? Newly diagnosed, trying to get cat to gain weight

Discussion in 'Feline Health - (Welcome & Main Forum)' started by cabreu, Jul 30, 2020.

  1. cabreu

    cabreu Member

    Joined:
    Jul 30, 2020
    Hi, I'm posting here because my cat was recently diagnosed and my vet isn't helpful. Also, I'm about to drive across the country with my cat, and I can't get a glucometer until that is over. So I need to know if my approach is ok for the drive.

    Cat was diagnosed 2 weeks ago. She had been urinating and drinking a lot, and was down from her healthy weight of 13 lbs to 11.5 lbs. Her BG was 570, so we they gave her some fluids and we started on 1 unit of Lantus pen, twice a day. Did a BG curve a week and a half later, and levels are still really high: 600 an hour after eating/insulin, down to just below 400 six hours later. Vet said, that's expected, we just want to make sure the BG wasn't too low, since insulin takes months to work. But she had lost another half pound in that week and a half!

    I think the problem is her diet-- Hills Science diet Indoor/Senior food, which they got us to start using last year when her kidney levels were slightly off. It has ~35% carbs, so I bought some low-carb Weruva food. My plan for the road is to give her mostly Weruva, with a little of the old food, so that the change isn't too drastic. Should I be worried about hypoglycemia? I just really want her to gain weight.
     
  2. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    WELCOME TO FDMB! We are a community of kitty cat lovers that share a common goal. We all want our kitties to THRIVE not dive from diabetes. We also want to help you! We are so glad you found us! We are here to help you learn to navigate this disease in the best way possible. I take it you are not testing your kitties blood sugar at home. We can help you do this because it IS the ONLY way to keep your kitty safe.
    Would you be comfortable sharing your names? "Hey you" gets rather old. :p
    The best food for any diabetic is one that has low carbohydrates. A lot of us feed Fancy Feast pate's, but any food that comes in under 10% carbs will be a good choice. Also dry food is packed with carbs you may want to slowly remove that from kitties diet.

    I dont want to scare you but any shot of insulin should be preceded buy a blood glucose test. Most here use just a plain old human meter. The strips are cheaper and they work just as good if not better than the meter your vet may try to sell you. We CAN help you with this! ( my hubby is a diabetic and he would NEVER shoot insulin without checking his BG first) We believe the same for our furies.
    Hold on for more welcomes and replies FYI You will be asked to set up a spread sheet and a signature (that will appear at the bottom of each of your posts) you can find out how to do this here:
    Suggestions, Tech Support & Testing Area
    Again welcome to the best darn site to learn everything there is about feline diabetes!
    jeanne
     
  3. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi there, and welcome to you and your kitty.

    That's a big drop in carb load between the current dry diet and the Weruva. Although your kitty was relatively high when tested, dropping to a low carb food from 35% has the potential to massively lower blood glucose levels (BG) in an extremely short space of time (hours, potentially). We always recommend that a diet change is only attempted when you're able to monitor your kitty's BG throughout the transition.

    I see there's a problem with your getting your own glucometer at the moment. Do you know any human diabetics that might have a meter that takes affordable strips? If yes, then members here could help you learn to home test, advise you on the safe BG values used with a human meter (they read slightly lower than veterinary meters, but that's not an issue provided you're using the right BG reference range). If you could swing this then maybe you could complete the diet transition before you need to travel.

    If it were my cat and I couldn't home test I'd keep it on the current dose and higher carb food and do daily urine tests with Keto-Diastix or similar (tests blood glucose and ketones in a kitty's urine). You can collect a big enough urine sample by making a hollow in your kitty's favourite spot in the litter box and covering it with a couple of layers of cling film. Some people catch samples by sticking a ladle under their kitty's derrière while they're peeing. (The indignity!)

    The urine test strips will give you an idea of how much, if any, glucose is tipping into your kitty's urine (applies to unregulated/poorly regulated cats). Also it will show you if your kitty is producing any ketones (anything more than a trace requires IMMEDIATE veterinary care to prevent the cat from going into diabetic ketoacidosis).

    Unregulated cats tend to drink and pee more. In the absence of blood testing, another thing to keep a proper eye on is your cat's water consumption (accurately measuring how much water you put out and how much is left after 24 hours). If your cat's water consumption changes then that can give you at least a little information on what's happening internally, but it is very, very crude. If the volume drank goes up then BG may be increasing; if it goes down then BG levels may be getting lower.


