Newly diagnosed and using Lantus

Status
Not open for further replies.
kim and simon

kim and simon

Member Since 2012
Hi everyone,
I posted some of this info on the Health board and people suggested I consult the Lantus authorities :) I'm just starting to gather data but I thought I'd post here and show my spreadsheet (and introduce myself).
Hi everyone, just introducing myself!
---
My 12 year-old boy Simon was diagnosed on Thursday. I suspected something was wrong in December because he had pretty dramatic polyuria/polydipsia. WOW! (I had two carpal tunnel hand surgeries in December, so I did not get around to dealing with this until this week, 1/5/12). He had a blood glucose in the mid 400s at the vet, and very low K and Cl. Along with the urination and thirst, we felt it was enough to confirm the decision to start insulin.
Our vet has prescribed one unit of Lantus twice daily. Also a K supplement for a week. We've switched to canned food and the vet gave us a copy of the Janet/Binky list. I gather that's a good sign that he knows what's going on. I've been feeding him foods with less than 10 carb and greater than 45 protein.
As a little bit of background, I'm a part time (people) dentist. I've always been a cat person! Simon was my first cat on my own as a single adult. Now I'm married with three kids 6 and under, a chocolate labrador, Simon (he looks like a siamese mix--we call him simonese), and Molly, a calico cat (also 12). She's not diabetic but is overweight, so I'm feeding her the same as Simon.
So. . .my household is busy. Husband and human kids will come first, but I do want to do what I can to help Simon. I may not be able to religiously test his blood. Our vet actually did not insist on my testing his blood at home, but I have figured out how to do that and am gathering some data. I'm not sure what to think quite yet. As a dentist, I am experienced with needles (insert evil laugh here) and I got my BG on his ear on my first try!
---
So--do I just keep holding the 1 unit twice daily as his storage shed builds up? I will try to get several readings today.
 
Hello! Good morning and welcome to both you and Simon! It sounds like you are on the right path so far! I'm still new myself, so while I can't offer advice, I wanted to say HI! I'm sure the more experienced LL crew will be along shortly. Oh! and great job on the hometesting!
 
I said "welcome" over on Health but welcome to Lantus Land.

Here's the link to your initial post on Health.

Nice job on getting those tests in. You want to hold the dose for 5 - 7 days in order for the "shed" to be established. I would be attentive, however. That 99 is indicative of a very good response to Lantus. You may want to try to get at least a +2 test routinely. Typically, in a "perfect" curve, the +2 is the same as your pre-shot test result. (There's a description of a curve in the New to the Group sticky.) If it's markedly lower, it's likely to be an active cycle and you will need to monitor a bit more closely. This morning, you are seeing a bounce -- because Simon isn't used to spending time in lower numbers, his liver dumped stored glycogen along with other counterreglatory hormones which cause the BG level to spike. It can take up to 72 hours for that bounce to clear.

Do you know why your vet was recommending potassium supplements? I'm concerned in that those lowered electrolyte values can be indicative of diabetic ketoacidosis. Clearly, Simon wasn't that sick but he may have been on the edge. I'd encourage you to get a pack of Ketostix at the pharmacy. Testing for ketones until your cat is regulated is an inexpensive method of prevention that is well worth the cost. You follow the instructions on the Ketostix -- dip the stick in Simon's urine, wait 15 sec., and then compare the color on the strip to the key on the label.
 
Good morning and welcome to Lantus Land! You are doing great and your vet seems to be getting you off to a good start (unlike many others :sad: ). Sienne gave you excellent advice (as always). Congrats on doing the home testing - that is a big step and very important for Simon. Be sure and ask all of your questions. The collective expertise here is amazing. By the way, Zener has two moms. When I post, I sign my name and Anne doesn't. Happy Sunday!
Liz
 
Welcome to you and sweet Simon! I love the simonese!

