feeling better. I am so thankful for this site and you

There is your answer Caninsulin is a dog insulin it works hard and fast in a cat tge word says it CANINsulin, that is your main issue, you need to speak to this vet and tell her you are not comfortable with this insulin that you want to switch to ProZinc or Lantus and a reduction in dose, you are in control, now I am more positive about searching for another vet, WOW ! I’m impressed! Girl, you got this!!I will tag a member that can give you a larger prospective and knowledge on how to handle Caninsulin until you get the right insulin, don’t worry we will get it right

@Sienne and Gabby (GA)

 

[CORKY]

Omg, thank you for telling me. I did not know this! I will call another vet and will ask for different insulin and get her in for a Ketones test. If someone could help me with the Caninsulin do now, would be great. And of course I will need help with how to properly switch and dose with the new one. Cause I do not trust the vet anymore. My poor little baby.
Thank you so so much!!! You have no idea how much this already helps me feeling better. I am so thankful for this site and you

I did tag a member that will help you with dosing, also you do not need a vet to check for ketones, you can do this yourself, purchase the KETONE STRIPS, while she pees you get the strip close to the pee and match it to the chart on the vial, it will tell you the ketone balance, any brand is good

 

[Lulsimb99]

Maike -

I'm guessing that you may not have come across the German counterpart of this group. A few years after FDMB was started, there was a group in Germany that was involved in providing research on feline diabetes. The originator of the German website, Kirsten Roomp, PhD worked with a vet from University of Queensland to publish the Tight Regulation Protocol for Lantus and Levemir. They have a great deal of information on their website. The website is available in both English and German.

Where it may be helpful for you is if you need recommendations for a vet or for food or other items that are available locally. Most of our membership is in the US and Canada.

Please don't think I'm trying to chase you away. We're happy to lend a hand.

A couple of thoughts...
We increase doses in smaller amounts -- dose changes are in 0.25u increments. 5.0u is a large dose especially of Caninsulin. Are you feeding Lulu about 20 - 30 min prior to giving her insulin? Caninsulin works quickly and you need to have fed your cat prior to giving a shot.

Are you giving insulin twice a day? From the spreadsheet it doesn't look like you're giving a shot in the evening. Cats have a fast metabolism and need insulin twice a day. I

Please get at least one test during the evening cycle. Testing before you go to sleep is helpful so you know your cat is in safe numbers while you're asleep.

Yes, you’re right. I haven’t come across this page. But I will certainly have a look at it now.
No, don’t worry I not think you’re chasing me away. I am grateful for every reply and recommendation.

My vet told me to go 0.5u she even said to go 1.0u sometimes….. I guess she does not have any clue, honestly. I usually give her the shot while eating, since that’s what the vet said. I always do wait a couple of minutes so there’s at least something on the stomach already. And yes, I give twice a day, 12:30 pm and am. I just usually don’t test cause my vet told me that over the day would be enough when she’s acting normally.

Honestly, from what I get so far is, that I do need another vet regardless. I always thought it was me and that I don’t do enough. But I guess that the vet did not explain anything and every time I ask I she kind of plays it off like “yeah we will see”. So o trusted in her. Anyways, I will make an appointment tomorrow with a new vet and ask for different insulin and a proper explanation. I also will look through the other site you mentioned.

Again, I am grateful to be here

 

[Lulsimb99]

I did tag a member that will help you with dosing, also you do not need a vet to check for ketones, you can do this yourself, purchase the KETONE STRIPS, while she pees you get the strip close to the pee and match it to the chart on the vial, it will tell you the ketone balance, any brand is good
View attachment 75968

Great!!! I will purchase that now. Why did the vet not say anything about it…. I am getting a little bit angry. But anyways, thank you so so much!!

 

[CORKY]

Yes, you’re right. I haven’t come across this page. But I will certainly have a look at it now.
No, don’t worry I not think you’re chasing me away. I am grateful for every reply and recommendation.

My vet told me to go 0.5u she even said to go 1.0u sometimes….. I guess she does not have any clue, honestly. I usually give her the shot while eating, since that’s what the vet said. I always do wait a couple of minutes so there’s at least something on the stomach already. And yes, I give twice a day, 12:30 pm and am. I just usually don’t test cause my vet told me that over the day would be enough when she’s acting normally.

Honestly, from what I get so far is, that I do need another vet regardless. I always thought it was me and that I don’t do enough. But I guess that the vet did not explain anything and every time I ask I she kind of plays it off like “yeah we will see”. So o trusted in her. Anyways, I will make an appointment tomorrow with a new vet and ask for different insulin and a proper explanation. I also will look through the other site you mentioned.

Again, I am grateful to be here

Before you make that appointment make sure the vet has experience in Feline Diabetes, question the vet, do not be shy let the vet know your concerns and what you have learned so far, home testing during the day IS very important, before each shot and several times during the day it gives you data on how the insulin is working, and assist you to know how Lulu is evolving and if any dose decision needs to be made, Best of luck to you tomorrow, let us know how it goes, Also if the vet when you are there speaks to you about a curve, you do not need the vet for that you can do that at home without stressing Lulu, is only testing every two hours for a cycle (12 hours) a curve at the vet does not work, it will have very high BG numbers due to stress, causing the vet to usually unnecessary increase the dose.

 

[Lulsimb99]

So for you guys an Update. I went to the vet, they did a blood test, they told me that Lantus in Germany is always the second option since it’s not officially approved for cats. But she agreed that Caninsulin for Lulu seem to not work and gave me the prescription for Lantus. She then told me that Lantus could sometimes work with only one shot a day? Is that true?
She advised me to start with 2u when I switch now. Then she explained that it works different than Caninsulin, there will not be a proper Nadir, moreover it works in a line and then will fall down again. She said to figure out the “end” of its effect, I would have to give her the shot in the morning and then over the day to measure BG and see when it’s up again. She said if it will be high again ,300 something, I should give another 1u? Does that make any sense? I am a bit confused about the dosing honestly.
Anyways for the Ketones she said that it wouldn’t be necessary if I am on insulin and not the medication. I still asked to check the blood on that too and I also bought the stripes and when they arrive l’ll test myself.

She also gave me an expired Lantus (04.2024) for free, since another cat did not use it. She wasn’t sure if I could still use it, do you know that? I am not comfortable to be honest.

Yeah that the update so far

 

[CORKY]

Lantus is a 12-hour insulin, which means the same dose every 12 hours, why would she give exported Insulin? Is not going to work, is almost a year long, it needs refrigeration Did she give you some starter syringes?? You that’s a very high dose for you to start with as well,please do not give that insulin until one of the members I tag can assist you with mine and especially your correct concerns, none of it sounds good, very good alway follow your instincs
@Sienne and Gabby (GA)

 

[Lulsimb99]

Yeah, I was wondering myself. But it was in the refrigerator whole time apparently. But I guess I will not use it. And yes, she gave me some starter syringes at least.
And I will not start with Lantus till i am confident in the dosing.
Thank you again

 

[squeem3]

Lantus is an insulin made for Humans. It's used off label for cats and works very well. It does not work once a day in cats. If the vet suggested a starting dose of 2 units once a day, just give 1 unit twice a day instead. Or even give 0.5 units twice a day if you're worried how your cat might react. Insulin can pack a punch so better to start as small as possible and increase as needed.

Take a read through the info stickies to understand how Lantus works: Lantus / Levemir / Biosimilars There's one sticky that explains how Lantus works and where nadir generally is. Lantus takes about 7 days to build up the depot so while you can do pre-shot testing as usual and a few spot checks, there's no point to do a full curve until the depot is full.

I would not use the expired insulin. I'm not sure if pharmacies in Germany require a prescription to buy Lantus. If they do, ask the vet for a prescription. You want the box of 3ml Lantus pens, not the 10ml bottle. While both can be used, the bottle tends to not last very long while a pen can last to the very last drop and the entire box of five pens is at least a year's supply.

You can test ketones via a fresh urine sample. It's always a good idea to check ketones just in case.

 

[Sienne and Gabby (GA)]

Frankly, pretty much any vet will tell you they know how to treat diabetes. They do get training on the topic in vet school. I look at it more from the perspective that general practice vets have an impossible job. They are expected to be knowledgeable about every possible condition for every possible species. My head would explode. There's no way they can be experts at everything.

This post on interviewing vets may be helpful.

It sounds like your vet is not fully up to speed on how Lantus works. Regardless of the insulin, cats need to be given insulin on a twice a day schedule. They have a fast metabolism. For humans, Lantus can be dosed once a day -- it doesn't have the same duration for cats. Id encourage you to look over the sticky notes at the top of the Lantus forum like suggest3ed above.

As far as dose, ordinarily you can switch from Caninsulin to Lantus at the same dose. However, at a 5.0u dose that was rapidly raised, I'd be very reticent to suggest that you keep that dose. There are two options for a starting dose of Lantus. Which you choose is base on the dosing method. The Tight Regulation Protocol uses a weight based formula to calculate the starting dose (initial dose = 0.25 x ideal weight in kg). For Start Low Go Slow, the starting dose is 1.0 if the cat is not on an entirely canned food diet. One note -- you can't. use Tight Regulation if you're feeding your cat any dry food.

I also suspect that what you're feeding Lulis is not entirely low carb. You can't base a food choice on the ingredients. Most manufacturers do not provide information on the carbohydrates. You can get an estimate of the carbs by using a cat food carb calculator and there are several available on the web. We consider low carb as under 10%. If you switch to a low carb diet, you will likely need to reduce the insulin dose.

Also, can you please update your spreadsheet to indicate if you are giving a PM shot? If you are skipping a PM dose, either write "NS" in the U column or put some other indication that you are not giving a shot.