Merlyn:Feline | |
---|---|
Male red short haired classic tabby, Amer. Shorthair mix | |
Born | Jun-1990 |
Dx | Apr-2004 |
Oral meds | Glipizide 2 months:FAILED. |
Regulated | Feb-2005 |
Regulated between 90 and 200 | |
easier once off dry food in December '04 | |
Remission | May-2005 |
Insulin | Lantus |
Caution About This Case Study
For those not experienced in feline diabetes (newbies): When I was giving Merlyn insulin shots, I would shoot at lower numbers than most because I knew more or less how he responded to Lantus and was trying for tighter regulation (the Lantus curve was very shallow for Merlyn). Please do not do this before discussing with your vet and only when you have a lot of data and/or experience.
See the FAQs at the link below[1] for info on what to do with lower than normal preshot levels.
Remission Information
Merlyn's last shot of insulin (so far! ANTIJINX!) was May 9th 2005! We are at the falls!!
Of interest to other seeking remission/diet control with their cats, I regularly test and curve Merlyn even though he is not longer on exogenous insulin.
Background
I am Lisa in SF CA, Mombean to 3 kitties. Started volunteering at shelter 8mos after adopting Janeway, working there for 4 yrs now. Civies Janeway (16yrs, brown tabby girl, first cat, adopted in 97), Conor (9yrs cream tabby boy, 2nd cat, adopted 9 months after Janeway), and Merlyn, my diabetic cat. I fell in love with Merlyn on Petfinder.org[2], and begged until I got a ride to Sacramento from a dear friend to go get him. He was/is perfect for my other 2..so he joined us 2/6/03.He is 15 yrs 1 mo (est) old.. a red tabby boy.
Merlyn has stomatitis and feline odontoclastic resorptive lesions (FORL)[3], and he had a chronically infected big toe as a result of prior declawing. I dont know how long he was in pain with that. Toe amputated in July of O3.
Was given one 3 week course of prednisolone for the stomatitis and 2 weeks later, he was diagnosed with diabetes.
- Diabetes DX April 04,(BG 523)
- Hills M/D dry food slowly switched on DX.
- Glipizide for 2 months, some improvement not enough, started U40 PZI Vet 6/16/04.
Experience with IDEXX PZI (PZI Vet)
Merlyns response on PZI Vet was very inconsistent with duration, overlap was a huge problem, double peaks when on 2U, too low for my comfort and the preshots never came down. The shots merge together leading to WONKY numbers. So when there's more than one shot working, low numbers for a while, then almost no insulin working and higher numbers for a while, then middling numbers for a while, and the whole thing started again. No predictable peak. PZI numbers in FDMB Profile Archive[4].
Current Information
- Using Ascensia Contour meter and love it!
- No obvious neuropathy, does have some arthritis.
- 9/23/04 started 2 Zukes hip action treats per day. Started methyl-B12 (12/2/04) as precaution and it has made a huge difference, he is now (1/17/05) able to jump on tree that he couldnt before.
- Was feeding 1/8 cup m/d dry am/pm and 1 Nutromax pouch am/pm.
- 12/19/04 Off dry food totally. Just eating Nutro pouches. 1-1.5 per meal.
- 1/30/05 Merlyn has decided to eat Wellness canned "sometimes" ; as well as Nutro pouches. (lower carb ones)
- Mid April 05 added Triumph pouches rotated in with Nutro. eating 2 pouches per day
References
Lantus
2004
Started Lantus 1U BID 11/1/04
11/1 AM PS 392
+4 307
+8 364
PM PS 399
11/2 AM PS 346/+4 390/PM PS 288
11/3 AM PS 299/PM PS 254/ +5 326
11/4 AM PS 429/+5.25 322/PM PS 368
11/5 AM PS 377/PM PS 368
11/6 AM PS 324/ PM PS 352
11/7 AM PS 377/ PM PS 294
11/8 AM PS 465/ PM PS 341/ +5 322
11/9 AM PS 404/PM PS 311
11/10 AM PS 359
+2 346
+4 283
+6 219
+8 231
+10 308
+11 297
11/11 AM PS 335/PM PS 257
11/12 AM PS 381/PM PS 368
11/13 AM PS 384/PM PS 326
Increase to 1.5 Units Lantus
11/14 AM PS 367/ PM PS 186!! shot full dose
+2 283
+4 380
+6 379
+8 354
11/15 AM PS 383/PM PS 268
11/16 AM PS 314/PM PS 409 (mopey in bathroom)
11/17 AM PS 390 (ate bit Js wellness, mopey after shot)
+3 365
+6.50 320
+9 337
+10.75 322 (PM PS)
11/18 AM PS 292/+6 275/PM PS 190(full dose)
+3 179
+4.5 146
+6 130
+7 129
+9.5 119
11/19 AM PS 189 only 1U/PM PS 397(:( wrong dish,ate 1/8?hi carb dry)
11/20 AM PS 253/PM PS 354
11/21 AM PS 247/PM PS 363
11/22 AM PS 420/PM PS 261 (cranky am)/+5.5 299
11/23 AM PS 391/+6.75 432/PM PS 404
11/24 AM PS 246/PM PS 151/+2 230
11/25 AM PS 264/PM PS 311
11/26 AM PS 288/PM PS 377
11/27 AM PS 390/PM PS 257
+4 133
+5.75 135
11/28 AM PS 210/in 45mins 282/PM PS 195/+4 439
11/29 AM PS 385/PM PS 163/ +4 172
11/30 AM PS 186/PM PS 210/ +4.25 299
12/1 AM PS 388/+6.5 403/ PM PS 294
12/2 AM PS 307/ +6 303/ PM PS 309 Started MethylB-12 today..PM
12/3 AM PS 376/ PM PS 431/ +5 food vomit 317
12/4 AM PS 262/ PM PS 157/ +6 161
12/5 +11 114/ AM PS (+12) 200/PM PS 398/ +4 326
12/6 AM PS 281/PM PS 295
12/7 AM PS 306/ PM PS 172/ +2.25 276 PU/PD great today, 3 pee clumps!
+2.25 276
+4 226
+6 156
+8 121
+9.5 132
12/8 AM PS 209/went to vet BP for dental/ PM PS 175
STARTING 1.75 U Lantus BID
12/9 AM PS 444/ +3.25 406/PM PS 294/+4 350
12/10 AM PS 345/PM PS 82!!!wait 1 hr 113 full dose/+2.25 222
12/11 AM PS 394/PM PS 344/_4 376
12/12 AM PS 355/PM PS 146/+4 315
12/13 AM PS 300/PM PS 320/+6 352
12/14 AM PS 325/ +7 320/PM PS 101, wait 1 hr 120/+3 114
12/15 AM BG 244/no insulin am Dental one extraction/ PM PS 456/just nibbling/ wait 1.25 hrs, gave 1 unit
+2.25 Vomit
+3.5 63
+4.25 54 Karo on gums high carb wellness lite
+5 56
+6.25 65
+7.25 76
12/16 AM PS 97/+13 167-1U Lantus
+1.5 ate rest of dry food
+3 152
PM PS 220
+3.25 218
12/17 AM PS 217/+6.25 275/PM PS 310/+5 148
12/18 AM PS 189
+2 299
+6 346
PM PS 355 not wanting his dry food, ate all wet.
12/19 AM PS 392/PM PS 388 (change to 1.5 Nutro pouches am pm no dry)
12/20 AM PS 181/PM PS 153/+ 3.5 308
12/21 AM PS 387/PM PS 231/+ 2 295
12/22 AM PS 313/PM PS 240
12/23 AM PS 198
+2 140
+4 75!!
