? New to FDMB; questions re: kitty on Lantus

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Squeakycats

Squeakycats

Member Since 2017
Hi, all--I'm reposting this from the Introductions forum and would love your advice! My kitty, Misha (who is male...I know, bad name choice), was recently diagnosed. It was a surprise--he had been struggling with a bad coccidia infection, and his high blood glucose measurement came up in a routine panel. I've been following my vet's instructions since then--he started on 2 units of insulin, went down to 1 for a while, and I haven't given many shots over the last few days because his BG was less than 150 (the vet said not to give it below that).

I've always fed him a grain-free diet and tried to get him to mostly eat canned food. He kept having horrible itching and scabbing on his face and neck; when we finally realized that might be an allergy to chicken, we switched him to eating just rabbit, venison, and an occasional bit of fish. He seems to be doing well on that front, but I think the diabetes may have been caused by all the times he was on steroids (he's not overweight). The vet was also giving him an herbal medication for anxiety in a base that, as it turns out, is basically corn syrup--Lixotinic. So that probably messed with his blood sugar a ton. Obviously I feel horrible about probably being responsible for his illness. He's now eating Primal nuggets (raw freeze-dried food), more because he's willing to cheerfully eat it than for any other reason--he had lost a lot of weight prior to his diagnose. But I think it's a very low carb food!

I just recently discovered this board and all of the wonderful information and thought I would introduce myself now that I've had time to set up a spreadsheet (I have been keeping my own much-less-fancy one). Sorry it is so sparse and random--I didn't know what I was doing for a while there. I now plan to test before every shot (or at the time he'd usually get one).

I wasn't aware of the possible protocols when this all started and thus haven't been following any. I work full-time, and my husband attends grad school about an hour from here, so we are out a lot. I think it would be tricky to try to do tight regulation, but I really want to give Misha the best chance of going into remission. I think he may be headed that way, based on his recent numbers. And that's the source of my biggest questions:

1) How often should I be testing now? How often do I need to do a curve?
2) Is my vet probably right about not shooting if BG is <150? Misha's lowest measured BG has been 68, and he didn't seem hypoglycemic--but he often sleeps a lot, so it's hard to say.
3) How can I best try to help him go into remission? I am worried about missing all these shots and wonder if we should be going down to .5 units or something instead.

Thank you very much for any tips, guidance, resources, etc. you can share, and best wishes to everyone and their beautiful kitties!
 
Hi and Welcome! Your ID makes me grin...and I'm sure you can immediately see why - :)

Squeakycats said:
1) How often should I be testing now? How often do I need to do a curve?
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Test before each shot (which you're doing) and if possible, at least somewhere around +6 after shot. If you can get one at +6 one cycle, another couple at like +4 and +8 over another cycle - those will soon be showing you a good picture. I rarely do an actual curve - by testing at different times throughout the cycles, I can put together a curve picture. Others do them every few weeks. My vet doesn't do any and, after so many years, he doesn't even ask about Dakota's FD anymore - he knows I'll holler if he's needed on that front.


Squeakycats said:
2) Is my vet probably right about not shooting if BG is <150? Misha's lowest measured BG has been 68, and he didn't seem hypoglycemic--but he often sleeps a lot, so it's hard to say.
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For non-depot insulins such as Vetsulin and ProZinc, not shooting if below xxx# is appropriate. For the depot insulins such as Lantus and Levemir, the shots need to be at such a dose that they can be given each cycle without driving numbers into below normal range.


Squeakycats said:
3) How can I best try to help him go into remission? I am worried about missing all these shots and wonder if we should be going down to .5 units or something instead.
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Rather than skipping shots, a reduction would be a better approach. Your goal is to let his pancreas rest while you're supplementing his insulin needs. A cat is a rare creature who's pancreas can heal and begin working again. THAT is how you can help him go into remission.

Your spreadsheet is the best tool after your meter - the more data you gather, the more patterns will emerge.

Again, WELCOME!
 
Oh my, that must be your adorable Squeaky--what a beauty! Thank you so very much for this incredibly helpful information! I am going to get started on this approach tonight--I'll try him on 1/2 unit, if I can figure out how to measure that with my syringe.

