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Adrienne & Eli

Adrienne & Eli

Member Since 2012
Previous Condo

Hi, I'm new to the Lantus Forum. I've attached my previous condo which should give some background info. I thought Eli was progressing well with removing the high carb food until his AMPS +6 today which was 338 and higher than the pervious nadirs. Can someone look over Eli's numbers and provide any insight.

On a side note, Eli hasn't pooed in about 30 hours - someone on the other board said he might get constipated if I changed his food so fast (which I did). Is it too early to be concerned about this? Is there something I can do to help it or does it require a vet visit?

I also have a vet visit for this afternoon, not required, more on my panic of making sure Eli is okay. His neuropathys has gotten worse the past few days (no worse today than Sunday), from researching, I don't think there is anything really the vet can do at this time - do I need to go to the vet this afternoon, or continue to monitor his BG and wait? I have an appt next Tuesday for them to do a curve (which I may now be able to do myself at home). Thanks!
 
Welcome to the Lantus forum! You'll find a lot of helpful information at the top called Stickies, and there'll be a wealth of information provided to you by the experts, and experienced folk on here.
 
Adrienne

Just as quick note, your SS has 10/19 for today instead of 10/16 :-D

Thanks for allowing me the time to look back over everything. First, the vet visit is up to you. If he hasn't pooed in 30 hours, that would be my major concern and worth a vet visit. Typically changing food, especially dry to wet where there is more water, would more likely result in diarrhea but if he has had normal poos until the switch, it could be the food. I would ask the vet about giving him miralax.

Insofar as seeing the vet about FD, the vet will likely tell you to raise the dose and quite often, they want to raise it by large amounts. We don't do that here because you could miss the "fitting dose"...the right dose....and get him overdosed. Throw in the factor of you stopping the dry food and raising his dose too much could really put you fighting low numbers.

So...if I understand correctly, you stopped the dry food two days ago and he's been getting only FF classics since then. I would hold this dose one more cycle and see what he does tonight. If he does not come down into a blue number, I'd increase his dose to 1.25u tomorrow but it's important that you monitor him. The dry should be out of his system by tomorrow at the very latest. The typical starting dose for lantus is .25u/kg of IDEAL weight and so if his ideal weight is 18 lbs, the starting dose was probably a little low. But, because he was on dry, it's good to be cautious and slowly move up the dosing scale, if necessary, now that the dry is gone.

I know you said you will have limitations on monitoring him. In a perfect world, starting out, you would get a PS, +3, +6, +9 tests. But if you are limited in the ability to do that due to work, you can do it on the weekends or whenever you have off during the day. For those who work, they try to arrange their schedules so they can get a PS and a +2 test because the +2 test will give you an idea of where the numbers might be headed that day. If you can't do that, then you will need to get an out the door test and then when you get home, an in the door test.

A couple things on previous condos. First regarding methylB12. Zobaline is made specifically for cats and is FD friendly. Second, I saw someone advise you to feed him as much as he wants while he is unregulated. I'd like you to read Feed Kitty as Much as They Want? because it offers a different perspective that most of us follow here. The best way to know how much to feed him is to determine how many calories/day he needs for his body weight. A very, very general formula is 20 calories/pound but if he was overweight, it might need to be less. The post above gives Dr. Lisa's website and I would encourage you to read her comments on how to calculate how much he should get.

Lastly, regarding his numbers today, any meter can have up to a 20% variance and so his numbers are pretty flat. Let's see what he does the rest of the day and tonight. But I think he will probably need some more insulin come tomorrow morning.

Again, welcome and please let us know your questions.
 
Thanks for the info.

As an update, I did take Eli to the vet. It appears that he has hurt his left hip which was causing alot of his mobility problems, not the neuropathy. I was given Metacam as pain treatment, and the vet assured me this wouldn't affect his diabetes/insulin use. She wanted to increase his dosage to 2 units - we agreed to 1.50. Do you think this is too high and I should just go to 1.25 and then monitor to increase to the 1.50? I'm not going to increase the dosage until the AM shot, and I will be here all day tomorrow and Thursday to monitor.

As a happy note - she kept Eli's spreadsheet for his file and didn't run any of her own blood glucose tests (although I'm pretty sure she thought I was somewhat crazy)!
 
Please do not give Metacam. It has a black box warning for cats. Most of us here have red flags in our cats' files against giving metacam or convenia which is a long acting antibiotic.

Yes...I do think 1.5u is too much of an increase especially in light of his diet change. I would stick with the increase to 1.25u. Is this the same vet that had you dose lantus once a day and put him on dry w/d? I never want to disparage anyone's vet but I am not sure she understands how long duration insulins work. But she would not be in the minority among vets. Most of us have dealt with the same issue.
 
