New to Lantus, So Confused

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John & Apollo

John & Apollo

Member Since 2011
Hi everyone, I could really use some guidance.

My cat Apollo is 14 years old, weighs 12lbs, is indoor only and his been diabetic for a year or so now. I have been trying to regulate him and it's been a roller coaster ride. Let me give you some background info first.

I first started him on Humulin N (this is what the vet gave me and I had no idea better options were available), giving 2 units twice a day for a few weeks, then bringing him in for a fructosamine test. My vet suggested this method as he felt home testing wasn't practical. This went on and on for months. Each time we would bump him up another 2 units, wait a few weeks, then give the fructosamine test. Apollo never seemed to do well on the Humulin N. His numbers did come down, but never to the normal ranges. When we reached 10 units twice a day I decided to start looking for alternatives.

A few weeks ago Apollo had picked up some sort of virus while at the Vet and began to vomit several times over the next few days. The virus then spread to our other 2 cats and we had all 3 vomiting multiple times a day. It was NOT fun! I unfortunately didn't know I wasn't suppose to continue to give him his insulin and he went hypo. That was the most scariest thing to experience! Luckily I was aware of the signs of hypo and we rushed him to the ER and got him stabilized. He is currently eating normally again and I am ready to begin the task of trying to regulate him again. That brings me here.

Now let me give you some more info. We have 2 other cats in our household and all 3 have always been free fed. Apollo tends to eat more during the night as our other cats rule the household. We are currently feeding all of them dry Purina One Hairball and Health Weight. I know he should be on wet food, but it's just not feasible with all the other cats and I am afraid to switch him from free fed to timed meals. I did try to convert them all to Blue Buffalo Wilderness dry, but they all hated it and we went back to the Purina One after a week.

I spoke with my Vet and explained to him that I wanted to switch Apollo from Humulin N to Lantus. He had heard of Lantus, but didn't have much experience on using it on animals he treats. He agreed to let me try Apollo on it and see how he does. He wrote me a script for the Lantus Pens and instructed me to begin at 2 units (ONE) time a day. He said to do this for a week and then bring Apollo in for a fructosamine test. I questioned him on why only give Lantus one time a day instead of twice? I said everything I have read said two times a day with Lantus. He sort of brushed me off and said lets do 1 time a day and see how he does and he has heard some cats do fine on just 1 time a day, etc.

I worked up the courage to try to test Apollo's blood sugar. I was successful this morning and Apollo was at 579. I then gave him his first Lantus injection at 2 units.

What do you all think? Is giving 2 units one time a day enough at this point? Should I ignore the Vet and give him injections twice a day? Do I have to home test or can I just bring him in for the fructosamine test a couple of times over the next few weeks instead? I'm so confused. I just want to help my little buddy feel better soon. If you have any questions please feel free to ask. Thanks so much in advance for your help.
 
Hi John and Apollo-

Welcome to LantusLand! To quote someone else, this is the best place you never wanted to be. The folks here know diabetes and Lantus inside and out.

Relatively speaking, we're fairly new here, too, so I'm not comfortable going into the finer points of your post; however, I will say that Lantus definitely works best when dosed twice a day, on a 12/12 schedule. By dosing just once a day, you'll end up on a never-ending roller coaster. Most of us start out on 1 unit, twice a day, and based on test data, we adjust dosage from there. And, dosage is based on the nadir, or lowest point in the cycle, rather than pre-shots. There are some very experienced folks here who can help you determine what dose would be best for Apollo.

I will also say that it will be more difficult to regulate Apollo while he's eating the dry food. Most of us feed low carb canned only - and we generally don't go by way of the prescription foods; there are lots of commercially available foods that are a much better quality, and much less expensive. This food would not only be great for Apollo, but it would also be great for your other kitties, too! You can take your time with the transition from dry to wet, and from free-feeding to scheduled meals, so no one gets excessively stressed over the changes. However, you will want to keep a close on on Apollo's BGs while making the change, because even a simple change in diet can greatly reduce the amount of insuline he may need.

If you haven't done so already, read the stickies at the top of the forum; they're all a good starting point.

And, it's fabulous that you've begun home testing. If you'll notice our signatures here, we all have links to spreadsheets. You'll want to set up a spreadsheet to track your data. We all use the spreadsheet in GoogleDogs, and if you hop over to the tech forum, there is help there with getting your SS set up. Having your test data available this way will help the experienced folks guide you through this journey.

There is a lot of information, and it can be overwhelming. Just ask as many questions as you need to! This group is amazing, from both a support and knowledge perspective. They have helped many cats go into remission or get regulated - you can't argue with those stats!

Again, welcome!

Amy
 
Welcome John!

You're right -- your vet isn't familiar with Lantus and hasn't done his homework. You might want to pass this journal article along to him. Sometimes, giving a vet the actual publication from a feline veterinary journal goes a long way to convincing a vet that you know what you're talking about. Lantus is a once a day insulin in humans. Cats' metabolism is faster and dosing is twice a day. We see a lot of cats here that are on Lantus. I don't recall very many cats who have achieved any consistent degree of regulation on a once a day dosing schedule.


Home testing will give you a great deal more control over what's going on with Apollo. You would have had far more warning about low numbers if your vet were encouraging you to home test. I'm really glad you have started to get numbers. Setting up a spreadsheet will also help you to keep track of what's going on and to see patterns in how Apollo is responding. It will also allow us to help you. Home testing will also save you a small fortune. You will not need fructosamine tests -- all they do is provide an average of blood glucose levels over a 2 - 3 week period and your spreadsheet will demonstrate those levels admirably. If your vet is running curves, you won't need that either. Personally, I can't emphasize the need for home testing enough. When I first came to FDMB, I was lurking on the Health board. When someone asked about home testing, a member responded by stating that if this were your child, would you give insulin, which is a potent medication, blind when you could test and know what your child's blood glucose was and whether it was safe to give a shot. I closed my laptop and went out and bought a glucometer and took charge my cat's diabetes. If you found this board and are asking these questions, you are obviously concerned about Apollo's safety. Home test. The trips to the ER are too emotionally draining to shoot blind and testing will allow you to change your cat's dose in order to keep him safe or to manage his diabetes effectively.