Is there any number below which you wouldn't shoot, given that it's a depot insulin (such a helpful concept!), or do I just need to learn what his patterns are, watch his behavior, and try not to do anything that would send him below his personal "acting weird" threshhold? I guess I should probably reserve dose changes for the weekend so one of us is here to see how he does. I've got a ton of notes about his behavior, urine output, etc. in my non-FMDB spreadsheet; I'll definitely keep that up. I'm hoping that the fact that I'm dividing his food into 3 meals and one "overnight snack" portion might help keep his GB levels somewhat steadier...but maybe that's not true with low-carb food and insulin in the picture? I haven't read enough about feeding patterns here yet :)

Again, a million thanks!!!!
 
Squeakycats said:
Oh my, that must be your adorable Squeaky--what a beauty! Thank you so very much for this incredibly helpful information! I am going to get started on this approach tonight--I'll try him on 1/2 unit, if I can figure out how to measure that with my syringe.

Is there any number below which you wouldn't shoot, given that it's a depot insulin (such a helpful concept!), or do I just need to learn what his patterns are, watch his behavior, and try not to do anything that would send him below his personal "acting weird" threshhold? I guess I should probably reserve dose changes for the weekend so one of us is here to see how he does. I've got a ton of notes about his behavior, urine output, etc. in my non-FMDB spreadsheet; I'll definitely keep that up. I'm hoping that the fact that I'm dividing his food into 3 meals and one "overnight snack" portion might help keep his GB levels somewhat steadier...but maybe that's not true with low-carb food and insulin in the picture? I haven't read enough about feeding patterns here yet :)

Again, a million thanks!!!!
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Until you have a lot of BG data, any pre shot at or below 200 should make you pause and post here for help. The usual advice will be wait without feeding for 20 minutes, retest and if BG is above 200, give the dose or post here to ask.
 
Squeakycats said:
Oh my, that must be your adorable Squeaky--what a beauty!
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Actually, that cutie in my Avatar is my extra sweet 16 year old Dakota! I laugh, I'm 'Squeaky'....got that nickname long ago and have used it everywhere for more years that I care to admit. :p Even our antique store we owned was 'Squeaky Hollow'. It began due to the fact that I've collected Mouse figurines for 40+ years and, at one time, had the largest 'Non Disney' mouse figurines in the USA. Now you know something that very few here do...:)

Squeakycats said:
I just need to learn what his patterns are,
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THAT is your key - when you begin to see what food does what, what dose does what, what stress does...all that rolled together, it will tell you what you need to do. Keep reading, keep asking questions, start posting daily, it will come together. Dose changes with Lantus takes 2-3 days to begin showing what it will actually do because of the depot action.

I really can't give you a 'no shoot' number altho' I would DEFINITELY skip a shot if it's still within the 'normal' range and likely reduce the dose. If it's below 200, post here and someone will help guide you thru it. Read both the 'TR' protocol and 'SLGS' protocols - they explain this well. 'TR' is a published scientific protocol, 'SLGS' is an adaption of that that's used here.
 
Hey there and Welcome Squeakycats! Glad you found us and yes there is lots of information here and peeps who will help you along the way. You have all ready done lots of homework by reading up here and all the stickies in this forum are really helpful to read.

You are right about the steroids causing the transient diabetes and the good news is that a lot of kitties that get diabetes from the steroids go into remission after the insulin jump starts the pancreas again along with diet change. It looks like your diet was and is good and glad that you realized that the orally meds were sugar ridden.

I like Lyresa's suggestion to take the dose down and hopefully you will be able to get 2 doses in every 12 hours. I would keep to the no shot under 150 until you get more data on Misha with shooting lower numbers. Good test to get are of course pre shots and one in the middle of the cycle and a before you go to bed test. A good test to get in to see how active the cycle is going to be is a +2. If the +2 is the same number or lower than the preshot then it indicates the cycle could be active and more testing would be required.

I like your idea of dose increases for weekends when you can monitor more. The more data you get and see how he reacts then you will start lowering the no shoot number and the experienced peeps here shoot anything over a 50 using a human meter and anything over 90 with a AT2 as long as they can monitor. Since you are using the AT2 keep in mind that if you get anything under a 68 it would be an immediate reduction.

A weekly curve is a good idea then you have a better picture of what goes on during the middle of the cycle while you are at work.

If you haven't all ready, read the stickies on Hypos and have some medium carb food ( 10-17 % ) and higher carb food (18% and higher) to use if you need to steer Misha up in the event that he goes too low. You can always add a few drops of honey, karo, or pancake syrup to his food to steer also.

