Hello All, I have introduced my 8 year old tabby, Krismas in the general Health board and got the go-ahead to post on the Lantus board. I already have received wonderful replies regarding comparison of the Alphatrak and human glucometers, and reference to a cat specialty clinic in my area, so thank you all so much. I read the stickies and the protocol and am trying to set up a spreadsheet, have received directions and links, but am having technical problems and it may take another day or so. So, here is Krismas' basic data.
Med Hx: 8 yr old spayed female, weight 11 lbs, adopted at three years as stray, front declaw. Recent (six months) immunizations and dental. Had near fatal reaction (swelling, breathing difficulties) to immunization 8/10, received antihistamine shot and recovered. Receives antihistamines before all immunizations and does not receive any except reqired by law. Otherwise healthy until Dx diabetes 9/30/2010 following acute episode 9/1/2010 of vomiting, lethargy, not eating, treated with Lantus 1 unit bid starting 10/2/2010, Purina DM dry and wet. Labs done 9/10, abdominal ultrasound, chest and abdomen x-ray, urinalysis and culture, cystocentesis, PL1/CF Index, analysis of fecal culture, all had negative results, with exception of bronchial pattern on chest x-ray, leading to dx 10/6/10 of asthma, treated with Accolate 20 mg in divided doses AM and PM. Emergency hospitalizations 10/2, 11/23, and 12/26 with dehydration and constipation, treated by fluids and enemas. Lantus increased by new vet to 2.0 10/30.
NOTE: I use the Alphatrak monitor, discussion results from the board indicate there is significant difference in reading "trends" between feline calibrated Alphatrak (AT) and most human calibrated monitors, in that AT reading may average about 30 points higher than readings on human monitors.
So, those of you used to human monitor readings may wish to mentally subtract 30 points from my reported readings to fit into your own frame of reference.
10/2-10/29/2010, BG readings ranged from 350-250 from my own spot checks and what I recall from vet. I was not able to complete a 'curve' independently because I could not do the tests thogh had no prob with shots, relied on vet to do it weekly, and did not write down results. During this time kittie was eating mainly dry DM, would not eat canned, though I was trying out various wet foods.
Changed vets 10/30, new vet doubled dose to 2.0 units. I did spot checks AMPS and usually +6 hrs about 3 days a week. Results ranged from AMPS average of 250 to +6 average reading of 100 (nadir). This pattern continued till Jan 2011, Kittie's hospitalizations prompted me to learn more, get over my 'block' about home testing. Vet was satisfied with kittie's status and did not expect to do curves more than monthly. I started kittie on twice daily doses of salt free chicken broth, canned pumpkin, and boiled slippery elm bark decoction, and dehydration and constipation was greatly relieved. No more hospitalizations.
Jan 2011 I found California vet's tight regulation protocol, read more on food issue, realized probable impact of dry food and that greater control and even remission might be possible. Over next six weeks I spoke with over thirty vets and vet techs from north and west Chicago suburban clinics regarding tight reg, not one acknowledged even being aware of it (including the cat specialist who diagnosed Krismas), and all but two indicated they had only worked with few diabetic cats if any, most had been euthanized soon after diagnosis or had died within two years.
By March kittie was eating only canned food I had found in Binky's food list (Fancy Feast classic series, Wellness Core, EVO canned). Early March I was doing curves and could successfully test every time. I gave CA dr's protocol to local vet and asked her to review it and provide advice regarding dosing for tighter reg.
Data from 3/14, data taken Mon and Wed, curves done Fri and week's data phoned into vet Sat at 8:00am
3/14 AMPS 267 TX 2.0 LANTUS +6 BG 140 PMPS 234 TX 2.0 lANTUS
3/16 AMPS 204 TX 2.0 " +6 BG 125 PMPS 212 TX 2.0
3/18 AMPS 212 TX 2.0 +3 BG 234 +6 BG 178 +9 BG 98 PMPS 275 TX 2.0
3/21 AMPS 187 TX 2.0 +6 BG 103 missed pmps and tx, fell asleep-rats!
