What dosing should I give?

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MyTitan (GA)

Member Since 2017
This is our first post. Titan was diagnosed on 6/27/17. We immediately changed his diet to wet food. He
went on 2u of Lantus morning and evening. On 7/11 vet did glucose curve. Blood sugar stayed at 450 all day with no dips. On 7/12 we went to 3u twice a day. On 7/17 4u twice a day. Urine strips still go right to 1% with
every sample. We even switched to a new insulin pen thinking our vial was compromised. He is so thin. We are frantic. Are we being too patient?
 
This is our first post. Titan was diagnosed on 6/27/17. We immediately changed his diet to wet food. He
went on 2u of Lantus morning and evening. On 7/11 vet did glucose curve. Blood sugar stayed at 450 all day with no dips. On 7/12 we went to 3u twice a day. On 7/17 4u twice a day. Urine strips still go right to 1% with
every sample. We even switched to a new insulin pen thinking our vial was compromised. He is so thin. We are frantic. Are we being too patient?
What are you feeding him?
 
Hello and welcome!:bighug:

Are we being too patient?
Do forgive me for saying but I think you are being impatient....But we all being in your shoes.. ;)

You see, the curve performed at a vet's office isn't accurate because of the stress kitty experiences and that's drive the glucose levels up. Significantly up. As a result many vets prescribe higher than necessary doses. And too much insulin can act as not enough insulin.
 
I'm not very computer literate so I hope I'm doing this right. Titan gets Core canned food. The vet just called and
wants him to switch to Science Diet d/m. She said to give that 5 days to see if it helps. He doesn't feel well and 5 days
seems like an eternity.
 
HI and welcome to you and Titan!

Take a deep breathe.....your patience is not the problem. Your vet's LACK of patience IS! The normal starting dose for Lantus would generally be 1u or perhaps 1.5u twice daily (0.25u per kg. of ideal weight). We recommend making dose changes in increments of 0.25u at a time and absolutely not more than 0.5u. Our cats are small creatures and a 100% increase in dose is huge and will often lead to you skipping right past the best dose of insulin for your cat.

This is a marathon....not a sprint. Titan didn't become diabetic overnight so it's going to take some time to get him regulated and increasing the dose at the speed your vet is recommending is only going to slow the process down more. As strange as it sounds, too much insulin can look just like not enough because the cat's body fights against the insulin to keep his BG from falling to numbers he is no longer comfortable with or possibly numbers that are too low.

I think the dose needs to be reduced and then increased slowly and methodically in smaller increments to get Titan on a better path. Does Titan have any history of ketones or DKA?

We strongly recommend home testing because it lets you know when it is safe to give insulin and makes monitoring how a dose is working for him much easier for both you and Titan. Most cats get stressed out going to the vet and that alone can cause elevated BG which the vet then interprets to mean kitty needs more insulin.

The Science Diet M/D is NOT going to improve anything. It's high priced food no better and maybe not even as good as what you are feeding him now.

We can help you get on the right path with Titan so let us know if you'd like to learn how to home test and we'll help any way we can. :)
 
Thank you so much for your input, Tanya and Ducia. Maybe we should be starting over at 2u at home with better
monitoring system.
 
No no the food you are feeding now is better. The wellness core chicken and duck is 8%. Some of the other wellness flavors are a bit higher. The dry dm food is like 16%. No good for diabetic cats. Most of us feed fancy feast classic or Friskies pate foods. Here's a wet food list. Just find something under 10 %carb. http://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf
My vet doesn't seem to be up on nutrition a choices. I mentioned Fancy Feast but she is sold on d/m. Time to be assertive for my boy.
 
Thank you so much for your input, Tanya and Ducia. Maybe we should be starting over at 2u at home with better
monitoring system.
You are very welcome!

However, I do not have much dosing experience and want to ask you to wait for others to share their thoughts on the matter. Giving dosing advice requires to know the BG history and food intake details.

Here is what I suggests: go to your 1st, the original post on top of this thread. On the upper right hand corner you'll see Thread Tool - put cursor to it and click on Edit Title. It will allow you to edit the subject line to something more dosing related like "What dose should I give?" or something like that. Also, on the left of the subject line/title small box for Prefix; click on it and choose the question mark as you title's prefix. This way more people with knowledge in dosing will stop by to answer the question.

Does it make sense? I doubt there is anyone less familiar with computers than me...:p You doing just fine!
 
If it's Science Diet, it's M/D. If it's Purina it's DM. ;) Neither is an optimal choice for Titan. The vets are provided with their nutritional training by the big brands like Purina, Science Diet and Royal Canin and basically brainwashed into thinking that those brands of food are superior to store bought. Most of the prescription food ingredients are inferior to many retail brands and there really is no good reason to call them "prescription" diets at all.
 
