Newly diagnosed

Leopold was just diagnosed about two weeks ago, he has been drinking a lot of water lately, and he is getting 2 units of lantus insulin twice a day. He started out with 1 unit, then 1 unit twice and day, and now to this. We have 4 cats and we switched all their food after researching that wet food is better for diabetics. So now they are getting wet food. The vet said his liver enzymes were elevated as well, and gave me Adenosyl pills to hopefully help that. He has not had his enzymes rechecked yet but he has been back a couple times for his sugar and it still isn't lowering. It is in the 400's. We purchased a glucometer to check him at home, he is an angel at home but he puts up a fit at the vet. I read that some cats can get elevated readings from being stressed so I hoped by doing it at home it would show that it was actually a little lower. We checked it the other night after his dinner/insulin and it was 360, but tonight after his dinner/insulin it was back to 440. I want to do everything I can to help him, and I want him to get regulated so he feels better, but all these constant trips to the vet are getting expensive especially without any results. Does it take this long to get his sugar lowered? Is there anything else that I can be or should be doing? Before we bought the glucometer the other day I had thought he was doing bettter because he has started to act like he is feeling a little better, but he still drinks quite a bit. Anytime I turn on a sink he comes running to try to stick his head in it. We already have a pet fountain for him and a couple of extra bowls of water set out for him. He is spoiled as can be! I have been researching and researching over the last couple of weeks to find anything that can help him. What is the best time to be checking his sugar? I appreciate any advice and help anyone can give! (So does Leopold and his sibling who are worried about him!)

 

Hi and Welcome,

You've come to the right place. I'm not going to give you alot of advise because my Harley was on and off insulin within 3 weeks by changing his diet to wet food. Good job on that!

More experienced people will be along soon with some great advise. There is lots to learn. But you can do it.

Testing at home is the most empowering thing you can do for your cat. It will give you instant information on how he is doing. Congrats on that too!

Hang in there.

 

Since you're using Lantus, you can post in the Lantus forums as well. There are lantus dosing specialists in there that can help.

You should be checking the BG before every meal before you shoot the insulin. This is the minimum amount of testing that should be done. The more testing you do, the more you'll know how the insulin is affecting your cat. Please have a look around the lantus forum and familiarize yourself it. You should only make one post per day in there to keep it from getting confusing since there are so many cats there. Everyone will reply to your questions in that post.

You'll also want to set up a spreadsheet with your cat's numbers. This will help the dosing experts get the "big picture" and they'll be able to help you more.

Since your cat is newly diagnosed, he has an excellent chance at remission. They helped me so much and now my cat has been off insulin for almost 2 months!

 

Hello! I'm so thrilled you are already hometesting! It really can take quite a while for blood glucose numbers to come down. As you can see though, through your "Whole Cat Report" (we call that WCR), he *is* acting better, so he is benefitting from the insulin. The protocols for lantus recommend raising .5 units at most each time rather than a whole unit. Most of us even try just going up .25 units, just eyeballing an approximate 1/4 of the little space. If you have a syringe with 1/2 unit marks, which are available, it's a little easier. With lantus and levemir (Pearl is on Levemir), it seems like in most cases numbers come down over all, and then they may bounce up again. You can click on my little spreadsheet link in the signature and see how Pearl has slooooowly come down since getting on lev, sometimes having really nice midrange numbers for a couple of days, then bouncing back up for a couple of days, but you can see, we have sat on a dose for at least 3 days before raising and we have only been raising .25 units at a time.

So you need to start keeping track of what numbers you are getting. YOu can use a spreadsheet if you want. They are real handy and make things easier to see. There is a template here:

http://spreadsheets.google.com/ccc?key= ... 0WXc&hl=en

Always test before feeding and shooting and then try to test between shots too. If you are home, you can do every couple of hours on a dose. Try to get spot checks other times. like two hours after, 6 hours, 9 hours (we write that like this +2 +6 +9...you will see that a lot. ) And also with these insulins, trying to keep a real close, 12 hour space between shots is going to help.

Whew! That's a lot and more people will come on. You can find a lantus specific board on the index where you can post regularly. Bear with us as we transition from our old board. You may find this board adding things this next week. You can *always* post on this board too if you need help.

 

Re: Newly diagnosed - need Lantus eyes

Congratulations on a very good start, and welcome to FDMB.

Lantus is a good insulin for cats. Switching to wet food is great. Testing at home is also very good You are right that levels at home can be much lower than at the vet.

It sounds to me like his insulin has been increased too fast, but I'll let people more familiar with Lantus speak to that point.

