Newbie having trouble getting regulated on Lantus

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NatCat

NatCat

Member Since 2015
Hi, Friends. My beloved tuxedo cat, Pax, was diagnosed a few months ago. I have done a lot of reading and am working closely with my veterinarian, but I am having trouble getting him regulated.

Pax is around 10 years old. Otherwise healthy. He was always heafty, since I have owned him (5 years), but never fat. He lost weight, and was diagnosed quickly. The vet sees no neuropathy. Before and since his diagnosis, he has not been especially thirsty. He is still extremely shiny, and he does not act any different than pre-diagnosis, except for his increased interest in food.

When he was diagnosed, my vet wanted to try Novalin. I was hesitant because of what I read about it, but he insisted that we try it because he has known several cats who responded well to it. After several months, the vet and I finally made the switch to Lantus. I was hoping for a really miraculous result, but instead, my readings are looking similar to what they did on Novalin. His fasting numbers are usually in the 500s. It comes down slowly, but not to normal numbers. We are now doing 3 units, twice a day.

I have switched foods. Because I have four cats this hasn't been easy, but my vet recommended anything with a protein percentage of above 13. I have been shopping around with a few different foods, but nothing has made a huge difference.

Is there anything else I can be doing? I keep careful logs and upload them for the vet to see. I have done several curves on my own. We test constantly. I just want to get him better.
 
Hello and welcome. You'll see the expression ECID, or every cat is different, and it really applies to how long it takes a cat to get regulated. Lantus is a great insulin for a lot of cats. We have several people here who have a lot of experience with Lantus and dosing. If you could enter your test data into the spreadsheet that we use here, maybe we can give some suggestions. Here are the spreadsheet instructions. And good for you for doing testing at home. What type of meter are you using?

What food are you feeding now? We recommend low carb wet or raw food. Check out the www.catinfo.org site, it's a great one on feline nutrition. She also has a list of commercial canned/raw foods. Anything under 10% carbs is considered low carb. Protein isn't so much a consideration unless Pax has issues with his kidneys. Don't change your food unless you are also closely monitoring Pax's blood sugar. We determine the Lantus dose by how low it takes the kitty, so that would mean some mid cycle tests. Changing to low carb wet from dry food can make a huge difference in the amount of insulin needed.
 
Thanks so much for responding so quickly. I am so thankful!

I'm a little confused by the spreadsheets. I looked at yours. My vet instructed me to keep just fasting blood sugar and give it to them so they could adjust the dosage. I looked at a few samples and they seem confusing. Right now, this is the log I have been keeping: https://docs.google.com/spreadsheets/d/1DslliD4TKsRMw7d6FL37JKQ02Ivmn8UcjBqa64sDwcM/edit?usp=sharing

As far as the meter, unfortunately, I'm using the expensive kind. AlphaTrack 2 It is great as a newbie because there are no conversions, but it is really expensive. I figured that once he is regulated, I'll dive into finding a better meter.

Food has been tough because I have four cats. One is in need of a diet and only will eat dry. I have another with a chronic vomiting disorder. The third is fine eating anything. And then there is Pax. We leave out dry for the other kids, but he sometimes gets it. Right now we have him on Science Diet Kitten Salmon because that was one of the highest protein contents I could find. That is 12% carb. He doesn't have kidney issues.

I'm a teacher and I just got done school for the year, so I'm planning on doing some mid cycle testing in my newly found free time. Any ideas?
 
The strips for the Alpha Track 2 are expensive. Many of us use Walmart's ReliOn Micro or Confirm glucometer, which costs under $15. (I prefer Micro for easy set up and use) and ReliOn strips, which cost about $35 for a box of 100.

You want to focus on a high protein, low carb diet. 12% is too high. Fancy Feast Classics is excellent and around 4% carbs. So is Wellness Grain-Free chicken or turkey (I think it's around 6%). Small portion sizes are important and it is best if your cat is not a grazer. If you can find a way to keep your cat out of the dry food, you'll have better success in getting the BG (blood glucose) #'s down. There is great information about getting your kitty off dry kibble at http://www.catinfo.org/ In the right-hand side, is a link to "Transitioning Dry Food Addicts to Canned Food". I don't know the carb content of Stella & Chewy's but a lot of us feed that to our sugar cats. It's a freeze-dried raw food you can leave out for your cats. I add water to it and leave it out when I am not home. Some people here freeze and then leave it out to defrost, helping it to last longer if your cats gobble it up too fast.

If you don't get answers here for your Lantus issues, you may wish to post in the Lantus forum. There are many terrific Lantus folks here who can assist you.
 
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Cat Ma, Do the Relion or Confirm glucometers require a conversion? I was kind of worried about doing that wrong.

Thank you for the food suggestion. Looking at those charts are really overwhelming! Luckily, my diabetic kitty isn't really a fan of dry food. But the other guys are, so we offer both. My vet said "No Fancy Feast Ever." Is there a reason for that? I have never heard of Stella & Chewy's. Is that commonly sold in the US?

Thank you!
 
No conversions on the meter readings. See my signature link Glucometer Notes for more details.