I think with some home testing using a glucometer will help you really understand what Titan needs. Things have changed very quickly and you may have just shot past a good dose for him. Full unit doses are big changes! Especially for little kitty bodies.

You started insulin and switched foods all together. The food change alone can really drop BG's.

I personally have never taken Jones to the vet's for a curve. She never asked me too and I was never inclined to. He is stressed and you want him to sit there all day and be manhandled by people he doesn't know? I don't know about Jones but I think my body would be pretty wired.

I would stick with the foods you had, they are good food and the right carb%. If he is willing to eat it then why possibly upset his tummy with another new food.

And if Titan is thin and losing weight - let him eat as much as he wants until you get testing and get him regulated. Then more structured meal times can come in handy.
 
HI and welcome to you and Titan!

Take a deep breathe.....your patience is not the problem. Your vet's LACK of patience IS! The normal starting dose for Lantus would generally be 1u or perhaps 1.5u twice daily (0.25u per kg. of ideal weight). We recommend making dose changes in increments of 0.25u at a time and absolutely not more than 0.5u. Our cats are small creatures and a 100% increase in dose is huge and will often lead to you skipping right past the best dose of insulin for your cat.

This is a marathon....not a sprint. Titan didn't become diabetic overnight so it's going to take some time to get him regulated and increasing the dose at the speed your vet is recommending is only going to slow the process down more. As strange as it sounds, too much insulin can look just like not enough because the cat's body fights against the insulin to keep his BG from falling to numbers he is no longer comfortable with or possibly numbers that are too low.

I think the dose needs to be reduced and then increased slowly and methodically in smaller increments to get Titan on a better path. Does Titan have any history of ketones or DKA?

We strongly recommend home testing because it lets you know when it is safe to give insulin and makes monitoring how a dose is working for him much easier for both you and Titan. Most cats get stressed out going to the vet and that alone can cause elevated BG which the vet then interprets to mean kitty needs more insulin.

The Science Diet M/D is NOT going to improve anything. It's high priced food no better and maybe not even as good as what you are feeding him now.

We can help you get on the right path with Titan so let us know if you'd like to learn how to home test and we'll help any way we can. :)[/QUOTE
 
and print out the food chart we linked and highlight the ones you wanna feed to show your vet.
 
We are bringing Titan's insulin down slowly. Getting glucometer. I'm afraid of hurting him but I know it has to be done.
I'm not usually this overwhelmed but Titan and I are inseparable. Thanks for giving me hope.
 
We are bringing Titan's insulin down slowly. Getting glucometer. I'm afraid of hurting him but I know it has to be done.
I'm not usually this overwhelmed but Titan and I are inseparable. Thanks for giving me hope.
there are very few nerve endings in the edges of a cats here. It won't be painful. he might not LIKE it at first, but it won't be painful.
 
Our kitties are more upset by the commotion of testing and having to sit still than they are the little poke of their ears. If Titan gets wrestless, grab the bead of blood on a clean fingernail and test from there. That limits the time you need to keep him patiently waiting for you and the meter which is actually pretty quick but seems long in the beginning. Use low carb treats like Purebites or Orijen to teach Titan that good things happen when he gets tested. Fuss with his ears at every opportunity so he gets used to them being handled more. And most of all, take a deep breathe and go at testing with a can do attitude. If you show confidence, Titan (I love that name!) will show confidence in you! ;)
 
After 3 days and multi pokes to Titan and our own fingers, we have our first reading. Six and a half hours after his morning shot of 3.5 u of Lantus he is at 359. We are dropping his Lantus very slowly so we don't rock the boat too
much. Not happy about the high number but relieved that we accomplished it. Also ditching the Rx food. He came to us with a gun shot wound to the face. Most of his teeth were lost. He's had PU surgery for a new urinary opening and radiation for hyperthyroid. Titan the wonder cat has been through some rough times. I'm so grateful for your support
As we try to clear this hurdle. He's an amazing boy.
 
After 3 days and multi pokes to Titan and our own fingers, we have our first reading. Six and a half hours after his morning shot of 3.5 u of Lantus he is at 359. We are dropping his Lantus very slowly so we don't rock the boat too
much. Not happy about the high number but relieved that we accomplished it. Also ditching the Rx food. He came to us with a gun shot wound to the face. Most of his teeth were lost. He's had PU surgery for a new urinary opening and radiation for hyperthyroid. Titan the wonder cat has been through some rough times. I'm so grateful for your support
As we try to clear this hurdle. He's an amazing boy.
Good job getting a reading. Put a cosmetic round or cotton ball behind the ear when you poke to protect your finger.
 
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