Esse is diabetic. (Curve done, numbers added) - Page 2

NoniMe · 09-24-2009, 07:32 AM

After a long conversation with the vet, we're going to change the insulin type that Esse uses. The insulin she's on right now - Humulin N - is giving her a huge curve and a rebound, and that's not good for her.

So we're changing to Lantus, and going to give that a try. Hopefully, we will be able to get her sugars under a bit better control, and then we can mess around with the dose. But for now, she'll go on Lantus starting today, and I'll be doing more sticks to figure out how it's working in her system. The good part is once we get consistent numbers, we will be able to lessen the earsticks, and perhaps even reduce the number of injections in short order...and there have been a lot of folks who've gotten their cats into remission shortly with Lantus...meaning, no injections at all.

So...the adventure (!!!) continues...

Best-
Noni

NoniMe · 10-09-2009, 09:28 PM

Just thought I'd update the thread.

Esse has been on Lantus for two weeks; and while the numbers aren't quite as good as I'd hoped, they're at least heading downward...slowly, but downward. The biggest accomplishment is that I've been able to keep her under 500+ since we started...but I've not managed to get her lower than 330 (iirc...). Still well above where the vet and I would like to see her.

We upped her dosage from 3 units to 4, twice a day. Lantus is one of those insulins which doesn't give immediate results; it's more of a gradual kind of thing. So we're hoping the uppage will bring her under 300 -if not regularly, at least moreso than not.

She's still being a wonderful girl about earsticking and injections...just a dear one. Doesn't give me the least bit of grief...

That's the update...we're not yet anywhere near out of the woods or even close to stable...but maybe that will change over the next few weeks.

Best-
Noni

sundancer maiden · 10-09-2009, 11:20 PM

The one thing I know is, Esse is a lucky girl to have you working on her! Thanks for the update, even though it could be better.
Sometimes it just sucks that we can't instantly fix our babies when they need it. But, you are doing great!!

bunkie · 10-10-2009, 05:59 AM

Lantus is a long acting insulin. Which is great and she apparently needs that, that is why her fasting blood sugars are so good. But she also needs a short acting insulin with food intake. She should also be on a short acting which would need to be given prior to her eatting. This is not to eliminate the Lantus, but in addition to. Lantus should be given daily at the same time each day. With her normal morning BS results, I would say that her dosage of Lantus is correct. Simply add the additional Short acting insulin for meal.

NoniMe · 10-10-2009, 08:40 AM

Bunkie, I agree with you. Unfortunately, the vet doesn't believe in sliding scale coverage/prandial coverage. Sigh.

I'm going to suggest it again, if her numbers don't come down decently. I think that 1/2 to 1 unit of regular insulin at breakfast/dinner will correlate with the spike, and help the Lantus do it's job...and bring her BS lower.

It's frustrating...I don't know why she doesn't believe that additional coverage should be given...I know cats' metabolism is different than humans, but she's having difficulty; and this is an answer. It may not be the right answer, but it's still an answer, and could be given a shot to see if it works.

Sundancer, I'm the lucky one. She's such a dear, that Esse Mama cat...I just want her to feel better...

Thanks, guys.

Best-
Noni

bunkie · 10-11-2009, 04:48 AM

I really hope you can convince your Vet to let you give it a try with the added insulin. You are correct in starting it at a very low dosage and checking her BS a couple of hours afterwards to watch for hypoglycemia. Good Luck and keep us updated.

NoniMe · 10-16-2009, 09:12 PM

We are having some success with Lantus and the different feeding regime. It's not wildly successful, but I am hopeful. She spiked up this morning (502), but has been at 242 for the last two afternoons, and this afternoon, she was 280. If she hadn't gotten into the kitten kibble (which Malachi no longer eats...it's gone to the barn now...), I'll be willing to bet she'd be much closer to 200 than not as of the morning.

And I also suspect she's got something called Somogyi effect; her blood sugars in the morning are really high, and that might be a rebound hyperglycemic reaction to a low reading overnight. So, tonight, I will get up at 3, take her sugars, go back to bed, take her sugars at 6, and note the difference...and give her the insulin then. If the sugars are significantly different, she is most likely suffering from Somogyi. If they aren't, then it's back to the drawing board to figure out why she spikes overnight, and is somewhat normal in the afternoon.

But like I said, I'm beginning to feel some hope. Lantus, while insanely expensive, may just do the trick...and that would be worth it.

Best-
Noni

dixiesmom · 10-17-2009, 09:29 AM

A lot of vets left PZI because it was not going to be available any longer, but we've been able to find it. It may eventually be gone, but it seems to work the best for cats. Are you doing twice a day injections? Generally we try and get them on an every 12 hour injection schedule. Free feeders can be harder to regulate since ideally with animals we want you to feed breakfast and then inject, feed dinner and then inject, but if she likes canned food, you could give her a bit of canned before her injections?

Have you had her urine rechecked to be sure that's cleared up since that can throw off regulation.