Getting glucose levels regulated can take time. How much time differs with different cats. Not many would be anywhere near regulated in two weeks, though.

When to test: Before each shot (which also means before feeding). Eventually you want to be testing a couple of times in between shots also, to see how the insulin is working. For the in-between tests, you don't worry about whether the cat has eaten recently.

Now that you are testing, trips to the vet for rechecks of the glucose level aren't necessary. If I recall correctly, it isn't unusual for liver enzymes to be elevated while the diabetes is uncontrolled. Once you get better control over the glucose levels, the liver enzymes will probably come down, too.

It sounds to me as if you are doing a lot of things right. If your kitty is acting like he feels a little better, then he probably does feel better.

Things to change:

• If you are testing after kitty eats, try testing beforehand. There might be a big difference, which would make you feel better about his numbers, and this is a piece of information that it would be good to have. Some kitties are very food-sensitive. If yours is one of those, you need to know.
  
  Many people on this list are experienced with Lantus. Listen to them when they suggest how to handle finding the right dosage.
  
  Don't keep taking kitty back to the vet for glucose checks. These don't give good information, and as you've noticed, they cost you a lot.

Keep posting and asking questions! All this will get much more manageable in a short time.

 

Welcome!

I see you are already getting fantastic advice so i just wanted to jump in and give you a warm welcome!

I know you want to do everything you can for Leopold and i hope you are proud of yourself for all that you have learned already. Leopold is one lucky kitty!

Try not to get overwhelmed (i know, easier said than done - we've all been there), read lots and keep asking us questions, that's what we're here for!

Welcome again! -Michele

 

Welcome!

Home testing is the best thing you can do for Leopold. It will give you a much better idea of what his body is doing, and will give you control. Instead of having to wait for the vet to open up, or take an emergency visit to a hospital, you can check him at home and understand exactly where he is. My cat hypoed on me, and that is when I decided to start home testing. I felt so helpless having to drive 35 minutes to have someone else confirm my diagnosis!

The least amount of testing you should do is directly before injecting. Test him to make sure he needs insulin - inject - feed. Doing a day curve is also beneficial. If you have a day off where you know you'll be home - test Leopold every 2 hours, as many times as you can, will give you a visual of exactly what the food is doing to his numbers, and how the insulin counteracts.

Also be careful with treats, as they can make the bg numbers rise.

Anytime you are uncertain or have a question be sure to come here. There are a lot of experienced people here that will be able to help you through it all.

 

Welcome!!

You mentioned that you have switched all of your cats over to canned food. That's a great first step. If you've not already found Lisa Pierson, DVM's website on feline nutrition http://www.catinfo.org/, it is a true resource. Likewise, not all canned foods are created equal. You will want to be feeding Leopold low carbohydrate (i.e., less than 10% of the calories should be from carbs) food. Janet & Binky's food charts give a pretty comprehensive list of the canned foods that are available along with the carb count.

As others have noted, Lantus doses are increased (and decreased) in small steps so your ideal dose is not missed. We follow a modified version of the German Tight Regulation (Tilly) Protocol[/u]. The protocol is described in the link.

Please take a look at the Lantus Insulin Support Group forum. There are several permanent notes at the top of the page that provide a great deal of information about Lantus and about the forum. Please join us there. It is a busy forum and there is usually someone around 24/7 to answer questions or provide support.

 

Welcome, sounds like you are learning a lot and it is great that you switched his diet and are starting to home test.

In addition to having his insulin raised to much too fast, I think you are missing some key blood glucose (BG) tests - namely at about 6-9 hours after the shot, as these should be closer to his nadir (lowest point) so you can see how the dose is actually working. He may go down to a nice low number like 80, or he may go too low to something below 50, you just can't tell without those tests. It is usual for BG to be the highest at shot/meal time. I feed and test right after - within 10 mins and I don't think there is a raise in BG that soon, but after 20 mins there could be - that is my experience with my cat.

I think getting some spot checks between shots will tell you a lot - and show you that there has been progress.

 

That's the wrong link to the spreadsheet template.

Here is the correct one ---> http://docs.google.com/previewtemplate? ... ode=public Click on Use This Template. If you are not currently a Google.com user, it will prompt you to register.

Instructions on how to set up and use the template are here ---> viewtopic.php?f=6&t=16

 

Thanks everyone for all the help and info! I'm glad I found this site. It's nice to know that I'm not alone and I feel a lot better reading all your responses. Leopold seems to be doing okay today, Friday I am off of work so I will be able to spend the full day with him and see how he is throughout the whole day. Thanks again everyone, I really appreciate it!!!