? Questions before starting Lantus

[Julie mueller]

Hello. I made a post earlier today but I am making a new one with all my information and all the questions I have.
Smokey was diagnosed in April but was always borderline diabetic (levels ranging from 120-220) so we haven't started insulin yet. Over the past week however I noticed signs of diabetic neuropathy (weak hind legs, losing balance and not always able to jump) so I decided to do a new curve chart today. Here are my numbers .. these are all with the alpha trak meter and insulinX strips .

8:00 am -286 (ate a handful of hard food after reading)
10:30am- 268
12:30- 261 (ate 6 oz of friskies canned after reading)
4:00- 360
6:00- 306
9:00- 332
Will be feeding him 6 oz of fancy feast at 10pm


Also - I am currently trying to switch him from free feeding hard food to an all canned scheduled diet (so hard!!!). He does not like pate .. he will only eat gravy bits from friskies. As of now I have him on one can of friskies gravy bits in the morning and one at night and at mid day when hes begging for good I put a small can of fancy feast pate and he will pick at it .
I ordered zoboline today for the neuropathy and I'm really hoping that helps fast .
I'm pretty sure my vet is going to call me tomorrow and tell me to start him on 1 unit twice a day.

My questions are ...
1. Do you think 1 unit twice a day is a good starting place for him based off of today's curve?

2. Is it ok to be having a mid day meal while doing insulin?

3. My biggest fear of doing insulin is that after giving the shot when is the time frame that he will drop the lowest ? I'm asking this because with my schedule the best times to do shots would be 11am and 11pm .. but I do go to bed around 11pm-midnight and I'm scared that he would drop too low while I'm sleeping ? But doing an earlier shot than 11am is going to be hard with my schedule.

4. I have the lantus pen and was told I can shoot directly from that .. is that ok ? I understand though if I have to do shots in .5 increments I would need a syringe.

5. Does anyone have some tricks to make a very picky eater eat pate? I've tried mixing it with the bits/gravy and tried adding water already.

6. Please tell me the neuropathy is reversible.. it makes me sad seeing him struggle .

7. How bad is it to skip an evening and next morning shot (2 shots) due to being out of town ? (This would be in 3 weeks.

 

[Bron and Sheba (GA)]

Do you think 1 unit twice a day is a good starting place for him based off of today's curve?

There are two methods to follow here...the SLGS (start low go slow) method or the TR (tight regulation method) and it depends which one you choose. I think SLGS would suit you at first and you can swap over any time to the TR. So if you are feeding just wet food, you would start on 1/2 unit. If you are still feeding a dry food diet you would start on 1 unit.
Because his blood sugar levels (BSLs) are not high, I think you should start on 1/2 unit. You will need to hold this dose for at least a week unless Smokey drops below 68.

Is it ok to be having a mid day meal while doing insulin?

Yes, we recommend you feed before the shots of insulin and then a couple of other small meals at say + 2 and +4 or 5 both morning and evening cycles.

My biggest fear of doing insulin is that after giving the shot when is the time frame that he will drop the lowest ? I'm asking this because with my schedule the best times to do shots would be 11am and 11pm .. but I do go to bed around 11pm-midnight and I'm scared that he would drop too low while I'm sleeping ? But doing an earlier shot than 11am is going to be hard with my schedule.

You need to choose the best schedule that suits you. Are you at home normally or do you work?
Every cat is different (ECID) so we need to see how Smokey reacts to the insulin, but he will probably start to drop around +2 or +3 and the lowest point will probably be about +6 or +7. BUT he may be a bit different and the only way to tell is to test. Whatever schedule you choose, you are going to need to set the alarm to get up and test Smokey to see he is safe.

I have the lantus pen and was told I can shoot directly from that .. is that ok ? I understand though if I have to do shots in .5 increments I would need a syringe.

We go up and down in 0.25 increments so yes you will need to buy some insulin syringes. The ones you need can be bought at Walmart and are the U 100 0.3 (3/10) 30 or 31 gauge, 6 or 8mm insulin syringes with 1/2 unit markings.

Does anyone have some tricks to make a very picky eater eat pate? I've tried mixing it with the bits/gravy and tried adding water already.

It doesn't have to be pate, it needs to be 10% or under carbs so look at Lisa Piersons chart for other ideas. Look at Weruva site, it has low carb options with all the nutritional values available.. if you are still stuck, make a separate thread on the main forum for ideas.

Please tell me the neuropathy is reversible.. it makes me sad seeing him struggle .

Yes it is reversible but will only improve once the BSLs drop closer to normal. The zobaline is good too. My Sheba had neuropathy badly and could not jump, and would slip and slide and had trouble walking up stairs. She fully recovered.

