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Maresydotes

Maresydotes

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Hi, I am a new user. My cat, Missy, was diagnosed with feline diabetes in mid-March. My vet got me to do home testing and injections. After finally coaxing her from dry food to canned EVO Turkey and Chicken, she started to lose weight (4 pounds since March, more to go)and went in to remission in mid-April. (honeymoon phase, I guess :-( ) I checked her weekly until the end of July and she was always fine...80's to 100. I missed a week or two and noticed that she had started begging for food around the beginning of August. I tested her on August 10 and she had a BG of 225. Took her in to the vet and they verified she was spilling sugar into her urine. They checked he for a urinary tract infection, but she was clean. So, we have started twice a day BG testing and injections again. She is getting 3 units of Lantus insulin. I have noticed, recently, she seems to be drinking more, although I haven't seen excessive urine output, but she DOES go outside. She seems active and alert, although maybe not quite as much as she was prior to this relapse. Her only other health problem, right now, besides diabetes and weight is she has had persistent chin acne. I have been treating it for over 6 months. First with pyoben, which dried her skin out quite badly. Now we are using Douxo. It seems to work better, but she still has the acne.
I have a couple questions I would like to ask. #1. What is the optimal time to do testing? I have been testing her at 10 AM (husband a second shifter) before she eats and 10 PM. She gets breakfast after the 10 AM test and injection. Then she gets a couple small meals (staying within her calorie limits) during the day, usually the last one about 8 PM. Is this a good way to test her or is there a better schedule? Should I feed her an hour after injecting (isn't that when the insulin starts to work, so she will absorb nutrients?) or is it ok to feed her right after her injection?
Also, since she seems to be drinking more and her numbers are fairly consistently in the low 300's (sometimes less and a few times when I didn't inject her) should I be increasing her dosage? Isn't my goal to see 'normal' numbers, even though she has to get injections? It doesn't seem like I am doing her much good if her numbers are consistently that high. Any help would be GREATLY appreciated! Thanks a LOT
 
Welcome Missy and Missy's Mom!

Since you are familiar with diabetes, my suggestion would be to post in the Lantus forum (under Insulin Support Groups) for advice about dosing. (have you always used lantus?)
Your schedule is fine. You should give lantus doses on a 12 hour schedule, same dose each time. Most people test, then feed, then dose. That way you know she is eating enough to dose her. With lantus, the best thing to do if at all possible is to also get a test about 6 hours after dosing, when she reaches "nadir". Lantus dosing is very dependent upon the time of day when her BG would be at its lowest point.
The small meals during the day are fine, you just want to hold food back a hour or two before testing so that the BG test does not reflect sugar she might be getting due to eating.
I am sure some lantus users will be along soon to advise, and I am sure they will encourage you to post in the lantus forum, where there are many long time lantus users who can help to answer any questions you might have regarding dosing.
Again, welcome!
Carl in SC
 
Thanks, Carl in SC. (hope you weren't affected by Irene) I was SO proud of her weight loss and her very rapid response to food change, this was such a blow. 3 months of normal readings and then WHAM! My vet and I cannot figure out why the change? We haven't changed anything in her routine or feeding. Is it possible she will remit, again? Has anyone had a cat do this?
 
Yes! My cat went into remission twice. 31 days on the juice first time. 2.5 years otj, than back on the juice for 1 and 1/2 years, not otj again.
Good Luck!
 
Thanks, Lori. It was heartening to hear it CAN happen. My vet thought she would remit quickly, but it has been almost a month with no change in sight. She is such a sweet cat.......purrs the whole time I am testing her, reminds me when its time, if I am late (loves those Live-a-Littles) and handles all of it so well. I feel so bad having to do this to her, but I have M.S. so am somewhat used to giving injections and knowing that even though you have to do unpleasant things, it can make your quality of life much better. I just wish I could explain it all to her. Tonight she was all wild and wooly (sp?) and it makes me feel so much better seeing her all playful and acting like she feels good. Thanks for the hopeful message!
 
Hi,

I'm sorry Missy fell out of remission.

I just thought I'd pop in and make sure you've started this round of treatment with a fresh vial or pen of Lantus. If you kept it in the fridge all this time then it would no longer be effective. I just wanted to double-check that with you.

