looking for some advice

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Tals, Jun 23, 2015.

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  1. Tals

    Tals Member

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    Jun 23, 2015
    Hi everyone, never thought I'd end up here... in 1 day I learned everything there is about feline diabetes. Yet, one thing they don't teach you is how to deal with this...on emotional level. Devastated....I keep looking at Shimi and my heart breaks. The vet won't say how long he has, only that his state is progressive.
    Now what? Does Shimi feel pain? Am I being selfish by trying my best to keep him alive? We just increased his dose today...again...I don't know what to think or how to feel or whats appropriate, I'm honestly not looking for someone to tell me its going to be ok, because its not going to be ok...its just getting harder and harder every day. Any advice would be greatly appreciated. Thank you, kindly
    Tals.

    Shimi tried to catch a fly today, made mommy so happy... I thought he was getting better...
     
  2. Shiloh & Rhonda (GA)

    Shiloh & Rhonda (GA) Well-Known Member

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    May 9, 2015
    Tals, when was Shimi diagnosed? What kind of insulin? What are you seeing as far as symptoms that make you think he is in pain? Are you worried that the shots are causing pain, or testing?
    I know they don't teach you how to deal with it emotionally. My breakdown was about 4 weeks in. Shiloh had gone pretty low, and I was up most of the night, then work, and I was just exhausted, then I burned myself making DH's dinner. that was all it took. But I got some sleep, took some get deep breaths and got back to it.
     
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  3. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Diabetes doesn't seem to hurt cats, although they may develop nerve weakness from the high glucose. This shows up as difficulty standing and walking.
    Well cared for, a diabetic cat can live a normal life. This means a low carb diet (there are over the counter options like Fancy Feast Classic Pates), insulin (it is possible to become diet-controlled, and home testing for safety using an inexpensive human glucometer like the Target Up and Up or The WlaMart Confirm or Confirm Micro.
    You can do this and we'll coach you as much as you need.
     
  4. Tals

    Tals Member

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    Jun 23, 2015
    wow Thanks for getting back to me so quickly. Shimi was diagnosed fist by me at home about a month ago, then by the vet about 25 days ago. he spent a day at the vets on IV, he almost had a ketoacidosis...I starterted him on 3 units twice a day (glargine), changed his diet from free feed to portion control (w/d cat food) and got a OneTouch machine to test his glucose levels at home. I noticed he was urinating excessively again, plus his sugar was through the roof, so I rushed him to the vet today. we increased the dose to 5 units twice a day. He is constantly starving it seems. sleeps all the time, doesn't play. The vet said its an aggressive form of diabetes...what the heck does it mean? How long does Shimi have? I love him so much...my God.
     
  5. Shiloh & Rhonda (GA)

    Shiloh & Rhonda (GA) Well-Known Member

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    May 9, 2015
    Didn't want you think we abandoned you. I'm not sure about the w/d. Is that canned or dry? I don't know about aggressive diabetes, never heard it described that way. The insulin is Lantus? And how much does he weigh?

    Can you give us some of his numbers?
     
  6. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    VERY IMPORTANT: The Lantus dose is adjusted based on the lowest glucose post-shot.
    Also, by changing the food and starting insulin together, you may have started too high, which would explain why he is so hungry - he could be eating his way out of hypoglycemia. Or, he might really be a high dose cat, though the W/D dry is pretty high carb.
     
  7. Tals

    Tals Member

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    Jun 23, 2015
    Hi! Yes for sure...Shimi is 11 years old. he was 11.6 lb when I got him to the vet, he is 12.2 lb today. The Insulin is called Glargine a.k.a Lantus. w/d is a special food for diabetic cats, I give him both wet and dry, its low fat high fiber & protein. I give him exactly as its indicated on the diabetic cat food charts and the package. so he is getting 1.5 cans per day plus 1/4 cup of dry...I mix them together, since I've noticed that only wet food makes him hungry faster. I don't' know whats aggressive means. I researched it, comes up as acute form of diabetes in humans.
     
  8. Tals

    Tals Member

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    Jun 23, 2015
    Hi BJM,
    It was the vets decision to give him that dose....he spent more than 24 hours at the vets where they tried to check his glucose levels every few hours. They started him at 2.5 units of course and increased it to 3 units. he seemed to be ok, but about a week ago Shimmi started to drink and pee a lot again, his sugar at the peak of Lantus (6 hours after the shot) was 22... every day I checked his sugar and every day it grew higher until I couldn't wait anymore and rushed to see the vet again. He bumped it to 5 units. Whats your experience with Lantus BJM?
     
