Sugarcat Malon - New to the board and need dosing advice please.

Status
Not open for further replies.
NMazur

NMazur

Member Since 2020
Hello all,

Our cat Malon was diagnosed with diabetes less than two weeks ago, she's an almost 14 year old Siamese cat. We noticed her urinating outside of the litter box, which is very unusual for her, so after the vet did some testing we discovered she had diabetes. We were started on Lantus last week at 2units twice a day. We are waiting until later this week to do her first BG curve (as suggested by our vet). Her initial readings at the vet were 500 (probably high due to stress and a UTI). The vet was able to order us an AlphaTrak meter so we've been getting comfortable testing her (which has been a bit challenging since part of her ears are amputated from frost bite when she was brought into the SPCA as a stray).

Her at home PS numbers so far have been in the 8.2-11.8 (~150-200mg/dc), but this evening her preshot number was 4.4 mmol or around 79mg/dc. We switched her over immediately to low carb wet food after her diagnoses as recommended, and this is the first number this low that we have seen. We are thinking that this PS number is too low to giver her her insulin this evening, so will it be alright for us to skip it and check her levels again tomorrow morning?
 
I agree with @Red & Rover (GA) no shot tonight. It may very well be a combination of things, the change to low carb canned food, and the starting dose appears too high for what we would normally suggest. It is based on weight, but 2u seems high to me. Regardless, you are using an AT2 meter, and don't have much data yet to see how the dose is affecting her, we usually like to see mid cycle tests, to determine how low the dose is taking the kitty. No isssues at diagnosis with ketones, or no past history of diabetic ketoacidosis?
 
Christie & Maverick said:
I agree with @Red & Rover (GA) no shot tonight. It may very well be a combination of things, the change to low carb canned food, and the starting dose appears too high for what we would normally suggest. It is based on weight, but 2u seems high to me. Regardless, you are using an AT2 meter, and don't have much data yet to see how the dose is affecting her, we usually like to see mid cycle tests, to determine how low the dose is taking the kitty. No isssues at diagnosis with ketones, or no past history of diabetic ketoacidosis?
Click to expand...

Thank you for the information! She's a larger girl at 18lbs, so I'm not sure if that would make a difference or if that's still a large starting dosage. No there was no ketones or a history of diabetic ketoacidosis. I will start testing her mid-cycle after this, our earliest suggested date to do a glucose curve was Wednesday so we'll definitely be doing it on that day.
 
NMazur said:
We were started on Lantus last week at 2units twice a day.
Click to expand...
As @Christie & Maverick said, 2 units can be a high starting dose. The usual starting dose is 1 unit.

NMazur said:
but this evening her preshot number was 4.4 mmol or around 79mg/dc.
Click to expand...
And this number tells us that the 2 unit dose is too high, especially since you have cut the carbs. At the beginning, it is generally recommended that no shot be given if under (11.1) 200. As you become more experienced, that number drops to 8.3 (150).
FYI: the "take action" using an AlphaTrak meter is 3.8 or 68.
Please read and print off for quick reference the following links:

NMazur said:
We switched her over immediately to low carb wet food after her diagnoses as recommended, and this is the first number this low that we have seen.
Click to expand...
Switching to low carb food can make a difference of up to 5.5 (100).
It is recommended that the switch be gradual so that you can test and monitor to make sure that the cat does not go too low.
It is also a good idea to introduce new food gradually so that there is a smaller chance of stomach upset (possible cause of vomiting over the last two days).

NMazur said:
We are waiting until later this week to do her first BG curve (as suggested by our vet)
Click to expand...
It is important to get some mid-cycle tests. No one knows how low Malon went this afternoon. Testing just at shot time does not give you the nadir (the lowest point in the cycle).
A BG curve is good and they do need to been done periodically. The downside is that it is a sample of one particular day and that one particular day might be a day when Malon does not throw you a curveball 4.4 at shot time. Testing at random times during each cycle will give you a better overall picture. Does your schedule allow for that?

NMazur said:
The vet was able to order us an AlphaTrak meter so we've been getting comfortable testing her (which has been a bit challenging since part of her ears are amputated from frost bite when she was brought into the SPCA as a stray).
Click to expand...
Thank you for adopting this lovely girl. Some people test using the paw pad. There a couple of videos on youtube.

NMazur said:
Her at home PS numbers so far have been in the 8.2-11.8 (~150-200mg/dc)
Click to expand...
As I mentioned above, the dose is too high – even if she is 18 lbs. I would immediately take the dose down to 1 unit until you can fill in the spreadsheet with some mid-cycle tests.
If it turns out that 1 unit is too low a dose, you can always go up the dosing scale in 0.25 unit increments so that you do not go right past the best dose.
Better a few days too high than 1 hour too low.

Again, welcome to the best place you never thought you would be. And thank you for having the spreadsheet up and running. We are data driven and the spreadsheet is the first place we will look. There is years and years of experience here at your beck and call. This is a peer-reviewed forum and the people here have done their research.
 
And after you have a chance to breathe (sorry about the information overload), can you remove the "GA" from the thread title please? In the top righthand corner of this thread you should see something like "Thread Tools." Click on that, then click on "Edit Title."
GA stands for Gone Ahead or Guardian Angel. Our hearts drop when we see "GA."
 
Thank you so much for your detailed replies @Red & Rover (GA) and @Christie & Maverick. We've been reading through all the suggested links slowly over this past week, but didn't expect her to throw us a curveball reading like that! We had our testing strips come in yesterday so now we can start testing her more times a day without worrying about running out before we have to do our curve testing. Our work schedules should allow us to be able to do some mid cycle testing the days we are working from home, so we will try and incorporate that as well into our routine! We will try your suggestions of dropping her down to 1unit tomorrow and see how she goes with that. Again thank you!
 
I know there is a lot to absorb, please do post any questions, we really are glad to help. Last little tidbit, I also try and suggest people get familiar with the basics...

Learn how YOUR kitty is responding to insulin:
  • Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
  • Peak/Nadir - the lowest point in the cycle
  • Duration - the length of time insulin continues to lower blood glucose
To me, this really is key, especially when first starting out.
 
Oh my goodness You've already been through so much. You are being helped by two of our VERY BEST. As you have already learned you and Malon have landed in a safe place. WELCOME TO FDMB.

I dont have much to add except maybe ... We are all dedicated to helping any and all that find our forum. Your first post makes you part of this great community.

WELCOME TO OUR FAMILY:bighug:

We all look forward to getting to know you and Malon:)
Jeanne;):coffee:
 
jt and trouble (GA) said:
Oh my goodness You've already been through so much. You are being helped by two of our VERY BEST. As you have already learned you and Malon have landed in a safe place. WELCOME TO FDMB.

I dont have much to add except maybe ... We are all dedicated to helping any and all that find our forum. Your first post makes you part of this great community.

WELCOME TO OUR FAMILY:bighug:

We all look forward to getting to know you and Malon:)
Jeanne;):coffee:
Click to expand...
Thanks @jt and trouble (GA) ! I was freaked out when she first was diagnosed but after my husband and I have spent some time researching and after finding this group I feel much more comfortable with everything and not so very worried anymore!
 
Status
Not open for further replies.
Back
Top