+4.5 67 3 crunchies (wellness lite dry)
+5 61 10 crunchies
+5.5 61
+6.25 65
+7 76
+8 74
+9.5 65
+10.5 68
foodies
+11.75 122
Gave Point 5 units Lantus, +1 gave him more food
+2.25 148
+4.5 140
+5.75 119
REDUCING DOSE TO 1.25U Lantus BID
12/24 AM PS 234/PM PS 271
+2 317
+4.5 176 and hungry-gave chicken livalittles
+6 227
12/25 AM PS 310/PM PS 330/+6 325
12/26 AM PS 388/PM PS 117/+3 185
12/27 AM PS 311/PM PS 142/+7 118
12/28 AM PS 194/PM PS 262/+5.45 149
12/29 AM PS 189/PM PS 217
12/30 AM PS 343/PM PS 136/+2.25 227 (off food a bit, brought home new suitcase)
12/31 AM PS 324/+7.5 104/PM PS 96
+2.25 84
+4 59 25-30 wellness lite kibbles
+4.75 67
+6 102
2005
HAPPY NEW YEAR 2005 REDUCING DOSE TO 1unit lantus BID
1/1 AM PS 258/+7.75 165/PM PS 155/+5.5 201
1/2 AM PS 321/+3.25 202 and very hungry/PM PS 86!!/+4 188
Vacation +catsitter til pm 1/16
1/3 AM PS 207/PM PS 198
1/4 AM PS 127/PM PS 260
1/5 AM PS 363/PM PS 190
1/6 AM PS 204/PM PS 212
1/7 AM PS 190/PM PS 109 (civie crunchies-peppy overnight!)
1/8 AM PS 111(tsp Karo in food)/in 1 hour 209/+3 293/PM PS 144
1/9 AM PS 337(some civie crunchies)/+10 175/PM PS 212
1/10 AM PS 122/in 1 hr 159/PM PS 146
1/11 AM PS 142(some civie crunchies)/PM PS 318
1/12 AM PS 130/PM PS 143
1/13 AM PS 210 (overslept)/PM PS 126
1/14 AM PS 229/PM PS 238
1/15 AM PS 192/PM PS 262
1/16 AM PS 325/PM PS 121
1/17 AM PS 223
+4.25 very hungry, tested at 40!!!
inhaled 3oz Nutro pouch
+5 58
+6 64
+8.25 73
+10 98
+11 PM PS 75 No shot
DOSE REDUCTION TO POINT 75
1/18 +24 195/+7.5 106/PM PS 108
1/19 AM PS 303/+3 264/PM PS 230
1/20 AM PS 258/+8 68!!/PM PS 135 DECREASE TO .5 UNITS PM SHOT
1/21 AM PS 196/PM PS 340
1/22 AM PS 164/PM PS 168
1/23 AM PS 108/PM PS 175/+5 90
1/24 AM PS 158/PM PS 254
1/25 AM PS 104/PM PS 184/+3.5 93
1/26 AM PS 216
+5 111
+7 105
PM PS 143
+1.5 vomit all over (added canned nutro to food:()
+2 171
ate 3oz pouch btwn +2 and +4
1/27 AM PS 123/+5.25 85/PM PS 130 (started offering 3 pouches or 1/4can Wellness
1/28 AM PS 133/ PM PS 122
1/29 AM PS 215/ PM PS 137
1/30 AM PS 117/ PM PS 277/+5.75 68/+6.5 93 offering Wellness wet too,each meal
1/31 AM PS 196/ PM PS 231/+3.5 95/+5.5 117
2/1 AM PS 134/ PM PS 249/+3.5 189
2/2 AM PS 142
+2 122
+4 66
+5 64
+7 83
+9 77
+11 PM PS 119
2/3 AM PS 211/+6 96/+10.5 97/PM PS 119
2/4 AM PS 155/+11 105/ PM PS (+12) 115/+6 76
2/5 AM PS 162/PM PS 117/+4 70/+5.5 72/+6.5 84
2/6 AM PS 145/PM PS 133/ +3.5 95
