Numbers all over the place since switching

[Shiframb]

My cat Austin was diagnosed in Jan this year, and started on Lantus. Dose started at 1 unit, and per my Vet's direction, went to 2 units, then 2.5, and finally 3, with blood sugars never out of the 400s. Then she started to recommend further testing for a UTI. He had been on antibiotics for an infection just prior to diagnosis, but I agreed to a needle aspiration and culture. $200 and a negative test. After that she began pushing for an abdominal ultrasound and an endoscopy (which would cost upwards of $1600).

I wanted to try a trial on the insulin my dog was on, Vetsulin, and did see some response, finally, but as predicted, it was not long-acting enough to go the 12 hours. At that time, I found this site, and had gone slower on the increases. With my Vet's urging I decided to retry the Lantus, and since I was at 3 units of Vetsulin, I tried starting at 2 units and am presently at 2.5 units twice a day. I saw my first blue numbers-but they were followed by weird bounces and I am at my wits end as to what to do. He just can't seem to get regulated. Urines are slight trace ketones only. He is fed 3 cans of Fancy Feast pate daily, as his former weight of 11 pounds is down somewhere around 9 pounds now.

What am I doing wrong?

 

[Wendy&Neko]

Hello and welcome. Some cats take longer than others to get regulated, and some need higher doses of insulin. But there is a dose out there that will move Austin.

First thing I would do is throw out the dry food he seems to be getting into. Dry food can make a huge difference in the insulin needs. Second, I would look at the Sticky Notes on Tight Regulation Protocol and the Start Low Go Slow method and pick one as the method to follow for dosing, then follow it. Both are methodical approaches to dose changes that will get you safely to a dose where you will see better numbers. Don't worry if you go above 3 units, some cats need more insulin. Also, it is very common for newly diagnosed cats to bounce, and even some not so new to insulin. There isn't a lot you can do about them but wait them out and get to a good dose. Once they spend more time in good numbers, the bounces will lessen. It's hard, but you need to be patient, Regulation can take a while.

Lastly, for now, make sure you get a test before every shot, you need to make sure it is safe to give insulin.

 

[Shiframb]

Thank you Wendy. The dry food is what my other cat eats. It has taken me along time to find something that doesn't irritate her allergies, so I don't want to change it-Taste of the Wild Salmon, grain and fowl free. I feed her in the bathroom, with the door closed, LOL. Austin usually wolfs his food, and since there is usually something left in the other cat's dish, I keep him out as I pick up her bowl-but once in a while he is faster than me. Perhaps I can switch who eats where.
I read both stickies and am not sure which protocol to follow. I am worried that he has been unregulated for so long, risking diabetes-related problems. So far he's been ok, but not sure how long he can continue to be. I can certainly get preshot numbers, and want to try a curve on a day off. The first shot is after midnight, and when I try for a curve, I wind up falling asleep at some point. I leave for work 2.5 hours after his noontime dose and don't return home till the next dose is due. When I get a chance, I try to get a mid-cycle glucose to see what his low is.

 

[Wendy&Neko]

Spot checks when you can will help fill in the picture . Often a +2 test gives good information about the cycle and it sound like you could get that before you go to work which would help if you decide to follow TR. the choice of dosing method is based on what works for your situation.

 

[Sandy and Black Kitty]

Hi there

my $0.02:
I would not increase at this time.
Test before each and every shot.
monitor closely and focus on sprinkling some tests in the times the ss is missing data: AM+6 -11, PM+1-3 and PM+10-11.
If there is a blue number that causes a bounce, allow up to 6 cycles for it to clear.

I saw my first blue numbers-but they were followed by weird bounces and I am at my wits end as to what to do.

You must wait out the bounces. Since bounces can take up to 6 cycles to clear, there is a possibility that you may have passed up a good dose when you increased to 2.5u just 3 cycles after the blue on 04/28.

Urines are slight trace ketones only. He is fed 3 cans of Fancy Feast pate daily, as his former weight of 11 pounds is down somewhere around 9 pounds now.

Please step up ketone testing to several times daily. Mix as much water as he will tolerate into his food. Any reading higher than 'trace' means a call to your vet.


Read about the methods practiced by folks here
start low go slow
Tight Regulation Protocol

Hang in there and hang in here.
http://www.felinediabetes.com/FDMB/threads/lantus-levemir-tight-regulation-protocol-tr.1581/

 

[Shiframb]

Ok, I can keep the dose at 2.5 for now. I will get all my pre-shot tests done. I am off tomorrow afternoon, but have errands. Will fit in a 3 hour test and another at 10 hours after the 12 noon dose (pm dose), as I won't be home the next 3 afternoon/evenings due to work. Tonight's dose (my "am" dose) has been given.