Newbie on Lantus needs advice. 2nd shot *edit? 1/31

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Linda and Tasha

Linda and Tasha

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Hi everyone. New user here. Tahsa is on Lantus SID at the moment just diagnosed. 1/22/10. I know I will be adding a second dose very soon, but I am still trying to find out how long the first shot will last. She is very insulin sensitive and is still producing her own insulin from what I can tell. She uses so little. I have a daughter who is a type 1 diabetic so although I don't know much about cats with diabetes, I do know about diabetes. So far I found out that Lantus lasts about half the length of time in cats that it does in humans. Btw, my kitty is a tiny thing 7 lbs and has never been overweight. I am assuming that she must have type 1 and wont go into remission. Am I wrong? Are there tiny diabetic cats that have had remission using Lantus? Anyone here who has had that experience? Her vet (clueless) insists that all cats must be on at least 3 units a day (duh) and that .5 has no affect on a cat no matter what the size. I spoke with him yesterday and he said stop all her shots and she must have something else wrong with her because she had that 57 BG on only .5 units.
Today I am grateful I found this site. After talking with some people I reduced her AM shot to .25 (aprox.) So far she has only had a low of 91 and I am waiting to see how long the lantus lasts with her if she has no rebounds from lows.
I am open to all any any recommendations from people as to how we are doing and what pitfalls to look out for. :-D

*Edit. I finally got my 12 hours (every 2 hours) curve. Wondering if I should give a second shot (I never have before) this is first day at .25 from .5 and hardly any reading before. No rebound for the first time. Your thoughts?
 
Re: Newbe on Lantus needs advice.

Hi

welcome to the Lantus forum. Take some time to read the information stickies, ...ur spreadsheet looks interesting thou. Full of possibilities!

Good for u for home testing!

We were on Lantus for 3 months and a couple of weeks ago, my cat Luna went into remission, so yes it is possible.
There are always possibilities.

Can u tell us what food you are feeding?

Others will be along to assist with the dosing concerns, keep asking questions and read read read! check out some threads in here, click on spreadsheets.
:-D
 
Re: Newbe on Lantus needs advice.

Thanks for your reply. I am giving her Friskies wet food that is high protein/ low carb (as per the information on this site) 1/2 a can in the morning and the dry DM to munch upon throughout the day about 1/3 a cup.
I have no idea what stickies are here. I am just trying to learn to navigate the site. Was your kitty who went into remission a thin kitty? I have looked at a few spread sheets and for only being on a single shot at the moment, Tasha's numbers seem to be unlike any others here.
 
Re: Newbe on Lantus needs advice.

Hi and welcome to Lantus Land!
I believe I read somewhere that ALL cats are type 2. And I know from personal experience that the dosing is different for every cat. My Morris was 26 lbs and on various insulins for 10 years, is now on .50u of Levemir and was as low as .10u and as high as 1.0u. He now weighs only around 15 lbs. but he's been sick and had stabilized at 17 lbs. on the low carb wet foods in the Janet & Binky's food list.

It's wonderful that you landed here and have an open mind to accept the help of this board...you will hear from some very experienced people here that can help you and Tasha.

Look forward to following your journey as you learn the sugar dance. dancing_cat
 
Re: Newbe on Lantus needs advice.

Hiya,

glad you came over.
Should have done it myself, but be good to copy and paste your health thread into a post here so everyone knows what has been said and what info you have given.

I would actually say Tasha potentially is a type 2 diabetic. Most cats are initially from what I have read.
The low carb food is the trick and dumping the dry (can have up to 50-60% carbs in-totally overwhelming for pancreas).
The sooner kitties are treated from being diagnosed the greater chance they have of remission (read the Rand study in one of Jills stickies)

Lantus can extend beyond 12 hours, but needs to build a shed first (like ptiing petrol in an engine)Then you get what is known as carry over.
If Tasha is above 200 at +12 then I would consider shooting another .25u (again, read the stickies and the Tilly protocol). You need to be cautous as you don't have a lot of data.The best thing to do is get a spot check around +11-11.30hrs, post the number and ask for advice (change the original post title so shows up on the list). Also bearing in mind your ability to be able to get some spot checks (well at least one before bed and at least a +2).
You may find that if you stop that dry immediately, you could drop to .1u and see how she holds her numbers and then you'll be on a trial after that (we don't like to jinx people!)