Keep asking questions , we are here to help. :)
 
Hello and welcome from me too. 68 is as low as you want a kitty to go on Lantus when using at AT. I would give higher carb food if he goes below that, to bring up his numbers. As far as numbers to shoot, take a look at some of the other threads on this forum and see what happens when you shoot a lower number. Mostly the cycles are a lot flatter.

We have two dosing methods here, Tight Regulation and Start Low Go Slow, and the don't shoot below number differs between the two, 68 on TR and 90 on SLGS when using the AT. But you can slowly work down shooting lower numbers when you are home to monitor and gather data on what happens when you shoot lower. On this forum, we use 150 as the stop, don't reduced and post for help number if following TR.

As for feeding, multiple small meals is better on the healing pancreas, but try to get most of the carbs in the first half of the cycle when the insulin is stronger.

I also agree that maybe lowering the dose to .75 units so you can shoot twice a day would be beneficial.
 
Welcome to the group!

I'd encourage you to read through the sticky notes at the top of the board. The amount of information in the posts and the associated links is completely overwhelming. Because there's so much to digest, please don't hesitate to ask questions. The members of this board are very generous with their time and knowledge and will do their best to explain so you become confident in managing your cat's diabetes.

I would strongly encourage you to test before giving a shot. It's the only way to know if it's safe to give insulin. With either Tight Regulation or SLGS, you want to do your best to get a pre-shot test and at least one test per cycle every day. If you look at my kitty's SS, you'll see I'm among those who has an affinity for data. (OK, I was a testaholic but in my defense, I had a cat that would plunge into low numbers early in the cycle.) Fundamentally, you want to do what you can to gather enough information that you understand where Lantus onset and nadir fall and how much duration you're getting.

Curves: With TR, you don't really need to do a curve unless you want to. The point is to learn your cat's patterns. A curve every so often in the beginning of this process can help. With SLGS, you should get a curve every week.

No shot numbers: Again, this is protocol dependent. With TR, I would shoot anything above 50. (I also work full time.) With SLGS, the initial no shot number is higher than with TR. Ultimately, if your goal is remission, regardless of the dosing method, you want to be able to work your way down to shooting numbers that are in the normal BG range.

Skipping shots: I think the information that Lyresa provided and others commented on was a good suggestion. It's a lot easier on your nerves if you work with a lower dose so you don't have to skip -- even if it means that the numbers are slightly higher. Lantus is a depot insulin. If you skip shots, the depot, which acts something like a reservoir and gives Lantus its duration, doesn't stabilize. Typically, you hold doses for anywhere between 3 - 7 days (depending on the dosing method) which allows you to evaluate how effective the dose is and allows the depot to stabilize.

 
Thank you all so much--you are so incredibly generous to take the time to give me such detailed information! I promise to put it to good use! I hope that maybe I'll be able to help others in the future.

Squeaky, I love the story about your name and am honored to know it :)

I'm going to go read all the stickies right now! I think I read them all through once before, but it is definitely a lot to process. And I'm going to look at the protocols, too...I was afraid it wouldn't be possible/appropriate to start them since we didn't do it early in this process, but perhaps not.

I hope all of you kind folks and your precious kitties have a wonderful evening!
 
Welcome! Keep posting and asking questions. :bighug:

In my signature there is a link "where can I find". It isn't in the sticky's but has a bunch of links on where to find certain information.

Glad you found us :)
 
We did pick it! This sounds silly, but when Misha first came to live with us, he reminded me of Mikhail Baryshnikov, the famous ballet dancer. Misha was good at leaping *very* high in the air, twisting around, and landing gracefully. "Misha" is a nickname for Mikhail. Misha is also not a good thing to name your male cat when the language you speak and are surrounded by treats names that end in -a as feminine. :p Sometimes we just call him "The Squeaker" to avoid confusion--his file at the vet's office says "Squeaky" and "Misha." I should probably know who the actor is, but I don't...any clues? (I love Gordy's name!)
 
Squeakycats said:
I should probably know who the actor is, but I don't...any clues? (I love Gordy's name!)
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Haha, i love your reason! Its super cute :)
I was thinking of Misha Collins; he plays Castiel on Supernatural.

Gordy loves his name too ;) i had some weird reason for picking it when he was a kitten, but I don't remember it. Those who aren't in the "know" of my life's timeline, i tell them I named him after Gordy Klatt, the founder of Relay for Life.
 
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