Only 10 days on Lantus - headed to remission?

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Jess and MrCat

Jess and MrCat

Member Since 2013
Hi Folks-
I rescued Mr. Cat in January 2013, a 13-year-old cuddly male who is a very large cat (13.9 lbs but not overweight). 10 days ago, he was diagnosed as diabetic with a BG of 375 but completely normal bloodwork otherwise. He seems generally happy and healthy, even with diabetes. I took him to the vet due to bleeding gums and when she ran a blood test, BG=375! Due to the bleeding gums, I switched him to all-wet food the day before I took him to the vet, so he was on all-wet food five days before his Lantus began.

He started Lantus at 2.0 units twice per day (this was the vet's recommendation) on July 15, 2013. I only tested once in the past week due to difficulty, plus the vet told me to come back in 7-10 days and she'd run a curve for him. Well, he didn't want to go to the vet yesterday (day 7) for his first insulin curve, so I started home testing.

Due to recommendations on this site about Trader Joe's wet food being high in carbs, I gave him his last TJ wet food yesterday morning and stuck to Natural Choice (NC) low-carb the rest of the day to see if it would influence his BG.
Today, he began at 166 but since everyone told me that Freestyle tests lower than True, so I gave him 1.5 units of Lantus. He tested BG 56 at +4. I gave him some food and he tested BG 81 at +5. Yesterday, his nadir was at +4 and I assume it's the same today? I'll keep testing him but I just wanted to know if anyone has experienced this..... A quick turnaround or just a fluke?

His spreadsheet is in my signature. Thanks!
 
Re: Only 10 days on Lantus - heading to remission?

That happens sometimes. The canned food is likely responsible. Was anything done about the bleeding gums?Maybe also an infection cleared itself. You may not want to give 1 1/2 units this evening. I would not.
 
Re: Only 10 days on Lantus - heading to remission?

Here is the link to your other post. So people helping you can follow the history. Diarrhea after 2nd insulin shot for newly diagnosed cat.

A quick remission sometimes happens. We see it fairly frequently here on the Feline Health forum with new members. Sometimes the food change to low-carb <10% can do it. Sometimes the cat has gotten a steroid shot and goes off insulin quickly after the steroid shot has worn off. Sometimes, an infection raises the BG levels. The red and bleeding gums could have been the cause for the High BG numbers. Vet stress also raises the BG levels. Sometimes there is a misdiagnosis.

You may not want to give 1 1/2 units this evening. I would not.
Click to expand...
I'm with Larry on the dose for tonight. I think the 1.5U was a bit much this morning. If Mr. Cat were mine, I would not give more than 1U. And only if his BG was over 200.
 
Re: Only 10 days on Lantus - heading to remission?

Thanks for the input! Mr. Cat received an antibiotic shot last week for the gums (before his diabetes Dx) and his infection has cleared. I think Mr. Cat was diabetic when I rescued him because he always seemed to drink a lot of water (more than a normal cat) and he had weak hind legs. I didn't know anything about feline diabetes at the time so I didn't know what to look for. Just thought he was old! ;-)

I will keep him on the low-carb wet food and will probably skip his shot tonight. I'll keep updating his spreadsheet. Thanks again, everyone! I am so glad we have your support with the home testing... who knows what would have happened if I'd kept going at 2.0 units with no BG tests!!
 
Re: Only 10 days on Lantus - heading to remission?

Excessive water consumption can also be a sign of hyperthyroidism.
 
Re: Only 10 days on Lantus - heading to remission?

He could be heading to remission or you could be finding a good dose for him. Although the more time he spends in blues and greens, the more his pancreas heals and the more likely remission is!

Did you start 1 unit today?

Wendy
 
Re: Only 10 days on Lantus - heading to remission?

Hi Wendy-
Thanks for checking in! Yesterday, Mr.Cat tested 176 at PMPS so I only gave him .5 units last night.
Today, Mr. Cat's AMPS = 197 so I gave him 1 unit of Lantus with breakfast (just started on FF classic and he loves it!).
Purring happily on my lap now. I'll keep updating my SS throughout the day. Thanks again!
 
Re: Only 10 days on Lantus - heading to remission?

Cool! Be careful with the food transition though - you go too fast and you might get diarrhea.
 
Re: Only 10 days on Lantus - heading to remission?

Mr.Cat had his first 2 cans of FF yesterday and had a normal BM today. He seems to only get diarrhea under stress or when he eats raw food. He seems to enjoy/digest just about any canned cat food. Just checked his +4 = 117.

What is the best BG range for him to have a good chance at remission? What is the ideal nadir BG?

I read somewhere that if you keep the BG in the 100 - 150 range, a cat may never go into remission. The article said that 60 - 90 was ideal to get a cat to remission. Is this true? Does anyone have a sample spreadsheet of a cat who went into remission (just so I can see the trends)?
 
Re: Only 10 days on Lantus - heading to remission?

Here are some glucose reference ranges for decision making using a human glucometer:

< 40 mg/dL
- Treat as if HYPO
- At nadir in long term diabetic (more than a year), may earn a reduction.

< 50 mg/dL
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50.
- At nadir, often indicates dose reduction is earned.

50 - 130 mg/dL
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers.

> 150 mg/dL
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

180 - 280 mg/dL
- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.

>= 280 mg/dL, especially if for most of the cycle between shots
- Uncontrolled diabetes and in danger of DKA and hepatic lipidosis
- Test for ketones; more than a trace, go to vet ASAP.
 
Re: Only 10 days on Lantus - heading to remission?

MrCat said:
What is the best BG range for him to have a good chance at remission? What is the ideal nadir BG?

I read somewhere that if you keep the BG in the 100 - 150 range, a cat may never go into remission. The article said that 60 - 90 was ideal to get a cat to remission. Is this true? Does anyone have a sample spreadsheet of a cat who went into remission (just so I can see the trends)?
Click to expand...

I use Wikipedia's Blood Sugar Guidelines for what "good" ranges are.

As to the article stating that there's an "ideal range" for cats to go into remission, I'd disagree solely because there are so many other factors at play as to why and how and when a cat might go into remission. To base it on just the BG levels is potentially ignoring why those levels are staying too high in the first place (too high or too low a dose, infections, chronic conditions, other underlying problems where hyperglycemia is simply a side-effect, etc...).
 
Re: Only 10 days on Lantus - heading to remission?

You want to keep your Lantus dosing consistent. Lantus is a depot type insulin, so some of the shot you give goes into storage for gradual release over time, the rest goes to work right away. If you are constantly changing the dose from shot to shot, the depot will be constantly refilling and draining.

Better to find a consistent dose you can give your cat 2x a day. It can change after 6 to 10 cycles if you are not seeing better numbers. Of the dose can change sooner if the BG drops below 50. That is an automatic 0.25U dose reduction.
 
Re: Only 10 days on Lantus - heading to remission?

Thanks! I think I'll stick to 1U twice per day and keep an eye on his BG. It makes sense to stay consistent with his dose, so thanks for the feedback!
 
Re: Only 10 days on Lantus - heading to remission?

Patience mr c.. If remission is coming it will come. Give this dose a few days (unless he drops under 50)
 
Re: Only 10 days on Lantus - heading to remission?

Mr. Cat's AMPS was 111 today (before any food/breakfast). Should I skip his Lantus shot this morning? Do I test throughout the day and see what happens? What do you recommend?
 
I would suggest waiting 30 minutes without food and retesting.

We call that stalling.
 
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