You are off to a running start. You did the research that led you here, you have the feeding question down (awesome vet!), you are home testing, with your spreadsheet up and running. Now you are ready for the day to day sugar dance. You will never be alone in this. We are all here for exactly the same reason you are and we will understand everything you experience with FD. I'm relatively new myself, so I won't have a lot of advice, but I look forward to sharing this journey with you.
 
Nice job on getting those tests in. You want to hold the dose for 5 - 7 days in order for the "shed" to be established. I would be attentive, however. That 99 is indicative of a very good response to Lantus. You may want to try to get at least a +2 test routinely. Typically, in a "perfect" curve, the +2 is the same as your pre-shot test result. (There's a description of a curve in the New to the Group sticky.) If it's markedly lower, it's likely to be an active cycle and you will need to monitor a bit more closely. This morning, you are seeing a bounce -- because Simon isn't used to spending time in lower numbers, his liver dumped stored glycogen along with other counterreglatory hormones which cause the BG level to spike. It can take up to 72 hours for that bounce to clear.
Click to expand...
Thanks! Great info.

Do you know why your vet was recommending potassium supplements? I'm concerned in that those lowered electrolyte values can be indicative of diabetic ketoacidosis. Clearly, Simon wasn't that sick but he may have been on the edge. I'd encourage you to get a pack of Ketostix at the pharmacy. Testing for ketones until your cat is regulated is an inexpensive method of prevention that is well worth the cost. You follow the instructions on the Ketostix -- dip the stick in Simon's urine, wait 15 sec., and then compare the color on the strip to the key on the label.
Click to expand...
My understanding was that the vet felt the electrolytes were low due to lots of drinking and urination flushing them out. He had been a thirsty rascal, flooding his box for a month or so.

I took a +2 value this morning and it does seem to be similar to the AMPS
 
Hmm.....I've not seen a vet prescribe supplements for PU/PD but if Simon's labs indicated the need was there, it makes sense. I'd still test for ketones. It's something most of us do intermittently (or when we're able to successfully stalk our kitty to the box) unless we have a ketone prone cat. It's such an inexpensive preventative that it's reassuring vs. finding out that your cat is in full fledged DKA and spending thousands of dollars on emergency, 24-hour care.

If/when you're able, getting a curve will be helpful This means testing every 2- or 3 hours. The purpose of a curve is so you can gather info on when Lantus onset and nadir occur as well as what kind of duration the insulin is giving Simon. This isn't immediately necessary. Knowing when your cat's onset and nadir are can be extremely helpful since this varies with every cat (and can vary for your cat -- they are not always fixed points).
 
I'm guessing you've seen this before. This is an example of a typical curve on Lantus, but ECID.

Example of a typical Lantus curve:
+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.
 
I saw the original post on health which is why I am came here for a moment. PU/PD is one of the main causes of low potassium. Seen more in kidney cats, it's also common to senior kitties, nearly 40% of seniors can become Hypokalemic. I did not know this until Tucker was dx with it. Some diabetics become hypokalemic when they start insulin because insulin helps bring K to and from cells.

I mentioned on the Health thread that one week of potassium supplements seemed odd, they usually need it for quite a few weeks. If this were my kitty I'd recheck electrolytes before stopping the supplementation.
 
tuckers mom said:
I saw the original post on health which is why I am came here for a moment. PU/PD is one of the main causes of low potassium. Seen more in kidney cats, it's also common to senior kitties, nearly 40% of seniors can become Hypokalemic. I did not know this until Tucker was dx with it. Some diabetics become hypokalemic when they start insulin because insulin helps bring K to and from cells.

I mentioned on the Health thread that one week of potassium supplements seemed odd, they usually need it for quite a few weeks. If this were my kitty I'd recheck electrolytes before stopping the supplementation.
Click to expand...

Thank you! I will see about doing the supplement longer. I am guessing I probably need a vet visit to follow up, though.
 
Status
Not open for further replies.
Back
Top