And now the bad news.... The Purina hairball formula that you are feeding is 27% carb. You will likely need a fair amount of insulin to counterbalance that high of a carbohydrate diet. We encourage everyone to feed a canned, low carb diet. Low carb is under 10% carb and most of us feed somewhere in the neighborhood of 5%, give or take. Is there any way you can transition all of your cats to canned food? The dry stuff is bad for all cats. I'd suggest you take a look at the website written by Lisa Pierson, DVM on feline nutrition. She discusses at length how cats are obligate carnivores and have no physiological need for grain, veggies, etc. She also has a section on how to transition even the most stubborn cat off of dry and on to a canned food diet. In the interim, you may want to try EVO cat and kitten food. While it's a dry food, it contains far fewer carbs (i.e., 8%).

Please keep asking questions. The people here are very willing to help. You may find answers to some of your questions in the starred, sticky notes at the top of the Board. There's a lot of information to absorb so, please, let us know how we can help.
 

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Hi guys .. I just wanted to stop in and say welcome .. I know others here have answered most of your questions which is great .. You guys will soon be pro's at handling lantus and your kitty and how his numbers will be changing .. but there are always people here to help offer support through it all ... so welcome from us and have a great day!
 
Thank you both for your suggestions.

I will definitely pass along the article you listed to my vet. He really is a good vet, but I just think he is inexperienced with treated cats and especially treating them with Lantus.

I know home testing is the best option. I just don't know how well Apollo will tolerate me doing it. That's why I thought maybe the fructosamine test was a better option (even if it was more expensive) as I would be able to get an average that way and not have to poke him. My vet suggested the fructosamine route instead of doing curves at the clinic since Apollo gets pretty grumpy at the vet. He felt the numbers would be off because of Apollo's aggression. I'm going to get some more test strips and try testing at home using the spreadsheet.

I had a feeling the food wasn't the best for them. Ok, dumb question. Why does it matter if the food is high in carbs, if you just adjust the insulin dose accordingly? Isn't the goal to get them into a regulated zone? Or are people just saying that the low carb food lowers the amount of insulin needed, and that's always a good thing. I was just a little confused when I read that.

If I switch to wet food for all my cats how would I handle feedings? Separate all 3 and give them their food? What if they just look at me and don't get that they are suppose to eat? Do I leave the food down (won't it just dry out)? Do I just pick it up and eventually they will figure out those are the times when they need to eat? Sorry for all the questions.

How often do you feed cats wet food? Do you leave it out? Like I said Apollo eats in the middle of the night, so it's going to be a hard switch for him. I just don't want to stress him anymore then he already is. He has been getting more and more frail in the backside the last few months. You mentioned the EVO dry cat food. Can you suggest me a version? That might be a good interm step while we transition them to the wet food. What wet food do you recommend for all 3 of my cats?

Thanks again for everyone help.
 
Welcome Extra sweet Apollo and John!

I understand your confusion - I was wearing your shoes a few weeks ago. First, you're told your sweet baby has diabetes. THEN you're told to give him shots which the majority of people never dreams they would do. THEN your vet tells you one thing but everything you read says differently. The vet says home testing isn't 'easy', isn't 'accurate' as well as other reasons. They tell you Humulin N will work. You try and try......and TRY.......and it still doesn't work. Now you're pulled 2 ways - follow what your vet says or follow what all the other diabetic kitties hoomans do. It's a decision YOU have to make. After all, all you want is your sweet baby to feel better.

THEN you read and read....and read some more.......after a while you know a lot more but it's all still a jumble. WHERE did you read this? HOW was that done? Humm........yep, CONFUSION!

Don't worry - the confusion WILL settle down and you WILL start remembering it - the dance isn't all that complicated, it's just different than any other dance so you have to learn new steps. Apollo will share that dance....happily.

A cat's metabolism is about twice a human. Lantus is a single once-a-day shot for humans but for cats and their metabolism, twice a day works better. We were trying our hardest to make Humulin N work but it's just too 'unpredictable'. The lows vary not only by numbers but also by time of day. It also doesn't work for 12 hours - we could only get about 7 hours per shot. Adding those up - that's 14 hours of a 24 hour day. That leaves 10 hours that Apollo's body doesn't have ANY support for his glucose levels.

Dry food - KT STILL begs for his dry food, especially since his 2 'main house' civvies are hard food addicts. I'm slowly working that out and finding ways to keep him from it but it's not easy yet. I have gotten the civvies (non-diabetics) to expect their dry food once a day, eat it then and I pick it up. KT gets either favorite wet food or some of his freeze-dried treats to keep him occupied. I'm transitioning them to wet food also but one of them is VERY hard-headed, he still will only eat a few bites of wet then want his dry.

Yes the vet will continue to want you to bring Apollo in for tests - they make MONEY. Their tests don't really tell you what his BG numbers are as a vet trip usually causes stress - stress raises BG levels. YOU have to decide which way you want to go. My vet didn't initially care for my taking charge of KT's care but when he realized I was going to do it anyway AND that I had a plan to follow, he let it go. NOW he's interested in what Lantus will do - this is his first experience with anything other than Humulin N. There aren't many vets with DETAILED knowledge to treat diabetes - they study it but it's only an 'overview'. Many vet schools even teach old methods because that's what's 'in their books'...

I didn't mean to write a book BUT I hope you at least get something out of it that will 'stick'. Don't worry about the confusion, it WILL get better...

