Re: Newbie in Health - Bear - needs dose/start over help
Welcome to FDMB and Lantus Land!
Ronnie and Gayle have provided a ton of information in your post in Health. Sorry if you're feeling more than a little overwhelmed. I know I certainly did when I first got here -- which was a while ago.
There are a couple of basics that are important with diabetes management -- hometesting, proper handling of your insulin, food, and a dosing protocol. You've gotten a head start with hometesting. Now that you have spreadsheet set up and have started to collect test data, we'll be able to help you even more with how to deal with doses.
First -- is this the first time you've shot 7.0u twice a day? If so, do you have a lot of strips on hand and any high carb food? I don't know if you will need it but I want to be sure you're prepared. Can you please get another test in an hour? Give treats when you test! Your cat will associate the test with something yummy! If you don't have low carb treats at home, use food.
I would pick up a box of Ketostix, as was suggested. This will allow you to test for urinary ketones. Once you have the strips, we can offer some suggestions on how to get a sample.
Food: Diabetics need to be on a low carb diet. It doesn't matter if they are humans or cats -- carbs convert to sugar which makes it very hard for insulin to work. Dry food is typically very high carb.
Janet & Binky's food charts contain information on most canned (and dry) food that's around along with the carb content. There is a food in every price range. Many of us feed Fancy Feast or Friskies in the low carb varieties. You'll also need to pick up some flavors that are high carb with gravy. We use that to steer numbers should they run low. If you want more info on
feline nutrition, this website that is written by a vet will be very helpful.
There is info in the starred sticky note at the top of the Board on how to handle Lantus. Most of us do not purchase the vials. We buy cartridges or pens. The initial investment is more but you get more insulin and you waste less.
Protocols: There is a sticky on this topic as well. This is the information that we base dosing decisions on.
In answer to your question about the shed, if you had been giving Lantus for more than a week, you have a shed (or depot) already established, provided you'd been dosing twice a day. Just because there is a shed, it doesn't mean that numbers won't be high. Blood glucose (BG) levels depend on more than the shed. If you are feeding high carb (HC) food, it may be overwhelming the insulin that you are shooting. The shed is like having a reservoir of insulin. It's what makes Lantus long-acting and for there to be overlap between doses. Other, shorter acting types of insulin peter out before 12 hours and BG levels can then spike. Even though you've been giving Lantus for months, you've been dosing once a day. Lantus is a twice a day insulin in cats. You don't have a shed since it is depleted by the end of 24 hours.
Regarding hypo, to earn a dose decrease, a cat needs to have a test at below 50. We differentiate between a low number and a symptomatic hypo. There are very few cats here who have had a hypo crisis. Even one of the new members who mistakenly shot 5.0u rather than the 0.5u that she was supposed to give, did not have a hypo crisis. The insulin overdose was managed with high carb food and Karo syrup. We keep both on hand.
I have to agree with Gayle. This seems like a lot of insulin to be giving. What was the dose that Bear was started on? In what amounts did you increase his dose to reach 7.0u? (And do you have syringes that are marked in 1/2 units?)