    Mogs
    .
     
    Last edited: Jul 30, 2020
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  4. cabreu

    cabreu Member

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    Jul 30, 2020
    Thank you for the information and tips. I will get a glucometer after I finish driving to the opposite coast, but I am leaving tomorrow morning and can't do that yet.

    It seemed like Willow (the cat) was drinking less in the days before her BG curve the other day, but then the numbers from the curve seem as if the insulin was doing absolutely NOTHING. Not sure if that should suddenly change, but that combined with her continuing to lose weight make me very concerned. I plan to mix her old and new food, which I have been doing over the past day, and she seems fine.

    Hopefully she does ok in the car. Any tips on the best, cheapest glucometer/strips to buy would be appreciated, although I'm sure I can find this elsewhere on the site. Thanks again!

    Clare
     
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  5. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Hello and welcome. Where do you live Clare? In the US, many people buy Walmart's Relion brand. Maybe there's one enroute. Their Prime has very cheap test strips. You basically want something with a fairly small blood drop requirement and tests strips that are reasonably priced. Here is that information on the site you were probably looking for: Blood Glucose Meter Ratings, Comparisons, and Recommendations
     
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  6. cabreu

    cabreu Member

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    Jul 30, 2020
    Thank you to everyone for the helpful tips. I have made it across the country with Willow and purchased a ReliOn Premier Glucometer. During the trip, I winded her food down to half high-carb old food, half low-carb new food (started with Weruva, switched to Fancy Feast because she didn't like it and got diarrhea).

    We did our first at-home BG test this evening before her dinner and shot (which I have added to her spreadsheet). It was 466- still very high. What should I do? Switch to all low-carb food? Increase the insulin? Thank you.

    I should mention-- I've been feeding her in the morning and evenings with her shot, and also lunch- low-carb food only, no shot.
     
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  7. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    Hi Clare very glad you and Willow arrived safely and it's great you got the meter and happy you are now testing.
    I can't give advice on her dose ,I'm not that experienced as other members here.
    But I think they will all tell you that now that you are settled we are going to have to see more tests for Willow to see how the lantus is working for her and how low it's taking her during the 12 hour cycles.

    Then we can suggest if she needs more or less. You need to gather more data now that you are settled in.

    Take a look at my spreadsheet or anyone else's and you will see what I mean.
    At the end I will give you a few links to read about lantus and other important links

    As for the food Fancy Feast Classics are fine to feed her. I assume that the Hills was dry food?

    Just keep decreasing that high car food little by little , but you really have to monitor her closely because taking that away completely can lower her BG, so you want to make sure she is safe.

    We feed our cats the biggest meal in the AM and PM after you test .
    Most of us feed our cats smaller portions after that AM shot at least 2 smaller meals, same thing during the PM cycle.
    No feeding 2 hours before you do your AM test and PM test, you don't want it to be food influenced.

    Feeding them smaller meals during the cycles is easier on the pancreas.

    You may want to pick up
    some high carb Fancy Feast Gravy Lovers and some honey just to have on hand just in case Willow ever drops to low and you need to bring her BG up to safe numbers

    Also pick up some ketostix to test for ketones in her urine.
     
    Last edited: Aug 16, 2020
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  8. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    If you could set up you signature that would be great
    • On the left, under Settings, Click on Signature. This is where you will put information that helps us give you feedback.
      • There is a limit of two lines which may include two links; you may separate pieces with commas, dashes, | etc. This is where you paste the link for your spreadsheet, once it is set up.
      • Add any other text, such as
      • Caregiver & kitty's name (optional)
      • DX: Date
      • Name of Insulin
      • Name of your meter
      • Diet: "LC wet" or "dry food" or "combo"
      • Dosing: TR or SLGS or Custom (if applicable)
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  9. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Well done starting to home test!!!
    Always test before every shot and try and get some tests in during the cycles so we can see what is happening and how the insulin is affecting the BGs.
    I would stay with the same dose of insulin until we see what is happening. You can slowly increase the low carb to replace the high carb but do it over several days.
    I would also suggest you give some snacks during the cycles as well as before the shots. I would give a snack at +2 and +4 OR +5 every cycle (am and pm cycles). If your kitty drops low or fast give some food and post and ask for help.
     