Hugs to Beans and scratches for kitties,
 
everyone's given you great information so far! there's not a lot for me to add, except to second it. i think nearly all of us have a story similar to yours - the bottom line is canned food is better for all of them. you won't need hairball med or weight control formulas if you're doling out the canned food.

i had punkin on easy-on-your-bladder vet prescription dry food. he had regular bladder infections, 1-3 times a year for probably 7 years. switched him to canned food last february - no more bladder infections.

we had anya (our non-diabetic) on easy-to-digest vet prescription dry food for chronic diarrhea - from it being untreated when she was a kitty at the humane society. she's completely fine on the canned food now.

if they show signs of hairballs you can give some butter and it will slide right out.

the food is fine left out all day. punkin is our diabetic 13 year old - i use fancy feast classic foods because 1) they love them, 2) they are instant portion control for us, 3) they are far cheaper than the prescription and 4) i can see how both cats' health has improved since the switch to canned food. their hair feels better, they simply seem better.

some people used timed feeders - i'm home a lot so for punkin (13.8lbs) i put out 1 can of fancy feast at shot time, another 1/2 can 3 hours later. then i repeat it again in the evening. i have to feed anya in a separate room because punkin will eat his and hers as well! he's got an appetite!

the reason for switching to low carb food rather than just giving more insulin is probably more complex than i know how to answer. for one, insulin is expensive. also, Lantus has a very good track record of cats going off of insulin, but if you don't change the diet that's simply not going to happen. think about a diabetic human. they still can't go out and gorge on sweets - some people can become diet controlled and not use insulin. it's the same way with cats. i've been on FDMB since february and have seen 29 cats go off of insulin in that time. it doesn't happen to all of them, but your goal is to have apollo be under control and as healthy as possible whatever it takes.

i'd switch all 3 of yours. their little bodies will thank you for it. in "real" life, a cat's ideal food is a mouse - not much about dry kibble resembles a mouse! if you have trouble getting them to eat canned, there are all kinds of tricks to help. mix the canned with the dry, gradually increasing the wet. grind up the dry and sprinkle it over the top. sprinkle on parmesan cheese or pour on tuna water.

if you have a hoover who will eat everyone's food, you might have to separate them to feed them. i feed anya in the laundry room and punkin just outside the closed door. when anya's done (she eats a fraction of what he eats) i open the door to let her out and he finishes up her plate. most of us feed our diabetic cats the bulk of their food in the first 3-4 hours after the shot, then they don't get food til the next shot. that lets the carbs be taken care of when the insulin is its most effective. it wanes on the second 6 hours of the cycle. another reason why only shooting once a day seems crazy to me - lantus reaches its peak about 5-7 hours (every cat is different) after the shot. so shooting once a day would leave a lot of hours of high blood sugar floating about in apollo's body.

testing done at the vet's is going to reflect stress - cat's can go up as much as 100 points there. apollo will learn to be fine with the ear testing - make sure you give a little low-carb treat every single time you poke him. pretty soon he'll tolerate it fine. also, neosporin with pain relief (i like the ointment) will take the ouch away. put it on in the evening and the ears will heal overnight. make sure you put a little pressure to stop the bleeding after you poke or it will bruise, which hurts more.

i don't want to overwhelm you with more info so will stop there. keep asking questions. post as often as you want and we'll try to educate you so you can help apollo! feel free to look at cat's spreadsheets and see how others do things - also read other posts. there is a ton to be learned from explanations to other people as well. don't go by punkin's spreadsheet, however, he has acromegaly, a tumor that changes everything in the game plan. we're here in colorado getting treatment for him right now.

and welcome to Lantus Land!
 
John & Apollo said:
I know home testing is the best option. I just don't know how well Apollo will tolerate me doing it. That's why I thought maybe the fructosamine test was a better option (even if it was more expensive) as I would be able to get an average that way and not have to poke him
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Apollo may give you a hard time at first. We have tricks if that's the case! First and foremost, no matter whether or not you have a successful test, Apollo gets a treat. Like I said earlier, cats can be very motivated when treats are involved. I also test on an elevated surface -- my kitchen counter. It's not a spot that's associated with play, Gabby is at my eye level, and it's her spot. She knows that's where she'll be tested 95% of the time. Many of our cats will jump to their test spot and sit and wait for you. If Apollo is cantankerous about testing, there are methods, like a "burrito wrap," that are a good temporary measure until he acclimates to testing.

Why does it matter if the food is high in carbs, if you just adjust the insulin dose accordingly? Isn't the goal to get them into a regulated zone? Or are people just saying that the low carb food lowers the amount of insulin needed, and that's always a good thing. I was just a little confused when I read that.
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Chemically, carbohydrates are the same as sugar. When you think about it in those terms, why would you feed a diabetic sugar? I guess you could keep feeding Apollo the dry food you're giving him and use more insulin but it doesn't really make sense nor will you ever have a chance of getting your cat on a lower dose or insulin or into remission. To use the kid analogy, would you feed your diabetic child a cup of ice cream at each meal? Probably not. Bottom line -- diabetes is a disease that is exceptionally hard on pretty much every organ system. The less sugar that's floating around, the better and healthier your cat will be. In addition, a cat does not need carbs in their diet. All they need is muscle meat. The most carbohydrate that a cat in the wild would get would be from whatever is in the GI track of their prey and whatever is in the GI track of prey is already partially metabolized.

If I switch to wet food for all my cats how would I handle feedings? Separate all 3 and give them their food? What if they just look at me and don't get that they are suppose to eat? Do I leave the food down (won't it just dry out)? Do I just pick it up and eventually they will figure out those are the times when they need to eat?
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I have 2 cats. They get the same food. (I feed Wellness chicken or turkey.) They each have their own bowl. I do not hover when they get fed. I also use a timed feeder for when I'm gone during the day. I don't put out a pile of food only because Gabby will eat what's in front of her and she'd probably hoover up all of the food that's sitting out. It's more likely that she's sleeping when the feeder opens and my kitten has a chance of getting his fair share. Many people here will free feed canned food. Gabby is on a feeding schedule but that's because of how she responds to insulin and it's a topic for another time. In the beginning, it's best to not offer food after nadir (lowest point in the cycle). This is usually around 6 hours after you shoot. Once BG numbers start to come back up, there's less insulin available to counteract the effects of food so it's best to not feed after nadir.