How bad is it to skip an evening and next morning shot (2 shots) due to being out of town ? (This would be in 3 weeks.

It is not really good to miss 2 shots. Is there anyone else you can get to come in and give the shots to Smokey? Who is going to feed him while you are away?

You need to make sure you test before EVERY shot to ensure it is safe to give the insulin dose. Then if at all possible test between the shots to see how low the insulin is taking Smokey. We change the dose on the nadir (lowest point) not the preshot number.
Post daily on this forum for help.
Ask lots of questions, it is a great way to learn.
Also go to the top of the lantus page (this forum you are on now) and read the yellow sticky on SLGS and TR methods. I would print it off and have handy..
Also I am going to give you the link to how to handle hypos. Please print this off and put on your frig. Also make sure you have some honey or karo in your hypo box as well as some high carb canned food in case you need it. Don't wait until something happens...be prepared.
http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

If you can set up the spreadsheet, that would be very helpful. We can't really give ongoing dosing help without data from the SS. Thanks

You can do this.
Bron

 

[Julie mueller]

There are two methods to follow here...the SLGS (start low go slow) method or the TR (tight regulation method) and it depends which one you choose. I think SLGS would suit you at first and you can swap over any time to the TR. So if you are feeding just wet food, you would start on 1/2 unit. If you are still feeding a dry food diet you would start on 1 unit.
Because his blood sugar levels (BSLs) are not high, I think you should start on 1/2 unit. You will need to hold this dose for at least a week unless Smokey drops below 68.


Yes, we recommend you feed before the shots of insulin and then a couple of other small meals at say + 2 and +4 or 5 both morning and evening cycles.


You need to choose the best schedule that suits you. Are you at home normally or do you work?
Every cat is different (ECID) so we need to see how Smokey reacts to the insulin, but he will probably start to drop around +2 or +3 and the lowest point will probably be about +6 or +7. BUT he may be a bit different and the only way to tell is to test. Whatever schedule you choose, you are going to need to set the alarm to get up and test Smokey to see he is safe.



We go up and down in 0.25 increments so yes you will need to buy some insulin syringes. The ones you need can be bought at Walmart and are the U 100 0.3 (3/10) 30 or 31 gauge, 6 or 8mm insulin syringes with 1/2 unit markings.


It doesn't have to be pate, it needs to be 10% or under carbs so look at Lisa Piersons chart for other ideas. Look at Weruva site, it has low carb options with all the nutritional values available.. if you are still stuck, make a separate thread on the main forum for ideas.



Yes it is reversible but will only improve once the BSLs drop closer to normal. The zobaline is good too. My Sheba had neuropathy badly and could not jump, and would slip and slide and had trouble walking up stairs. She fully recovered.



It is not really good to miss 2 shots. Is there anyone else you can get to come in and give the shots to Smokey? Who is going to feed him while you are away?

You need to make sure you test before EVERY shot to ensure it is safe to give the insulin dose. Then if at all possible test between the shots to see how low the insulin is taking Smokey. We change the dose on the nadir (lowest point) not the preshot number.
Post daily on this forum for help.
Ask lots of questions, it is a great way to learn.
Also go to the top of the lantus page (this forum you are on now) and read the yellow sticky on SLGS and TR methods. I would print it off and have handy..
Also I am going to give you the link to how to handle hypos. Please print this off and put on your frig. Also make sure you have some honey or karo in your hypo box as well as some high carb canned food in case you need it. Don't wait until something happens...be prepared.
http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

If you can set up the spreadsheet, that would be very helpful. We can't really give ongoing dosing help without data from the SS. Thanks

You can do this.
Bron

So I technically need to be testing him all day every day to make sure he doesnt drop too low?? I work 4 days a week and dont know how I'll do that those days??
Also for going away.. I dont know that my husband would be able to test him and I dont know if I want him shooting without testing

 

[Julie mueller]

For instance.. i know for a fact that both this Friday and satueday I'll be gone for 6-7 hours both days . and I'm scared to shoot If I am not able to watch him .. so how is this even possible ?!

 

[Julie mueller]

Also-- his numbers are SO erratic.. now today is 8am number is only 156.. and I wouldn't do insulin with that pre shot number right ?

 

[Julie mueller]

This Friday and aaturday are really busy for me and then on June 8th I will be out of town until the 9th . Starting June 10th I have no trips planned until November and my schedule changes for summer to be home with my kids much more ... I'm wondering how detrimental it would be if I help off on starting him on insulin until June 10th?? ( 2 weeks)