Newbie - SOOOO frustrated - any suggestions?

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kindypoo

Member Since 2012
My cat was diagnosed with diabetes about 4 months ago. I've been home testing for about 3. I give her between 1/2-1 unit of Lantus twice daily and feed her 3/4 can of Purina DM (wet) twice daily. I am sooooo frustrated because her BG is always all over the board. She tends to run high on 1/2 unit and has crashed multiple times on 1 unit. I've been trying to give her 1/2 during the day while I work (and maybe check her on my lunch hour) and then a full unit at night when I can watch her. Because she'd crashed a few times, I had been letting her run high rather than low but she wound up with DKA (she recovered) so I know I need to be more aggressive, but I'm EXHAUSTED staying up with her all night when she's running low. Unfortunately she never shows any symptoms when she's hypo so I just have to wake up and check her every so often.
I feel like there's got to be a better way!! Should I give her the higher dosage but maybe feed her more than twice a day to keep her more even-keel?
Please help! I love my cat dearly, but my utter exhaustion and frustration is starting to affect my health. I'm very open to suggestions at this point.
 
You can definitely feed her more than twice a day... mini meals help support the pancreas. 4 meals a day is fine, some (like me) do more though. But remember, no food within the 2hrs before each shot, so your preshot bg isn't influenced by food.

Do you have a spreadsheet set up anywhere? If not someone should be able to help you get one up, I can't find the guide for it right now ohmygod_smile
 
I may give the multiple feedings a shot. I know my cat would like that as she was a free-feeder before she was diagnosed. How long can canned food sit out? Do you know how long food effects the BG?

Unfortunately, I don't have a spreadsheet as I never knew where to find one, I just have her numbers written down on a notepad. If you run across it I would love to use it as I think it would be easier to see in graph form.

In reading through some of the FAQs on the forum I'm wondering whether I have given enough time before adjusting the dosage. Early on she had crashed at 1 unit twice daily so rather than giving her a consistent 1/2 or 1 unit dose, I've been dosing her based on her pre-shot BG. Now I'm wondering when she spikes or crashes whether I may not be giving enough time to overcome the somogyi. Or at least that's a theory. Do you think I should throw out my old data and start over with her from scratch and give the dose a full week to get normalized?
 
The primary points I think are important in your case-
Dosing is based on the nadir numbers rather than the preshot numbers.
Doses should be consistent and held for at least 3 days unless a decrease is warranted by the nadir number.
Multiple meals are helpful in many cats.

Others will be along to help:-)
Carl
 
Thank you both for responding! :YMHUG: It's nice to know there are knowledgable people out there.

I will definately review the information and begin using the spreadsheet.

Thanks again!
 
Since she had DKA you are going to need to test for ketones. It is important to know if she is still throwing them off, because ketones plus many things like not enough insulin, infection, not eating, can take you right back to DKA. You can find ketostix at local pharmacies, which will measure ketones in her urine.

I agree about feeding her more often, diabetic cats that are still unregulated, are hungry all the time. I feed mine Fancy Feast pates and raw gizzards, hearts and turkey meat, with boiled chicken as treats. It's good to find a treat that she likes to give when you test her, soon they associate the treat with the test.

I would go to the Lantus group and have them help you with the dosing, they are very good at figuring out what you need to do. And they are very good at hand holding .....

Good luck and remember this is not a sprint but a marathon .... you will learn many different things and you will find what works and what doesn't but you will get there, have faith.
Nancy and Payne
(who does not like me talking about ketones :)
 
Hi, I don't use the same insulin as you and can't advise you on dosage, but I just wanted to say how much I empathise with the exhaustion and frustration you are feeling at the moment. Some folks seem to be really lucky when they start out treating feline diabetes, and others just don't seem to get the results they'd like to see straight away, despite their best efforts.

My cat had BG's all over the place too for quite a long time. Mostly really high. Then he'd crash suddenly. I tried all sorts of ways of dosing him, including shooting TID (three times over a 24 hour period) with lots of tests in between all the shots. So I was shooting and testing 24/7 for a long time until I felt that my own health was suffering and I just couldn't continue with that. It can be a fine balance to strike sometimes: We want what's best for the animals in our care, but we have to look after ourselves as well.

I really hope there are folks here using the same insulin as you who have the experience to advise you on a more effective and less exhausting stratedgy.

Regarding my own cat, well, he just sort of evened out in his own good time....

With regard to feeding, I have low carb canned food out all the time so my cat can snack if he needs or wants to. I put some out in the morning and change it in the evening. (The only exception to this is if the weather is really hot, when it needs changing more frequently). Then he gets a snack of his favourite food with insulin shots.

I hope things improve for you soon.

Best wishes,

Elizabeth
 
Elizabeth and Nancy, thank you so much for the words of encouragement. It's comforting to know that others have been where I am and have come out ok on the other side.

I haven't had any luck with the ketone urine strip testing but am planning on purchasing the new meter that can test for ketones in the blood by this weekend. I just had the vet check a few days ago and so far so good but after spending $3000+ to get over her DKA, I want to be able to check for ketones on the fly.

I think I definately will try the multiple feedings as I think it may help balance out her blood sugar. It will also be easier on us as she gets ravenous and cries and cries for about an hour before her feedings (drives my husband absolutely CRAZY). Btw, I just discovered this morning that her BG drops off A LOT just before feeding time. I never knew because the vet was only having me do 5 hour curves and I knew her peak was between 12 and 3 so I'd never spot checked her later than 3. That may explain a lot as she may be rebounding daily and I had no idea. I will do a full 12 or 24 hour curve this weekend to be sure this wasn't just a fluke today.

Again, thank you all for your support. It's conforting to know I'm not alone in this. :YMHUG:
 
To answer your earlier question about leaving out canned food--if you're adding water to keep it moist, you can leave canned food out for up to 12 hours, and if you leave a frozen portion out, 18-24 hrs.

I have food aggressive cat who will eat until he pukes and/or sit there and gnaw on a frozen portion of canned food until it's gone, so when I'm not home to feed or if I'm in bed (Bandit eats every 6 hrs, 4 times a day), I put a frozen portion of his food into an automatic feeder that releases it at his meal time.

One thing that concerns me is that you say your cat dropped low on .5u-1u of insulin--can you get some daily mid-cycle checks to see how much the insulin is lowering her blood sugar? As others have mentioned dosing with Lantus is based on the nadir (lowest number of the cycle), so mid-cycle checks are very important. With Lantus, you want to test at least 3 times a day--once before each shot to make sure it's safe to give insulin, and then the mid-cycle test (about 6 hrs after either shot) to see how the insulin is working. You can test as frequently as you would like, of course, but that's the minimum. When Bandit was on insulin, I tested 4 times daily and then did a curve and a few extra tests on the weekend. Also, are your shot times consistently 12 hours apart? Moving the shot time around with Lantus can also cause some very wonky high/low numbers. Lantus works best when you shoot on a 12/12 schedule.
 
Welcome to the board! I think we've all been there with the frustration factor. angry(2)_cat

Get that spreadsheet posted so you can get some experienced eyes on the project. The folks here are very responsive and caring - they'll help you guys get on the right track in no time. Hang in there! Kitty knows you're trying! :thumbup
 
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