3/22 AMPS 347 TX 2.0 +6 BG 256 PMPS 268 TX 2.0
3/23 AMPS 256 TX 2.0 +6 BG 206 PMPS 279 TX 2.0
3/25 AMPS 212 TX 2.0 +3 BG 198 +6 BG 176 +9 BG 101 PMPS 243 TX 2.0
3/26 Vet rec increasing dose to 2.5 bid, which I did starting 3/26 AMPS about one hour later than usual (no data taken Sat or Sun)
3/28 AMPS 172 tx 2.5 +6 BG 98 PMPS 298 TX 2.5
3/29 Tuesday AM find Kitty lying flat with glazed expression in front of food bowl, BG 36 I thought HYPO rubbed gums w/ Karo, fed, withheld shot, called vet. Kitty revives, +3 BG 407, +6 387, +6 376, +9 369, vet not called back, call emergency vet who says since kitty NOW alert, eating/drinking/pooping/not obviously distressed, not emergency, call reg vet. I am thinking what the h***, leave reg vet more messages, call University of Illinois at Champaign and talk to vet at the vet school lab clinic who explains more about how Lantus works and that it might be rebound which I had dimly suspected but assumed that happened only if I missed a dose. She would be glad to see kitty but it is a four hour drive downstate and I am not sure kitty is in shape for that. PMPS BG 352, TX 2.0, I spend night on internet, read about rebound, check on kitty, 6 hours after PM shot BG 298, find Lantus group, what I read there ties in with what U of I vet talked about, it is obvious that this is where we need to be.
3/30 AMPS 275 TX 2.0 Vet calls back says cats dont have rebounds since she could not find articles on it, to continue at TX 2.5 to lower high readings, never returned further calls. +3 BG 278 +6 BG 241 +9 BG 215 PMPS 304, TX 2.0
3/31 AMPS 267 +6 BG 206 PMPS 255 TX 2.0
4/1 AMPS 191 +3 BG 189 +6 BG 173 +9 BG 164 PMPS 266 TX 2.0 kitty looking good, seems to be back to where she was before the incident
I am thinking we are probably reaching or in phase 3 and am for holding the dose at 2.00. My reference is Table 3B (using Alphatrak) from the University of Queensland protocol I printed from the board sticky. Her nadirs seem to be around +9 hours but something is happening between +9 and these relatively PMPS readings, and from what I read on the board stickies, I need to be testing +10 and +11 starting tomorrow. I am thinking to test AMPS, +6, +9, +10, +11, and PMPS, how does this sound? I can't think of anything else I can refine regarding her food, she eats low carb wet food well but not excessively unless she is actively sick. Her drinking is really a good parameter to watch since she does not drink plain water unless her blood sugar goes well over 200. I have other questions but enough bending your ear.
I promise I will keep to data in the future, I think I had to cathart, it is a luxury beyond description to talk to the level of expertise I have read here, rather than being met with silence or gentle but persistent hints from friends and family to put her down and end this. Thanks, Kathy and Krismas
Med Hx: 8 yr old spayed female, weight 11 lbs, adopted at three years as stray, front declaw. Recent (six months) immunizations and dental. Had near fatal reaction (swelling, breathing difficulties) to immunization 8/10, received antihistamine shot and recovered. Receives antihistamines before all immunizations and does not receive any except reqired by law. Otherwise healthy until Dx diabetes 9/30/2010 following acute episode 9/1/2010 of vomiting, lethargy, not eating, treated with Lantus 1 unit bid starting 10/2/2010, Purina DM dry and wet. Labs done 9/10, abdominal ultrasound, chest and abdomen x-ray, urinalysis and culture, cystocentesis, PL1/CF Index, analysis of fecal culture, all had negative results, with exception of bronchial pattern on chest x-ray, leading to dx 10/6/10 of asthma, treated with Accolate 20 mg in divided doses AM and PM. Emergency hospitalizations 10/2, 11/23, and 12/26 with dehydration and constipation, treated by fluids and enemas. Lantus increased by new vet to 2.0 10/30.
NOTE: I use the Alphatrak monitor, discussion results from the board indicate there is significant difference in reading "trends" between feline calibrated Alphatrak (AT) and most human calibrated monitors, in that AT reading may average about 30 points higher than readings on human monitors.
So, those of you used to human monitor readings may wish to mentally subtract 30 points from my reported readings to fit into your own frame of reference.
10/2-10/29/2010, BG readings ranged from 350-250 from my own spot checks and what I recall from vet. I was not able to complete a 'curve' independently because I could not do the tests thogh had no prob with shots, relied on vet to do it weekly, and did not write down results. During this time kittie was eating mainly dry DM, would not eat canned, though I was trying out various wet foods.
Changed vets 10/30, new vet doubled dose to 2.0 units. I did spot checks AMPS and usually +6 hrs about 3 days a week. Results ranged from AMPS average of 250 to +6 average reading of 100 (nadir). This pattern continued till Jan 2011, Kittie's hospitalizations prompted me to learn more, get over my 'block' about home testing. Vet was satisfied with kittie's status and did not expect to do curves more than monthly. I started kittie on twice daily doses of salt free chicken broth, canned pumpkin, and boiled slippery elm bark decoction, and dehydration and constipation was greatly relieved. No more hospitalizations.