2/7 AM PS 166/PM PS 101 1h40m later post food 175,FD/+3.5 158
2/8 AM PS 172/PM PS 133/+4.5 95
2/9 AM PS 170/+3 233/+7 160/PM PS 161/+5.25 130
2/10 AM PS 221/PM PS 167/+5.5 234
2/11 AM PS 120/PM PS 200
2/12 AM PS 118/PM PS 198/+5 89
2/13 AM PS 149/PM PS 124/+4 228
2/14 AM PS 161/PM PS 161
2/15 AM PS 186/PM PS 107
2/16 AM PS 193/+4.5 155/+8 97/PM PS 129/+7 191
2/17 AM PS 209/+6.5 145/PM PS 101/+4 182/+7 84
2/18 AM PS 75 (no shot)/+18.5 132/+24 286
2/19 AM PS 94/+11.5 175 (skinny)PM PS 269
2/20 AM PS 112/PM PS 142/+4.25 72/+5.25 85/+5.75 70 (nutro/triumph starts here)
2/21 AM PS 141/PM PS 141/+ 5 218
2/22 AM PS 140/PM PS 220/+5.75 65
2/23 AM PS 150 (just nutro)
+3 96
+4.5 71
+5.5 61
+7.5 70
+9.75 108
PM PS 109
+ 5.25 113
2/24 AM PS 136/ +2.5 105/PM PS 107
2/25 AM PS 139/+5.25 70/+7 92/PM PS 131
2/26 AM PS 112/PM PS 163/+5.5 91
2/27 AM PS 144/PM PS 112/+4 192
2/28 AM PS 161/PM PS 208 ate some civie high carb dry
3/1 AM PS 108/PM PS 127/+4 248!!!!nibbles of wellness turk/salmon!
3/2 AM PS 189/+4 129/PM PS 127
3/3 AM PS 124/+4.75 62/+6 91/PM PS 154/+4 197
3/4 AM PS 149/PM PS 118/+4.25 105
3/5 AM PS 172/PM PS 119/+5 142
3/6 AM PS 170/PM PS 146 (nibbled some of Js dry)
3/7 AM PS 189/PM PS 190/+4.25 157
3/8 AM PS 258/+4.5 191/PM PS 147/+5.25 175
3/9 AM PS 189/+5.75 120/PM PS 147/+5.5 239
3/10 AM PS 187/+3 141/+8.5 87/PM PS 124
3/11 AM PS 145/PM PS 222
3/12 AM PS 117/PM PS 121
3/13 AM PS 143/PM PS 111/+4.5 105
3/14 AM PS 183/PM PS 137/+6.5 64
3/15 AM PS 144/PM PS 146 (feisty bitey tonight)
3/16 AM PS 108
+3 121
+5 96
+7 116
+9 113
+11 118 (pm ps)
3/17 AM PS 200/+2 179/PM PS 127
3/18 AM PS 121/PM PS 196
3/19 AM PS 155/PM PS 148/+3.75 242
(shot 45mins late,regurg preshot,ate less after that.)
3/20 AM PS 150/PM PS 269 (shot point 75 pm dose)
3/21 AM PS 104/PM PS 174/+4.5 158
3/22 AM PS 153/PM PS 136/+5 176
3/23 AM PS 183(shot point 75)
+4 48 (fed half Nutro pouch)
+5 59
+7 56
+8.25 60
+11 120 (PM PS)
+4.25 189
3/24 AM PS 155
+2 169
+5 64
+7 75
PM PS 126
3/25 AM PS 131/PM PS 147
3/26 AM PS 191/PM PS 133/+4 128 (vomit probably J)
3/27 AM PS 128/PM PS 202
3/28 AM PS 175/PM PS 157/+4 215
3/29 AM PS 136/PM PS 113
3/30 AM PS 115
+3 117
+7 112
PM PS 149
+7.5 109
3/31 AM PS 163/+5.25 92/PM PS 115
4/1 AM PS 122/PM PS 136/+4 203
4/2 AM PS 142/PM PS 181 (been coughing? hairball?) pm shot late
4/3 AM PS 95/after 1h+food 145/PM PS 132 time change, lose an hour.