  9. Vyktors Mum

    Vyktors Mum Well-Known Member

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    Nov 15, 2011
    The thing is that too much insulin in a cat can also result in high numbers and look like not enough insulin. The normal starting dose is 1 unit per kg of a cats weight or ideal weight if they're a bit chunky. Around here we generally make increases in .25 or sometimes .5 units so that the ideal dose isn't missed. It seems to me that Shimi has gone up way too quickly.

    I can't see what basis your vet would have to decide Shimi has some sort of 'aggressive' diabetes at this point. Unfortunately, but not surprisingly since they have so many different species and ailments to deal with, most vets aren't well versed in how feline diabetes should be treated. Luckily the people here are so I'm very glad you found us :)

    There's a spreadsheet in the tech forum with instructions on how to set it up. We'll be able to see what's going on with Shimi then and be able to give appropriate advice on dosing. Kudos on getting on to the home testing quickly :) The lantus experts tend to hang around in the lantus/levemir insulin support group forum.

    Try not to panic, diabetes isn't a death sentence, in fact 85% of cats who start following the tight regulation protocol (see the sticky in the top of the lantus/levemir forum) using lantus within 6 months of diagnosis will achieve remission and become diet controlled :). Vyktor is a case in point he had diabetic ketoacidosis and I nearly lost him. We found the board, followed the program and three and a half months later he was in remission and over three years later he is still diet controlled.

    Up yours to his vet at the time who thought he was too old (he was only 15!) to bother treating!!!
     
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  10. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    I used Lantus and then ProZinc for Spitzer (passed from a blood clot) and was starting to use Levemir for Gracie when she passed (pancreatitis). I also have used Regular and NPH insulins as boosters when needed.

    Please look up the W/D food at Cat Info. Cats are obligate carnivores and do not need tons of 'fiber' in their diet. Ditching the dry may greatly reduce the insulin requirement as much as 1-2 units.

    Also, your vet may not know, or may have forgotten, that vet stress may greatly increase office tests ... by 100-180 mg/dL in one study.


    Before you make any food changes, you must be home testing the blood glucose to keep your cat in safe glucose numbers. Please see my signature link Glucometer Notes for more details.
    .
     
  11. Tals

    Tals Member

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    Jun 23, 2015
    you people are truly amazing! Thank you for your support. I'm going to reduce the dose to 4.5 units today check his sugar daily, if its not spiking and in a range of high-normal, I'll go down to 4 units (3 was really not enough for Shimi) I also think 5 units is too much, but I asked the vet 3 times if he is sure to increase so drastically and suddenly. I called another vet this morning and he advised me to reduce the dose. The inconsistency of the information I am getting from the vets is frustrating. Its all a matter of opinion it seems. I'm going to look at your charts and start following your advice. at least one thing is for certain. Everyone here loves their pets and wants them to live long. Thank you again and again.
     
  12. Brashworks

    Brashworks Member

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    Jun 21, 2015
    Hi Tals, I'm newly joined here as well - my girl was Dx just last Saturday - and you couldn't have come to a better place. If there is anything I can suggest, and what advice resonated with me, is to remember that insulin is a hormone. It requires patience to see what happens and although you want results as quickly as possible for your kitty, use the spreadsheet to track readings and give Shimi's body time to adjust to every change you make. Every cat is different, for sure, but hormones work in delicate balance in any creature - consider monthly changes in a human woman's hormone levels can sometimes make her a raging lunatic for a week -- or is it just me??? :nailbiting: Anyway, you get the idea!!

    My girl is 15 and does not seem to be in any pain - and I've read here that FD is not a death sentence. Hang in there, you are doing fine. While I can't guarantee Shimi will be "okay" you are absolutely in the right place to give him the best chance of having a great quality of life for years to come. You are not selfish at all and fantastic that you are doing so much for him.

    One thing you said I'm not sure about though, regarding diet, and that is "high fibre". I think the jury is out on that one but most of my reading indicates that high fibre is more for dogs than cats. Anyone else please pitch in on this?

    I have my girl on Fancy Feast - there are certain varieties that are low carb - and her numbers are doing well. I always test her BG before her meal and then a few hours after in the evening - using the spreadsheet on this site is fantastic and gives me a much better picture of how she is handling the diet change and insulin. Her reading at the vet's was 26 and because she is also exhibiting the neuropathy BJM spoke about (weakness in the hindquarters and sort of walking on her hocks) it's likely it's been up that high for some time. I have every hope that she will be regulated with the combination of diet, insulin (for now!), vigilant testing, observation and recording, plus tons of cuddles and love. You can do this!!
     