Jan 2011 I found California vet's tight regulation protocol, read more on food issue, realized probable impact of dry food and that greater control and even remission might be possible. Over next six weeks I spoke with over thirty vets and vet techs from north and west Chicago suburban clinics regarding tight reg, not one acknowledged even being aware of it (including the cat specialist who diagnosed Krismas), and all but two indicated they had only worked with few diabetic cats if any, most had been euthanized soon after diagnosis or had died within two years.
By March kittie was eating only canned food I had found in Binky's food list (Fancy Feast classic series, Wellness Core, EVO canned). Early March I was doing curves and could successfully test every time. I gave CA dr's protocol to local vet and asked her to review it and provide advice regarding dosing for tighter reg.
Data from 3/14, data taken Mon and Wed, curves done Fri and week's data phoned into vet Sat at 8:00am
3/14 AMPS 267 TX 2.0 LANTUS +6 BG 140 PMPS 234 TX 2.0 lANTUS
3/16 AMPS 204 TX 2.0 " +6 BG 125 PMPS 212 TX 2.0
3/18 AMPS 212 TX 2.0 +3 BG 234 +6 BG 178 +9 BG 98 PMPS 275 TX 2.0
3/21 AMPS 187 TX 2.0 +6 BG 103 missed pmps and tx, fell asleep-rats!
3/22 AMPS 347 TX 2.0 +6 BG 256 PMPS 268 TX 2.0
3/23 AMPS 256 TX 2.0 +6 BG 206 PMPS 279 TX 2.0
3/25 AMPS 212 TX 2.0 +3 BG 198 +6 BG 176 +9 BG 101 PMPS 243 TX 2.0
3/26 Vet rec increasing dose to 2.5 bid, which I did starting 3/26 AMPS about one hour later than usual (no data taken Sat or Sun)
3/28 AMPS 172 tx 2.5 +6 BG 98 PMPS 298 TX 2.5
3/29 Tuesday AM find Kitty lying flat with glazed expression in front of food bowl, BG 36 I thought HYPO rubbed gums w/ Karo, fed, withheld shot, called vet. Kitty revives, +3 BG 407, +6 387, +6 376, +9 369, vet not called back, call emergency vet who says since kitty NOW alert, eating/drinking/pooping/not obviously distressed, not emergency, call reg vet. I am thinking what the h***, leave reg vet more messages, call University of Illinois at Champaign and talk to vet at the vet school lab clinic who explains more about how Lantus works and that it might be rebound which I had dimly suspected but assumed that happened only if I missed a dose. She would be glad to see kitty but it is a four hour drive downstate and I am not sure kitty is in shape for that. PMPS BG 352, TX 2.0, I spend night on internet, read about rebound, check on kitty, 6 hours after PM shot BG 298, find Lantus group, what I read there ties in with what U of I vet talked about, it is obvious that this is where we need to be.
3/30 AMPS 275 TX 2.0 Vet calls back says cats dont have rebounds since she could not find articles on it, to continue at TX 2.5 to lower high readings, never returned further calls. +3 BG 278 +6 BG 241 +9 BG 215 PMPS 304, TX 2.0
3/31 AMPS 267 +6 BG 206 PMPS 255 TX 2.0
4/1 AMPS 191 +3 BG 189 +6 BG 173 +9 BG 164 PMPS 266 TX 2.0 kitty looking good, seems to be back to where she was before the incident
I am thinking we are probably reaching or in phase 3 and am for holding the dose at 2.00. My reference is Table 3B (using Alphatrak) from the University of Queensland protocol I printed from the board sticky. Her nadirs seem to be around +9 hours but something is happening between +9 and these relatively PMPS readings, and from what I read on the board stickies, I need to be testing +10 and +11 starting tomorrow. I am thinking to test AMPS, +6, +9, +10, +11, and PMPS, how does this sound? I can't think of anything else I can refine regarding her food, she eats low carb wet food well but not excessively unless she is actively sick. Her drinking is really a good parameter to watch since she does not drink plain water unless her blood sugar goes well over 200. I have other questions but enough bending your ear.
I promise I will keep to data in the future, I think I had to cathart, it is a luxury beyond description to talk to the level of expertise I have read here, rather than being met with silence or gentle but persistent hints from friends and family to put her down and end this. Thanks, Kathy and Krismas
Have a great weekend!