If you add water to canned food, it will not dry out. You can also make "catsickles." You mix canned food with water and freeze the mixture in an ice cube tray and leave a couple of cubes for the cats. They melt slowly so there's fresh food available. Like I said, we have tricks!
 
John & Apollo said:
He has been getting more and more frail in the backside the last few months.
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This could be because of diabetic neuropathy. Getting his BGs under better control should help clear this up if it is neuropathy, but you can also consider supplementing him with B12 - that has also helped a lot of cats here. There are a few folks here who use it; I don't so I can't remember exactly what they use, but I'm sure someone can make an approporiate recommendation.

We're all here to help, so ask as many questions as you need to! And, there have been a few tough kitties when it comes to home testing, so someone can definitely guide you there if necessary, too. The test really, truly does get easier. I didn't believe it at first, either, but it does! Like Sienne said, you want to give a treat at every test and every shot, even if the test isn't successful. And, you want to be sure that treat is low-carb, too! We use PureBites freeze dried chicken here...it's a huge hit with all 6 of my furbombs!

Amy
 
Welcome to Lantus Land, i see you've already gotten an avalanche of information and there is more to come. Vets don't get a great deal of training in things like diabetes. They get an overview and i suppose information on how to find specifics when the problem arises. They have to learn about all animals, diseases, traumas etc. My vet just looks at me now and says, "You're the expert, what do you need?" We have made this our focus, which they cannot. You will get there too.

That said if proper feline nutrition were taught, many of the diseases rampant today wouldn't be a concern. Diet is the key to everything. Cats are obligate carnivores, they evolved eating meat. Period. Cats do not have the enzymes needed to break down the carbohydrates we are pouring into them and their intestinal tract is much shorter than those of omnivores and so much of their food passes through undigested. Diabetes is a starving disease. Too much sugar in the bloodstream damages the pancreas, the pancreas then cannot produce insulin to allow the glucose into the cells for energy. Even though there is lots of energy supply available the cells cannot use it, so the cat is hungry and eats more food he cannot process properly. The excess carbs end up getting stored as fat, the ct gains weight all the while being under nourished. it's a vicious cycle and the key is getting the unuseable carbs out of their diet. Stepping off my soapbox now, but here are some great pages w/ detailed info on feline nutrition
http://catinfo.org/
http://maxshouse.com/feline_nutrition.htm

Bottom line is, canned food, or even better, home made food is far better for all your cats. It may even prevent problem occurring down the road for your other furballs.
 
Thank you all so very much for answering my questions. You really don't know how comforting it is to have knowledgeable people to turn to. It's hard when people look at you like you are crazy for going through all these steps to help your cat.

I am going to give it a go with the home testing and see how we do. Apollo wasn't too happy, but I think I can get him used to the testing. I am currently using a One Touch Ultra Mini that we got for free from the Doctor a few weeks ago. My wife was suspected of having low blood sugar issues, but it turned out not to be the issue. The monitor was just sitting in the box brand new, so I took it out and gave it a try. Is that the one people recommend? I read about the Bayer Elite in the support docs, but all I can seem to find for sale is the Bayer's Contour. I'm going to need some new strips soon, so before I buy any I'd like to get some input. Should I just keep the One Touch Mini or make the switch to the Bayer now. The one thing that I didn't like about the One Touch Mini was once you inserted the test strip in you have a limited amount of time to get the blood sampled before it shuts off. It's hard to hold the cat and grab the meter in that short of a time frame.

I'm going to take a look at the food list and give it another try to switch all 3 over to wet food. Thanks for the recommendation on treats. I'm going to try those as well. If I come up with any more questions I'll be sure to ask.
 
We call the freeze dried chicken "kitty crack" you can get it much cheaper at PetsMart in the dog food treats, they have a house brand. I just cut them smaller. keep the dust to sprinkle on the canned food, it works wonders. :lol:

A lot of people here use the One Touch , the problem is the cost of the strips. Companies are happy to give the meters away because the profit is in the strips. Many here use the Walmart Relion brand. Readily available and the strips are among the cheapest. If you stay w/ the One Touch you can get strips online cheaper. Check out E-bay and even Craig's list. Or can you wife still get strips on her medical? We tend to use a lot, because the cats can't tell us how they are feeling. Testing is the only way to know for sure.
 
If you get timed out on the meter, just pull out the strip and reinsert as long as you don't have the blood drop on it.
 
Welcome, welcome. Everybody has given you a lot of great information and a lot to digest.

I wanted to comment on the food. I know where you are coming from. We have two kitties who were always free fed dry science diet hairball control. They were definitely crunch addicted cats. We gradually transitioned them over to canned over a period of a month. The vet will try to sell you the prescription canned. Don't do it. Fancy feast classic is what a lot of us use. Mainly, any canned food that they will eat that does not contain gravy is a good choice to get them transitioned over. We still free feed with the canned. Tarragon is a night eater so I know what you are talking about. You can still free feed with canned. It can sit out for 12 hours. I mix one can of FF with about 1/2 - 1 can of water and it keeps it moist and then they get some water in their diet as well. A lot of people use timed feeders. However, my kitties will just eat until they are full and then leave it, so them eating everything at once is not a problem. Plus, I don't want to add the stress of not having food readily available.

The carbs are important because it is sugar. You want to give as little insulin as possible. My thought was the same as yours when we first started. However, the lower the carbs, the lower the insulin, the healthier the cat.