  10. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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  11. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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  12. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Sep 21, 2018
    Just in case you ever need higher carbs to bring his BG up

    Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

    Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy. 15% Med Carbs

    Fancy Feast Gravy Lovers Turkey Feast in Gravy. 15% Med Carbs

    Fancy Feast Gravy Lovers Chicken and Beef Feast in Gravy 15% Med CarbsCarbs
     
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  13. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Sep 21, 2018
    Also let us know what time your pre shot test are.
    Great job setting up your SS already.
    This is the best place you ever want to be, everyone here is/so helpful and there are a lot of experienced members here .
    Just remember to post any questions you might have.
    We have members that live all over and are on here at different times, so please let us know where you live or your time zone.
    I know we can help you with your kitty Willow, she is a cutie by the way :cat:
     
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  14. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Dec 28, 2009
    Welcome back Clare! So glad you both made it to your destination safe and sound. I just wanted to say what a cute Kitty cat Willow is!
    Hope you are both rested and well.;):coffee:
     
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  15. cabreu

    cabreu Member

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    Jul 30, 2020
    Thank you all for the help and support. Willow's blood glucose testing has been put on hold for a bit, since her paw started bleeding a few nights ago and I realized she has a bad infection in it. The emergency vet gave her a strong antibiotic shot but said she felt a lump that could be a tumor. Hopefully it's just an abscess but I'm preparing myself for the worst :( Appointment tomorrow, so we'll see.
     
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  16. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    My little Olwen once got an infection in her paw from harvest mites. Very sore. Aw, poor Willow! [​IMG]

    Fingers and paws crossed it's just an infection. Be sure to let us know how you both get on. :bighug:


    Mogs
    .
     
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  17. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Dec 28, 2009
    prayers and healing vines on the way~~~~~~~
     
  18. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Sep 21, 2018
    Please keep us updated , would you consider testing her ears instead of her paws

    As you test the ears they will grow more cappilaries and testing will become easier
    Aim for the sweet spot , You might want to purchase 28 gauge lancets and do it free hand on a 46 degree angle, eventually more capillaries will grow and it becomes easier
    Start to rub his ears to get him used to it, warm them up first, if need be put some rice in a sock and warm it in the microwave and put it on his ears, make sure its not to hot. You don't want to aim for the vein

    [​IMG]Diabetic Cat Care Home Testing Your Cat’s BG


    [​IMG]
     
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  19. cabreu

    cabreu Member

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    Jul 30, 2020
    Thank you for the well wishes. Still waiting for cytology results to test for cancer, but it could be that Willow just injured her foot on the trip across the country when she threw a fit in her car tent and got her claw stuck. I'm hoping it's just that.

    The vet advised me to increase her dose from 1 to 2 units twice per day, based on the fact that she hasn't gained much weight and her BG is still high. They tested it at the office, which was after a morning of sedation in which she missed both her food and insulin-- it was 690! Seems the insulin is working because it had worn off by then? After a day of the double dose, I tested at the +6hr mark, and BG is still at 369 (as shown in spreadsheet).

    I have a question about the ear pricking-- does warming the ear help with blood flow? And how much should I have to massage to get a big enough drop after pricking? Today is a hot day and maybe her ear was warm from rubbing, but there was plenty of blood. In the past it seemed I got almost nothing, or a lot, possibly hitting the vein.

    Also, my Lantus pen just reached the 28-day mark. I've been refrigerating it and warming it up before injecting- can I keep using it? It's hard to tell because she hasn't stabilized yet, but my expenses have been really high lately and I would like to reduce costs if possible.
     
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  20. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    If you could set up you signature that would be great
    • On the left, under Settings, Click on Signature. This is where you will put information that helps us give you feedback.
      • There is a limit of two lines which may include two links; you may separate pieces with commas, dashes, | etc. This is where you paste the link for your spreadsheet, once it is set up.
      • Add any other text, such as
      • Caregiver & kitty's name (optional)
      • DX: Date
      • Name of Insulin
      • Name of your meter
      • Diet: "LC wet" or "dry food" or "combo"
      • Dosing: TR or SLGS or Custom (if applicable)
      • DKA or other recent health issue (if applicable)
      • Acro, IAA, or Cushings (if applicable)
      • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
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    Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.


    You will see that the signature is in gray at the bottom of each members posts

    This makes it easier for members to see rather than go through all your posts or ask the same questions over again
    Thanks
     
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  21. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    When increasing the dose we do increase by 0.25 units, by upping it a full unit you may skip over the correct dose.
    Do you have syringes with half unit markings, it makes it easier to increase or decrease doses
    It could have been that high 690 because you said she missed her dose

    As for the lantus pen, one pen usually last for 6 months, you can continue to use it

    Yes warming the ear does help with blood flow. Some will put rice in a sock and warm it in the microwave then put it on the ears to warm them. Just make sure it's not burning hot.
    The more testing you do the ear will grow more capillaries and they will bleed better.
    Are you using 28 gauge lancets, they will make a bigger hole.

    As for her weight, are you feeding her the Fancy Feast Pate after her morning meal?
    We feed our cats at least 2 smaller meals during each cycle
    Just don't feed 2 hours before each pre shot
    How many cans are you feeding her
    What does she weigh?
     
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  22. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Sep 21, 2018
    I know you just started testing, is it possible for you to get more tests in after her morning pre shot and her night time pre shot so we can see how the insulin is working. Members need to see more data in order to advise on dosing
    Scatter the tests at different times
     
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  23. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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  24. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    @Chris & China (GA)
    Hey Chris can you please read #19 and then read what I wrote, I just want to make sure I gave her the correct information
    Thank you Chris
     
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  25. cabreu

    cabreu Member

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    Jul 30, 2020
    I'll add more info to the signature but just to check-- are you not seeing anything in my signature yet?
     
  26. cabreu

    cabreu Member

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    Jul 30, 2020
    Thanks- I have, I just always get the vague impression that some people make it work for longer even though it's only supposed to be good for 28 days. There have been a few days (during the car trip) when the pen was in a cooler bag and wasn't totally refrigerated, although I did put it in the fridge as soon as I got to my hotel that evening. I'm worried about using insulin that stops working but not being able to tell based on her high BG, since she's not regulated yet.
     
  27. cabreu

    cabreu Member

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    Jul 30, 2020
    Thank you, and yes she's also very sweet and loves to cuddle :)
     
  28. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Sep 21, 2018
    Yes I see a little, just add the meter, the food ,the insulin
     
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  29. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Sep 21, 2018

    As for the lantus pen, one pen usually last for 6 months, you can continue to use it
     
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  30. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Sep 21, 2018
    The 28-day limit on Lantus is for humans only who do not refrigerate it constantly because they carry it around with them.
    If kept refrigerated properly (not in the side door), Lantus is good well beyond the 28 days and you can use it to the last drop.
     
  31. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    As Diane says above, the temperature of the ear does affect blood flow.

    I was very surprised at how much - and for how long - I needed to warm Saoirse's ear when I first started testing. As Diane has already mentioned, with repeated testing it becomes increasingly easier to produce a blood sample for testing due to new capillary formation.

    As you've already observed, it is much easier get a sample on a hot summer day. You may find that you'll need to warm the ear longer in the cooler months of the year (assuming you don't live in the tropics! :) )

    I winced reading about Willow getting her claw stuck while you were travelling. Owwww! Poor baby!!

    Keeping everything crossed here that the lab findings will be favourable.


    Mogs
    .
     
  32. cabreu

    cabreu Member

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    Jul 30, 2020
    I see, thanks. I didn't remember not to store in the fridge door until about a week ago. Maybe I should get a new pen soon.
     
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  33. cabreu

    cabreu Member

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    Jul 30, 2020
    Thank you, this is all good to know. I feel bad drawing blood too often, but will try to test more. Her numbers still haven't come down with the higher dose, even though I'm testing when I think I should see a low point (~6 hrs after morning meal & insulin, before afternoon snacking).

    The lab findings showed mostly inflammation and scar tissue, and apparently some slightly abnormal spindle-y cells. So we will wait to see if it heals- if it does not, they will have to amputate the toe! Ouch.
     
  34. cabreu

    cabreu Member

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    Jul 30, 2020
    I do have some syringes, and could switch to them, but haven't because the pen needles are supposed to be more accurate for doses < 5 units. I haven't seen a reading below 300 yet, so I'm not worried about going past her correct dosage yet.

