Newly diagnosed cat

C

Candace Cat

Member Since 2019
Hello,

My foster cat, Candace, was diagnosed with diabetes two weeks ago - this is my first diabetic cat.

Candace is a 3 year old, spayed female with no other health issues.

Diet - Purina Pro DM Wet Food
Insulin - Lantus
Dose - 3 units twice a day at 10: 30 am and 10:30 pm
Monitoring - Freestyle Libre

I am trying to follow the tight regulation protocol. We caught Candace's diabetes fairly early - she has been in foster since May. She came from the shelter with her newborn litter of kittens. After her kittens were adopted in early September. It was at that point I noticed that she was drinking a lot more water and had standing urine in her litter boxes. The vet determined she had diabetes. She had two doses on ProZinc before being switched to Lantus due to my research. She has a timed food bowl and gets 1.5 cans of Purina Pro DM spaced out during the day.

I am really struggling to get her regulated. Today alone we've had two periods where she tested below 50. Yesterday, she ranged from 450 to 160 and Wednesday it stayed between 180 and 300. Both times that she went below 50 (this morning 1 am and 3 am and again at 12:30 pm) I used a can of "regular" wet food to get her numbers boosted back up.

Am I doing something wrong? My vet is trying to be helpful but has no experience with Lantus. She thinks we should to switch to a once daily dose.

Thank you!

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Lantus is a depot insulin and must be dosed twice a day to maintain the depot in the body.
Three units is a high starting dose. Usually, a cat is started on 1 unit, with increases of 0.25 units so that you do not go beyond the good dose for your cat.
A drop below 50 calls for an immediate dose reduction of 0.25. Since Candace was started on a high dose, I'll let other more experienced members chime in on a new dose for Candace.


The highs you are seeing are called bounces and are a result of Candace dropping low. Her body is not used to the low numbers, panics, and then she bounces.
The definition of a bounce is:
  • Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

It would help tremendously if you could set up a spreadsheet. We are pretty data driven.
FDMB Spreadsheet Instructions:
  • Please set up a Google Spreadsheet as soon as possible. Always keep spreadsheets up-to-date! Valuable time may be lost looking for information when a spreadsheet is not up to the minute.
  • If you have not been able to transition your kitty off of DRY food yet, please note it on your spreadsheet and in your signature. A dry food diet will often require higher doses of insulin to bring numbers down. Having this information plainly visible will help us help you.
Understanding the Spreadsheet/Grid

What to do in case of a hypo is here:
SYMPTOMS OF & HOW TO TREAT HYPOGLYCEMIA - what to do if your kitty experiences a hypoglycemic event
Jojo's HYPO TOOLBOX - what to have on hand in case of an emergency

Thank you for taking in a shelter cat. And it is fantastic that you are testing. It's the only way to keep your cat safe.
 
Welcome to you and Candace. She's so lucky to have a Momma that is willing to learn and help her to better health. Diabetes is a marathon and not a sprint. It can take time to get regulated and there can be a lot of frustration along the way. Most of us here understand how overwhelming it can be and know the steep learning curve it is. I'm so glad you found the forum and decided to join.
You've gotten some good advice from Red in setting up your spreadsheet, it's an invaluable tool for you and anyone trying to offer some advice. One other thing (I call it housekeeping) is to set up your signature. This is the grey info at the bottom of our posts and just avoids members having to ask the same questions over and over again. To set it up go to your name at top right of page, click and you'll get a drop down box. On the left you'll see signature, click and enter some info. We typically have cats name, weight, sex, age, date of diagnosis, type of insulin, current dose, type of meter you're using and any other medical issues there are if any. Geographic location is useful to as we have members all over the world. The signature is character limited so you may need to abbreviate a bit to make it fit. Once you have your SS set up this can be linked to the signature as well so leave a little room. Once done don't forget to save.

Again welcome and I'll see you on the Lantus board.:bighug:
 
You're not doing anything wrong!!

With TR,nthe initial dose is based on a weight based formula. Providing Candace's weight is in a reasonably good range, the initial dose = 0.25 x ideal weight in kilograms. Usually this works out to around 1.0u. You may be having a bit of difficulty because the dose was set too high. Most people find it easier to start at a lower dose and titrate up to a larger dose than worrying about their cat dropping into low numbers. From the standpoint of TR, any test that is below 50 warrants a dose reduction.

As the others have noted above, having a spreadsheet will be a big help. We're very numbers driven and it's useful to be able to gauge your kitty's progress. We're very used to working with a spreadsheet.

Please read the sticky notes at the top of the board. They will provide an overwhelming amount of information about Lantus and how it works. We're also here to answer your questions. The people here are very generous with their time and knowledge. We're here to help.

 
Thank you so much! I will work on her spreadsheet tonight. Her initial dose was set by the vet to be the same as ProZinc dose. I've been reading the information on the forum - as I mentioned even though the vets want to help they have no experience with Lantus so I am finding the advice isn't helping. Based on the formula above, her initial dose should have been 1 unit (she weighs a hair over 4 kilograms). What is the better option to reduce her dose by .25 or should I start over at the correct initial dose?
 
Last edited:
Candace Cat said:
Thank you so much! I will work on her spreadsheet tonight. Her initial dose was set by the vet to be the same as ProZinc dose. I've been reading the information on the forum - as I mentioned even though the vets want to help they have no experience with Lantus so I am finding the advice isn't helping. Based on the formula above, her initial dose should have been 1 unit (she weighs a hair over 4 kilograms). What is the better option to reduce her dose by .25 or should I start over at the correct initial dose?
Click to expand...


Hi. I just wanted to welcome you to FDMB :D. Once you complete your spreadsheet, definitely re post your question & someone will get back to regarding dosing advice :). The very experienced members are very helpful & generous with their time but they will need to be able to see the specific #s in order to offer suggestions. Sometimes the original message you post gets pushed down in the feed & it can be missed, so do not be afraid to come back & get it bumped back up. Also, please take a look at the yellow informational stickies at the top of the message board because they are extremely helpful regarding understanding dosing as well as the different options to manage dose changes etc.. When I initially came on the board, I printed them off & created a binder with tabs so I was able to access info very quickly & easily when needed. It takes some time to absorb all of the information, but building a basic understanding helps tremendously.
 
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