PLEASE ADVISE...I can't get my stupid vet on the phone!

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Mina&Tigress

Mina&Tigress

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I'm trying so hard not to be resentful towards my vet but I feel like it it were up to her my cat would be getting curves in a vet office completely stressed out and still eating prescription dry food.

I left two messages for her and she still hasn't called back.

My baby Tigress was DX 3/31, been in Lantus since 4/1. She was originally getting 1u twice a day. The first week was rough because I couldn't get a hang of the blood testing so I was dosing her blind. But her sugar was initially in the 400's and she was on dry food. The Vet insisted on prescription dry food, so that's what I was giving her. I finally got smart enough,and started giving her soft food around 4/11-4/13, I can't remember the exact date. On 4/18 I dropped her dose from 1u to 0.5u twice a day.

I've attached her records, can someone please give me some insight! I guess my main concern in that for the last 3 days I've been seeing her sugar go lower and lower and she hasn't received any insulin since dinner time around 6pm on 4/24.

Please help...I can't tell if this is a good or bad thing.
 

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If I'm reading her records correctly...you have the start of a diet controlled diabetic...or a kitty that is on an OTJ trial which is a very GOOD thing. Just keep testing her for the next two weeks if she can maintain BGs between 40-120 with most of those in the double digits...we get to throw you a party because you will be officially in remission and OTJ...

This is a time to celebrate!

Mel, Maxwell, Musette & The Fur Gang
 
I agree with the previous poster. It looks like Tigress has gone into remission and her diabetes is being controlled by diet. Cat's diabetes is similar to human type 2 diabetes so diet control is possible for many cats. Keep her on the low carb (canned food) diet and testing her blood glucose for 2 weeks and if she stays in the normal range then she's officially in remission. Then you'd just need to keep her on the low carb/canned food diet and monitor her (watch for increased thirst/urination and occaisionally test her blood glucose) to make sure she stays in remission.

Congratulations to you and Tigress!
 
One thing I am concerned about with those low preshots is that even .5u might be too high right now--cats going off Lantus may need what we call microdosing--fine doses of .1u-.25u. If you scroll down to the bottom of this post there's some pictures that show you how to measure them: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=18139.

I see that you've only been testing before each shot. Lantus is dosed based on the nadir, or, the lowest number of the cycle, which usually occurs about 6 hours after the shot. Would it be possible for you to get some mid-cycle tests in? They will be revealing as to if/how much you need to lower the dose as she's going into remission. Easing them off insulin gives you a better chance of staying in remission than suddenly stopping the dose.
 
Sadly I'm at work all day so I can only do a morning and evening test. Once I put her on wet food only the vet said to drop her to .5u 2x a day. But only to dose when she was over 200. That why she hasn't been getting any insulin, because her numbers have been so low.
 
Mina&Tigress said:
Sadly I'm at work all day so I can only do a morning and evening test. Once I put her on wet food only the vet said to drop her to .5u 2x a day. But only to dose when she was over 200. That why she hasn't been getting any insulin, because her numbers have been so low.
Click to expand...

I also work all day, but you can also get mid-cycle tests in the evening cycle, not just the day cycle. That's what I did when Bandit was on insulin, working two jobs and grad school. Or if you don't work too far away from your house (my work was an hr away so no luck there for me), can you run home on your lunch break? Or at the very least get some checks on your days off?

The "no shot over 200" advice is usually given when there is insufficient data (no mid-cycle checks) to determine if it's safe to shoot lower than that. If you have the nadir tests, you'll have more information to tell you if/how you should taper it off. Some cats can go right off insulin, but some cats need microdosing to get off it completely.

Unfortunately, you will get different advice here on dosing than from your vet. Most vets, (even those that are up to do date with feline diabetes) are not familiar with the details of how Lantus should be successfully dosed.
 
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