    I'm using 30-gauge ultra-thin lancets. It's gotten easier, maybe because the weather is warmer, or maybe because of capillary growth. I don't have a microwave so I'm just warming the ear by rubbing it.

    I'm feeding Fancy Feast roasted and flaked, since they are lower in phosphorous (she has slightly elevated kidney levels), but they do have a little more carbs than the pates (not by much though). And yes I'm feeding during the day- 1.5 (3-oz) cans in the morning and at night, and another can spaced out over the afternoon (but not before mid-day tests).
     
  35. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Ouch indeed! I winced just reading that. :nailbiting:


    Fingers and paws crossed Willow's paw will heal quickly.

    (((Willow)))


    Mogs
    .
     
  36. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    28-gauge lancets might make getting blood droplets more reliable in these early stages. Glad to hear you're finding it easier to get samples. Yes, the warmer weather does help.

    I used a 3ml plastic pipette containing heated water to warm the sweet spot area on Saoirse's ear. You can get the pipettes on eBay. Here's a pic:


    IMG_20160131_152925.jpg


    Maybe a similar solution - using some sort of receptacle containing heated water - might help you with warming Willow's ear when the weather gets cooler?


    Mogs
    .
     
  37. cabreu

    cabreu Member

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    Jul 30, 2020
    I just got a new Lantus pen so hopefully her BG will start going down soon. I have another question-- is it ok to warm the pen using my hands before injecting? I do this because I read that injecting cold insulin causes irritation. I want to try to make this pen last several months! Thanks.
     
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  38. cabreu

    cabreu Member

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    Jul 30, 2020
    Thank you for the tip!
     
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  39. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Did it help?


    .
     
  40. cabreu

    cabreu Member

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    Jul 30, 2020
    I just ordered the pipettes- I'll let you know.
     
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  41. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Dec 28, 2009
    Yes just dont shake it. I think you can roll it gently between your hands but is just as easy to take it out 10 mins early and let it sit to warm up.

    ETA: I think its ok to roll , maybe wait for more replies to be sure. ;)
     
  42. cabreu

    cabreu Member

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    Jul 30, 2020
    Thanks- do you know the reason for not shaking? I turn it upside down many times because I read you should do that instead of shaking, but don't understand the potential harm of shaking.
     
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  43. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Dec 28, 2009
    I'm not sure in the specifics. I read about it years ago but I will search to find it. Wait for more replies as someone here knows. They will probably beat me to the punch and post here.
     
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  44. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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  45. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    oops im AM wrong:
    Never shake or roll your vial, cartridge, or pen.
     
  46. cabreu

    cabreu Member

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    Jul 30, 2020
    I see... ok, no disturbing the pen then!
     
  47. PH&MonkeyPenPenFaFaTiger

    PH&MonkeyPenPenFaFaTiger Member

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    Apr 5, 2020
    Hi Cabreu,

    My cat Monkey was similar to your case. I know that people here have already given you robust advice. I would want to share what I learned from the recovery of Monkey.

    1. If possible, one should be very focused on learning the best practice asap. It saves the troubles and confusion later. And the cat would be happier.
    2. Cats need to feel safe, they need their owner to understand them to fulfill all their needs. Thousands of studies show that animals (including human) have the best recovery speed when they feel safe thus low stress. So my two cent is OBSERVE them carefully and fulfil their needs ASAP. Petting and Playing can help tremendously too. Monkey not only recover from FD, but also build the best ever connection with me.

    Peter
     
  48. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Dec 28, 2009
    Thank for the wise words Peter. The way you turned Monkey around is phenomenal.
    Your "Crew" are VERY lucky to have you as their caregiver. :bighug:
     
    Last edited: Aug 26, 2020
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  49. cabreu

    cabreu Member

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    Jul 30, 2020
    Hi Peter,

    Thank you for your thoughts. Is there anything specific that you think I should do? I haven't been able to get her BG down very much (see spreadsheet), but I have switched to syringes to adjust the doses more finely, and Willow doesn't have to sit still for 10 seconds now, which she was getting tired of.

    Thanks again,
    Clare
     
  50. cabreu

    cabreu Member

    Joined:
    Jul 30, 2020
    Hi again to everyone who has been so helpful. Willow's paw is healed! The vet also told me a few things that I wanted to get your opinion about:

    1. Going above 2 units of insulin isn't a good idea for cats.
    2. I should try not feeding her at all during the day to get her BG down- stick to the 8am/8pm food & insulin schedule.
    3. Using the syringe on the insulin pen is risky and I should buy the full bottle.
    4. She also gave me some probiotic for her diarrhea, which I'll try.
    5. She suggested using the Libre Freestyle 14-day port.

