Critter Mom
Member Since 2014
That is just the best news, Clare!
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)))
Mogs
.
Last edited:
