Say hi to Moe! Hoping to work towards remission

[Rick and Moe]

Moe was my in-laws cat, he's 8 years old and 12.5lbs. He was diagnosed with diabetes a few months ago, he tested 500 at the vet. That's a crazy high number! His diet was a mixture of "generic" wet food plus unlimited dry food. The vet put him on 1 IU 2x day lantus, and he tested 250 at the vet, so he upped his dose to 2 IU 2x day.

Since then, we transferred him to my care. I've switched him to a low-carb diet of wet food only (mostly fancy feast, I've picked those that have <10% carb), and put him on a calorie restriction diet (180 kcal). He gets 2 meals and injections, at 9am and 9pm respectively. I just got a harness and will probably take him on some walks to accelerate the weight loss, he really needs to lose 3-4 lbs.

The goal of course is to get him into remission, if possible. I don't have a BG level at 2 UI 2x day with the previous mixture of wet and dry food, but since he came here and I put him on the new diet I got a BG tester for humans and started getting some readings. Here is what I got so far in the last couple of days:

mg/dl - hours since injection
59 - +4
149 - +10
86 - +4
54 - +5
62 - +8
142 - +0

The nadir seemed pretty low to me, despite not seeing any symptoms of hypoglycemia, so I decided to cut back his dose to 1 IU 2x day. Here is what I got (+0 is exactly 24h after his first 1 IU injection):

180 - +0
157 - +2

The numbers are slightly higher but still in range, and support keeping him at 1 IU 2x day I believe.

I am planning to leave him at this new dosage for a week before I get more readings, and then look into decreasing it further, does that make sense? Is it a good idea to always decrease the dosage as long as the levels stay <200, or is there a benefit to keeping the dosage high and BG levels lower while letting low-carb, exercise and weight loss improve their insulin sensitivity?

 

[Bron and Sheba (GA)]

Hi Rick and Moe and welcome to th fdmb.
I'm glad you have changed Moe over to a low carb wet diet and are testing the BGLevels.
There are a couple of housekeeping things to do that will make it much easier for us to help you.

If you could set up your signature which will show at the bottom of all your posts and will give us information about Moe, that will be very helpful please.
Here is the link
http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/

Also we have a great spreadsheet to document all the Blood Glucose Levels. We find them very helpful when helping people with dosing questions. If you would like to set up one here is the link
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

Now that you have dropped the dose to 1 unit twice a day, you need to stay with that dose for 3 to 5 days so that the depot can fill. Lantus does not like chopping and changing doses unless a reduction or increase is earned.
Always test before EVERYshot of insulin and during the cycles if you can. Always get a before bed test as cats often drop lower at night. If the before bed test is lower than the preshot, that can mean an active cycle so you may need to set the alarm and test later in the cycle.

I would be very careful about restricting him too much with the food. Cats cannot lose weight too quickly or they risk getting hepatic lipidosis. You need to do it very slowly.
Moe will be hungry because when cats are unregulated they do not absorb all the nutrients.
Instead of giving him just two meals a day, it is better to divide the allocated food up and give a good portion before the shot and then two other smaller snacks at say +2 and +4 or +5. Do this for both the am and pm cycles every day.

With increases and decreases of insulin, we recommend going up and down in 1/4 unit (0.25unit) increments. This way you will not go past the best dose and it is safer for the cat. You can buy 1/2 unit syringes from Walmart.

The human meter is fine for testing cats. Our two dosing methods are based on the human meter.
I would not leave it a week to test again. You need to be testing every cycle as mentioned above...at least before every preshot and because we base the increases and decreases on the nadir (lowest point in the cycle) ...NOT the preshot...it is important to get tests in during the cycles. Nadirs are around +5 to +7 although some cats nadir earlier and some later than those times. Only way to tell is to test your cat.

Here is a link to important information
http://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

And here is a link to FAQ
http://www.felinediabetes.com/FDMB/forums/health-links-faqs-about-feline-diabetes.14/

When you get a chance have a look at the yellow stickies on the top of the Lantus page
http://www.felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/

Keep asking lots of questions.
Bron