4/4 AM PS 105/PM PS 112/+5 66/+6.5 68
4/5 AM PS 87/wait 1h15m after food 96..no juice/PM PS 109!/+24.5 186
Experiment without insulin
4/6 AM PS 112
+13.25 93
+15 102
+17 100
+19.25 96
+21 129
PM PS 124 (+22)
+24 194
+27 195
+29 140
4/7 AM PS 111(+34.5)
+37 156
+39 94
+43 144
PM PS 147 (+47)
experiment over..reinstituting .5 units bid Lantus.
4/8 AM PS 188/+4 112/+7.5 74/PM PS 159
4/9 AM PS 106Iskinny half/PM PS 162
4/10 AM PS 126/PM PS 103/+5 81
4/11 AM PS 117/PM PS 144/+6.5 61
4/12 AM PS 133/PM PS 137
4/13 AM PS 133
+3 130
+5.5 55
+6.5 84
+9.5 94
PM PS 124 (ate some high carb dry/wellness lite after this)
4/14 AM PS 112/+6 108/PM PS 112/+3 157
4/15 AM PS 95/1 hour later shot .25 at 132/PM PS 182
4/16 AM PS 130/PM PS 144
4/17 AM PS 98 (ate extra food-shot skinny half)/PM PS 121
4/18 AM PS 162/PM PS 127
4/19 AM PS 102/PM PS 158(ate some HiCarb dry/+5 114
4/20 AM PS 148
+3 107
+5.25 72
+7 80
4/21 AM PS 112/P PS 116
4/22 AM PS 120 (ate 1/4 can WTS-1/8 cup hicarb dry/PM PS 303!! DRY food!
4/23 AM PS 185/PM PS 133/+5 90
4/24 AM PS 125/PM PS 116
4/25 AM PS 87 no shot/PM PS 121 ate some dry!!ARrgg
4/26 AM PS 172/PM PS 83 no shot
Vacation-Catsitter = no insulin under 150 bg
4/27 AM PS 119 no shot/PM PS 104 no shot/2.5 hrs later 167 still NS
4/28 AM PS 144 no shot/PM PS 185
4/29 AM PS 101 no shot/pM PS 193
4/30 AM PS 112 no shot/PM PS 199
5/1 AM PS 105 no shot/PM PS 164 (mom home)
5/2 AM PS 83/ 1 hour later 113 .25U/ PM PS 107 (.25U)
Reduced to point 25 units BID as best I can eyeball it.
5/3 AM PS 108/PM PS 110
5/4 AM PS 122
+2 98
+4.5 72
+6 86
+7 87
+9 101
+11(PS) 95 No shot
+15.25 92!
5/5 AM PS 113
+2.5 128
+9.5 129
PM PS 177 (shot point 50)
+3.5 73 fed 1/2 3oz Turkey wellness midnight so I could go to bed
5/6 AM PS 89 (no shot)
PM PS 144
+3.5 58
+4.5 73
+5.5 74
5/7 AM PS 87 (no shot)/PM PS 152/+4 72/+5.5 79
5/8 AM PS 130 (no shot)/PM PS 125 (no shot)
5/9 AM PS 121 (no shot/PM PS 152 (.25) LAST SHOT SO FAR!!!
