Struggling to Start Insulin Because My Cat Won’t Eat — Need Advice

[CORKY]

If you read the information the Sienne offered you will understand better that Lantus is a 12 hour insulin and like she said it does not last all the way to the 12 hours that’s why is necessary to shoot twice a day, so if your vet tells you 1 unit as Squeen3 explained split it that unit as she said, you want to start slow but right, Sienne as I said before is a Wizard on Lantus, dosing and Medical explanations on FD, let yourself be guided by someone that has saved many cats lives including my Corky’s, you can also review Corky’s spreadsheet, although he is on ProZinc he gets 2 shot every 12 hours there is 3 years of data and also if you scroll to your left at the end you can get an idea how and what we feed and when, I’m like Sienne I am an obsessive tester, I test every two hours, but you don't Have to, last Friday I had toe surgery , and I left my house at 5:30AM came back at 4:00PM I made sure to test feed and shoot, I had a neighbor that gave a snack a 8:00AM and lunch at 1:00 PM, I came back and tested and he was great! Numbers as they should be, so I noticed that I have to learn not to test every 2 hours, like I said I’m learning still after 3 years, slow down follow suggestions When I started this forum it was 3 months after diagnosed, I was at the point of a nervous breakdown, my vet fired me, so I was alone guessing for 3 months, with Corky’s BG at 650 after he spend 8 days hospitalized, and only with this forum and only this forum I have been able to regulate, increase/decrease doses, and any other concern I may have and today Corky’s numbers are anywhere between 70-90 perfect!! Be kind to yourself, I’ll tell you what Suzanne( great coach for either Lantus/ProZinc) “ take a step back, breath in, breath out, cats are very sensitive to Stress you stress they stress”. It works every time

 

[Robo & B]

The vet who prescribed Lantus suggested that I start with 1 unit (0.01 ml) of Lantus, one shot per day. It’s a low dose, right? But I need to ask him about the two shots…

I think maybe there has been a misunderstanding on the one shot a day part. Or possibly your vet knows you are very stressed and worried about hypos and is showing an overabundance of caution and intends to move up to 2 shots a day after a short period of 1 shot a day. Just to get you used to the process.

 

[Robo & B]

i did the ketones test. Thank god, negative

Fantastic, you're getting the hang of this

 

[hellen_maggie]

Happy to reply.

If you look at the AAHA guidelines I linked, cats need twice a day dosing. While Lantus is long acting, it doesn't last 24 hours in cats. They require twice a day dosing. See page 4 of the guidelines in the paragraph above "Treatment for Dogs." It specifies insulin should be given to cats every 12-hours. How large of a dose you begin with depends on what you're feeding your cat. If you want to do what your vet is suggesting, give 0.5u of insulin twice a day -- a total of 1.0u daily.

You do not need to test every 2 hours. We recommend a minimum of 4 tests per day. You ALWAYS want to test before giving an insulin injection -- the AMPS and PMPS tests on your spreadsheet. This test will let you know if it's safe to give insulin. You then want to get a minimum of one additional test during both the AM and PM cycles. You can look at my spreadsheet. I tested a lot and I have 6+ years worth of data. I'm also someone who really, really likes having data. The exception to the 4 tests per day is if your cat's numbers are running low. You want to test more frequently to make sure your cat stays in safe numbers. We have information on managing low numbers.

Most of us feed our cats several small meals during the first half of the insulin cycle unless our cat is a grazer. I typically fed Gabby at shot time, and more food an hour, and two and/or 3 hours after, her shot. She also had an early nadir (lowest point in the cycle) versus a nadir that was about mid-cycle. When you feed your cat is more of an "art" than anything else and depends on your cat. Because Lantus generally doesn't start working immediately, you can test, feed, and shoot all within a few minutes. I gave Gabby her shot when her head was in her food bowl.

Most cats have a "curve" -- numbers are highest every 12-hours when the insulin has mostly worn off and are at the low point (nadir) around 6 hours into the cycle. However, some cats typically have an early or late nadir. Gabby's nadir was at around 3 hours post-shot except when it wasn't. Nadirs can and do move around. Cats do not like to be predictable! Keep some high carb food at home (e.g., Fancy Feast Gravy Lovers) or your can use a few drops of corn syrup or honey if you need to bring low numbers up. Many members find that having a timed feeder helps with managing numbers when at work. If I saw that Gabby's numbers were running a bit low before I left for the day I would make sure she had food and might load the feeder with something that was a bit higher in carbs. A lot of this depends on your cat and how carb sensitive your cat is.

