Posted on intro forum, but new and learning over here and appreciate advice =)

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Sasha & Maximus

Member Since 2015
Hi everyone! I'm Sasha and my sweet diabetic buddy is Maximus. He is 16 and been diagnosed since sometime in November. The vet put him on Lantus and we are up to giving him 5 units twice a day and are trying not to feel frustrated with the numbers bouncing around and not settling anywhere. The good news is we do home test now, we have an AlphaTrak, and he's eating nothing but wet food. We have been feeding him Hill's W/D but have been reading up on Tight Regulation and are hoping to change that to more affordable food that does the job. We tried our first can of fancy feast classics (chicken) yesterday afternoon and were shocked with the glucose level at 750 this morning so my husband is automatically assuming that did it. Is that possibly the case?


He's been losing weight so we are feeding him more now in hopes he'll put some back on. I'm looking forward to learning from y'all and hoping to help get my buddy in a good place!
 
Hi Sasha,

I had a gander on your thread in the Welcome section and I see that Larry has already advised that 5 units of Lantus is quite a substantial dose of insulin. I note that you wish to change Maximus' diet from w/d (I am assuming the canned version) to Fancy Feast classics.

First up, it is great that you're home testing! :)

Next up, as Larry advises on your Welcome thread, w/d is a high carbohydrate food (26.4% carbs dry matter basis - and possibly the reason why Maximus has needed a larger dose of insulin). Fancy feast Classic patés are low in carbohydrates.

When changing foods for a diabetic kitty it needs to be done gradually and you need to monitor blood glucose levels regularly throughout the transition - at preshot AND during each cycle - in order to keep your kitty safe. The diet change may result in a very significant lowering of blood glucose concentration in a short space of time, and therefore there is a very strong possibility that the insulin dose will need to be reduced.

We tried our first can of fancy feast classics (chicken) yesterday afternoon and were shocked with the glucose level at 750 this morning so my husband is automatically assuming that did it. Is that possibly the case?

Here's a tricky thing about insulin. Sometimes too high a dose can result in higher numbers because the body may release counter-regulatory hormones to signal the liver to release more glucose into the bloodstream to protect the cat from hypoglycaemia. If a cat's diet is changed to one with significantly lower carbs it can result in a situation where a previously safe dose of insulin ends up becoming too high. Without seeing more of Maximus' data it's not possible to gauge properly how he's responding to his current dose of Lantus. This is only speculation on my part but it is possible that after eating the lower carb food yesterday Maximus' BG may have dropped significantly on his current dose and then his liver may have dumped extra glucose into his bloodstream to protect him against becoming hypoglycaemic. That may then have resulted in the higher reading you got this morning, even though the Fancy Feast is lower in carbohydrates.

I suggest that you start a thread on the Lantus and Levemir Support Group's board asking for help with dose management during a slower food transition. Sorry to be sending you all over the place on the forum but there are experienced members on the Lantus board who can help you but who don't post on Feline Health very often and therefore may not see this thread. Particularly with Maximus being on such a significant dose of insulin I think they are probably the forum members best placed to help you right now. They will be able to keep an eye on you and Maximus during the transition and should be able to help you with safe Lantus dosing suggestions if Maximus' BG levels start to improve as the switch to lower carb food progresses (highly likely). I'd also suggest that you keep Maximus exclusively on the w/d food until such time as you have experienced members here keeping an eye on proceedings who could then help you with any dosing adjustments that may be needed during a food transition. You'll then be able to restart the transition safely. :)

I see that Larry has given you a link on the other thread to instructions on how to set up a shareable spreadsheet so that members will be able to see more information on how Maximus is responding to his insulin and therefore offer better suggestions about how to help him. For ease, here's the link to the spreadsheet instructions again. You need to choose the US template because that's the one that matches your meter. If you get stuck, just give a shout out and someone will help you set it up.


Mogs
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Welcome. Do start posting on the Lantus/lev forum. Lots of experience there. I haven't read your intro yet but that is a very large dose in such a short time.
 
Thank you all! I'm in the process of starting up my spreadsheet and will put up a post in the Lantus/lev forum when ready. I appreciate it!
 
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