The other issue with the higher numbers might be due to a starting dose that is too high. 3 units is a little high to start with - most cats start at 1 or 2 units. If the dose is too large it could force her into higher numbers when her body goes into a protective mode.

Good luck,
Pam & Layla
 
Hi Pam,
Thanks for the concern. I DID get a new vial of Lantus. I have read about the pens, but don't know much about them, as yet. I need to look at where we started her in March, but 3 units was where she was during most of that time. My vet had me go to 4, but when I tested her at 6 hrs after that dose, she was way low, I think around 40, scared me to death. That was when I really realized how important testing was. If I hadn't tested her then, I could have given her her second injection and put her over the edge! Scary.
She seems to be feeling so much better than the first go-round. Maybe the weight loss contributes, but her numbers are pretty similar and she is way more active than before. I guess she went into remission so quickly the first time, I hadn't really had time to dig in to dosing, etc. Just doing what the doc told me. This time I am not so freaked out (sad and disappointed, maybe, but not freaked) so I am questioning a little more. I read a LOT about feline diabetes in March, but didn't really have time to process much when she remitted. All I thought was 'hallelujah'! So, this time I am trying to get help from all of you all who have been there. My vet is awesome, but she only has so much time to answer my questions....
I appreciate your input. It would be really easy to overlook the time span. I recently read somewhere that insulin strengths can vary from lot to lot. Has anyone experienced that? I never made it through the first vial before she remitted. Is that something you really have to watch when you start a new vial?
Thanks again :-)
 
Welcome!

How was the dose of 3u determined? Most cats on a low carb canned diet don't need much more than 1u of insulin. Testing before each shot is great. Can you also get one more test in daily around 6 hours after one of her shots? This is the number that you want to adjust her dose from. 3u is a very high starting dose of insulin, and one possibility is that her dose is too high. Too high a dose will keep a cat in high numbers just as much as too low a dose at the preshot tests, so that's why the daily mid-cycle test is so important.

If too much insulin is not the problem, I would look for a possible source of pain, infection or another secondary medical condition. Dental problems and UTIs are two common issues that can drive cats out of remission. Bandit was in remission from 9/2010 until the end of this past June, and he had to go back on insulin because of a traumatic medical procedure. He went back off insulin a couple weeks ago. Once the source of pain or infection has been dealt with, usually the cat will go back into remission.

Can you set up a spreadsheet to help chart your numbers? http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207&start=0 (workaround if the template won't copy: http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=50130)

This will make it easier for people to give you advice because they'll be able to see your testing data.
 
Julia,
Thanks for the links to the spreadsheet. I will work on it and get it posted. I don't really remember how we ended up at 3 units. Could it be this high because she was so overweight? She was 27 pounds (I cringe to admit). I don't know if that has anything to do with it or not. She is down to 22 lbs and a few ounces, now. I certainly didn't realize too HIGH a dose would keep her numbers up! I emailed my vet about it, wait to see what she says. I will check her at 6 hours and see where she is. I haven't done that (or a glucose curve) yet, this time around. Guess I better stock up on some testing strips.
When I brought her in to her vet after finding her numbers were back up, she checked her for the UTI and she didn't have one. Just had her shots and teeth looked at (ok) in June. Right now, her only other health issue, besides weight is the dang persistent chin acne. My vet feels this MAY have something to do with her relapse, even though she has had it all along. I mentioned maybe doing another antibiotic shot in my email, hoping we can get it totally cleared up. I guess that is why we (my vet and staff) are so confused by her relapsing after not having had any insulin since April 7th! She had the chin acne when she was initially diagnosed. Nothing I can see has changed. Same food, same routines......the only stressor I know of is her brother, who can be mean to her sometimes.....but even THAT is nothing new :-(
Do you know anything about the insulin pens? I was trying to find the cheapest way to go on the insulin. Right now, I am getting it at Target in the vial for approx $105. I forget the exact amount. That and the test strips are so expensive (I use an AlphaTrak meter) and I retired the month before she was diagnosed, so our income is reduced.(hubby still works) Looked at some posts and may check out the Canadian pharmacies. I saw one place online when she was initially diagnosed that was about $75, but I have to see if that price is still good and how to get the scrip to them. Haven't been able to find strips for less than about a dollar a pop. Any advise on that stuff would be really welcome, as well.
I will get to work on her spreadsheet tonight.....thanks a lot.
 