Home testing - I never thought we would ever be able to do it. Just use a lot of treats and be consistent with your testing spot so your kitty will know what to expect every time. Always do your pre-shot tests and try to get a full curve at least once a week. +2, +4, +6, +8 are very valuable as much as possible during the week. You want to find the nadir (lowest point in the cycle) to be able to adjust your dose. You will be amazed at how the kitty will know what to expect and stop fighting you after awhile. It will be less stress on the kitty than going to the vet and you can make sure they don't have another hypo.

We are all here for you and there are some really knowledgable people on this board. Please be sure to ask a lot of questions.

Welcome again.
 
Are the dog and cat treats exactly the same other then size? Seems like more places carry the dog ones.

I will definitely by the strips online. I've found various brands of strips much cheaper online. Amazon would be my preferred place to by as I have prime membership and can get anything amazon sells directly in 2 days shipped for free. I just wanted to get a good solid meter recommendation before I jumped in and bought the strips and the lancets. No my wife can't get the strips on her medical insurance as they are for Apollo. Since she doesn't have diabetes they would flag her for fraud I'm sure. Why can't Apollo just be covered under our family medical insurance? He is my "kid". :smile:
 
Hi John and Apollo and DW, you're at the right place to get advice, suggestions, support, and a good laugh! We all totally agree that our kitties are part of the family and should be covered under our medical insurance. You've gotten a ton of good information and it will take some time to digest but you are heading in the right direction. It's a marathon, not a sprint, according to Julie (I think).
Liz
 
John & Apollo said:
Are the dog and cat treats exactly the same other then size? Seems like more places carry the dog ones.

I will definitely by the strips online. I've found various brands of strips much cheaper online. Amazon would be my preferred place to by as I have prime membership and can get anything amazon sells directly in 2 days shipped for free. I just wanted to get a good solid meter recommendation before I jumped in and bought the strips and the lancets. No my wife can't get the strips on her medical insurance as they are for Apollo. Since she doesn't have diabetes they would flag her for fraud I'm sure. Why can't Apollo just be covered under our family medical insurance? He is my "kid". :smile:
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hello and welcome to the group!

the Whole Life brand Freeze Dried Chicken Treats we use are for both cats and dogs. whatever brand you choose, read the label before purchasing. some of them add other ingredients such as sodium. this could be problematic for some kitties.

i've been using the freestyle brand meters for the last 5+ years. freestyle strips cost more than the Relion brand meters many use, but i was getting too many error messages when i tried the relion meters to feel comfortable with daily use. you can get a freestyle meter kit which comes with a freestyle lite meter and 200 strips for less than the cost of 200 strips alone at American Diabetes Wholesale: http://www.americandiabeteswholesale.com/product/free-freestyle-lite-meter_28_53.htm. i order the kit whenever i need test strips and give the free meters to my vet for his new diabetic patients. shipping is free on this kit. ordering online results in a savings of close to 50%.

i won't bombard you with any more information for now. you've been given a lot to digest.
hope to see you posting often!
 
I was using the One Touch Ultra Mini until just last week. I did love it, but the cost of the strips - even when I ordered them online - was just getting to be too much. I switched to the Relion from WalMart, and I have to say I wish I made the switch much sooner! The strips cost a fraction of the price that the OT strips were, especially if you order them from American Diabetes Wholesale (IF you order from ADW, the strips are "Arkray" brand.). The meter itself was only $9. And, it takes less blood than the OT Mini did.

As Ann said, you just have to pull out the test strip and reinsert it if the meter times out. When we first started testing Trix, I would keep the strip inserted, but not all the way, until I saw that drop of blood forming. As soon as I saw the blood, I pushed the strip in the rest of the way to "boot up" the meter.

The dog and cat treats are usually the same, at least the PureBites are. It's definitely more economical to buy the largest bag of dog treats possible, then just break them up into cat-sized pieces.

Amy
 
TrixieCat said:
As Ann said, you just have to pull out the test strip and reinsert it if the meter times out. When we first started testing Trix, I would keep the strip inserted, but not all the way, until I saw that drop of blood forming. As soon as I saw the blood, I pushed the strip in the rest of the way to "boot up" the meter.
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Yeah I figured that out, but it wasn't so easy when trying to keep Apollo still, keep the drop of blood from flying off, then reaching for the meter to push the strip in, etc. My wife helped me this morning by handing me the meter exactly when I needed it. Unfortunately Apollo tends to get a little skidish when my wife is very close by. He does love her and all, but we think he affectionately refers to her as "The Blonde Monster". :-D
 
Hi! Just want to add my 2 cents. I am new to feline diabetes but have been a diabetic, type 1, for almost 50 years so the routine and steps were not unfamiliar to me. It is, however, different treating my cat and treating myself but testing IS the key to all control and good care. If you do not know where your kittie's BG is, you can not know how he is doing. That is the same with humans and unfortunately, feline diabetes behaves much like type 1 in cats even if it isn't. Cats generally need insulin if they can't be diet controlled so please do keep testing your cat.

Morgaine was not easy to test at first. She is now assuming the position because she knows it means a treat or food. She loves to eat.

Read Lisa Pierson's article on feeding your cat, linked upthread and do read the Lantus study also linked upthread.

I am pretty new to this board and I can tell you that with all of my knowledge of this disease, I could not be doing what i am doing for my cat without the wonderful people here. We are a community here and we all welcome you and your family of felines. It will get better. When you see those numbers coming down and your sweet cat feeling better, you will know you made the best possible decisions.

As a human diabetic I can attest to the excellent advice and knowledge of those here. My endocrinologist would applaud this community and he is an expert in human diabetic care.
 
John & Apollo said:
TrixieCat said:
As Ann said, you just have to pull out the test strip and reinsert it if the meter times out. When we first started testing Trix, I would keep the strip inserted, but not all the way, until I saw that drop of blood forming. As soon as I saw the blood, I pushed the strip in the rest of the way to "boot up" the meter.
Click to expand...

