trouble getting regulated

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mteller

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Hi everyone!
Charles was diagnosed about a month ago. I'm now up to giving him 7 units of glargine twice a day (he started at 3). He goes to the vet once a week in hopes of having a curve done, but his level has been too high each time. He eats Purina UR dry food for urinary blockage issues. I was told to continue feeding him that, but now that we are having a hard time getting regulated, my vet is supposed to be sending me a list of approved wet foods... I would like to test at home but have been overwhelmed with everything and the vet hasn't suggested it. I also have a dog who has been recently diagnosed with a rare skin disease that is expensive to treat. In order to pay for those bills, I started another job, and am just overwhelmed with everything! I want to help Charles in any way I can. I live in Norristown, PA.
 
Other will help you with your insulin (I haven't used it). Testing at home not only will help you save money, but will help you figure out what his true numbers are and how the insulin is working. Cats are usually stressed at the vet. Stress raises blood glucose levels. Then when the cat gets home, the numbers go down and the dose may be too high. We use human glucometers (ReliOn from Walmart is the cheapest with the cheapest strips and works well). We can teach you over the Internet.

Dry food can mean consistently high levels. This website by a vet explains why: www.catinfo.org. BUT don't switch over to wet until you are testing at home. Oliver went down 100 points overnight when we switched from dry to wet. If we hadn't been hometesting, he would have hypoed.

I'd suggest you read the info on this site, especially the starred topics on the Lantus forum (same as Glargine) which explain how it works best in cats, how it is dosed, etc. Then come back and ask questions.
 
Welcome to FDMB.

You're absolutely right -- the beginning of this process is hugely overwhelming! We've all been there and I suspect everyone will tell you that it does get easier -- much easier.

The Walmart Relion products are reliable and among the least expensive around. If a Walmart is not convenient, the same company that makes their products sells their "generic" Arkay meter online.

To be frank, 7.0u of insulin is a huge amount of insulin. The majority of the Lantus users here follow the Tight Regulation protocol for dosing decisions. With this approach, dose changes are typically made in increments of 0.25u. This protocol has been published in one of the leading veterinary journals and has been very successful in getting cats into remission. You may want to share the journal article with your vet:

Please don't be surprised if your vet isn't familiar with the article. Many vets are better acquainted with insulin other than Lantus and/or apply their knowledge of other, shorter-acting insulin to Lantus. Lantus is very different than those types of insulin.

If you start home testing and are planning on changing your cat over to a low carb (less than 10% carb), canned food diet, please lower your insulin dose. I suspect that you need this much insulin due to the high carbohydrate level of what you're feeding. Just as an FYI, the UR food is 42% carbs. That's a huge amount of carbs for a diabetic. The link that Sue provided to Lisa Pierson, DVM's site on feline nutrition also has an excellent section on urinary track health. That section may also be very helpful to you.

There is also a great deal of information about Lantus located in the starred, sticky notes at the top of the Lantus insulin support group page. An outline and links to those notes is below:
  • Tight Regulation Protocol: This sticky contains the dosing protocol that we use here. There are also links to the more formal versions -- the Tilly Protocol developed by the counterpart of this group in Germany and the Queensland/Rand protocol developed by Jacqui Rand, DVM and published in one of the top vet journals.
  • New to the Group: Everything you wanted to know about this forum and more. Info on our slang, FAQs, links to sites on feline nutrition and to food charts containing carb counts, how to do a curve and the components to look for, important aspects of diabetes such as ketones, DKA, and neuropathy, and most important, info on hypoglycemia.
  • Handling Lantus: how to get the maximum use from your insulin and what to not do with it!
  • Lantus depot/shed: This is an important concept for understanding how Lantus works.
  • Lantus & Levemir: Shooting & Handling Low Numbers: What data you need in order to be able to work toward remission or tight regulation as well as information if you have a low pre-shot number or a drop into low numbers during the cycle.

There are two additional links you may find useful. Both pertain to food and contain information on carbohydrates and other constituents of food. Since it sounds like money is stretched pretty thin, both Fancy Feast and Friskies have several options for low carb food. Just as an FYI, if you buy larger cans, the price per ounce drops considerably. For example, Wellness, which is a premium, human grade food ends up costing the same as Fancy Feast if you buy the largest sized cans. The food charts that we use are Janet & Binky's list and another list of nutritional values that was compiled by a former FDMB member and has some of the more recently available foods.
 

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Wow, you live really close to me. I'm in Chester County. My feline diabetic Clark had several blockages, over the years, before his FD diagnosis last year. He ate Hill's c/d dry food for years...but now only eats low carb Friskies Pate. I do add lots of water to the Friskies Pate, and make a "soup"...just to be on the safe side.

You should absolutely test at home. Not paying big vet bills for something you can do at home...may help you to be less overwhelmed? Please let me know if you need local home testing help.

Deb
 
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