We are new, Amos diagnosed 10/4/2013

[cathyfriend & Amos]

Hi! I am grateful for this resource and hope to find help here, perhaps be of help much later on in this process to pay it forward. We are using Lantus, I have performed 3 curves so far, and we are now up to 4 units twice per day. Nadir for all three has not changed much, remains around 340. I will do another curve tomorrow. I test with an AlphaTrak 2 meter.Amos is about 11 1/2 years old, big brown tabby at 16 lbs., down from a high weight of 28 lbs. in August of this year. The sudden, dramatic weight loss was my first sign that he might be diabetic, along with the thirst, excessive urination, ravenous appetite, and sudden left-sided hind leg neuropathy. I have recently become unemployed when my contract ended, so this has been a financial hardship of some magnitude-the Lantus alone is $198.00 per vial. I am determined to care for this fellow, I love him very much. He is one of 8 total rescue kitties living with me, so feeding is a challenge. So far, I isolate him in the bathroom for feedings and insulin shots so the others don't bother him and he doesn't eat their food as well as his own. He seems to be showing signs of insulin-resistance so far, which I will search this board to find info on.If tomorrow's curve is still high (I'm sure it will be, based on a high spot glucose yesterday near the nadir time), we will likely increase to 5 units twice per day, but then I will need to find the money to do an IgF-1 and renal tests (BUN/Creatinine) to make sure there isn't something else causing this resistance. Is it common for kitties to be difficult to regulate at first? How many units can a cat get up to? Is Lantus the best choice for Amos? Please describe where exactly the "scruff of the neck" is located, as I was under the impression from all the online videos I've seen that it is exactly where the insulin should be given, but see on this website that it really isn't a good site due to poor circulation in the area.I've been injecting into the big area of loose skin between the shoulder blades. Is that the "scruff"? Also, which wet cat foods do you experienced cat people think best for diabetic kitties?-I'm not sure I trust the pet food manufacturers' data concerning carbs and protein and calories. My name is Cathy, I'm a Medical Lab Tech for over 30 years, and I love critters, especially kitties. Thanks for being here and any help you can afford me during this new process.

 

[Larry and Kitties]

Welcom.
We recommend that you enteryou BG readings in a spreadsheet and post a link to that here. For how see:
viewtopic.php?f=6&t=50130

4 units is higher than typical but not that unusual. My MurrFee is on 11 units twice daily ov Levemir. When I adopted him he was on Levemir but I switched hi to Lantus since my other three cats used Lantus. However, I switched back to Levemir since I could not get consistent BG readings. Since I switch back his reading have been more consistent.

For food, y want canned with less than 10% carbs. The following lists most canned food and their carb content
http://catinfo.org/docs/FoodChartPublic9-22-12.pdf

Some caretakers says the flank (side of the cat) injections are better. Other find the scruff is OK. I conclude is just be consistent.

 

[Elizabeth and Bertie]

Hi Cathy and Amos, and welcome to FDMB!

So, to summarise, Amos was dx in October of this year and is on 4 units Lantus BID?
You're hometesting using an Alphatrak meter.
Nadirs around 340.

Couple of questions, Cathy;
1. What are you feeding Amos at the moment?
2. How did you determine the dose increases (how did you arrive at the 4 unit dose?)

Given that Amos was only dx in October it's still very early days in his 'sugardance'. And some cats do take a while to respond well to insulin. (My own cat was one of those. It was as though I was injecting him with water initially).

As Larry says, 4 units is higher than the typical dose but is not that unusual.
What you're seeing as "resistance" could just be caused by 'glucose toxicity'. Given that Amos has had diabetes long enough to develop neuropathy it is likely that he has a fair degree of this. But as his blood glucose comes under better control his tissues will heal more and his response to insulin should improve. The following is from the Pet Diabetes Wiki about glucose toxicity:

“Glucose toxicity can continue to raise insulin requirements for some time, even after the…blood glucose is brought under control. This effect may take a long time…to wear off, due to the gradual healing of formerly glucose-damaged tissue.”
The page that quote came from is here: http://petdiabetes.wikia.com/wiki/Glucose_toxicity

Cathy, do you ever see any low blood glucose numbers?
The reason I ask is that sometimes high numbers can also be caused by too much insulin. What happens in this instance is that the blood sugar drops too low causing the body to compensate by pushing glucose out into the bloodstream, raising the blood glucose high again. ("Too low" may not necessarily mean 'dangerously low'. It could just be too low for the cat's current comfort level.) It's called 'rebound' or what we refer to around here as 'bouncing'.

Re where to give the shots, yes the loose skin around the shoulder blades is the scruff. But basically you can give shots pretty much anywhere there is some nice loose skin (either side of the chest, or on the abdomen.) Some people report absorption issues from shooting in the scruff but I've never had any problems with that. It is helpful to vary the site of the shot slightly though (a little to the left or right, or forwards or backwards), to reduce build up of scar tissue etc.

It's probably too early to tell if Lantus is the right insulin for Amos. But there are lots of experienced Lantus users on this forum who can offer advice on how to get the best out of using it. And it has a proven track record of being a good insulin for cats.
Regarding the cost of insulin, we've found that insulin lasts way longer than is suggested on the vial if stored and handled properly, and this can help to keep insulin costs down quite a bit.

Welcome aboard, Cathy!

Edited to add: Many of us have given our cats a vitamin supplement, methyl B12, to help heal the neuropathy in the legs. It can produce excellent results. There is a brand name version, 'Zobaline'/'Xobaline' (there's a version especially for cats, but I can't remember which is which...)

Eliz

 

[Wendy&Tiggy(GA)]

Just so you know, that contrary to what the label says, lantus will last up to 6 months if kept in the fridge
Wendy

 

[Amy & Papaya (GA)]

Hi Cathy! Welcome to you and Amos! I just wanted to mention something about the costs - I'm doing this on a really tight budget so I can understand the stress. A lot of the costs seem to be up front just getting the diagnosis so it will get more manageable as time goes on. The test strips are a big part of the ongoing costs of looking after a diabetic cat so that's a great place to look for savings. You mentioned you are using an AlphaTrak and from what I understand those strips are pretty expensive. A lot of people here use a human meter sold at Walmart in the US, the Relion Prime. As far as I know it is the hands-down cheapest option, since the strips for it are only $9 for 50 strips. The numbers you will see on a human meter are a bit different than on the Alphatrak, but it just means that you want to see slightly different numbers to know you are in a good range or too low than you would on the Alphatrak.