    I am wondering what you all would do, given this advice, and given my ability to test Willow's BG 1-2 times per day. Thank you!

    p.s. One more question: A bubble usually forms in the syringe and I cannot get it out. How much does this change the amount of insulin in the syringe?
     
    Last edited: Aug 26, 2020
  51. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    That is just the best news, Clare! :cat: I'm delighted - for both of you! :)


    Utter horse feathers.

    The only time going above two units would be bad for a cat is if the cat didn't actually need that much insulin.

    A diabetic cat requires the insulin it requires. Some cats with 'high dose' conditions receive insulin doses that would make your vet's eyes water.


    Disagree.

    'Frontloading' cats with large meals at the beginning of a cycle is necessary when using insulins that hit hard and fast after dose administration and peter out many hours before the next dose is due (e.g. Caninsulin/Vetsulin, Novolin N). The action profile of Lantus is very different. It has a gentler onset and typically does not drop BG like a rock when it kicks in. Lantus also typically has much longer duration than intermediates like Caninsulin and Novolin. Therefore, there is much greater freedom when it comes to feeding schedules for cats on Lantus and other long-acting insulins.

    Feeding smaller, more frequent meals is less likely to spike BG levels during the cycle and can be easier on the pancreas. Some cats, for example those with pancreatitis, need to be fed little and often and that works well when paired with a long-acting insulin such as Lantus. For cats without complications receiving Lantus, it is best to get most, if not all, of the feeding done in the first half of each 12-hour cycle, but it's not strictly necessary. Food only needs to be withheld for the two hours before each preshot test so that the reading won't be food-influenced.


    More horse feathers. Countless members here draw doses from insulin pens without any problem. Have done for years.

    Cost-wise, the 10ml vials are usually wasteful: most cats need only small doses of Lantus and they would not use up all the insulin in a 10ml vial before it became unusable.


    Sensible course of action. If this probiotic works, great, but if it doesn't and it's not s. boulardii, I suggest trying the latter (and let your vet know you want to try it). Members here have had good results with it, and some reputable feline IBD internet groups also recommend it.


    Some members have had good experiences with the Libre, others not so much. It's a great idea in principle. When the Libre works it provides a lot of data. On the downside, each unit only lasts 14 days and there have been reports here that sometimes they stop working sooner than that. Also difficulty keeping it attached to the cat seems to be a common issue.

    Even when using a Libre successfully, it's also necessary to still have a standard glucometer (e.g. you'd need one to test BG if the Libre failed or if it came off the cat).


    The change in amount would depend on the size of the bubble(s).

    Try the following:

    * Draw up about 1 - 1.5 units more than the dose you need (e.g. if giving a dose of 1 unit, draw up 2 - 2.5 units of insulin).

    * Hold the syringe with the needle pointing upwards.

    * Give the side of the syringe a series of flicks to move any bubbles up to the top of the barrel. If there are several small bubbles, try flicking the side of the syringe until the small bubbles 'pop' and form a single larger bubble (easier to remove).

    * Keep the syringe needle pointed upwards and express most of the excess insulin. This should remove the air bubbles.

    * Finish by doing the fine adjustment to set the required dose.

    Go shopping for a vet with better FD knowledge?

    I'm only half joking here. If Willow will need more than 2 units - and the data you've accumulated for Willow thus far looks to indicate this* - will your vet and yourself agree to disagree and will they support you going forwards? If you're happy with your vet in general and have a good relationship with them, then perhaps a bit of negotiation on treatment approach would help (e.g. can you try things the way you would like to work for a set period of time and then both of you review the situation?). Some vets are willing to learn together with their clients. If your vet were to take a 'my way or the highway' stance on insulin treatment and Mimi's health could potentially suffer as a consequence (poor regulation) then finding a more FD-savvy - or at least a more collaborative - vet may be necessary. When managing long-term health issues in our cats we need a supportive and collaborative relationship with our vets. It's tricky when the approach of the vet and the desired approach of the caregiver conflict.