Under 50 at any point counts for a dosecrease. As you've stopped the .5u, this may be why you have a slightly higher number at nadir (91)-good number. Aim is to get kitty consistently in non-diabetic numbers.
 
Re: Newbe on Lantus needs advice.

lmaty said:
Thanks for your reply. I am giving her Friskies wet food that is high protein/ low carb (as per the information on this site) 1/2 a can in the morning and the dry DM to munch upon throughout the day about 1/3 a cup.
I have no idea what stickies are here. I am just trying to learn to navigate the site. Was you kitty a who went into remission a thin kitty? I have looked at a few spread sheets and for only being on a single shot at the moment, Tasha's numbers seem to be unlike any others here.
Click to expand...


Opps, sorry about that - "stickies" are these:

viewtopic.php?f=9&t=157
viewtopic.php?f=9&t=151
viewtopic.php?f=9&t=150
viewtopic.php?f=9&t=147
viewtopic.php?f=9&t=1581

You'll see them up above with the "star" icon

Can I ask why dry food is available? You know there are ways to leave out wet food so kitty has snacks thru the day.
Most people here use "wet pucks"
they take some wet food, place it in ice cube trays for example, add a bit of water and freeze...they pop out the "pucks after and leave them out for the day in the cat bowl, stays fresh and voila!
There's also automatic feeders you can try if ur gone for the day or while u sleep.

My cat was very thin at DX time 6 months ago now. For his size and age (9) he was just under 12lbs...but visibly thin...
He was on Caninsulin (Canada's Vetsulin version) for 2 months with bad results, then went on Lantus for 3 months, gained his weight back, he is about 15lbs now and much healthier.
 
Re: Newbe on Lantus needs advice.

Hi there,
Regarding the food, it may be an idea to eliminate all dry food for the reasons already given. It's really not good food for any kitty, no matter the companies claim. Since Tasha is already eating wet food, you won't have to worry about removing all the dry during the day.

I can appreciate that you want to leave food during the day because a tiny kitty is a worry. My civvie, Booboo, weighs around 6.5lbs soaken wet. What I have done, as many others have, is to set up an auto feeder with 5 compartments.
I divide the day's worth of food into 5 little bowls and freeze them. I think others may use ice cube trays to freeze the food, they call them food pucks.
In the morning, I just drop in the frozen bowls of food into the compartments, then leave for work. The portions are not so large, so they are thawed by the time each compartment is exposed in the feeder. I am gone for almost the entire time between amps and pmps, and food is important.
Another good thing about the auto feeder is that kitties can't gobble down all the food in the morn and then go hungry for the rest of the day. If you divide the can into five equal parts, then set the feeder to turn every 2 hours, Tasha would have a little bit to eat all the time. It's just a suggestion that may be good for Tasha.
 
Re: Newbe on Lantus needs advice.

welcome to another beautiful Siamese diva!

Tasha's numbers are very good and IMHO she has a great chance at remission. In almost every case, we find that smaller doses BID are better than a larger dose SID. Cats' metabolisms are much faster than humans. Lantus usually lasts 12-14 hours in cats, and that extra 2 hours of overlap gives us the ability to get the cats onto beautiful low flat curves. Those low, flat curves give the pancreas a chance to heal, and voila! Lots of cats go off the juice. The SID dosing is allowing her to get up to those pink numbers, and by giving shots every 12 hours you'll hopefully keep her from going that high.

Based on today's numbers, my recommendation would be to give the 0.25 units twice a day, every 12 hours. Get a preshot test before EVERY shot, and whatever spot checks you can get during the cycle. Hold that dose for several days or a week and see what happens (post here every day, we'll help you watch her patterns). If she goes too low, of course, then you'll need to reduce the dose. We usually reduce the dose to 0.1 units (about a drop of insulin) before taking the insulin away completely. Our goal is to keep the cat on a small amount of insulin for as long as we can, to give the pancreas maximum healing time before trying to remove the insulin.

Tasha looks great, hopefully we can help level her out.
 
Re: Newbie on Lantus needs advice. 2nd shot **edit?

Got my 12 hours. Your thoughts before a shot and if I should give one. see initial post.
 