Yeah I figured that out, but it wasn't so easy when trying to keep Apollo still, keep the drop of blood from flying off, then reaching for the meter to push the strip in, etc. My wife helped me this morning by handing me the meter exactly when I needed it. Unfortunately Apollo tends to get a little skidish when my wife is very close by. He does love her and all, but we think he affectionately refers to her as "The Blonde Monster". :-D
Click to expand...

Now that you mention it, it was a 2-person job for us in the beginning as well, until we all got used to the routine. I think it probably took us 2-3 weeks before we all (me, hubby, Trixie) were comfortable testing on our own. But, if we got there, you can too :-D !

Funny about your wife...well sorta :lol: ! Maybe if she gives him enough treats, he'll change his tune. Funny how easily adaptable kitties become when good food is involved!
 
Just wanted to say Welcome to Lantus Land! I won't add advice as there is so much going on in this condo already but you're doing great. Everyone here has been so helpful to me and Smokey. It is like a big family. Apollo is such a handsome boy! Keep asking questions- it gets easier for sure.
 
Welcome to LantusLand! Sammy and I have been here since June and the PZI just couldn't get him regulated. He was off the juice for over a year and then went back on the insulin.

You will find that his BG will go down when you start feeding canned. I still have a couple of crunch addicts at my house and it doesn't help that the dog likes cat food more than dog food. We feed Fancy Feast Classics or Friskies Pates. Those are the cheapest and best. You can also feed Wal-Mart brand Special kitty or 9Lives. Anything WITHOUT GRAVY. Gravy is a no-no. To much wheat gluten/corn. You will find yourself reading every cat food can too.
Good luck with Apollo. cat_pet_icon
 
Hi John and Apollo and welcome to Lantus Land.
I'm not going to add anything to all the great advice you have been given already. Just remember that it does get easier. And a tip on the blood drop: blood beads up much easier if you put a little vaseline near the edge of the ear before you poke. We have had good luck with the Relion meters (Walmart brand) and also with the FreeStyle Lite. Both take a tiny blood drop.

Welcome again. Don't forget to breathe!!

Ella & Rusty
 
Thanks again for all the great advice and support.

I only have a couple of testing strips left (didn't get enough blood on a few and had to trash them). I have more testing strips and lancets on order and they should be here sometime tomorrow. I am going to go to Petco and get some Purebite treats.

I am trying to take it slow, but feeling a bit overwhelmed by all the changes that need to happen for this to work. I am gaining confidence on the blood testing part. I think once I have the treats to give Apollo he will be more accommodating. He can definitely tell when I prick him though, cause he gives a huge flinch. Does that lessen as they get used to it or is it just something that is going to happen? Also I am having a little trouble with making sure I get a big enough drop of blood to test. I am learning what size it needs to be before I attempt to test and not waste a strip, so that is good.

Now the biggest obstacle for me is the food. I've tried to change all 3 cats twice in the past and both times Apollo wouldn't eat the wet food. I would put him in a room to eat and he would just look at me like "what"? I'd come back in a bit and he would maybe eat a few bites or so. I think he is just used to free range eating (or maybe he likes dry food better) and doesn't get that this is the time to eat and not when he feels like it throughout the day. I am afraid of him not eating enough and then I will have to stop with the shots to avoid having him go too low on blood sugar. It's a vicious cycle. Maybe I can just put out the wet food free range and let him eat when he wants? My only fear is one of my cats is a porker and will each it all if I let him. Should I switch to the EVO dry and continue going free range in the interim? Or just leave him on the Purina for now and change the food later while I am curving him? I know it's in his best interest to switch to the wet food in the long run, but I'm just trying to come up with a plan to get us there. I'm just torn on what to do with the food situation.

I now have a Google Spreadsheet setup. I am planning on doing my first curve as soon as my test strips arrive. Do you all think I am giving the correct dose thus far? I know if I change his food over to something else that it can change the amount of insulin needed to be given.

Btw Apollo has been VERY lethargic the last few weeks or so. He gets up to eat and use the litter box, but otherwise sleeps the rest of the time. Now he always slept a lot, but this is much more then he usually does. For example, when he would sleep before he would perk up and be wide awake if someone came in the room or he heard a noise. Now he just opens his eyes like half way and goes back to sleep. The extreme tiredness started a few weeks ago. Going back to when he was still on Humulin N and then he went off that and now he is starting on the Lantus. It could just all be a symptom of the diabetes not being controlled properly, but is a little scary to see him like this. How long until he should start to feel better on the Lantus?
 
Now that you have your spreadsheet set up, you will want to start a "condo" each day like you see on the forum. That way you have a place to ask questions and get answers without sifting through old posts. You would title it as:

9/22 Apollo AMPS 579

Then you can put "Question" or "Dosing" or just "Help" at the end of the title to catch people's attention. :-D

I haven't read back through all of the posts on this thread. What is the reason for two different doses yesterday? 2U at AMPS and 1U at PMPS?
 
John & Apollo said:
Yeah I figured that out, but it wasn't so easy when trying to keep Apollo still, keep the drop of blood from flying off, then reaching for the meter to push the strip in, etc. My wife helped me this morning by handing me the meter exactly when I needed it. Unfortunately Apollo tends to get a little skidish when my wife is very close by. He does love her and all, but we think he affectionately refers to her as "The Blonde Monster". :-D
Click to expand...

It's MY hubby that makes KT skittish when testing. Why I have NO idea - wait, maybe I do. He's extremely uncomfortable with the whole routine - it scares him. Maybe his being nervous translates to KT.

All that will get easier. I can now plug in the strip while KTs eating his first couple of treats. I then warm his ear with his rice sock, he lays down when treats are gone, I poke and 'drink drink' (my words for "be still") and we're done. Is there a longer setting on your meter?
 
Hi Melissa,

Thanks for the "condo" suggestion.

