Noob to the group! 9/10/13, Boots, PMPS 360 +4 265

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Jade77

Member Since 2013
Hey y'all! My name is Jade, I have an 11 year old diabetic kitty named Boots, diagnosed in July. I also have another non-diabetic named Freya :) He started on humulin, but has recently been switched to Lantus, and Wendy said this was a good group for advice and feedback! Boots is doing a lot better than he was a couple months ago, when we first found out he was a sick kitty, but still learning about all this and trying to regulate him.
 
Welcome to Lantus Land!!

I just went to look for your posts and it looks like there is a lot of dialogue on Health. Would it be possible for you to give us the short summary of Boots diabetes? (Are there any medical issues, history of ketones, food, etc?)

If Wendy didn't already suggest it, I'd encourage you to familiarize yourself with the starred sticky notes at the top of this Board. With Tight Regulation, you want to evaluate each dose change after 3 days/6 cycles. It looks to me like you've been holding the dose a bit longer than you need to. When you're ready, I think you can increase Boot's dose to 1.25u.
 
FYI she was on humalin before and this kitty is DKA prone. SHe was on humalin and switched recently to lantus on aug 25.

She asked on health if its ok to increase when she won't be home for half a day.

Jade, Remember that lantus is a depot insulin so it takes a few days to see the impact of a dose change. Plus you have a lot of wiggle room since he isn't dropping that low.. So IMHO I would increase tomorrow morning.. To 1.25 as sienne suggested.

Wendy
 
Welcome Jade & Boots! This is the second best place for your kitty to be!!! The first, of course, is the Falls (the place where kitties go when they no longer need insulin and are OTJ "off the juice"!) :-D Glad you found this place!!!
 
Thank you!! :) Not any serious health issues. When I first realized something was wrong it was because his coat looked a mess, he was lethargic, not really eating, drinking a TON, and he started peeing on the carpet which he NEVER did before. Then I noticed the fruitflies and took him in. The vet I initially took him to was an a$$ and gave me pretty much no options: either put him down or pay upwards of 1000 a month to regulate him and wouldn't give me anything but an expensive script of the vial. I took him home to think about what to do. He got REALLY sick, barely moved, didn't eat or drink anything..that's when I found this message board and was instructed on what to do to force him to eat and drink. Deb helped me with a testing kit and keytone sticks, and he was the darkest color on the spectrum. I forced fed him chicken and water with tuna water through a syringe, and a friend with a diabetic pet let me have a bottle of humulin til I could afford the scrip I was written, which is why I started him on that first. Within days he was eating again, purring, sleeping with me, drinking normally, and acting like the cat he used to be. He also lost 5 or 6 pounds very rapidly before he was diagnosed, ANOTHER indicator for me. Despite his higher numbers, I test for keytones every few days and get no color on the stick, so that's good. But we are still have an issue with the peeing on the carpet, and some days he doesn't eat as much as he should be eating, but nothing I'm alarmed about. Is that enough info? I'm trying not to leave anything out.
 
That helps to fill in the gaps. Thanks. When you have a few minutes, if you can complete a Profile and attach it to your signature that will help us to not keep asking you these same questions again (and again and again....).

If you've not already considered this, given what sounds like a less than ideal experience with your vet, you may want to look into finding a vet you feel better about using. Frankly, I would have been very hesitant to suggest that you try to manage a ketone reading that was as high as you indicated at home. You were very lucky that Boots was not experiencing diabetic ketoacidosis (DKA). We recommend that you have your cat seen by a vet if the ketone reading is above trace. DKA is life threatening and really can't be managed at home. But, hopefully, that is all behind you and Boots!
 
I did find a new vet, less than a month ago actually. A clinic that specializes in cats and is completely supportive of home testing and curves. And I am not in a financial situation where I can afford vet visits. Which is why I had no choice but to deal with it at home. The diagnosis visit alone cost me half my rent that month.
 
Hi Jade and welcome to our Lantus family!!!

It sounds like you're doing a great job :-D Boots is SO much better off getting Lantus instead of Humulin. What are you feeding him?
 
Hi Jade,
No advice from me just wanted to welcome you and Boots to LL!
They will get you up to speed in no time. You have found the best place to help Boots.
The people here are absolutely the best!!
 
Hi Jade! No advice from me, either, but welcome - this place has been a lifesaver for Tigger & I, & the people are wonderful - we'd be lost without them. Hope Boots does well on the Lantus increase!
 
thank you all for the warm welcome :) I am currently feeding him a variety of the friskies pate, and it was a pretty easy transition from the dry food..he's much more fond of wet food.
Yes Wendy, we did increase the dose starting with his AM shot up to 1.25. He had one blue number today, but I just tested him at +6 and he's back in the 300s.
 
Welcome to Lantus Land Jade and extra sweet Boots!!

You're in the best place you could possibly be to learn how to manage Boots' diabetes at home...and save a lot of money with vet bills too. I'm so happy to hear you have a new vet who's not only willing to work with you, but also supports home testing. That's hard to find sometimes! It's hard to believe some vets are still telling their clients to euthanize their cats!!

Once again, welcome and hope you and Boots are happy here. I know you'll get all the help you need to get his diabetes better controlled...and maybe even a ticket to the Falls!