*Edit. I finally got my 12 hours (every 2 hours) curve. Wondering if I should give a second shot (I never have before) this is first day at .25 from .5 and hardly any reading before. No rebound for the first time. Your thoughts?
Click to expand...


you'll want to put any updates as a new reply in your thread here, ok? we dont want to be scrolling from top to bottom looking for ur updates, so just hit reply anytime u want to update...awesome blue by the way!!!

will u be home to monitor tonight?
 
lmaty said:
Got my 12 hours. Your thoughts before a shot and if I should give one. see initial post.
Click to expand...

When is the last time this cat had dry food? If today, I recommend you do not shoot this cat tonight. Remove all dry from her immediately and keep testing for 24 hours. I have a feeling your cat may not be diabetic.
 
Thanks for the blog etiquette. Yes I will be around. I have decided to not give her insulin at least not yet. I will check her at +14. I took away the dm dry food and put out wet food for her. She is a grazer anyway. With no second shot and high rebounds, she still did not have dangerously high bg. after rebounding yesterday her hour before her AM shot(+23) was 293 coming off of a 364 at the +12 after the AM shot with no second shot, so she has something working for her. Maybe her own insulin. Her +12 bg today was 115.


@Ronnie & Luna actually the on call vet wanted to do this. If my daughter was not a diabetic I would not have had a clue that this was so wrong. He actually felt that .5 units has no affect on a cat. He thought because she tanked and went to a 57 yesterday that she must have pancreatitis or pancreatic cancer. That something else must be wrong. When I said I thought she was honeymooning he thought that meant the somogi effect. :roll:
 
It didn't sound like you were overflowing with confidence in your vet. Are you sure that anything medical, even an ear infection, has been ruled out? Likewise, has your cat had a dental within the last year or so? These are things that can raise BG numbers in a kitty.
 
please test in the morning before you give her shot, and post here before shooting. Maybe test an hour before her shot is due so people will have a chance to respond. There's a good chance that if you can keep dry food out of the picture, that Tasha may not need insulin anymore.
 
lmaty said:
Thanks for the blog etiquette. Yes I will be around. I have decided to not give her insulin at least not yet. I will check her at +14. I took away the dm dry food and put out wet food for her. She is a grazer anyway. With no second shot and high rebounds, she still did not have dangerously high bg. after rebounding yesterday her hour before her AM shot(+23) was 293 coming off of a 364 at the +12 after the AM shot with no second shot, so she has something working for her. Maybe her own insulin. Her +12 bg today was 115.
Click to expand...


Please don't give her insulin at all. Just keep the dry food away from her, feed her whatever wet food she wants if she's hungry. Test every few hours for the next 12-24 hours. You may see some creeping, but don't jump on the shot. She may just be adjusting from the insulin.

If she's not a diabetic, the insulin could have caused those high numbers by forcing the liver to protect the body. When the liver senses the blood glucose dropping too low, it floods the system with hormones to protect from hypo. Thank goodness you started at a low dose or the liver might not have been able to combat the insulin. How was she diagnosed? By blood test in office (like a meter), or a test called fructosamine? This is important to know. Check your bill if you got one from the vet. Unless your cat was diagnosed by fructosamine, I think the diabetic diagnosis is suspect.
 
She had dry food yesterday and some today to. She isn't a big eater. (1/6 of a cup of DM maybe a bit more. Normal portion is 1/3 C.)

She did have other blood work done and it was all negative and she was drinking a lot and her litterbox was soaked in 2 days and she lost about 3/4 of a lb. All the classic symptoms. This was going on slowly for about a month starting with a slight increase of drinking and urine output to a much larger amount less then a week before I took her to the vet.

* I had to wait a day for the results so it wasn't by meter. She presented in the office at 365 I think when checked with a meter there when I brought her in for treatment.
 
That could have been a pancreatic flare, without an ultrasound along with FPLI it's unlikely that would have shown up on bloods either. See if a fructosamine was done or if she just registered high on the lab glucose, which all cats register high on by the way. The more stressed they are, the higher they are. If there was infection anywhere, upper respiratory, dental, urinary, all those could drive glucose up and affect drinking and peeing.

Even if she IS in fact a diabetic, caught and treated quickly, she is going off the juice as we speak because she's got dry on board (it can last in the system 24-48 hours) and threw you a non-diabetic preshot after a reduced dose. :) EXCELLENT work getting these tests done my dear, I believe you have successfully saved your cat's life.

