Newbie in Health needs lantus advice

[beggargirl]

viewtopic.php?f=28&t=47398

Hello. I am new here and hoping someone can help me.
My cat Lucy was recently diagnosed with diabetes, and has been on Lantus for about a month now.
She is given 1 unit twice a day as prescribed by the vet.

I was getting too paranoid about how much water she was drinking and how enthusiastic she got about food, which was difficult to tell, so I started testing her BG at home about a week ago.
In the begenning I had a lot of difficulties getting enough blood, so I could not test often enough.
I am getting better at it, and today, for the first time, I was able to test 4 times between meals.(!!!)
But I realized I don't know how to interpret the results except that it should not go too low or too high.
Could you please take a look at her today's results and let me know what you think?
I give her insulin shot right after her each meal.

10:30 am : 8.0 mmol/L (=144 mg/dL) --- 4 hrs since last meal & insulin shot
11:30 am : 7.6 mmol/L (=137 mg/dL) --- 5 hrs since last meal & insulin shot
02:30 pm : 4.9 mmol/L (=88 mg/dL) --- 8 hrs since last meal & insulin shot
06:00 pm : 5.9 mmol/L (=106 mg/dL) --- 11.5 hrs since last meal & insulin shot (right before next meal)

What concerns me is that her BG dropped to 4.9 mmol/L at 2:30 pm, but went up slightly to 5.9 mmol/L at 6 pm.
Is it OK that her BG elevated even a little bit when furthest from the last time she ate?
I thought I would get the lowest BG right before the meal.... No?
Does this mean that the effect of Lantus wore out sometime between 2:30 pm and 6 pm?
Shouldn't BG decrease steadily as time passes since last meal?

I am new to caring for a diatetic cat and very concerned if I am doing things right.
I just discovered about this forum today, and will read the past log to lean more about feline diabetes before I ask more questions here (I have a lot!!).
But for today, please let me know what this slight increase of BG between 8th hour and 12th hour since last meal & shot indicate.
Is this normal or bad?

Thank you very much for reading this. Hoping to hear some advice.

I am going to translate this to american numbers for any experienced eyes that pop in to check this out:
+4 = 144
+5 = 136
+8 = 88
+11.5 = 106

Thanks guys.

 

[mariko]

Hello. I would like to add some more details on her feeding and other health issues.

I am feeding Lucy one can of Royal Canin / Medi-Cal Hypoallergenic a day.
I used to feed her 3/4 can of Medi-Cal Hypoallergenic plus a scoop of Hypoallergenic dry a day, but since diagnosed with diabetes I feed her canned food only.

She is also on prednisolone (5mg every other day) and ursodiol (0.5ml a day).
According to her blood allergy test, she is allergic to some ingredients (venison, lamb, egg, white potate, etc.) so I try to avoid these ingredients although I don't think her food allergy is severe.
She also has mild asthma, but is controlled with prednisolone of 5mg tablet every other day.
She most likely has mild but chronic pancreatitis which flared up just once end of last year.
She also has a very small (about 2.8 mm) gallbladder stone.
I don't know if the gallbladder stone is causing the pancreatitis, thus diabetes??

The vet mentioned that the prednisolone may interfere with Lantus, but I think insulin is working.
Or do you think it has something to do with her result?

 

[Sienne and Gabby (GA)]

Welcome Mariko!

Lucy's numbers look very good. I do wonder, though, about the amount of carbs in what you're feeding. Royal Canin is generally not low carb, even in their canned food lines. I can't find the variety of food you're feeding to know what the % of carbs is. It sounds like Lucy has an impressive array of allergies -- including some foods that are novel proteins. You might want to check into some of the foods people here often use to see if they are within the scope of what Lucy can eat (e.g., Merrick Before the Grain, Wellness Core, EVO 95% varieties). In looking at the ingredients in what you're currently feeding, there's a good deal of rice and rice flour. It may be that getting Lucy on to a lower carb diet may do the trick and bring her numbers down into the diet controlled range. Another option may be to feed her raw food. You can make this at home so you can control the ingredients. Lisa Pierson, DVM has a website on feline nutrition that includes information and her recipe for a nutritionally complete raw diet.

Steroids, like prednisolone, don't so much interfere with insulin as they act to raise BG levels. Because the pred is needed for medical reasons, we work the insulin around the drug.

The following is from the National Digestive Diseases Clearinghouse. It's related to humans but may be applicable to Lucy, as well.

The most common cause of acute pancreatitis is the presence of gallstones—small, pebble-like substances made of hardened bile—that cause inflammation in the pancreas as they pass through the common bile duct.

Please let us know if you have other questions. Your questions will get more attention if you open your own thread. (People will look here to go to your thread on Health.) Also, if you're going to keep posting here, and I hope you will, you may find it helpful to set up a spreadsheet so we can help you follow Lucy's progress. The instructions for setting up a spreadsheet are in the Tech Support forum.

 

[mariko]

I really appreciate the information and suggestions you have given me.
I tried raw food about 5 years ago for a while, but for some reason Lucy did not do well on it although she loved the taste.
She was losing weight and vomiting and sometimes having diarrhea even though the the meat I was using was not the kinds she was allergic to.
But I'd like to look into other kind of canned food with lower carbs if that will give her more chance of going off insulin.
I have a vet appointment this Friday, so I'll talk to Lucy's doctor about it.
Thank you very much also for your information on prednisolone-insulin as well as gallstones-pancreatitis relations.
I'm going to set up a spreadsheet soon (trying now!), and also I'll try to lean more about feline diabetes before I come back and post again here at the Lantus Suppoert Group.
In the meantime, I'll keep my own thread on Health "sub: NEW TO HOME TESTING" posted on 7/10 as you suggested.
Thank you again for taking such a good care of this "newbie". So glad everyone at FDMB is so kind and helpful!