relapse

[catmom15]

I am new to the forum but I have read much of the information and it has kept me sane for many a night. My name is Terry and I have 15 kitties left. Pregnant mothers were dropped off in my yard when I lived on a farm. I lost 4 last year due to cardiomyopathy and cancer at the ages of 14-17. My kitties are getting old as am I. I have one who is 12 that has cardio. also and was supposed to die a yr. ago. He gets 4 meds. per day. His brother Bootsie ( big mommas boy) was diagnosed this yr. with diabetes. Due to urinary problems he ate dry c/d most of his life. He would not eat the wet. We started him on Lantus and changed his diet to wet d/m. After a month he was ojt. He stopped eating d/m so I switched him to FF chicken classic. He began vomiting and not feeling well. With x-ray ( not definitive I know but not going to put him through any more than I have to) and symptoms he was diagnosed with IBD and given RC venison and pea, fortiflora, flagyl, weekly b-12 shots. He quit eating it and changed him to wet NB venison and pea. After a month had to rush him to emergency vet due to vomiting, dia., and fever. He was diagnosed with IBD and a return of diabetes after 5 months in remission. I found out wet NB has way too many carbs. Chanaged to EVO 95% ven. Vet gave him another month of flagyl. Finished flagyl 4 days ago, still on fortiflora daily and B-12 weekly. No vomiting or stool problems. He has had UTI's often and kidneys are not the best. I do not like the phos. levels in EVO but am pretty boxed in when deciding what to feed him. The problem is his blood sugar levels went back to normal for a week when I put him on EVO but for the last two weeks they have been high again. He does not like to be tested so I do not do it often, about 2-3 times per week. I test his urine constantly. He has had zero days without any sugar on the test strip for 2 weeks. For a few days it looked like it was at 100 or so. His lowest ear test was 202. His Highest was 277 yesterday am. Today it was 245 in the am. I have Lantus on hand but my vet. warned me to only give it until he hits 300. Vet. does not think these values are harming him and that something else might be going on and I need to bring him in. Couldn't it just be that his diabetes has returned? It is a 2 hour round trip to take him to the vet. and he shakes and is stressed out the whole time. Also, with so many I have to try to handle some things on my own as my vet. bills are already unbelievable. Lantus is scary to me as I used Idexx PZI the first time I had a diabetic cat. It was so easy. No testing except urine and after 2 yrs. he went into permanent remission. No hypo. or hyper. episodes. I tried to order BCP compounded PZI but I live in the only state they can't send it to. Please send advice. I am ready to try Lantus again if I must.

 

[BJM]

There's a lot going on with your kitty which may make it difficult to get everything synchronized simultaneously.
You've got him on decent food, though you are concerned about renal issues. Check out this forum link for some ideas

You vet seems to be out of date. Many members here routinely give insulin below 300; they are testing the glucose religiously. Each cat is different (ECID), so in some cases, they are giving tiny doses and in others higher ones. It just depends on what the cat needs. In my signature block are some options for alternate monitoring methods, which while not perfect, can give you some clues about how he is doing, especially urine ketone testing and glucose testing, if you can get fresh specimens to do it.

A tip for testing: pick up some Neosporin Ointment (not cream) with pain relief. Apply a dab to the ear a few minutes before testing. Wipe off to test. It helps the blood bead up and reduces the annoyance of being pricked.

In the Lantus forums are descriptions of how to use Lantus and adjust the dosing based on regular glucose testing a minimum of before each shot (so you know it is safe) with frequent mid-cycle tests near the nadir &/or weekly curves. Lantus doses are adjusted based on the LOWest level of the 12 hour interval. You may find it helpful to read over these instructions.

 

[catmom15]

Thanks so much for your helpful reply. Bootsie lets me get fresh urine samples easily so I test several times a day with the 10 parameter Regent sticks. I am going to look at some additional foods by Nature's Variety. Due to IBD he needs limited ingredient food with a novel protein source. My cat was very sensitive to the Lantus and did not need nearly as much as the normal dose would have been. I think my vet may be being conservative because of that and the way he responded so fast to the food change. I ordered some no carb treats to give to him after testing. The Neosporin is a great idea. What is considered to be a tiny dose? If he stays over 250, I think I will give him .25U twice a day. What do you think? I am just going to have to get over my mental block about so much ear pricking.

 

[Sienne and Gabby (GA)]

Frankly, we suggest that new Lantus users shoot as long as the pre-shot test is above 150. The more experienced users shoot numbers that are considerably lower. It would be easier to make suggestions if you could set up a spreadsheet so we could have a visual of how you're dosing. In addition, you need to remember that Lantus dose is based on the nadir and not on the pre-shot numbers.

 

[catmom15]

Thanks again for your reply. I talked to my vet. yesterday and after 2 weeks of spot testing and finding values between 200 and 277, she told me to give Bootsie .5U two times daily. I started this am. Scary stuff. I will set up a spreadsheet now. He does not like me testing his ears. I have been doing it every 2 hours today. Getting ready for another test. It stresses me out but I try to calm down for Boots. I am too chicken for tight regulation.