? New with worries about dosage

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SarahNOLA

Member Since 2017
Hi everyone! I'm going to repost my cat's thread from the intro forum, with an update and a question.

Starbuck is almost 11, and she was presenting as totally healthy at the vet at her annual until I mentioned she was drinking a lot of water lately. He did a senior cat panel and her glucose was 385. There was glucose in her urine but no sign of ketones, so he thinks we caught it early. She isn't a large cat & about 4 years ago she started to put on weight until she was up to 14 lbs at her heaviest. The vet wanted me to get her to lose the weight, so I reduced portions and instituted feeding times with not much luck. So he started her on 2 units of Lantus.

I have another senior cat with a history of urinary blockage, so they were all on Royal Canin Urinary SO. And looooooved it because I suspect it is very salty to make them drink and pee a lot. So he suggested both cats can eat Royal Canin Glycobalance, which works for both conditions. However, I've been doing reading and decided to switch all 3 of my cats to a high protein low carb wet food only diet. I've been working on that this week, although my youngest has been on kind of a hunger strike, so I've been sneaking him handfuls of the SO because I have to use it up anyway. I've been doing Friskies pate but I'm going to try the Purina urinary because it looks like it has both the low carbs for Starbuck and the low phosphorus for Jolee.

I have anxiety and I decided to buy a glucometer and start home testing because there's no way I could get through my day if I didn't. I have just begun to work from home, so it works with my schedule right now. Which is lucky because I'm basically terrified to leave Starbuck alone in case she gets hypoglycemic. For the first week, I kept waking up in the middle of the night. Once I started to test, I realized she was WAY too high still for me to be worried about that.

I just started a chart, but you might notice there's a big hole in it, so here's what happened. Did a week of insulin shots with Starbuck and then had to go out of town for a week. My husband didn't want to test her, but he practiced giving her the shot and I figured I have cameras where I can see the cats, so that would have to be good enough. Well, the second day he scared her by yelling at her when she scratched him and hid under the furniture, and she basically was off insulin the next 3 days because he couldn't catch her again. Then that weekend, he had to go out of town, so he took her to be boarded at the vet. The vet did a glucose curve there and said he wasn't seeing enough of a curve, but he wasn't going to up her dosage because she'd been on and off insulin and we weren't consistent enough yet. I mentioned I was home testing and he said let's check back next week, either bringing her in or using my numbers, before we do anything with the dose.

So upon getting back from my trip I started to transition from dry food (combo of SO and glycobalance, which they did NOT LIKE anyway, so I'm fine with telling the vet that and going with wet). I finished that transition two days ago, and Starbuck immediately started getting into numbers under 100 in the middle of the day. Because I had read, I knew this might happen with a diet change. Today I got a 64 at +5 and she's been slowly coming up from there. I can't help but be freaked out seeing the lower numbers.

UPDATE: OK so for her PM preshot she tested at 174. I didn't give her the shot, because I'm too new at this to do that overnight. I wouldn't sleep at all. From how her numbers took that big drop over the last two days, it seems like she went down A LOT when I removed all the dry food from her diet. Right now I am thinking I call the vet on Tuesday, tell him the numbers, and take down the dose. Does that seem right? Or should I keep at it a little while longer?

I'd appreciate any input! Sorry if my spreadsheet's all over the place. My CAT is all over the place. We're very new at this.
 
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Have you fed her yet?

What we suggest doing if you get a Pre-shot that's lower than you're comfortable shooting, you should stall, DON'T feed, and post for help.....then test again in 20-30 minutes

With Lantus, it's important to learn to shoot lower numbers, but at first, 200 is about as low as we go until you have a little more data on how she responds to both food and insulin

As you can see, reducing the carbs can make a big difference in the numbers!!!

What kind of meter are you using? Human or Pet?

I suspect that now that you've cut out the high carb kibble, 2U is going to be too much for now.....60's are a safe number but scary at first!!

As you gather more information on how she responds, you'll gradually lower the number you're willing to shoot.....those of us with enough experience and data will shoot anything over 50 (on a human meter)
 
Thank you! I did feed her, because it was already kind of late. Next time I will wait and retest.

I have perused the forum and I see all these other people shooting at low numbers, but I'm waaaaaay too scared. I'm using a human meter. I was just alarmed to see her dive like that only 2 days after stopping the dry food! The 2 units was only getting her into the mid 200s 2 weeks ago before when she was on a mix of wet/dry.
 
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I was just alarmed to see her dive like that only 2 days after stopping the dry food!

Oh we know!! That dry food is pure poison for our sugarcats....and it's not good for non-sugarcats either!!

We have a member here whose cat was on 5.5U and she was 110% sure that although she had dry out for her other cat, her diabetic couldn't jump up to get to it. She finally threw out every bit of dry in the house and over the next 36 hours, her cat went into remission!!

We have had lots of cats here that were told they needed to eat that S/O too.....we've found that the vast majority do better by going onto a low carb canned diet.....it's the water that's important to keep the kidneys flushed out, not some "prescription" ingredient

There's really absolutely nothing "prescription" in those foods and if you read the label, you'll see they are full of garbage and no better nutritionally than the cheapest food you can buy at any WalMart. There's even a class action lawsuit against the "prescription" pet food industry for false advertising (basically)
 
Now that you've started over with the diet you may want to start over with the dose. Going down to 1 unit and see how she does. Read the yellow stickies about the two approaches to dosing.
 
Now that you've started over with the diet you may want to start over with the dose. Going down to 1 unit and see how she does. Read the yellow stickies about the two approaches to dosing.

Thanks! I'm going to start with SLGS for now because I'm nervous. If I'm going to start that, would I just drop her from the 2 units to the 1 unit all at once? Or do it in increments?

After last night's skipped shot, Starbuck bounced up to 400 but is already back down at 160 halfway through. I can't believe the diet change did this in just 3 days!
 
Thanks! I'm going to start with SLGS for now because I'm nervous. If I'm going to start that, would I just drop her from the 2 units to the 1 unit all at once? Or do it in increments?

After last night's skipped shot, Starbuck bounced up to 400 but is already back down at 160 halfway through. I can't believe the diet change did this in just 3 days!
Going from 400 to 160 is bound to cause a bounce, so don't be surprised if you see another pmps in the 400's.

I'm not a dosing expert on lantus... it would be fine to go back to 1... What do others think? Lowering doses doesn't have to be done incrementally. Raising should be done incrementally so as to not skip the ideal dose.

@Chris & China
 
Going back to 1.0 unit might be too big a step backwards. The 2.0 units got her into nice and safe greens, just lower than you are used to. With SLGS, Starbuck (hmm, guess where I am typing this:)), would have earned a reduction down to 1.75 units. If you are reLly nervous, you could go down to 1.5 units.
 
Well, she's at 118 preshot. I'm going to try again in a bit, and then skip it again if nothing changes.

Update: Nope, 125, no shot tonight. She definitely needs a lower dose with the wet food! Wow. I am going to run all this by my vet on Tuesday.
 
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I am going to run all this by my vet on Tuesday.

Your vet may not know as much as the people here do about treatment....The sad truth is that vets only get about 5 hours worth of "formal" education in school on diabetes and that covers every type of animal they see. Unless they have a special interest in feline diabetes, they just don't have the time to stay up to date on the latest treatments. Most see a lot more diabetic dogs than cats too and they can't be treated the same way.

Keep testing! It will be interesting to see how she does over the next couple days with the low carb only diet!!
 
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