Hi....and Welcome!

First....the lantus pens are super easy to use....don't use the special pen needles, you can draw right out of the end of the pen with a regular U100 insulin syringe. 5 pens cost me about $215.....but will last about 6 months.

Second, a human glucometer works just as well as the Alphatrack.....plus the strips are cheaper. I use the Accu-chek Aviva - strips run me about $20 for 50 strips.....I usually buy them off of eBay. A lot of people here use WalMarts Relion brand.

My Zoe was on insulin for 6 weeks and then in remission for 2.5 years.....she developed pancreatitis in March and has needed insulin since April.

Keep asking questions.....lots of good people here.

Here is a link to Lantus info...... http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=18139
 
A couple of questions and thoughts..

1. what kind of bowls does she have for water and food? If not stainless steel, that may be the cause of the acne. If not, perhaps a food allergy.

2. just because she was on 3 units doesn't mean she should have been started on that dose again. If she was in the 200s when you restarted insulin, I'd have given no more than 0.5 units max. So yes, you may in fact be overdosing.

3. I'm not familiar with the med you are giving, but is it a steroid? Some steroids have been known to cause diabetes...while some steroids are absolutely necessary, we caution people against using them unless necessary.

Jen
 
Hi again!
Thanks for the info on the Lantus pens, Sherry. That sounds like a much cheaper way to go.
Jen, Missy has ceramic bowls, both water and food. They are very shallow and washed at least once a day. My vet said ceramic or stainless steel when we first started talking about the acne. Do you think I should try stainless, instead? Guess I have nothing to lose by trying.
The Douxo is not a steroid....I just double checked on their web site. I can't really explain what it is, but it appears to be something the body makes naturally, so should be ok? It is also used for seborrhea.
It is sort of scary to think I am overdosing her. If I back down her dose (the vet said to start her back at her old level, so I did) what should I expect to see? The few times I gave her less than the 3units, she was up in the 300s the next check. But that was only dropping her down as a one-time adjustment (like her numbers were 181, so I reduced dose) How long would I have to have her on the lower dose before I could expect to see her numbers decrease? What kind of behavioral changes will I see? I am already nervous, because she has been hitting the water bowl a bit more lately.
How does giving her too much insulin cause her BG to be higher? I don't understand the physical mechanisms for that. Just curious. Since I was DXed with MS I have made a habit of trying to understand what I am putting in my body and why, drug-wise and would like to understand for her, too. If anyone can explain, I would really appreciate the info.
I just checked her BG at +6 (assuming this means 6 hours after her injection) and she was at 260, when she had 273 this morning. She has had several teaspoons of food over the day, but nothing to eat within the last hour or two. What does this tell me? Most likely I need to do a curve, huh?
 
Welcome!

It seems like you have 3 different questions, and you are getting great advice:

1. Why is my cat back on the juice? As a number of users have mentioned, this could be just a natural relapse, but it is also quite possible that there is some underlying condition that is exacerbating the issue. It is definately worth trying to figure that out. I don't have any new suggestions here.

2. What could be going on with the chin? There are a lot of people with a lot of experience here on cat's in general, so you might get some good ideas. Again, I don't have anything to add here.

3. How should I treat Missy? Here is where I may be able to help. It is great that your vet encourages home testing, that is a good start. People here, and in various published studies, have taken that a big step further, and applied experience from human diabetes control to develop a much safer and more effective (>50% remission rates) approach called "Tight Regulation" (TR).

As you suggest in your first post, the goal of TR is to get the BG down into a normal range for the cat (~50-150) so that the pancreas can heal, and the cat can be as healthy as possible. HOWEVER, this is very dangerous if you do not test significantly more often than just 2 times a day. If the cat drops too far below 50, they can experience FATAL hypoglycemia. To be fair, fatal hypoglycemia is also a real risk even when you are trying to keep then numbers >150 (as many vet's target) because cats can drop BG very fast if they start to go into remission and you don't realize it! Because of the risk, the recommendation here is to test 5 times a day or more, absolutely before both shots, ideally at 4-6 hours after each shot, and another few scattered in the gaps.