    My greatest concern here is about how much knowledge your vet currently has about feline diabetes and how much experience they have of treating the disease. The maximum 2 unit insulin dose for any cat is completely wrong (and it's the first and only time I've read a report here of a vet expressing such a view). The pen/vial thing is minor. It's easy to argue away that particular objection on cost grounds if necessary. The flawed approach to meeting a cat's insulin needs is a real biggie.

    (* A caveat about the above comment on possible insulin requirements: with 1 unit jumps in dose it's possible to skip over the 'goldilocks' dose a particular cat needs at a particular time. I can't tell from the available data whether or not this caveat might apply in Willow's case (re the jump from 1 to 2 units), but it's something for you to be generally aware of. Any time you'd like feedback on how Willow's dose is working just give a shout out here.)


    This thread was written for people following the TR protocol but it contains some very helpful suggestions on how to fit testing around a busy schedule, regardless of which dosing protocol you're following:

    Can You Do TR with a Full-time Job?


    If there's any way you could snag some mid-cycle tests on the PM cycle that would help you. Even a few PM+2 tests could throw a little more light on how Mimi is doing.

    Once again, Clare, I'm so happy Willow's paw is better. (((Willow))) :cat:


    Mogs
    .
     
    Last edited: Aug 27, 2020
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  52. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    1-3 trash bin. jmho
     
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  53. cabreu

    cabreu Member

    Joined:
    Jul 30, 2020

    Thank you for all of this advice. I will try to get more data from Willow. I work from home, but she doesn't enjoy the testing, and I am starting a new postdoc job which I have to devote a lot of energy toward.

    I'm getting discouraged that Willow's BG hasn't budged despite changing her food and putting her on insulin (and increasing it). Reading this: https://www.felinediabetes.com/bg-curves.htm makes me feel overwhelmed, and I'm not sure if I will be able to figure this out, or if Willow can be regulated. I'm living in an expensive place and not making a lot of money, so I can't keep taking her back to the vet every week. If it's possible that too much insulin can also cause high BG, then I have absolutely no idea what to do!

    But again, thank you so much for all of your advice- I would have even less of an idea what is going on without it.
     
  54. Pabs&Ro

    Pabs&Ro Member

    Joined:
    Aug 16, 2020
    Please don't despair. Diabetes can be overwhelming and create a very confusing picture and we all find it difficult to understand. Someone will be able to help you who is on Lantus. Dig in - you'll get there.
     
  55. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    We all have felt the same way. Trust has to be built. It will be. When you are overwhelmed come here to share. This is what we do. And believe me the fist day you FEEL success this pace will become HOME.

    We WILL get through this together.

    Keep up the good fight!
    jeanne
     
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  56. cabreu

    cabreu Member

    Joined:
    Jul 30, 2020
    Thanks for the encouragement. I was able to get her BG this morning before her food/shot, and then put some gabapentin in her food (vets prescribed this a year ago because she has developed a short fuse in old age-- she was on it during her curve at the vet in July so I hope it doesn't alter the readings) and will do a curve today.
     
  57. Maddie Mouse

    Maddie Mouse Member

    Joined:
    Jul 31, 2020
    I don't know what your PhD is in, but I have a science background and I find that article rather overwhelming!

    It's possible that Willow's BG readings are higher than they should owing to stress. When I took Maddie in for her first glucose curve, the graph was like a rollercoaster because she hates being at the vet's, so we'll be doing one at home this weekend (fingers crossed I can get the blood samples!). Maybe the best thing to do is to work on making the testing less stressful, rather than worrying about getting the perfect numbers right away? I know we all really want our kitties to be better RIGHT NOW KTHNXBAI, but as everyone here says so often, FD is a marathon, not a sprint.
     
  58. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    It is rather heavy going, n'est-ce pas!


    Mogs
    .
     
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  59. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Yay! You speak LOLcat!! :woot:


    Mogs
    .
     
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  60. cabreu

    cabreu Member

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    Jul 30, 2020
    Curve results are in, and they aren't great. It doesn't seem to be a curve at all. The BG ceiling has come down since diagnosis, but I can't break through the floor.

    Any advice on dosing? Bring up/down? I'm afraid I don't want to consult the vet because I didn't follow any of her previous directions (except probiotics).
     
  61. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    I'm NOT an expert bu am wondering if this insulin is working for Willow... GUYS?
     