:thumbup
 
Game Plan

Ok you need a game plan for tomorrow morning since most of the people you are seeing now won't be here early. This is gonna be a rough draft of info for you cuz I can't type it all or I'd be here all night LOL but this is what you need to know.

Normal non-diabetic numbers can range from 40-120. You do not need to worry about that right now, because with cats coming off the juice they can run a little high while still maintaining the majority of their day in normal non-diabetic numbers. She is gonna be a little bouncy from insulin dosage fluctuations and that DM.

So let's say you wake up tomorrow and she's under 200. Do not shoot. If you have to go to work, put a bunch of canned food out and go. Do not stress out if she's anywhere under 200, it may not mean anything. If she's over 200, give her .25u and put a bunch of canned food out and go to work, or anywhere you need to go. We can revisit tomorrow night and see where she's at and if she needs another shot --- this is NOT your game plan forever, just for the morning. We need more data to make a firm call on a good protocol for you ok? She is definitely not your usual diabetic, that's for sure!

Most importantly, don't worry if she runs high for 12 hours, she will be okay, but it's much more important that you don't react to a false number than if she runs a little high for a bit. She will still be safe. I assume since you have a human diabetic that you have ketostix or ketodiastix? Test her urine at least once tomorrow if you can if you have not shot her to make sure she doesn't start throwing ketones. It's unlikely, but better safe than sorry.
 
Fortunately I do not have to go to work tomorrow. I got the +14 hour number and it is up quite a bit to 249 but I am aware that it may not mean much. I doubt that she would be throwing of keytones in such a short period of time, but I will let her rest without being poked at tonight and see what she is in the morning. This has been very stressful day for her. I would not be surprised if her number will be lower then the 249, but we shall see. So far, treating diabetes in a cat does not seem that different then in a person except for the peak time of the insulin which seems half that of a human. At least she can't sneak a candy bar like a child can and her food can be controlled. Thank you all for your help and I will see or hear from some of you in the morning I might imagine. If not, I think I can handle what to do next based on my knowledge of diabetes in general. I have learned a lot today from all of you regarding the differences. Especially thanks for the tips regarding the dry cat food. Good night all and thank you so much again! I-)
 
lmaty and Tasha said:
Morning all,
Looks like Tasha will need the second .25 shot at +12 and a morning shot as well. The +23 was 310.
Click to expand...

Morning! Ok can you start a new "condo" for today? Just put a link in the new one to this one and that way people will know you're posting because you'll have today's date on it. Go ahead and give her the .25u.. With her dropping on a +24 reduced dose yesterday and having dry food in her system, she will have to be watched VERY closely over the next few cycles. I don't expect she will stay at this dose and I'm still not sure how much of that number is a bounce, ie: false. If she's truly a diabetic, I think the removal of the dry food is going to be your key to a diet controlled kitty. I am *so* happy you were testing and caught this. Congratulations!
 
Hi,

Just thought I would let you know that what you need to do now is open a new "condo" (=thread) for today.

The subject line should be
2/1 Tasha AMPS=xxx Advice?
The "Advice" could be "Help" or Dosing advice" or "Eyes" or something similar.

Then, every time you have a new number, you:
1) edit the subject line of the original post for the day
2/1 Tasha AMPS=xxx +2=yyy
3) Reply to your message with the new information to make sure your post comes to the top of the list in the forum.

This will ensure that you get the attention you need and don't get lost!

You also want to go to the thread of the day before, copy the url in the browser bar and then, in your new post, add a link to that thread this way:
1) Click the URL box up at the top of the message form. That will put this
[ url ] [ / url ]
(without the spaces) into your message.
2) after the first "url" in the above type and equal sign (=)
3) after the equal, paste in the url
4) after the first "]"type the words: Yesyterday's Condo

Hope this helps a bit!
 
lmaty and Tasha said:
At least she can't sneak a candy bar like a child can and her food can be controlled.
Click to expand...

Oh don't let those sneaky kitties pull the wool over your eyes! Stash can find the smallest crumb of dog kibble and shoot over 400 in a heartbeat. I swear he hides it when he finds it, and then muches just to give me grief!

:dizcat
 
You speak the truth! But it gets easy after a day or two.

At first, I thought, hey! This board must be organized by someone who is OCD. But, now I see how well it streamlines the whole procedure and how, when you are in a hurry for an answer, it makes it that much easier for someone to understand your situation quickly.
 
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