New Members Julie & Charlie

Hi. I’m Julie, mom to 13+ yo Charlie who was diagnosed with diabetes 8/20. I took him to the vet because he was drinking and peeing a lot and after some tests, discovered that his BG was something over 500 (I need to get a copy of the test) and he had lost some weight. The intent was to start him on 3 units of Lantus 2x day starting the following day-Friday, after I was able to get his insulin and supplies. That evening I researched FD and thankfully found felinediabetes.com and catinfo.org. Since we hadn’t started the insulin yet, I decided to try the fast switch from dry to low-carb canned food, hoping to get my vet’s approval the next day before our appointment. It turns out she wasn’t working that day so I rescheduled the instruction appointment to Monday. His BG at that appointment was 254 I believe, so I asked about lowering the dose based on the information on these websites about starting low and going slow. After some initial resistance they agreed to start him at 1 unit.

I did a curve 7 days after starting him on insulin with a starting point of 259 getting to a low of 99 at +4 & +6 and at 159 at +11.5. The vet clinic was closed so I decided to skip the evening dose worried about a 160 point drop overnight. The next couple of nights were all below 200 so I continued to skip the PM insulin dose, and at the follow up apt with my vet she didn’t advise me to change course so I’ve continued to do that. Morning numbers have stayed 284 or below since last Friday except a jump yesterday to 331. I thought skipping the nighttime dose was the right thing to do except now that I’ve had some time to do additional research I see a concern with uneven morning and evening dosing on Lantus.

I need to make a follow up appointment with the vet but I’m wondering what input you have.

I’m also just learning about “depot” and if that is a factor in the higher BG level yesterday.

The vet thinks that his diabetes was caused by the prednisolone he was on the last several months for asthma (plus he’s always been a bit, hefty ). He is off the steroid now and we’ve switched to an inhaler (with limited success) and my vet thinks there is a chance he may go into remission. But if I’m understanding correctly, TR is a better protocol than SLGS to achieve remission. I’m not sure what that looks like for Charlie.

Charlie seems to have arthritis, and asthma/allergies. He was previously treated with I-131 for hyperthyroidism summer of 2017 and has a heart murmur.


Thank you to everyone who posts to this forum. I’ve been reading and learning from the background. But boy, this is all so overwhelming.

 

Hello Julie and Charlie!

You definitely seem on the right track, so glad you switched to low-carb before doing insulin and requesting a lower dose!
Charlie's got some good numbers so far. I imagine the AMPS numbers are higher because you keep skipping the PM dose. If you leave food available at night (either with an autofeeder or freezing chunks of food) and get a "before bed" test, you'll be alright giving him his evening dose, and that will get him into remission faster (I do think he has the potential for it sooner rather than later!!).

It's good he's off the steroid, and if you do follow TR that means getting the PM test every night (unless he's TOO low), and getting at least 1-2 tests every cycle - including night cycles. I think if you put in some extra effort right now to get him into remission while his numbers are still low, you'll save yourself months/years of doing the "sugar dance".

I think it will be beneficial to scoot you over to the Lantus forum, where you would make daily posts and the members there will guide you through the process day by day. I would post for help over there, copy+paste the info from this board, and link back to it so everyone can see it.

 

Welcome Julie & Charlie! Disclaimer: I am very new (two weeks into or diabetes journey). I am super impressed you advocated to start with 1 unit -- I wouldn't have known to do that when I started, but I think now (after two weeks of absorbing as much as I can from this forum) that that was very smart of you. My cat is 19 lb and started at 1 unit and that has been plenty. Kudos, you're awesome.

As they say, ECID (Every Cat Is Different), but I started on SLGS because I personally wasn't ready to test as much as TR required, and Baker has been doing so well that this forum and his vet are in agreement that we can lower his dose. Re: skipping the evening shot, For what it's worth, my vet said Lantus was designed as a once a day human insulin, thus I have a choice to shoot 1 unit in the morning or .5 unit in AM and .5 in PM. He said if it were his cat, he would shoot AM and PM.

Hopefully some of the more experienced members will chime in here about your dosing questions.

EDIT: I want to add that on the Lantus page it says that hypo events on Lantus are rather rare. That was comforting to me when I was shooting between 100 and 200.

 

Hey Kate, just wanting to check - where did you see that hypo events are rare on Lantus? Lantus is a not as dangerous to use in cats like Vetsulin/NPH but you do still need to practice caution with shooting lower numbers, hypo events can still happen.

EDIT: Found the sticky that says symptomatic hypos are rare - this doesn't mean they won't drop low, just that you're less likely to see symptoms of low BG.

 

Welcome to FDMB! I am very impressed you have taken care of all the things you need to do to function here! WELL DONE!
As you see we are a caring community of kitty cat lovers connected by one main thing feline diabetes.
I dont have much more to add except to say ...
WELCOME TO OUR FAMILY!
We all look forward to getting to know you and your extra sweet Charlie!
jeanne.

 

Thank you for the welcomes and the information, especially the reference to the Lantus Forum. It looks like I'll need to do a lot more nighttime testing. I'm just really nervous about giving a pm dose and if he drops too low at night I won't know.

I just got an auto feeder and coincidentally, the morning with the higher number (331) was the first time he ate during the night. I left food in the feeder last night but he missed it (I have it set to go to an empty spot 2-hours before we wake up so he can't eat right before the am test) and he was back down to the mid 200's.

I have a window to keep up with more frequent testing but will be moving out to the country soon and won't be able to run home for daytime testing. Charlie and I were supposed to move and join my husband the weekend after he was diagnosed but I have put off the move for a little while so we are closer to the vet and I can monitor him more closely for a while.

This is my first time on a forum and I'm not very tech savvy so don't hesitate to let me know if I'm not doing something right. In the meantime, I'll see what I can do on the Lantus Forum.

Thanks again for the warm welcome. I can't say how grateful I am for the time and guidance I can see that members spend helping others. I wouldn't have known to switch food or question the dosing (and test which my vet didn't think was necessary for a couple of weeks) without the information here and felinediabetes.com!

Thanks again!

 

Really? You could have fooled me! You're doing great so far.

 

Welcome. If you go over to the Lantus forum And read the yellow stickies you will see how to be able to give the night shots safely. Read the methods sticky and how to handle low numbers. We will guide you through how to do it too. We have an unwritten rule that if we tell someone to shoot lower than they are used to we will stay with you until your cat is in safe numbers and you are comfortable. If one person can’t stay they will find another. You are seeing great green nadirs and testing a lot so it should not be hard. You numbers will be a lot faster dosing every 12 hours. Lantus likes consistency. Believe it or not shooting low gets contagious!

 

Okay, thank you. I will plan on trying that tomorrow night. Going into the weekend will help too as I will be around more.