New to Lantus-need dose help please

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Traveling Cats

Traveling Cats

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I am brand new here and brand new to diabetes. We do not have a vet to help us. I don't know what dose to give him right now or if I should be giving insulin at all.

You can see my first post here: http://www.felinediabetes.com/FDMB/viewtopic.php?f=3&t=14128

Nay is 13 yo, weighs 20 lbs. He had been drinking/ urinating frequently for a few months so I brought him to a vet to be tested for DM. Fructosamine levels were 386. The vet told us to feed him Hills MD and limit food intake to 3/4 cup a day. At the same time she prescribed 1 unit Lantus 1 time daily. Nay was not hospitalized and has never had a glucose curve done. We will not see that vet again nor do we have a relationship with any vet (we live in a motorhome and travel all the time). We have been giving insulin injections one unit once daily since 5-6-10 (only 5 days). We have learned to do blood glucose testing on the internet. His preshot tests at home have indicated a glucose in the 190's. He continues to drink and urinate a lot.

Right now (4:25 pm) his glucose is 210. He is due for a shot in one hour. Should I change to injecting twice daily at .5 unit? Should I hold insulin if PS is < 200?

Thanks for your help!

Edited to remove the "!" icon.
 
hi and welcome. I took a quick look at your link and see you got responses there. I didn't read through them yet, but wanted to respond to your questions/concerns


You need to shoot lantus twice a day (BID) in 12 hour increments. It's great that you are home testing - or shall I say mobile home testing ;-) , as that is going to be key for you to manage this journey that you are all now on.

While the number 190 is high, it's not a dangerous number and the choice is what are you right now more comfortable doing, shooting 1 unit or .5? Either is fine to start, as you will now shoot BID.

As you gather your data - BG readings throughout the cycle, we will be better able to advise you when to change your dose.

Also, in order to make it easier to understand (we are all in different time zones) - we don't say the time such as 1:00 pm or 12:30 pm, rather we use the clock in the number of hours since the AM or PM shot - so it looks like this:

AMPS = morning pre-shot BG number
+1 = 1 hour after amps
+3 = 3 hours after amps
.
.
.
.
+11 = 11 hours after amps
PMPS = evening pre-shot BG number
+2
+4
..
.
.
+11
Next day AMPS

Also, here is a link to the google spreadsheet we use to track BG's - if you start using it and attach it to your signature, we can all follow it very easily:
http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=16


Now let's talk about food, as that could also be a concern here - what foods are you feeding Nay? If you are using dry food, even dry treats like pounce or temptations - dump all that and use .5 as your starting dose.

If you are feeding canned food - which ones are you using? Not all canned food is the same, some are very high in carbs and good to keep in your hypo tool kit:

You want to keep the carb % below 10% and around 7% is great. The other link is to a site by a vet "Dr. Lisa DVM" ... who also posts on this board from time to time ... there is in-depth info. there about many things, including nutrition and how to make raw food.
Nutrition/food info


Oh and welcome to the group.
 
Hi Melissa, welcome!

I posted a response in your Health thread, but I'm copying it here to keep everything together:


melissapeterman wrote:
His fructosamine at the vet office was 386 before changing his food. We have not seen any BS numbers like this at all at home since we switched food.
Click to expand...


question, was the fructosamine 386, or was his blood glucose reading 386?

Fructosamine is a blood test that is usually sent out to a lab. It is a great tool for diagnosing feline diabetes because it gives a clue as to the cat's average blood glucose over a period of time, instead of just one blood glucose taken at the vet's office in a stressful situation.

They are two different tests, though, and the numbers don't correlate directly (a fructosamine of 386 doesn't mean his average blood glucose was 386). According to this chart, 386 is just barely above the range for a non-diabetic cat, and would point toward "excellent control" of a diabetic.

To answer some of your other questions, I would definitely change to shooting twice a day (BID) instead of once a day (SID). Cats' metabolisms are faster than humans, and we see far better stability among cats who are dosed twice a day. My vet recommended SID dosing too, so I just split the dose she told me to give in half and gave it twice a day, so the total amount of insulin was the same as what she said. Then I adjusted the dose from there.

