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Christina

Member Since 2015
Hello!

Our kitty was just diagnosed wth diabetes last month. We have been trying to manage with Lantus and get numbers all over the board, but mostly on the high side of the board. I look forward to gaining some valuable insight and wisdom through this shared experience.
 
Welcome to FDMB.
Some reading about how Lantus works, how to store it, and 2 protocols for using it are in the Lantus forum, if you'd like to do some reading to get oriented.
 
Hello! We are currently feeding the Purina DM canned, with a tablespoon of the DM dry on occasion but I'm cutting out the dry. He was previously on Natural Instinct LID Turkey canned, but the vet suggested the DM (of course) and said if he didn't eat that then to try another high quality, grain-free canned food. Of course, when we got the news and went in to be shown how to do the glucose readings at home, they sold us the Alphatrack2 meter. Probably a mistake, but I had never had to research diabetes in pets so I figured it was really, really made for cats & dogs. The price of the strips are insane! I've read that the Abbott Freestyle Lite work with the meter, but I didn't want to take the chance in this situation.

I read on another post in this forum that it isn't ideal to switch diets while on insulin. Does anyone have experience doing so, perhaps a slow switch over so that I can go back to the Natural Instinct LID canned?

We have so far tried Lantus at 2-units AMPM, 2Units AM/1.5PM, 2Units AM/.5PM, and 2Units AM/1unitPM. Initially, his nadir from the morning dose would get down as low as 60's and up to about mid-100s. The problem was always that after the evening dose, his would be back in the 400-500's by as early as 4:45pm. Therefore, that is why the PM dose has varied. The vet mentioned the Somogyi effect, but I've read many places that most discredit this. Last night/this morning has been the highest we've seen so far, 692 and his nadir yesterday was 472 from his AM dose (he started at 490 and strangely went up to 511 after his dose) and after his PM dose, he went from 509 to 376 within 4-hrs, then 4.5-hrs later (3:00am) he was at 692/648!

I'm grateful to get insight from people doing this and learning from doing which hopefully will be more helpful than the vet (which I also get charged $36 to do an over-the-phone consult about the GC results!). It feels like we can't have a life of any sort out of the house right now!
 
You can switch diets. What is harder to do safely is to change from dry (high-carb) to a low-carb canned without home testing.
Is there a reason why you were using the LID (Limited Ingredient Diet) food? I looked at the ingredients of the food you were feeding
http://www.naturesvariety.com/Instinct/cat/can/LIDTurkey
And it looks good, relatively low carb.
Before y get a spread sheet worked out it is better for use reviewing your BG data to display it as follows:
AM PS (or PM PS) what AM is morning and PM is evening and PS is the BG value before the shot.
Then display between shot BG with the BG followed by a +X where x is the time since the last shot.

This previous post compares the AT using AT strips and using Freestyle strips.
http://www.felinediabetes.com/FDMB/...-monitor-fslite-human-monitor-updated.135726/
You do have to test each lot of freestyle strips against AT strips to help ensure they are close enough to use the Freestyle strips.
 
I forgot to mention that they were also on free feed Acana Grasslands in addition to the Natural Instinct (since we have 5 cats, which are now all on timed feeding of canned only). No specific reason other than I was trying to offer them the best possible foods. The diabetic kitty had been affected by the melamine poisoning in Natural Balance back in 2007, so after that I became a little more cautious of the quality of ingredients in foods (and from where they were sourced). This has by far been the highest that he has been (as far as we are aware); He has gotten into the high 500s, but this is a 1st in the 600s, during a test anyhow. Two weeks ago, his nadir was about +9 and at 117 with a PMPS of 66 (no insulin given); It had been the PM reads/very early AM that were an issue, but now it seems the AM dose isn't quite working like it had been.

4/13:
AMPS 490
+1: 511
+4: 484
+8: 472
PMPS 509
+2: 491
+4: 376
+9: 692/648 (used 2strips to double-check)

4/14:
AMPS: 679
+2: 611
 
Ho much insulin did you give those three times?
Maybe the dose is too high or maybe it is too low.
On some of my cats I have seen a good response at first but shortly afterwords I had to increase the dose. Maybe that is your case.
 
He is getting 2-units in the AM, and 1-Unit PM. The AM dose was initially getting him into normal to low range, but the PM dose is always an issue. The PM dose started as 2-units, then we tried 1.5-units, and then 1.0-unit, per discussion with the vet. She thought perhaps he was getting too low during the night and his liver was kicking into panic mode because it would be >400, but usually greater >500 the following AMPS reading.
 
Lantus is a deppot insulin. When it is injected, small crystals form under the skin. These slowly dissolve and release the insulin to work. At the end of 12 hours, when you inject again, some crystals remain and are still dissolving. This means there is overlap in the effects from each shot.
Because of this, injecting on a fairly strict 12 hour schedule and keeping the dose the same for all shots, for 3 to 5 days at a minimum is needed to determine how well the dose is working. You do this by checking in the +5 to +7 hour period after injection when the lowest glucose (nadir) tends to happen. In general, the nadir determines if the dose needs adjusting, not the pre-shot tests.
 
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