Well I started with 2 units since he was very high and before I had a chance to get all the great advice from the group. I then changed to 1 in the evening because his blood sugar did come down a bit. Then back to 2 in the AM shot because he went back to very high again. I realize it makes more sense to stay with 1 consistent dosage at the beginning, but I just don't know for sure what starting dose he should be on based on his circumstances? My vet isn't much help as he has no experience with Lantus. He told me to give 2 units 1 time a day which I now know is totally misinformed.
 
Squeaky and KT said:
It's MY hubby that makes KT skittish when testing. Why I have NO idea - wait, maybe I do. He's extremely uncomfortable with the whole routine - it scares him. Maybe his being nervous translates to KT.
Click to expand...

I have had Apollo since my college days (pre-wife). I think he just never completely embarrassed the idea of sharing his daddy. :smile:

Squeaky and KT said:
Is there a longer setting on your meter?
Click to expand...

Nope it's a One Touch Mini and just shuts off if you take too long at the collecting blood stage.
 
he's likely lethargic because his BG is so high. btw, stick with the same dose morning and evening. not sure why he got 1unit last night, but you want the same dose every 12 hours.

those are some pretty high numbers - have you had a chance to check him for ketones yet? we want to get those numbers down as quickly as possible.

i'd say do whatever it takes to get him to eat the canned food. you can pulverize the dry and sprinkle it on top, add the water from a can of people tuna, sprinkle on parmesan cheese. i'd also get some water into him to help flush out any traces of ketones that might want to be showing up.

any chance of getting a mid-cycle test so we can see how low he's going on this 2 units? or a last minute at night one?

my husband didn't want to have anything to do with the testing or shooting, but he was willing to help me hold punkin while i mangled my way through learning it. after he'd sat next to me for a few weeks he tried it - and guess what, now he does all the shooting and tests part of the time. try having your wife just help holding apollo - also she could be the treat-giver, that might reduce her Blonde Monster reputation!!! :lol:

the way Lantus works is that when it's injected it turns into a precipate, micro-crystals, that then dissolve over time. we call that deposit a "shed." every time a dose is increased some of it is used to build the shed and the rest is available in the body. the size of the shed corresponds to the size of the dose. for the first few days a lot of the lantus is going to build the shed, that's why we say to hold the first dose for 5-7 days and do a lot of testing. then we start tinkering with the dose, based upon the BG test numbers we see. any subsequent dose changes you have to wait for the shed to change as well, up to 3 days or so, so you see what the dose truly is doing in apollo's body.

we'll help you with all of that - it's hard to "see" the changes when you're learning how it all works. we're all generous with our time and help because others did the same for us. it's a great site.

re the testing equipment - i use a Freestyle Lite and am happy with it. i go through mrrebates.com to sign up, then i click on American Diabetes Wholesale to buy my supplies. doing it that way i get 8% rebate on the ADW purchases. ADW is already about 1/2 of the cost of retail in your local store. the packaging all comes "not for retail sales" but they are the same thing exactly that you buy in the store. so my 50 strip package is about $27 minus 8%. i use about 5 strips a day. the walmart relion is probably the cheapest but i don't have a walmart within 1/2 hour drive, and i wanted something i could run out to get strips if i needed to.

i set the test equipment on the arm of the sofa: the lancet device with a lancet in it, the meter with the strip in it, but not pushed in to make contact, a tissue to stop the bleeding afterwards, vaseline for a morning slick onto the hair so the hair doesn't absorb the blood drop, and neosporin with pain relief for the end of the day so he's ok by morning.

grab one punkin and hold him against my body under my right arm (i'm right handed), and start with the poke. i don't push the strip into the meter until i have a big enough drop. the freestyle lite drop needed is about the size of a plastic sewing pin head.

i had to burrito wrap him in a beach towel for about 2 weeks, but then he got used to it and now he comes and jumps up into the spot. that's because he wants the piece of boiled chicken that he always gets after the poke. he's quite food-motivated! :lol:
 
julie1220 said:
he's likely lethargic because his BG is so high. btw, stick with the same dose morning and evening. not sure why he got 1unit last night, but you want the same dose every 12 hours.
Click to expand...

See my comments in a post above.

julie1220 said:
those are some pretty high numbers - have you had a chance to check him for ketones yet? we want to get those numbers down as quickly as possible.
Click to expand...

Unable to check for ketones as I have 2 other cats and can't get a reading even if I wanted to. I do know he drinks a ton of water and the urine clumps are huge.

julie1220 said:
any chance of getting a mid-cycle test so we can see how low he's going on this 2 units? or a last minute at night one?
Click to expand...

I can't until I get more strips tomorrow. I only have 2 left. One for tonight and one for tomorrow morning. Once I get more I plan to do a full curve on him.

julie1220 said:
my husband didn't want to have anything to do with the testing or shooting, but he was willing to help me hold punkin while i mangled my way through learning it. after he'd sat next to me for a few weeks he tried it - and guess what, now he does all the shooting and tests part of the time. try having your wife just help holding apollo - also she could be the treat-giver, that might reduce her Blonde Monster reputation!!! :lol:
Click to expand...

I like the idea of letting her give him the treats. That just might work. :)

julie1220 said:
the way Lantus works is that when it's injected it turns into a precipate, micro-crystals, that then dissolve over time. we call that deposit a "shed." every time a dose is increased some of it is used to build the shed and the rest is available in the body. the size of the shed corresponds to the size of the dose. for the first few days a lot of the lantus is going to build the shed, that's why we say to hold the first dose for 5-7 days and do a lot of testing. then we start tinkering with the dose, based upon the BG test numbers we see. any subsequent dose changes you have to wait for the shed to change as well, up to 3 days or so, so you see what the dose truly is doing in apollo's body.
Click to expand...