Generally there is no problem shooting Lantus at around 150, even for newbies. Those of us who are not newbies routinely shoot lower than that, once we have collected enough data on our cat to enable us to do so successfully.

I hope this helps, and isn't too much information.
 
I have a copy of the lab in my hands. Fructosamine was 386. Glucose read > 450 (he hates going to the vet and was very stressed out). Based on that chart he is barely diabetic! Maybe he would be better controlled with diet alone!

I have created a google spreadsheet, it is in my signature line titled "sugar profile".
 
you're currently feeding dry DM, is that right? Any wet? Have you tried just feeding low carb wet?

Sorry for all the questions, just trying to gather information. :smile:

So far it looks to me as though the insulin is needed. That may be because of the dry food., or it may not. What if you shoot your usual 1 unit tonight, and then do some spot checks to see what the insulin is doing? Unfortunately it's nighttime so that would mean a long night, or setting the alarm a couple of times during the night. The spot checks will help us see what is going on.
 
Ok we made a decision to change our dose to .5 BID and monitor blood sugars after this shot. I am SO glad that I found this board!
 
Welcome Melissa and Nav and Chris!

A BG level of over 450 is diabetic BUT, if Nav was stressed at the vet's office, it may have inflated his numbers. The fructosamine may be a much better indication of where his levels have been.

Given that you are on the road, trying to buy prescription cat food is an unnecessary headache. The Hills MD is higher in carbohydrates than (i.e., 14%) than what we encourage you to feed a diabetic cat (i.e., under 10% carbs). If you are feeding MD dry, it's carb content is about the same. However, both are poor quality food in that they contain primarily meat by-products. I'd encourage you to read Dr. Lisa Pierson's site on feline nutritionand select canned foods that are less than 10% carb from Janet & Binky'sfood charts. (Sorry, I wrote this before looking at your Health post.) Will Lexi eat canned food, as well? There's no reason that Lexi and Nav need to be eating different food.

Not to waste some typing, I do think getting Nav on a lower carb diet while slowly transitioning him to wet food may drop his numbers -- which look pretty good already. One caveat, though. The Walgreen's meter has a tendency to underestimate BG numbers. You may want to see if you can pick up another meter. Many people here use the Walmart Relion meter which is inexpensive, as are strips. He may be able to be diet controlled, as you guessed but, he will need to be on a low carb diet to help him get there.

Please let us know if you have any questions. The front end of this learning curve is huge. We're here to lend a hand.
 
Hi melissa.
happy to see you found your way over to lantus land.
sorry I overwhelmed you w/ information :shock: You're going to do fine.

I think starting at .5 BID is a good choice given then numbers you had on SID dosing.
although this is your 5th or 6th day shooting, since you were only shooting SID the shed might be a little wonky so your dose will need a few days to settle.
I look forward to seeing how Nay handles his new shot sced. numbers wise. keep us posted !
( Did you get your hypo tool box put together ? )

meterwise.... sorry the one your friend sent you didn't work out.
I would be happy to send you a OTU mini or a Bayer Contour if you are going to be in one place for few days to get mail. Thing is, with those meters strips at the store are not cheap. I always bought my strips on ebay. Not sure how that would work for you. You might be better off with the Walmart relion meter and strips that others have mentioned b/c of the convenience of getting more strips easily (and inexpensively) on the road. let me know and if you decide you would like one of the meters I have send me a mailing addy via private message aka pm. don't want to post that kind of thing on the open board for your safety.

no more information from me tonight :razz: I think you have plenty of reading to do. :smile:

please keep the questions coming and welcome to lantus land !
 
Ditto what the previous posters said about food- I've noticed a nice drop in the last week or so since I finished transitioning my newly diagnosed cat to wet only. We have a non-diabetic cat too, and she's slower to take up the wet, but these last couple of feedings with wet only have been soooo much easier.

It will get easier, I promise! Good luck and welcome to the board!
 
Welcome to the board. I have to agree with everyone about the prescription food. An expensive waste of time. There are plenty of good canned food out there that you can buy at a supermarket or wal mart that you pass on your travels.
 
Just want to welcome you this board is the best place to be they have really helped Do Lou and I take time to read the sticky's at the top when you can they can really help you learn a lot and again welcome to LL. :mrgreen: :mrgreen:
 
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