If you are interested in TR, the main sticky is: LANTUS & LEVEMIR - TIGHT REGULATION PROTOCO, and there is a lot of experience here to hold your hand through it minute by minute when things get a little crazy (and they will :lol: )

Of course, you need to want to do this, and be comfortable with the added testing. If you would rather stick with your vet's advice, that is certainly your choice, and people here will be more than happy to help you with the first 2 items.

Edited to Add: The too-high-lantus = higher-BG observation is certainly something that we have seen here, but I can't find any scientific study to support that observation. No one has intentionally overdosed the cats to show what happens. The theory I've heard here is something like the liver is releasing as much glucose as it can in order to compensate for the excess insulin level, but I'm not sure if there is any data for that theory.
Unfortunately, for Missy, there is no easy way to tell if 3u is too low, or if you're already over target.
 
Hi Sam,
Thanks for the input. I do think that there is a wealth of great information here. I cruised the message board a few times on Miss' first go round. It is nice to hear from other people who have been where you are.
I have thought about doing the TR in the past, but then she remitted so quickly it was a moot point. I may have to try it in the future. I need to gather up some of the hypo supplies. I have had the Karo syrup, but it sounds like that is short acting and I will want to get some higher carb food. So, before I try, I will get my kit together...and I need to get some more test strips, so it will be a week or so before I am ready. I will read through the protocol in more detail while I am getting my stuff together. I guarantee I will need some hand-holding, so thanks for the offer :-)
My vet's office called about putting her on Clavamox to help with her chin acne. Has anyone had an adverse reaction, diabetes-wise, with antibiotics? She was on it when originally diagnosed, because at that time she DID have a UTI. I guess that means it should be safe for her, but I will start monitoring at least 3 times a day, now.
Wow, I thought I was doing ok until I started reading all this. Missy had one episode where she was at 47 or so, so that really drove home the need to test before injecting, but I guess I just have to make myself do it more often, like it or not. That is probably why I didn't know she was creeping up again...I was testing her weekly while she was in remission, but got lax and missed 2 weeks....and this is where we are.
Well, I have my homework set out for me.......supplies to buy, spreadsheet to fill in, reading up on TR.....and I want to get a picture (all of mine are too large) of her on my posts. She is such a sweet and pretty cat.
Thanks to everyone for all your advice, thoughts and well-wishes. I am going to be getting busy!
 
Hi,

Just following up to see how you are doing. Reading back through the posts, I noticed a couple questions that did not get answered:

1. Vial-to-vial variation? I don't think there is much variation here at all, but people make sure to put when they change vials on the spreadsheets. Any change observed to a new vial is probably the old vial going bad, not the new vial being different.

2. AlphaTrak: Are you using the feline-calibrated meter? If so, and you don't decide to change to one of the much cheaper options, you need to make sure to put that info all over your SS, and all over your posts, because the readings on the AT are something like ~20% higher typically than most human meters (and up to 30 points higher at the low end), and all of the guidelines on this site (and the published studies) are based on the human-calibrated meters. Given that, the 40 on an AT is very very scary...

Hope that helps.
 
My vet's office called about putting her on Clavamox to help with her chin acne. Has anyone had an adverse reaction, diabetes-wise, with antibiotics? She was on it when originally diagnosed, because at that time she DID have a UTI. I guess that means it should be safe for her, but I will start monitoring at least 3 times a day, now.
Click to expand...

I wanted to chime in here. Both my older girls hit a nasty bout of chin acne for some reason we couldn't figure out and just could get stopped. They ended up with some infected spots. It took 2 rounds of Clavamox while cleaning extenally and using the pyroben gel before it cleared up for them. Every cat is different, but Clavamox is the AB we use most on Smokey and I haven't seen much effect on her numbers. If Missy has a pretty nasty infection going on under the acne it could account for some of the BG creeping that you are seeing.
 