So how much should I be giving him to get started? With his numbers so high I am afraid starting at just 1 unit twice a day isn't enough? At his peak he was on 10 units twice a day with Humulin N and still not in normal ranges. I realize they are both completely different in the way they work though. I just want to get his numbers down as quickly and safely as possible. But not sure if I should give 1 unit, 2 units, 3 units etc twice a day to get started? Or do I just have to wait to do a curve before I make any changes beyond 1 unit twice a day?

julie1220 said:
re the testing equipment - i use a Freestyle Lite and am happy with it. i go through mrrebates.com to sign up, then i click on American Diabetes Wholesale to buy my supplies. doing it that way i get 8% rebate on the ADW purchases. ADW is already about 1/2 of the cost of retail in your local store. the packaging all comes "not for retail sales" but they are the same thing exactly that you buy in the store. so my 50 strip package is about $27 minus 8%. i use about 5 strips a day. the walmart relion is probably the cheapest but i don't have a walmart within 1/2 hour drive, and i wanted something i could run out to get strips if i needed to.
Click to expand...

I just decided to get some more test strips for the One Touch Mini ,since I am used to it. I will reevaluate switching to a different meter once I get more comfortable though.
 
Hi John & Apollo,

Generally speaking the starting Lantus dose for most cats is 1 unit every 12 hours. If one of the very knowledgeable dosing people thinks he may need to start on a higher dose after having been on 10 units of Humulin N, they will advise you. I suggest you put this question in the new condo that you should open today. Here is the rubric you can use in your subject line to get eyes on your problem:
9/22 Apollo AMPS 579, dose?
(I think I remembered seeing AMPS was 579, but correct the number if my memory is faulty)

I'm sure that Sienne, Jill, Libby, and some of the other very knowledgeable folks will be along soon.

Good luck with the test strips. It's always good to have a back-up meter and strips, so when you get your new meter you can use the present one as a back-up.

Ella & Rusty
 
Another Lantus Land welcome coming at you!!

You've been given a ton of information, so I won't pile on much more!

The treats definitely do help... Willie wasn't enthusiastic about pokes at first (though, without teeth or claws, my job wasn't that difficult! :lol: :lol: :lol: ), and we couldn't do treats right away because the vet suspected he was allergic to poultry and we were avoiding fish b/c of the phosphorus. After eliminating the possibility of an allergy, we started the chicken purebites and life got MUCH easier! He will actually track me down when he has numbers he wants to show off!!

My one suggestion is to print off the stickies at the top of the page and put them in a binder with the address and phone number to your regular and emergency vets on the cover. There is so much information in the stickies, and I always found that when I really needed a particular piece of info, I could never seem to remember which sticky I had seen it in. The binder allowed me to take my own notes and tab/highlight/etc. so I could easily find what I need when I needed it.

I would definitely look at the Walmart Relion meter if you walmarts nearby as it is extremely cost effective, you have reasonably priced strips available at all hours (my walmart sells the strips at $36 for 100 or $0.36/strip) and an online option for purchase through ADW (the Arkray Glucocard 01 is the generic version of the Relion Confirm) that is even less expensive.

One other product suggestion if you are looking to transition to wet food... Fortiflora is a probiotic supplement made by Purina. While probiotics certainly help with digestion, stinky poo, etc., the magic of fortiflora is that it contains the same animal digest that is used to coat dry cat food, which is what makes it so addictive to cats. When Willie is less than enthusiastic about a food, I can waft the fortiflora packet under his nose, then sprinkle a bit on the food and it usually does the trick. We do a homemade diet, and because I work full time, I rely heavily on "kitty cubes" or food frozen in ice cube trays so that Willie can eat throughout his cycle without gorging himself.
 
Christie & Willie said:
The treats definitely do help... Willie wasn't enthusiastic about pokes at first (though, without teeth or claws, my job wasn't that difficult! :lol: :lol: :lol: ), and we couldn't do treats right away because the vet suspected he was allergic to poultry and we were avoiding fish b/c of the phosphorus. After eliminating the possibility of an allergy, we started the chicken purebites and life got MUCH easier! He will actually track me down when he has numbers he wants to show off!!
Click to expand...

I just picked up some Purebite treats tonight and Apollo LOVES them. Woohoo!

Christie & Willie said:
My one suggestion is to print off the stickies at the top of the page and put them in a binder with the address and phone number to your regular and emergency vets on the cover. There is so much information in the stickies, and I always found that when I really needed a particular piece of info, I could never seem to remember which sticky I had seen it in. The binder allowed me to take my own notes and tab/highlight/etc. so I could easily find what I need when I needed it.
Click to expand...

That's a great idea. It is a little hard to sort through all the posted information.

Christie & Willie said:
One other product suggestion if you are looking to transition to wet food... Fortiflora is a probiotic supplement made by Purina. While probiotics certainly help with digestion, stinky poo, etc., the magic of fortiflora is that it contains the same animal digest that is used to coat dry cat food, which is what makes it so addictive to cats. When Willie is less than enthusiastic about a food, I can waft the fortiflora packet under his nose, then sprinkle a bit on the food and it usually does the trick. We do a homemade diet, and because I work full time, I rely heavily on "kitty cubes" or food frozen in ice cube trays so that Willie can eat throughout his cycle without gorging himself.
Click to expand...

I will definitely pick up some fortiflora to see if that helps. Thanks for the link.
 
Just wanted to comment on the concern you have about Apollo's weakness. If it is neuropathy, be patient because it takes time for that to heal since it has effected his nerves. I have read many good reports about it improving for many of the kitties here but like all of this, it takes patience. Same with humans.

You are doing such a great job dealing with all of this. It does get easier and both you and Apollo will find a nice rhythm to dealing with this. Morgaine also loves the Pure Bites. I buy mine at Amazon as i am a prime member and i get free shipping. I get the large bag, about 12 oz. I can now get Morgaine to allow me to do anything by offering her a treat. No treat until I am finished but we clean her chin, her nose, her ears, by offering treats, along with doing her many blood tests. :smile:
 
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