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09-24-2009, 07:32 AM
NoniMe Seasoned Join Date: May 2007 Location: Southern California Posts: 4,749	After a long conversation with the vet, we're going to change the insulin type that Esse uses. The insulin she's on right now - Humulin N - is giving her a huge curve and a rebound, and that's not good for her. So we're changing to Lantus, and going to give that a try. Hopefully, we will be able to get her sugars under a bit better control, and then we can mess around with the dose. But for now, she'll go on Lantus starting today, and I'll be doing more sticks to figure out how it's working in her system. The good part is once we get consistent numbers, we will be able to lessen the earsticks, and perhaps even reduce the number of injections in short order...and there have been a lot of folks who've gotten their cats into remission shortly with Lantus...meaning, no injections at all. So...the adventure (!!!) continues... Best- Noni __________________ Apparently, I have a warped sense of humor. "Who knew?"

10-09-2009, 09:28 PM
NoniMe Seasoned Join Date: May 2007 Location: Southern California Posts: 4,749	Just thought I'd update the thread. Esse has been on Lantus for two weeks; and while the numbers aren't quite as good as I'd hoped, they're at least heading downward...slowly, but downward. The biggest accomplishment is that I've been able to keep her under 500+ since we started...but I've not managed to get her lower than 330 (iirc...). Still well above where the vet and I would like to see her. We upped her dosage from 3 units to 4, twice a day. Lantus is one of those insulins which doesn't give immediate results; it's more of a gradual kind of thing. So we're hoping the uppage will bring her under 300 -if not regularly, at least moreso than not. She's still being a wonderful girl about earsticking and injections...just a dear one. Doesn't give me the least bit of grief... That's the update...we're not yet anywhere near out of the woods or even close to stable...but maybe that will change over the next few weeks. Best- Noni __________________ Apparently, I have a warped sense of humor. "Who knew?"

10-09-2009, 11:20 PM
sundancer maiden Long Yearling Join Date: Jul 2007 Location: Udall, KS Posts: 1,499	The one thing I know is, Esse is a lucky girl to have you working on her! Thanks for the update, even though it could be better. Sometimes it just sucks that we can't instantly fix our babies when they need it. But, you are doing great!! __________________ You don't have to be crazy to be my friend, but it helps!!!

10-10-2009, 05:59 AM
bunkie Halter broke Join Date: Nov 2008 Posts: 99	Lantus is a long acting insulin. Which is great and she apparently needs that, that is why her fasting blood sugars are so good. But she also needs a short acting insulin with food intake. She should also be on a short acting which would need to be given prior to her eatting. This is not to eliminate the Lantus, but in addition to. Lantus should be given daily at the same time each day. With her normal morning BS results, I would say that her dosage of Lantus is correct. Simply add the additional Short acting insulin for meal.

10-10-2009, 08:40 AM
NoniMe Seasoned Join Date: May 2007 Location: Southern California Posts: 4,749	Bunkie, I agree with you. Unfortunately, the vet doesn't believe in sliding scale coverage/prandial coverage. Sigh. I'm going to suggest it again, if her numbers don't come down decently. I think that 1/2 to 1 unit of regular insulin at breakfast/dinner will correlate with the spike, and help the Lantus do it's job...and bring her BS lower. It's frustrating...I don't know why she doesn't believe that additional coverage should be given...I know cats' metabolism is different than humans, but she's having difficulty; and this is an answer. It may not be the right answer, but it's still an answer, and could be given a shot to see if it works. Sundancer, I'm the lucky one. She's such a dear, that Esse Mama cat...I just want her to feel better... Thanks, guys. Best- Noni __________________ Apparently, I have a warped sense of humor. "Who knew?"

10-11-2009, 04:48 AM
bunkie Halter broke Join Date: Nov 2008 Posts: 99	I really hope you can convince your Vet to let you give it a try with the added insulin. You are correct in starting it at a very low dosage and checking her BS a couple of hours afterwards to watch for hypoglycemia. Good Luck and keep us updated.

10-16-2009, 09:12 PM
NoniMe Seasoned Join Date: May 2007 Location: Southern California Posts: 4,749	We are having some success with Lantus and the different feeding regime. It's not wildly successful, but I am hopeful. She spiked up this morning (502), but has been at 242 for the last two afternoons, and this afternoon, she was 280. If she hadn't gotten into the kitten kibble (which Malachi no longer eats...it's gone to the barn now...), I'll be willing to bet she'd be much closer to 200 than not as of the morning. And I also suspect she's got something called Somogyi effect; her blood sugars in the morning are really high, and that might be a rebound hyperglycemic reaction to a low reading overnight. So, tonight, I will get up at 3, take her sugars, go back to bed, take her sugars at 6, and note the difference...and give her the insulin then. If the sugars are significantly different, she is most likely suffering from Somogyi. If they aren't, then it's back to the drawing board to figure out why she spikes overnight, and is somewhat normal in the afternoon. But like I said, I'm beginning to feel some hope. Lantus, while insanely expensive, may just do the trick...and that would be worth it. Best- Noni __________________ Apparently, I have a warped sense of humor. "Who knew?"

10-17-2009, 09:29 AM
dixiesmom Weanling Member Join Date: Dec 2008 Location: North Carolina Posts: 434	A lot of vets left PZI because it was not going to be available any longer, but we've been able to find it. It may eventually be gone, but it seems to work the best for cats. Are you doing twice a day injections? Generally we try and get them on an every 12 hour injection schedule. Free feeders can be harder to regulate since ideally with animals we want you to feed breakfast and then inject, feed dinner and then inject, but if she likes canned food, you could give her a bit of canned before her injections? Have you had her urine rechecked to be sure that's cleared up since that can throw off regulation.