This has been such a roller coaster ride, I thought this would help and now I'm back to step one. Is there an alterative to Metacam? Please let me know so I can call the vet in the morning and return the Metacam and go another route. Luckily I didn't administer it yet. The dosage was 1/2ml once day for three days and the 1/2 ml every other day for 4 days.
 
Welcome to the forum! You will find tons of good information and lots and lots of experience here. Marje is a wonder woman, and she gives great advice and will also answer any questions you have about anything - I've been here a couple months and I realized pretty early on that my vets don't understand FD as well as the folks here, but they have been very willing to learn. They understand I'm following this protocol, and they don't tell me what to shoot anymore - instead, they are really interested in Leo's spreadsheet and the fact that we test and monitor him so closely! We went up too high on dosing in the beginning, based on our vet's advice, and Leo did some terrific bouncing all over the place and we ended up down where we should have been in the first place. It takes some patience sometimes, but keep asking questions and good luck to Eli.

Thanks Marje, for reminding us about Dr. Lisa's feeding page - I've been meaning to reassess Leo's feeding since he's gained weight back to his normal weight. He will not be happy that I think he may be getting to much food now. :o

Lisa & Leo
 
I'm glad Marje mentioned the issue with Metacam. The FDA Black Box warning is due to it's causing acute renal failure in cats. (Your vet should really know this.)

Many of us use buprenorphine or tramadol for pain management. The downside is that they both have narcotic properties and some vets are reticent to prescribe them. I would really push for one of these vs. any of the nonsterioidal anti-inflammatory drugs (NSAID) since all of them, especially Metacam, can be problematic for cats.

Given that Eli has seen some nadirs that are below 300, the dosing protocol we use recommends a dose increase of 0.25u. You would hold this dose for 3 days and then evaluate the next step unless Eli's numbers drop below 50. In that case, he gets a dose reduction.
 
Hi Adrienne-
Glad to see you over here in LL. You are going to get great input from the 'experts.' Many vets just don't have the same understanding of FD as these people that have 'been in the trenches' with their furrybabies. I shudder to think what could have happened to Fur Ball had we not home tested and kept him on the 2 units twice daily dose our vet recommended. We also made the food change at the same time we started insulin. Yikes. So glad we found this sight and closely monitored FB. You would never tell a human to take insulin without testing so why would we do that for our babies.

Keep up the good work as you care for Eli.

Karen
 
I agree with Sienne. I have a kitty with arthritis and we use buprenorphine for pain. If it is an arthritis issue, talk to her about using cosequin which is non prescription or adequan which is an injection.

I will bet you 90 to nothing that your vet will tell you MetaCam is safe to use in cats in low doses. Please do not buy into that. We have had a member who lost her kitty to renal failure due to MetaCam and who was instrumental in getting the black box warning. This is your kitty and you have the final say as to what goes in his body. I know my vet used MetaCam in her clinic cat with arthritis for many years and Taffy did fine. But, considering the amount of times it isn't fine, it isn't worth it to me.

Don't get discouraged. We've all been where you are....starting out is hard. It's also difficult to decide whether to put your trust here or put it in your vet. But we live FD 24/7 and we will be here for you the first time his numbers go low. We will guide you through this. This site has gotten a few hundred cats into remission. I wonder if your vet has that kind of a record. But, ultimately, it's your decision and we will support you in any way we can.
 
Thanks for all the great advice. There is absolutely no way I'm using the Metacam. I did an internet search about it and saw enough to scare me away from it forever.

Also, I agree with only going up .25. That was my plan even though I got the vet to agree to 1.5. I think she already thought I was a little wacky when I walked in with my color coded spreadsheet and told her Eli was no longer allowed to eat the perscription food.
 
Made me chuckle that your vet thought you were 'wacky.' Well. if Wacky gets you a healthier happier cat and hopefully remission, then I'll take wacky any day. :lol: :lol:

We haven't been back to the vet since 9/11. And I am soooo looking forward to returning with a handful of paper/information, our color coded spread sheet, return the dry prescription food she had us purchase and tell her that he is OTJ!!!!! What an amazing day that will be. And, if we can provide her w/ education that helps other kitties then this will be so worth it.

Fortunately our guy has not had any other health problems so I can't offer any input on those questions.

Hang in there. You are doing great. Just keep reading and learning.
Karen
 
Made me chuckle that your vet thought you were 'wacky.' Well. if Wacky gets you a healthier happier cat and hopefully remission, then I'll take wacky any day. :lol: :lol:

We haven't been back to the vet since 9/11. And I am soooo looking forward to returning with a handful of paper/information, our color coded spread sheet, return the dry prescription food she had us purchase and tell her that he is OTJ!!!!! What an amazing day that will be. And, if we can provide her w/ education that helps other kitties then this will be so worth it.

Fortunately our guy has not had any other health problems so I can't offer any input on those questions.

Hang in there. You are doing great. Just keep reading and learning.
Karen
 
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