Keep asking questions!!

So, it seems clear in my mind that Maggie will be at high risk every day. I will give her insulin and then leave for work, which means she will be alone for a full 9 hours. For example, after test and shot I will give insulin at 7 a.m., feeding her a small meal at the same time, and then continue with a few more small meals. By 8:30 a.m., I will leave for work.

This means that when she reaches her nadir (for example 3, 4 ,5, 6 hours later) she could experience hypoglycemia and I won’t be there to help her. i also can’t use automatic feeder yet since we haven’t completed the transition from dry food to wet food. But i need to start insulin now, so what can i do at the moment? I feel that i will be putting her life at daily risk. the same at night.

 

[hellen_maggie]

I think maybe there has been a misunderstanding on the one shot a day part. Or possibly your vet knows you are very stressed and worried about hypos and is showing an overabundance of caution and intends to move up to 2 shots a day after a short period of 1 shot a day. Just to get you used to the process.

Exactly! He told me so! But why does he ask me to test her every 2 hours for 3 days, since he suggests 1 shot??this is what i cannot understand

 

[Robo & B]

Exactly! He told me so! But why does he ask me to test her every 2 hours for 3 days, since he suggests 1 shot??this is what i cannot understand

I don't know. I would trust the dosing and testing advice you are getting here Sienne absolutely knows what she's talking about.

Since your cat is naturally a grazer what happens if you leave extra food out? Will Maggie help herself every now and then?

 

[hellen_maggie]

I don't know. I would trust the dosing and testing advice you are getting here Sienne absolutely knows what she's talking about.

Since your cat is naturally a grazer what happens if you leave extra food out? Will Maggie help herself every now and then?

I’m worried that wet food will go bad if I leave it out in her bowl all day, right? I thought only dry food can be left in the bowl while I’m away

 

[Robo & B]

I’m worried that wet food will go bad if I leave it out in her bowl all day, right? I thought only dry food can be left in the bowl while I’m away

Wet food will be fine all day in most climates. Over summer you can always use ice cube trays to freeze part of the food. Then leave out half normal temperature and half frozen food. Then Maggie can eat the second half of her food when it defrosts.

 

[CORKY]

There is also the option of a wet food feeder I found these two at Walmart one even has a camara you can see from your phone when she eats

 

[CORKY]

We also would like you to start a new thread e like to keep the thread post to 50 you have 57, you can title it the same, but type Continuation on the front of the title. Yu are doing great, keep that spirit up, in a week you'll smile, knowing that all these worries and stress will be gone!

 

[hellen_maggie]

We also would like you to start a new thread e like to keep the thread post to 50 you have 57, you can title it the same, but type Continuation on the front of the title. Yu are doing great, keep that spirit up, in a week you'll smile, knowing that all these worries and stress will be gone!

Thank you for telling me i will do it!

 

[Sienne and Gabby (GA)]

You might want to take a look at this thread on working full time.

 

[squeem3]

Insulin can pack a punch so it's best to start a low as possible. Some people start at 0.25 units twice a day. You will need half unit marked insulin syringes to measure quarter and half unit doses.

There's no point to test every 2 hours for 3 days immediately starting insulin. Lantus is a depot insulin and needs at least a full week to build up the depot. Here's info on the depot: Sticky - What is the Insulin Depot? Just test before giving insulin and if you see any possible hypo symptoms. Save the curve for when your cat has been on a consistent dose of Lantus for at least a week.

Invest in a programmable timed feeder so your cat can have small snacks throughout the day to keep blood glucose levels stable. Canned food is a cooked product and is fine to leave out in a feeder all day. There are ways to keep the food fresher long such as a feeder that has an ice pack feature or freezing food into portion sizes and putting the frozen chunk in the feeder to defrost. There's a fancy feeder called the Libro some members use. Here's info: https://felinediabetes.com/FDMB/thr...wet-food-feeder-read-this.302714/post-3276487 It only has 3 compartments so you may need to buy two feeders.

The feeder in the picture Corky posted above only works for dry food. I bet air dried raw and kibble-shaped freeze dried raw would also work in such a feeder. Both are healthier low carb options than any dry food.