Stuggling with insulin dosages

[Vicki Smith]

My 13yr old was diagnosed with diabetes in March. Started on Lantis at 1 unit. Her dailies were very high and her curves were all over the map. Most of time she rans between 425 to 500. Her dose has been increased slowly over the last months to 7u 2xdaily. I am working on decreasing the carbs in her diet by adding a slurry of chicken, celery and carrots. Her last curve she ate all she wanted in the am and we started every two hrs with her fasting being about 348 after eating she went up slightly and then stayed steady throughout the day. This is better than the last one, 3 weeks ago, that was high to begin with and then went down to the 280's and at her last test skyrocketed to 501 before her evening dose.
Suggestions?

 

[Wendy&Neko]

Are you testing her blood sugars at home? If so, and you could record the numbers in the spreadsheet we use here, we'll be better able to help you. Also, Understanding the Spreadsheet/Grid

What type of food is your kitty (name) eating in addition to the slurry? Low carb wet or raw food is best. Carrots aren't particularly low carb.

Also, how did you reach the 7 unit dose? What information was used to decide to increase? What size of increases have you been doing? Typically we try to determine how low the Lantus is taking the cat, which means either spot checks or curves. Based on those lows, we may increase by 0.25 or 0.5 units at a time. 7 units is a fairly high dose. There are some cats that need higher doses of insulin. My girl for example, had two secondary endocrine conditions, acromegaly and insulin auto antibodies, that meant she needed a higher dose. But I also started low and increased slowly to make sure I wasn't giving too much insulin.

And one last question, what type of meter are you using?

It would also be great if you could create a signature with some basic information in it, such as date of diagnosis, that meter name, etc. Details of what should go in the signature are in this post:http://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216680/

 

[Vicki Smith]

I am testing at home in a controlled environment and have the curves recorded. Each curve is forwarded to my vet. We usually increase at first 1 unit 2xdaily when the readings were so high. now we are to .5 2xdaily increase. We are using a human meter but it has be checked against a kitty meter and they read very similar. Food is Hills Chicken pate or 9 lives by 1/2. We are looking into the nutritional additive to get the taurine and other supplements missing in the slurry.

 

[Wendy&Neko]

We are using a human meter but it has be checked against a kitty meter and they read very similar.

Not really. The majority of people here use human meters. We also have a couple of dosing methodologies here for use with Lantus, and they were designed with human meters in mind. Not that long ago, that's all people used. Good to see you are testing at home though, vet stress can definitely make a big difference in numbers.

Which Hills Chicken are you giving? Is it the one from the vets? Those veterinary foods are extraordinarily high in carbs. As are most of the Hills you can buy in the stores. We like to feed foods less than 10% carbs. This list on the catinfo website lists a large number of the commercially available cat foods in North America, and their carb%. The website was written by a vet specializing in nutrition.

However, I wouldn't make any changes to her food, until there is enough testing to catch any blood sugar drops.

 

[Vicki Smith]

I will try to post the curves - I have actually taken about 6-7 curves over the course of the spring,summer and fall. I find the chart on the side of the can totally confusing. My vet says It is not what they seem. so this chart is very helpful - the 9-Lives I have been using is a gravy! Dud, I will go to the pate. Yes we are changing things slowly and my vet is updated at every turn.

 

[Wendy&Neko]

FYI, we do curves every week here. A cat’s insulin needs can change that quickly. My girl went from 7 units to 4 units in the space of a month. A bit extenuating circumstances, but it happens. 7 units is also a rather large dose, the majority of cats need less than 3.

Be very careful swapping out high carb food for low carb. I have seen a kitty go from 5.5 units to zero in the space of a day and a half when dry food was removed. Only though testing many times a day and night was that caregiver able to keep her cat alive.

It is possible to figure out dosing with our help. I got tired of waiting for my vet to be on shift to give me answers As it turns out later, my girl’s conditions were beyond her training. It’s OK, we learned together, but the site here kept Neko alive.

 

[Vicki Smith]

My girl was very under-socialized before this happened . She is so much better now but I have to lock her up to catch a sample. I generally do a 12 hour cycle for each curve. insulin injection to insulin injection.

 

[Sienne and Gabby (GA)]

Welcome to FDMB.

Just as. you indicated a curve is testing every 2 hours for a 12-hour period. However, we test more than a curve every few weeks. I was, admittedly, a testaholic so if you want to look at Gabby's spreadsheet, it's in my signature. You do not need to test as often as I did. As Wendy noted, a cat's insulin needs can change fairly often. Without home testing, you have no way of knowing if your kitty is in safe numbers or needs a dose reduction.

You may want to take a look at the sticky notes over on the Lantus board. There's a great deal of information there about the use of Lantus, our dosing methods, etc.

 

[Vicki Smith]

I have not posted or checked in lately, You know life just gets away. My girl is doing OK. we are on a 3 months between curves. Have been doing the foodless curve and she does ok but it is not life so I really dont know why my vet wants that. So March is the next curve and I will try and mimick real life with her - She is looking brighter and has done some grooming.
She diabetic neuropathy is getting a bit better but I am sure her numbers are still higher than I would like.
I just love the food chart link you gave me and have forwarded it friend who fosters diabetics for our shelter. TY and I will check back when I can.

 

[Deb & Wink]

Unregulated diabetes does make the neuropathy worse and it gets worse over time if BG levels remain too high. Getting the BG levels under control would help immensely. Nerve pain like Neuropathy hurts. Lots. Ask any human diabetic. Or anyone who has ever had sciatica nerve pain.

You never set up a spreadsheet, so no way to tell if the BG readings are getting enough better to help with the neuropathy. That's the best thing you can do, to help with the neuropathy, improved blood glucose levels. Some people use methylcobalamin (specific form of B12) like is found in the Zobaline for pets (no artificial sweeteners in that version) but if that is really what is working for the neuropathy or if it is better BG levels hasn't been scientifically studied. Maybe ask your vet about gabapentin to help with the neuropathy pain.

My Wink had one of the worst cases of neuropathy when he came to me from the shelter. Walking totally on his hocks, couldn't walk more than 3-4 steps without stopping, couldn't jump, hard time negotiating steps. Took time to get him switched over to a low carb canned diet because he was a dry food addict. Tested his BG levels to find the nadir (how far down the lantus dose took him), slowly was able to get him on the better food, adjusted the insulin per the protocols used here and he went OTJ. No more insulin needed. Diet controlled kitty. Neuropathy totally disappeared and walked normally like a cat should. No more pain.

Maybe go back and read through some of the original responses to your post and see if there are things that could make your kitty feel better. Lots of useful information there.