These numbers are at the time a PS would have been taken..but no insulin
5/10 AM PS 102 (no shot)/PM PS 115(no shot)
5/11 AM PS 130/+5.5 after PS 59!/PM PS 97
5/12 AM PS 100/PM PS 60
5/13 AM PS 125/PM PS 127
5/14 AM PS 89 /PM PS 95
5/15 AM PS 105/PM PS 113
5/16 AM PS 98/ PM PS 102
5/17 AM PS 87/ PM PS 131/+4.5 hrs after PS 91
5/18 AM PS 92/ +6 after PS 68/PM PS 104 playing with "da bird"
5/19 AM PS 90/PM PS 106
5/20 AM PS 117/ PM PS 107
5/21 AM PS 101/ PM PS 115 /+ 5 after PS 63 next to toilet, hot in apt
5/22 AM PS 91/ PM PS 120
5/23 AM PS 97/ PM PS 126
5/24 AM PS 80/ PM PS 91
5/25 AM PS 90/ PM PS 103 Adding wellness for variety
5/26 AM PS 111/PM PS 90
5/27 AM PS 108/PM PS 118
5/28 AM PS 104/PM PS 127
5/29 AM PS 102/PM PS 97/+6 after PS 91
5/30 AM PS 110/PM PS 85
5/31 AM PS 94 /PM PS 88
6/1 AM PS 88 /PM PS 109
6/2 AM PS 97 /PM PS 101
6/3 AM PS 119/PM PS 104
6/4 AM PS 119/PM PS 112 no more wellness start6/5..numbers better after..
6/5 AM PS 99 /PM PS 76
6/6 AM PS 70 /PM PS 89
6/7 AM PS 63 /PM PS 75
6/8 AM PS NA /PM PS 68 grouchy, missed am
6/9 AM PS 102/PM PS 92
6/10 AM PS 83 /PM PS 99
6/11 AM PS 98 /PM PS 92
6/12 AM PS 79 /PM PS 82
6/13 AM PS 78 /PM PS 77
6/14 AM PS 84 /PM PS 89
6/15 AM PS 121 (overslept, 1hr 20mins)
+2 108 (after PS)
+5.25 65
+8 64
PM PS 65
TESTING ONCE A DAY MOSTLY
6/16 6:30A 86
6/17 6:30A 71
6/18 6:20A 72
6/19 6:25A 75
6/20 7:35A 86
6/21 7:10P 88
6/22 8:05A 98
6/23 7:00P 86
6/24 7:20A 88
6/25 7:25A 96
6/26 7:50P 88
6/27 7:50P 97
6/28 7:30A 92
6/29 8:10A 81
6/30 7:25A 83/7:15P 80
7/01 6:30A 80/6:10P 103
7/02 7:30A 84
7/03 7:30A 87
7/04 7:20A 77
7/05 7:25A 102
7/06 7:25A 76
+2.5 161! food spike
+5.5 84
+9 73
+12 66
Ran out of strips
7/23 7:30A 99
7/24 7:30A 75
7/25 7:30A 63
7/28 7:00A 84
7/29 7:35A 94
7/30 7:30A 106
7/31 7:00P 71 FIRST 100ccs fluids,after eating (2x a week)
8/1 7:30A 80
8/3 7:20A 65 100ccs fluids at 11:30 pm
8/4 10:15A 84
8/5 7:30A 74
8/7 7:10A 80
8/8 7:22A 98
8/9 7:30P 61
8/11 8:30A 91/6:30P 76
8/12 5:30P 95
8/14 5:20A 77
8/15 7:30A 80
8/19 5:15A 81
8/22 7:20A 82
8/25 7:30A 86
+2 101
+4.5 69
+6.5 78
+9.5 84
+10.5 77 (6:30P)
9/10 3:40P 75
9/26 8:20P 89 (off food)
9/27 8:20A 120 (only ate 1/4 pouch)
7:45P 78
10/09 6:15A 76
10/13 2:00P 63
10/17 8:35A 118 (+1 after food)
10/20 10:40A 98 (+2.5 after food)
10/23 10:30P 95 (Vomit food 10:15P)
11/17 7:45A 78/9:45A 90/1:45P 79
12/1 8:10A 78 (prefood)
10:15A 94
12:45P 43
2:20P 79
4:50P 77
6:30P 56 (prefood)
Further Reading
More at His FDMB profile