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  62. cabreu

    cabreu Member

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    Jul 30, 2020
    Could still really use some advice here...
     
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  63. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    Bump.
     
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  64. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Clare,

    I'm going to tag @Chris & China (GA) to ask her to have a look at your spreadsheet when she's next online and hopefully she may be able to suggest a course of action.

    FYI, Clare, I tend not to give dosing input unless I think a cat may be getting too much insulin. Also, there's a question mark in my mind about the jump from 1 to 2 units. Chris is a very experienced Lantus user and I think she may be able to better interpret your spreadsheet than I can. Very sorry I couldn't help on this one.


    Mogs
    .
     
  65. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    Have you read the Sticky on the different dosing methods and decided anything?

    Also, I understand how overwhelming it is, especially at first, but we really do need to see at least 1 test on the PM cycle (other than the PMPS) Most cats go lower at night so it's important. Also, without testing on the PM cycle, you're literally missing half the picture. That's like trying to figure out what the puzzle picture is when you only have pieces filled in on one side.
     
  66. cabreu

    cabreu Member

    Joined:
    Jul 30, 2020
    Thanks for the link. I had been looking for something like this but all I found was the 1995 article about curves, which emphasized the midpoint rather than the high or low point.

    I will add some PM tests (can't test all night, though, realistically only up to +4hrs), but I still don't know what to do. I guess I'll try the SLGS method, which would have me increase her dose. Not sure if that's the right thing to do, but I'll try. Was hoping someone would have some insight on that.
     
  67. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    TR would give her a better chance at remission. It does require a little more testing (and a lot more nerve) but on TR you only have to hold the dose for 6 cycles if it's not getting the results you want.

    Reductions are earned when they drop below 50 and you have to learn to shoot lower and lower Pre-shot numbers. At first, if under 150, you'd stall, don't feed and test again in 20-30 minutes and use that time to post here with a clear subject line like "STALLING! NEED HELP!" (it usually works....LOL) Once you have someone's attention, you can go back and edit the subject line to the correct format. As you gain more experience and data, you gradually learn to shoot lower and lower pre-shots. When I had enough data and experience, I'd shoot China if she was above 50 (and you can see she was very tightly controlled on her spreadsheet)

    On SLGS, you hold the dose for 7 days which means you have to hold the dose even if it's not getting the results you want which can lead to glucose toxicity where her body gets used to being in higher numbers even though you're giving insulin.

    It's totally your decision so think about it, ask questions and when you decide, add it to your Signature. You can always change your mind if you want to!

    All that being said, I think you could go up to 2.5 tomorrow.
     
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  68. Pabs&Ro

    Pabs&Ro Member

    Joined:
    Aug 16, 2020
    Vets advise you decide. I don't always follow advice and i usually give the vet a reason and i find they are fine with that. Afterall you know your cat best.
     
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  69. cabreu

    cabreu Member

    Joined:
    Jul 30, 2020
    Thank you for the advice. TR does seem riskier, so I am wondering what the statistics are on how much better it is at achieving remission? All I saw was the 64% remission in the German cat owner trial.

    Would it be possible to mix the two approaches at all? For example, increase her dose more often than every 7 days at first?
     
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  70. Critter Mom

    Critter Mom Well-Known Member

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  71. cabreu

    cabreu Member

    Joined:
    Jul 30, 2020
    Wow, her BG jumped this evening from 300s to 500s in 3 hours. Is this normal?
     
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  72. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    No you can't mix them, but as long as you're willing and able to test enough, you can start on TR and switch to SLGS later (or you can start on SLGS and switch to TR later if you decide you want to be more aggressive)

    Yes, it can be totally normal....what did you feed when you fed the "snack at +6.5"?

    Also, there's something we call New Dose Wonkiness (NDW)....it's when for some unknown reason, the first cycle or two after an increase, the numbers go up when you'd expect them to go down.

    Tomorrow, why don't you go ahead and move over to the Lantus Forum? This thread is getting very long and people start to pass over really long threads because they figure somebody else is dealing with it. On the Lantus forum, you'll get help from people with lots of experience using the depot insulin's. Each day you start a new thread so it's not as easy to get lost.
     
  73. cabreu

    cabreu Member

    Joined:
    Jul 30, 2020
    It was just part of the can that I space out over the day, like always.

    Oh I see, thanks!
     

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