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Donna & Doogle

Donna & Doogle

Member Since 2011
I wanted to introduce myself, my name is Donna and I have a 7 year old sugar kitty named Doogle. We live in Birmingham, AL. Doogle was diagnosed last September and the vet put him on Humilin N. At first he was on 2 units twice a day. That was going pretty good for awhile. I had already moved him to wet food (all because of this website) and that helped keep his numbers down. We were going in every two weeks and checking his BG to make sure it was ok. It was always around 350 at the 12 hour mark. Then his numbers started to climb after the first of the year to the 400s around but acted ok and was eating fine. So the vet decided to move him up to 3 units every 12 hours. So ok that did pretty good for awhile also. Now in the past 2 months he started losing weight, but eating like crazy and drinking more (I knew there was something wrong). So he bumped it to 4 units a few weeks ago. The whole time I have been saying we should try a different insulin but he is an old school vet (but a great one) and isnt to familiar with anything else. So we decided to start home testing (didnt before to be honest because I was to scared Doogle wouldnt like it and stress out). Testing was the best thing we could have done....it gave us the numbers we needed. He would be ok for at least 8 -10 hours then the check before his shot would be in the high 400s. So went to the vet today to have him see the BG numbers and its was 494. I told him about the numbers we got and that the Humlin N was lasting long enough (which I knew already from testing and from reading here). So the vet decided to go ahead and change him to Lantus at 3 units. So now my question is, He got a Humilin N shot at his regular time this afternoon (actually an hour later because of the vet visit). Do I go ahead and give him the Lantus tonight at his normal 12 hour time (which is 1am central) or do I wait till his BG gets high? Just tested him and he was at 345. So I guess my question is, will switching him make it drop dramatically? Also, when should I test him after giving it to him. I was thinking about 2 hours after it. I also want to say I absolutely LOVE this board!! I have found out more info on here that my own vet. He was very impressed actually on how much I knew. He was thrilled I started home testing because most of his patients that do have diabetic animals are to squeamish to do it. I have told everyone I know about this site and educated them on cat food (how dry is so bad for them and what wet foods are best). So I want to thank you so much for being here for us that have questions, are scared and just need to know there are others out there in the same boat.

Sincerely,
Donna
 
Hi Donna,
Glad you finally posted, and that you were able to get your vet to switch insulin! I am not 100% sure of the answer, since I've not had any first-hand experience with Lantus. I feel confident in saying that you could shoot at your normal shot time, because there shouldn't be any carryover of the Humulin since it is a shorter duration insulin.
What I am not sure of is what the dose should be.

You should always test just before giving the insulin, no matter what type you are using. With Lantus, when first switching, it would probably be a good idea to get a test a couple hours later, and again at six hours after the shot. What you will see is that the dose of lantus is determined by the "nadir", or the lowest point of the 12 hour cycle. You shouldn't see the rapid drop with Lantus that you would see with Humulin. It's a much more "gentle" insulin. Every cat is different when it comes to the timing of the "low point", but generally we think it happens around six hours after the shot. By testing during the cycles, you will learn when Doogle's lowest point is.

I am very happy to hear that you were able to share what you have learned so far here with your vet, and I hope that by doing so, you will help the next diabetic cats he sees. If nothing else, you have "introduced" him to a new insulin, one that is much better suited for use on cats than the Humulin is! Great job!

Carl
 
Donna,
I posted a request on the Lantus forum for one of our Lantus users to come over and let you know what they think as far as the appropriate starting dose.

Carl
 
Thank you for the warm welcome! We decided to give him 2 units instead of 3 units. I would rather start lower and go up. One thing I am not sure of, should he eat an hour before at least before giving him the shot like we had to do with the Humilin? We didnt give him his shot at 1 since we actually didnt give him his afternoon shot till 2...so we are about to test again here in a second and then give him the shot. I am going to start his spreadsheet at this time also. Thank you so much. I will be back with an update soon.

Donna
 
Hi Donna

It's great that you could learn from this website and present info to your vet. Lantus and Levemir are both long-lasting and great insulins.

Many of us in the Lantus Insulin Support Group (ISG) use a Tight Regulation protocol. The TR protocol was developed based upon the premise that a cat's pancreas may be able to heal and return to producing insulin if the cat's BG is kept in a normal range, ie, 50-120. Caregivers following this protocol adjust insulin doses following the protocol guidelines, to aim for that range. In order to follow the TR protocol, caregivers need to test a minimum of preshot time (to determine if it's safe to give insulin) and again mid-cycle (to find the lowest point of the cycle in order to determine dosing). If the cat is likely to get into low numbers, then the caregiver needs to test enough to keep the cat safe. The starting dose for the TR protocol is .25u/kg of the cat's ideal weight every 12 hours. So if the kitty's ideal weight is 10 lbs, the dose is calculated as 10/2.2 (there are 2.2 kg to the lb) = 4.55 kg x .25u = 1.1u so we'd start the kitty at 1u bid (twice a day).
If you want to follow the TR protocol, we strongly encourage you to post daily in the Lantus TR insulin support forum for a while to learn more about how it all works.

The Start Low Go Slow (SLGS) protocol has caregivers start with an initial dose based upon the BG at diagnosis and whether kitty has been transitioned to a wet low carb diet, hold that dose for a week or two while testing for ketones regularly, being consistent with food and shooting every 12 hours. Once a week a curve is done (test every 2 hours for one cycle) to check for the lowest point. The low number in that curve determines any dose change for the following week. If you want to follow the SLGS protocol, you can post for advice on the TR ISG, the Relaxed Lantus or Main health for guidance and support.