Thanks so much for the info! I haven't started my spreadsheet yet, but will be sure to annotate I am using the AlphaTrak. I may end up switching, because the test strips are pretty high, but don't know how to translate all my previous info over to the new meter. (I have a FreeStyle Light meter.....would that work? How do I translate the old numbers to the new ones with a different meter?)
Missy has had the acne off and on for quite some time. My vet says they seem to see that with overweight felines, which she is/was. (lost close to 5lbs with more to go) Thankfully, her chin isn't REAL bad now. She did have a flare up in July (maybe why she relapsed?) but it is better now.....just really stubborn. It seems to "travel". Like it will be on her chin and that will clear up but then it goes to lower on her jaw.
I have been nervous about the Clavamox since my vet wanted me to up Miss's dose to 4 units and most on here said she was already dosed too high. (please bear in mind, even with her weight loss, she is still 22 lbs...and should be 10 lbs less) I don't know if she is a 'high dose kitty' or not....don't know if we should have started her at a lower dose or not.... But she didn't present like a lot of the cats I have read about in this board. She DID start to drink and pee a lot (about 5-7 days before I took her in) but she did not LOSE weight..she gained, despite being on Science Diet.(whatever the weight loss formula is, I forget) Both her and her brother gained on it and acted like they were starving...which is why we let her get so heavy)
So, we upped her dose to 4units, which scares me to death, after what everyone says, but following the vet's recommendation. She was 314 AMPS yesterday, 210 at + 6 and 268 PPMS. 336 AMPS this am, 279 at + 6 and 281 PPMS. They said it may take a few days to 'normalize' so haven't done a curve, yet. Waiting for test strips to arrive , so hopefully Wednesday??
Anyway, thanks for the input. I feel like I am over thinking this, but she is my fur kid and I want to know WHY I am doing whatever I am doing to her. I love her and don't want to make things worse.....she is one of he sweetest cats I have ever had the pleasure to share my life with. (when I figure out how, I will post her pic.....need to do the spreadsheet and read about "phbb" and figure out navigation....in addition to the rest of my life, which includes a father-in-law who is 500 miles away and NOT doing well. ) I was overwhelmed in March, but now that I have more time to assimilate info, I am questioning thingsm more and more. Of course, I THOUGHT I had it all figured out when she remitted in less than a month with basically only a diet change...and some insulin.
Whoo! Well, sorry for the pity party...my DH is visiting his father..I am changing Miss' dose, contrary to what most say in this forum, going to add antibiotics to the mix.....I don't want to play chemistry lab with my cat! I am alone trying to decide what is right. Scared sh**less.
Thanks for the encouraging words on the Clavamox. Please forgive my ramblings... :-(
 
Hey,

You are definately NOT overthinking this, at least not compared to the people on this board :lol: . We are all pretty obsessed with numbers, interactions, dosing, food, etc. etc. etc. It sounds like you will fit right in. :lol:

I did not realize that you were considering a dose increase. We would really love the oportunity to help talk you through your options there. The 2 questions we ask are 1. should you increase, and 2. by how much.

If you go back and read through the posts on TR above, you can see the general guidelines. Basically for the "if", we ask if the BG numbers have been at least >200 for 3 days, with NO drops below 200 during that time. If it drops <100, the clock totally resets, if it drops <200, but stays above 150, wait 5 days. Once you have been doing this for weeks, if the cat is regulated, but not quite low enough, then we may push it a little higher to get the numbers down, but most cats seem to drop from the 200s down to <100 when the dose is finally right. (Note that all of these are with human BG meters, if you stick with the ATrak, we can post to find the best conversion)

As for the "how much", we have found that 0.25u changes can have a HUGE impact on the cat, even b/w say 4 and 4.25, so we strongly recommend increasing in 0.25u steps. With the "if" protocol above, you could be changing every 3 days, so you will get to higher doses soon enough if you need them, but not overshoot the perfect dose. we REALLY don't want to see another one of those 40s on an ATrak!!!

As for switching meters, the Freestyle works, but it is also very expensive. A lot of people end up with the Relion Micro from Walmart b/c the strips are cheap ($35 for 100). I would just switch over as soon as you get the meter and strips. You can test with both for a couple days if you want to get some overlap.

Clavamox is OK with diabetes, and any infections can be a bigger problem than the antibiotic. That said, watch out for any problems eating because all antibiotics can cause some cats to stop eating. That can become a very dire problem very quickly!

Hope this helps. Please follow up and let me know what you decide to do next with dosing.
 