Edited to add..His PMPS of 395 is most likely a "bounce". Looks like he dropped into the 150's (which for him is pretty low compared to where his body is "used to") so his liver panicked and released hormones and glucogen (sugar) to bring the numbers back to where it's "used to". Bounces can take up to 72 hours to clear, but as you get him under better control, the bounces won't be as high, and will clear faster.
 
what does it take to get a cat regulated? Will low numbers always cause this "bounce?" Geez, I still have so much to learn! :)
 
what does it take to get a cat regulated?
Click to expand...

Mostly time...some cats get controlled quickly with just a food change...some need a short time on insulin to give their pancreas a little help...and some cats will be on insulin the rest of their lives, but the Tight Regulation Protocol gives them the best chance at getting OTJ within 6 months of diagnosis.

Will low numbers always cause this "bounce?"
Click to expand...

Bouncing:
When a cat isnt regulated, the blood glucose has probably been high for a while. As the insulin starts to take effect and numbers start to come down, the liver has to learn to adjust to the lower numbers. We call this "liver training school". But before it relearns that low numbers are ok, when the BG drops to a number lower than the liver is accustomed, or if BGs drop low, or if the BG drops suddenly, the liver”panics” and reacts by releasing counterregulatory hormones and glucagon. This drives the BG back up. This is what we call a "bounce". Bounces can take up to 72 hours to clear so we are generally careful about increasing doses during the bounce. Once the bounce clears, then you can see the "real" numbers and determine if the dose needs to go up or down.

As the liver is "retrained" to what normal means, bounces won't go as high, and will clear faster. My own cat, China, used to bounce into the 400's and take pretty much the whole 72 hours to clear the bounce....now she only bounces into the 200's and usually clears them in a couple of cycles
 
That makes a lot of sense to me now. I was worried I was doing something wrong whenever I see those crazy high numbers after a good low one..puts a lot of what has been going on with his numbers into perspective.
 
We are pretty good, thanks! I upped his dose, (today was day 3) but I haven't really noticed a change in the numbers yet..still lots of pinks and a few yellows.
 
Maybe start a new thread tomorrow in this group and ask about a dose increase - Also as well as in the body of the thread include a ? in your subject line and maybe a few words about the question ie
? 09/14 Boots AMPS XXXX - dose increase?

Wendy
 
At this point, I'm not sure I can even continue keeping up with his insulin and regular testing :/ Gabe has expressed annoyance with having to help take care of my cat, and this morning he decided to change Boots AM shot time because he didn't feel like giving it to him at 530. And from what I understand, you can't do things like that with lantus. (he did that more than a few times with the humulin.) It has to be every 12 hours, right? I wish I could be here all day to do this by myself, but I am gone 11 hours a day and can't do it without help. And I certainly can't have someone giving him shots at whatever time is convenient for them...
 
Hi Jade. Welcome. My cat Ozy was diagnosed in July and we are working hard to regulate him. He is doing much better lately after much frustration with his all over the place numbers.

Who is Gabe? I missed that. I will assume a household member who is reticent to help with all this. Maybe Gabe will come around. My DH (dear husband) was a little slow to get on board but is now very supportive. It can be a little overwhelming to get used to all the testing and shooting and care.

I hope you can hang on and figure out how to manage it all. It WILL become easier. It WILL make more sense.

donaleen
 
Jade77 said:
... this morning he decided to change Boots AM shot time because he didn't feel like giving it to him at 530. And from what I understand, you can't do things like that with lantus. (he did that more than a few times with the humulin.) It has to be every 12 hours, right? I wish I could be here all day to do this by myself, but I am gone 11 hours a day and can't do it without help. And I certainly can't have someone giving him shots at whatever time is convenient for them...
Click to expand...
I'm sorry to read this. You're correct on the 12/12 hour schedule. You have to consistently give lantus every 12 hours (unless the cat has gone too low for a shot--in a newbie's case (on lantus)--we recommend not shooting under 150). You can move the shot by 15 minutes twice per day or 30 minutes once per day.
For example:

7:00 AM shot
7:30 PM shot

OR

Say PM shot was at 7:00 pm the night before:
7:15 AM shot
7:30 PM shot
 
Jade, yes, it's important to keep the insulin to every 12 hours and it's really important that Gabe understands this if he's responsible for shooting now and then. There's just no getting around that part.

The thing I can suggest is that you might want to go from the Tight Regulation protocol to the Start Low, Go Slow protocol

If the 2 of you can decide on a time that works for both of you,(for both shots) it might work better for you since there's not as much testing required. You could do your dose changes on weekends when you don't have to work and can get some extra testing in.

Just throwing out the idea.
 
Also Jade: you might want to let Gabe know that you are attempting to get Boots into remission, and the 12/12 consistency of the lantus is imperative to work towards that goal
 
Thank you all. He knows why it's important, I have explained all that to him before when we first started the lantus, because he made a lot of mistakes when Boots was on humulin. We have Boots on the 530am/pm schedule because that is the only time that works. My schedule is completely crazy, and Im gone anywhere from 8 am to 1030 or 11 pm, he is the one with the set mon-fri schedule. Any earlier than 530 and neither of us would get any sleep (I also have a toddler who still wakes up in the middle of the night) and any later than 530 am and there won't be someone here to test him and make sure he doesn't drop too low. If I could afford to work part time and be home more I totally would, because my kitty means the world to me.
 
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