The starting dose for SLGS is:

• 1u – 2u twice per day if kitty’s glucose was higher than 400mg/dL at diagnosis OR if cat is not on a low carb diet
• 0.5u – 1u twice per day if kitty’s glucose was less than 400,g/dL at diagnosis OR if the cat has been switched to a low carb diet

I hope this info helps in calculating a starting dose for Doogle.
 
darksoulvv said:
One thing I am not sure of, should he eat an hour before at least before giving him the shot like we had to do with the Humilin?
Click to expand...

I saw this after my initial post. Lantus does not typically onset until +2 to +3. Most of us test our cats and then feed and shoot within about a 15 min time span. If he doesn't eat right that moment, it's ok, but you definitely want to be sure he has food on board before the lantus onsets. Here is a typical lantus curve:

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.
Click to expand...

Lantus and Levemir work based on an insulin depot. The depot must fill before you start to see the effects of the insulin and before the kitty starts to use the shot you are giving. My point in providing this to you at this point is that it takes several cycles to fill this depot to the point where the shots will be used. So you wouldn't expect to see action from this insulin on the first cycle.
 
Ok, thanks for the info....it helps me a great deal. It will take me some time to learn the lingo but I know it will become a second language for me soon. We checked him about 30 mins ago for his preshot and it was 359 so we gave him 2 units (although the vet wants us to do 3). He is only 9.5 lbs at the moment after losing a whole pound in a few weeks. I started his SS with the PMPS and will test him again in a few hours. I am not sure if we should do a tight regulation or a relaxed since he was on the Humilin N for 8 1/2 months. So I guess advice is needed there also......lol. Had to make sure the hubby handled the Lantus right (he is so used to rolling it to get it ready). I will keep his sheet updated. This is actually our second cat to have diabetes but the one we had before I didnt even know this site existed and we did it all wrong. He lived for a year and a half and went into a diabetic coma because we didnt keep up with dosing correctly. So this time I am making sure we do it all right and hopefully get a regulated kitty soon.

Donna
 
Marjorie and Gracie said:
darksoulvv said:
One thing I am not sure of, should he eat an hour before at least before giving him the shot like we had to do with the Humilin?
Click to expand...
Click to expand...

You don't want to feed between +10 and shot time - this is to make sure that the test you are getting is not food influenced and that it's safe to shoot.

I am so glad you didn't follow your vet's advice to start at 3U!!!
 
Good job getting the SS set up so quickly. Make sure to enter the dose you shoot in the "U" column also. How's it looking this morning?
Carl
 
Well unfortunately we werent able to check him at the +6 and +9 (hard to wake up when you have worked all day and exhausted...lol) but we just checked him and he is 465. Which I am sure is because he doesnt have a build up yet of the new. So I am not going to panic. But looks like 2 units didnt last 12 hours. Should we bump it up .25? He is acting like normal (playing, active and wanting to eat).

Donna
 
I'm at work do it'll have to be brief...
Don't kick up the dose yet. Lantus works on consistency. It lasts at least 12 hours. Have you ever tested for ketones, and do you have any numbers from the last couple of weeks on humulin?
Abd how long has he been eating low carb canned and no dry food?
carl
 
We just started testing a couple of weeks ago (not super consistenant but enough to convince the vet to change). He has been eating FF classics and Friskies pates since Sept 25th (he was diagnosed Sept 29). His numbers were (this is just a couple of days, didnt have a SS at that time setup):
AMPS 450
+3 171
+6 254
+9 330
PMPS 484

This is pretty much the way it ran when we did test (I wasnt always home to test and the hubby never wrote it down). I am not going to panic....with the Humilin N I was pretty used to high number before the time to shoot. About to test now and give him his shot in about 10 mins. Update soon : )

Donna
 
Ok, AMPS 385 so we gave him 2 units. I suspect his high +10 at 465 was stressed induced. The other cats was getting in his face and then knocked off the testing supplies and Daddy got mad and yelled at them. Not good for my baby's nerves...........lol.
 
I will do that. Is that something to really worry about with Lantus? The vet didnt mention it and I have read about it on here but Doogle never showed any real signs of Ketones? Is there a recommended brand or way to do it? I am not always at home to do that and dont know if the hubby will be willing to do that (he does the morning testing and shots during the week). Yall have been so awesome........thank you again for being here for me and Doogle. I already feel like I am getting to know yall. I am going to post a pic soon of my baby.

D

Update on the high +10 number....I found out the hubby gave Doogle a can of Friskies Prime Filets Salmon and Beef with Sauce which I had one can of left (Found it was to high in carbs so gave it to the outdoor kitties I feed after the tornadoes made them homeless). No wonder his number was so high and then back down before his shot. I promptly told him never to give him anything outside of his FF Classics or the Friskies Pate. Thank goodness that was the last can of that.
 
You can just buy the Clinistix ketostix at the pharmacy. I suggest that when you open them, you use a marker to put the date on the lid as they expire six months from being opened.

Different members test different ways. Some are able to just hold it under the kitty as he pees and just get some on the little test site at the bottom of the stick. I make little foil trays and slip them under her as she squats and she pees in the tray and then I dip the stick in the urine. Some put saran wrap in the box but I've never used that method so not certain of the specifics. But you need the liquid of the urine...I don't know if it will work if you just stick it in a clump of urine and litter.

Once the urine is on the little colored test site at the bottom of the stick, time 15 seconds and then read it against the chart. And it's pretty sensitive to 15 seconds....any longer and it will continue to turn and you'll think it's reading more than negative.

If you can test just once a day, that is fine as long as it stays negative. If you get "trace", please let us know. If you get anything more than trace, call your vet.

Yes....it is important that an unregulated cat especially at high numbers, be tested at least daily for ketones. Diabetic ketoacidosis can be fatal and it can progress quickly. All it takes is not enough insulin, infection (that you might not even be aware of), not enough food/water. It's best to stay on top of it by testing daily.
 
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