Sam,
Any advice is welcome! The reason we were upping the dose is that her numbers were going up, not down. When she relapsed, she had 5 times in the first 2weeks where I didn't inject her. A few times she was in the high 100s, so I lowered her dose. But since 8/22 all her numbers have been in the 200s and 300s, with 1 exception on 8/30 when she was 181 AMPs (gotta do her spreadsheet, sorry). Her lowest other than the above was 210 +6 on 9/2. I have been giving her 3 units on most of her PM shots, because she would be at 268, 281,268. I didn't want to give 4units and have her go hypo in the night, when I am not watching her. Anyway, she has been on 4units only since 9/1 and only her AM shots. Even her +6 numbers are in the 200s since the 4 units (260 day 1; 210 day 2; 279 day 3) I really want to do a curve next week, when my strips get here, because if she is only going to 260 at her 'nadir' (which I realize I don't know yet her nadir is at +6) she SURE isn't responding like last time. I would have thought she would be lower upping the dose, esp since you all recommend going up in much smaller increments. She is making me crazy with this! She is over at the water dish drinking, right now :-( but this morning she caught a dragonfly, so she can't be feeling AWFUL. I am so confused.....maybe with DH gone, I have too mch time to think.
I guess I just have to wait until my test strips arrive and then I can really see what is going on here. In the meantime, I will try to work on my spreadsheet. I have been mulching in my yard.....and in western Wa. You have to jump on things when the weather is good. The rest of the country has been baking and we just barely started summer! But, I WILL get it done by the time I get my test strips, so you all can maybe help me with her. I am open to any and all advice.
Thanks.
 
Every time is different, so there is no reason to believe that 4u will have the same effect as last time.

In general here, we try to stay away from changing the dose AM vs PM. The reason is that Lantus actually builds up over many days to a stable level, and the body gets used to that level, so changing it around so much does not help heal as easily.

Getting more mid-cycle shots is nice, but so long as you are getting a reasonable number of +6's you really don't need to wait to adjust the dose. Based on the TR protocol, you would have gone to 3.25u (AM and PM) with your last dose on 9/1, and you would be ready to go to 3.5u today. TR is designed to ratchet up as fast as safely possible.

Higher than expected numbers sometimes point to an underlying "stressor" like an infection, but you still need to treat the high numbers anyway.

If it were S'mores, and based on what you've said (we're kinda adicted to spreadsheets here...), I would probably drop down to 3.25u or 3.5u AM and PM (known as BID), and keep up the testing. If you stick with the schedule, soon enough you will get up to the right dose, whatever it is.
 
Thanks, Sam. I guess I just HAVE to make the time to read the TR in greater detail. Hopefully, the Clavamox will help her numbers. My fingers are crossed. I hadn't started it yet, till I saw how she did with the new dose. Didn't want to change too much at once. This is pretty much a full time job.....I am SO lucky she waited to do this until :-( after I retired and am home with them pretty much 24/7. She is worth every minute of it, it just makes me feel so bad, because she is so sweet. The vet has to irritate her, to get her to stop purring, when she wants to hear her heart! I don't think her brother would let me do this to him.
I guess I will make a point of sitting down and reading the TR tonight and maybe even get started on her spreadsheet :-)
At what point (numbers) would you drop her dosage? I know I wouldn't want to give her 4units if she was at 181, but you think it is ok at 280? I think I am afraid of the hypoglycemic incidents. She only had one, but looked so miserable.
Well, better get going so I have some time to do some reading tonight. Missy and I both thank you for all your help. As soon as I get the spreadsheet done, I will be sure to let you know.
 
WhooHoo..... Maybe I am nuts, but I did a +6 1/2 on Missy (ran late cuz I was out enjoying Seattle sun) and she was @ 144!!! I guess she is responding to the increase in dose. The vet said it would take a couple days and it did. But that is the lowest she has been since 8/20. I know upping her dose is contraversial in this forum, but I am just happy to see her responding. Best news all weekend!
 
That's awesome! It does take a couple days for a new dose to build up the "shed" and come into full force.

Any chance you can get another reading before the PMPS to see how the rest of the curve looks? You want to watch out that the shed may be overflowing if the dose increase was too much. That 40 you saw before still scares me.

I hope I did not give you the impression that this forum is against high doses. Many cats need them! I've seen as high as 13u twice a day (and that cat is now in remission)! We do tend to want to start low, but we follow the cat up as high as needed.