We go by percent calories from protein, fat, and carbohydrate, not percent weight of protein, fat, and carbohydrates. Our target is under 10% calories from carbohydrate, and all things considered, getting the remainder of calories more from protein, than from fat is helpful if the cat needs to maintain or lose weight - fat has 8.5 calories per gram while protein and carbohydrate have 3.5 calories per gram (those numbers are for cat metabolism, not human!)
 
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NatCat,

No, the ReliOn Confirm and ReliOn Micro don't need conversions as BJM points out above.

I completely understand how overwhelming this is! I started out here a little over a month ago and I am still learning and needing to ask questions!

Lots of people here will vouch for Fancy Feast Classics (be sure it's not the Gravy Lover--too high in carbs--Gravy Lover is only good if your cat's glucose levels get too low). There's even a great link to why Fancy Feast is an excellent choice for diabetic cats and why prescription diets are not. I was skeptical myself at first.

Yes, Stella & Chewy's is sold in the U.S at many pet stores.

See www.catinfo.org
in Wendy& Neko's link above.
 
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NatCat said:
I'm a little confused by the spreadsheets. I looked at yours. My vet instructed me to keep just fasting blood sugar and give it to them so they could adjust the dosage.
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The older insulins like Novalin use the fasting blood sugars to help determine the dose. The longer lasting depot insulins like Lantus or Levemir use the nadir, or low point, to determine the dose. It may be that your vet isn't as familiar with Lantus dosing. Normally we'd start a cat on a lower dose that your cat is on. It's easy to bypass a good dose if you start to high or increment too quickly.

Regarding the spreadsheet, the AMPS is the AM or morning preshot (or just before shot) value, the PMPS is the PM preshot value. We typically test the cats sugar, feed, then give insulin. Since everyone is in a different time zone here, we don't use the current time, but rather the number of hours after the shot. Since the shots are 12 hours apart, you'll see a +1, +2, etc.
 
Okay that makes more sense. My vet said that they had never used Lantus because of the price. They had used PZI and Novalin, though.

I am doing a curve today- testing every two hours. What kind of low would I want?
 
NatCat said:
Okay that makes more sense. My vet said that they had never used Lantus because of the price. They had used PZI and Novalin, though.

I am doing a curve today- testing every two hours. What kind of low would I want?
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You can get Lantus for a good price through Mark's Pharmacy online. The link is on the home page here. A lot of Lantus users here buy from Mark's Pharmacy. If you need to get Lantus quickly, Costco or perhaps Target are options. Some buy from hospitals and nursing homes. There's probably a thread in the forum for where to buy Lantus.

PZI is a better choice than Novolin as it lasts longer. Novolin generally stays in the body 6-8 hours, not 12 hours, so your cat is not well-regulated. Some cats are on PZI, many are on Lantus. It depends on how your cat responds.

Don't know about curves. Someone else here will know.
 
I believe you don't fast your cat while on the curve. The 500 numbers concern me. You need some good guidance from Lantus users here.
 
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I am doing the curve how the vet instructed me. I will post in the lantus forum and see if I can get some help.
 
Hi Nat Cat,
Yes, that's right for a curve - test every 2 hours from one shot to the next, feeding as normal. My cat is on ProZinc, which is a PZI-type insulin, and it's working well for her. On an AlphaTrak meter, you don't want Pax to go below 68. If he does, you risk a hypoglycemic episode. There are instructions for how to handle a Hypo in the 'stickies' on the ProZinc forum.
Good luck,
Joan
 
Just a word of caution here regarding the meter and conversions.

If you are using the AlphaTrak2 meter, and your vet is using it then there is no conversion. If however you switch over to a human meter, you should take your meter to the vet and compare numbers so you can see what the difference is between your human meter and that of the pet meter.

I use the Alpha Trak2 myself just so I do not have to worry about my vet seeing lower numbers than she is used to when she gives me dosing advice. You can by all means switch to a human meter but you will have to make sure your vet knows and has some idea of how differently they read.

My vet darn near had a stroke when I even mentioned a human meter....not because she objects but because she suddenly thought we were comparing apples with oranges.
 
MrWorfMen's Mom said:
Just a word of caution here regarding the meter and conversions.

If you are using the AlphaTrak2 meter, and your vet is using it then there is no conversion. If however you switch over to a human meter, you should take your meter to the vet and compare numbers so you can see what the difference is between your human meter and that of the pet meter.

I use the Alpha Trak2 myself just so I do not have to worry about my vet seeing lower numbers than she is used to when she gives me dosing advice. You can by all means switch to a human meter but you will have to make sure your vet knows and has some idea of how differently they read.

My vet darn near had a stroke when I even mentioned a human meter....not because she objects but because she suddenly thought we were comparing apples with oranges.
Click to expand...

No conversion is needed. If a vet doesn't understand, have them read the Glucometer Notes in BJM's link above.
 
Sorry but as a retired R.N. I beg to differ. You cannot rely on your vet who is using a pet meter to make judgement calls re: dosing unless they are aware of the fact that you are using a human meter. The numbers are not the same between human and pet meters and anybody who is giving any dosing advice needs to know what meter they are dealing with.
 
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