In general, we do really recommend sticking with uniform morning and evening doses, because that shed I mentioned earlier can do weird things with occilating doses.

As for dropping the dose, you need to let the cat's pancreas heal before you remove the help it is getting from the Lantus. That healing happens faster the lower the BG is. Ideally, we would keep cats <150 at all times. To do that, we generally only lower the dose if we see a "too low" number <50, or if the cat is stable <150 for a few days.

That said, I had to work too, and I was also scared of hypos during the day, so I dropped the dose a little faster during the week, but you do want healing, so you can't undershoot too much either.

At the end of the day, it is your decision, and you need to be comfortable with what you are doing. We can just help answer your questions about what is really happening, to the best of our combined experience, but we cannot judge your cat as well as you.
 
Thanks again for the knew words, Sam! I didn't get another reading in last night pre PM shot. She was at 267 for her PM shot. AMPS today was 269. I will try to do a couple more readings today, but worried about running out of strips... I paid to have quicker delivery but not sure how the 3 day w/e will mess with that. Guess I can call my vet if I have to, but her prices are high. (and the prices are high enough!) I was a little bummed out this morning because she had peed a large amount in the litter box. Isn't it knd of funny that her PPMS and AMPS are almost the same? I don't get that.
Well, DH is home, so I gotta go, but thank you for being so encouraging! I appreciate it, immensely. I'll be back on later.
 
Looks like you are getting great advice here and there are people much more experienced than I am- drink it up but don't feel too overwhelmed- it's a lot. Similar to you, my Smokey was diagnosed with FD and I immediately switched him to low carb wet food. We had a "honeymoon" of about 2 weeks before he spiked again and we had to start Lantus.

Two suggestions that I've found useful... First is the switch to the Walmart brand ReliON. I very much dislike Walmart BUT this is the cheapest option I've found BY FAR. You can get a meter (micro or confirm models only need 0.3uL blood) for around $7-9 and the strips are under $20 for 50 strips. I've just had to bite the bullet and use Walmart- I've also switched Smokey's prescription to Walmart from CVS so I can get the ReliON syringes- they have half unit markings which I can't find otherwise and are very useful for shooting X.25 or X.75U doses.

My second suggestion is the Lantus forum (through the Insulin Forums). There are people there who are UBER familiar with TR (Tight Regulation) using Lantus and are wonderful at helping. Folks on the Health forum are obviously wonderful but I've found great Lantus dosing info via the Lantus forum- plus, it is easier for me to navigate with slightly fewer users and you get to know the people who are posting. It has been a Godsend for me in trying to figure this out with Smokey.

Wanted to say- hang in there and you're doing great! Missy's got a great bean (caregiver)!
 
SmokeyD,
Thanks, it helps getting encouragement, it really does. Thanks for the info on the RelION meter. My DH and I are on the same page as you, regarding WalMart and I have been reluctant to even entertain that option because of it. But,jeez, stuff is so pricey and retiring.....makes things tighter. I might just have to give in and go that route. The RelION syringes sound great! I am eyeballing 1/2 doses, but not always sure I am on it.
I am a little hesitant to get on the
Lantus forum just yet. It sounds like it is for more advanced users than I am. I haven't even figured out how to navigate or do smilies. :-( I want to read on that stuff, do my spreadsheet, etc.etc. I suppose I should take a day and put my mulch pile to the back of my mind on focus on learning this stuff. Hate to let this Seattle sun go to waste. Even the kitties are out ALL day. (they have, as my DH says, a 'gated community'. 1/2 acre fenced by 6 foot black chain link fence. I love it,they go out without me worrying about dogs...and come in in the evening to get their "treaties") maybe tomorrow I will do that. We are supposed to be almost 90 this week and that is too warm for someone with MS to be out working,anyway.
It is so nice that you all are so caring and helpful!
 
Hi there

Sorry that I wasn't around to respond but I was away from my computer for several days.

I would suggest starting a new thread with a question about dosing, here in hte health forum if that is easier for you.

Overdosing can and does lead to higher bgs, this is called rebound or the somogi effect. Starting out at 3 units is really not recommended in any of the lantus protocols, TR or otherwise. The body tries to protect itself and it does, for awhile.

I hope that you are doing well and that you consider starting a new thread so that you can get a wider variety of responses

Jen
 
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