    Last edited: Jun 24, 2015
    Reason for edit: Rhonda is the best editor!
  13. Shiloh & Rhonda (GA)

    Shiloh & Rhonda (GA) Well-Known Member

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    May 9, 2015
    @Brashworks , I second all that you have said, with one correction. The condition BJM was talking about is neuropathy, not necropathy.
     
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  14. Tals

    Tals Member

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    Jun 23, 2015
    Hi Brashworks, Thank you so much for a lovely note. 3 cats 2 dogs and 2 birds? hahahaha you guys are alright! Whats BG? oh!! Blood Glucose... People here use a lot of abbreviations I'm still not familiar with. Where do I find this chart? I looked, but the site is a bit complicated, I keep ending up in wrong places. is there a link to a chart I can download? I see we are using the same machine, One Touch. To your knowledge, are the readings similar to what cat readings would be? My vet said yes...but then he also said a lot of things which another vet contradicted.
    The food was also recommended to me by the vet. Shimmi was on Fancy Feast all his life, 11 years, and we had no problems. All of a sudden he started drinking a lot, at first I thought it was the salt content in the food, so I went to a specialty store and got him different kinds of mainly protein cans and treats, then obviously he developed diarrhea and I kept buying new and more expensive food all the time. The drinking only increased and then I smelled the nail polish breath. My heart just sunk :( I knew he has diabetes. Few days later the vet confirmed and we started this process. This is when the new food came in...he wasn't eating much of the protein food and kept loosing weight + all that commotion in his tummy...then he didn't go for 4 days, the vet recommended this food and I have to be honest, Shimmi loves it. I feed him mainly wet stuff anyways. The extra fiber just keeps things moving along for him and at least in that area of his life I have no more concerns.
    For 15 days everything was going smoothly, before I found this amazing group, I was doing my own chart. I hate pricking his ears, because I have my own issues...can't stand the site of blood :) but I manage...I cringe, but manage...
    date, time, dose, stool, urine, vomit, food, water, blood test, behaviour
    That's what my chart looks like.

    Day 15 he started drinking a lot again, his sugar was always high...I watched him like that for a week, then took him to the vet who said that his diabetes is aggressive, progressive and that he needs to bump him up to 5 units. I did that twice, last nigh and this morning and to tell you guys the truth, Shimmi didn't talk to me all day. He is usually very vocal, but not today. 7 pm was his last shot...I gave only 4 units...as was suggested by another vet over the phone.

    I need your chart guys, and I need to stop giving him different doses all the time. I know 3 is not enough, I know for sure...so should I stick to 4 units?
    Thank you everyone for your ongoing support.

    God bless,

    Tals
     
  15. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Can we get you started using our grid to record your glucose tests? It will help us give you better feedback. Instructions are here.

    Understanding the spreadsheet/grid:

    The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

    Each day is 1 row. Each column stores different data for the day.

    From left to right, you enter
    the Date in the first column
    the AMPS (morning pre-shot test) in the 2nd column
    the Units given (turquoise column)

    Then, there are 11 columns labeled +1 through +11
    If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
    If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
    and so on.

    Halfway across the page is the column for PMPS (evening pre-shot)
    To the right is another turquoise column for Units given at the evening shot.

    There is second set of columns labeled +1 through +11
    If you snag a before bed test at +3, you enter the test number in the +3 column.

    We separate day and night numbers like that because many cats go lower at night.

    It is merely a grid for storing the info; no math required.
     
  16. Brashworks

    Brashworks Member

    Joined:
    Jun 21, 2015
    Hi Tals,

    I don't have a ton of time to write but note that there are only certain varieties of Fancy Feast that are really low carb - some of them are actually pretty high. Look at labels, don't feed anything with veggies or wheat gluten, wheat, corn, soy, potato, etc. I have three varieties - Classic Chicken Feast in the Pinky/Red can, Tender Liver and Chicken in the goldy coloured can, and Turkey & Giblets in the olive coloured can.

    The spreadsheet is located here: http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/

    Looks daunting but the instructions are excellent and if you're like me ( I noticed your values are in mmol/L not the mg/dL) the World chart is invaluable. Give it a look - you can put your values in from your chart. This way you can share it with the folks on the board, who can decipher it at a glance (unlike me, who has to really think about what I"m looking at)
     
  17. Brashworks

    Brashworks Member

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    Jun 21, 2015
    Oh Rhonda, thank you for catching that. I'd claim typo but it's really my addled brain!! :banghead::banghead::banghead: I have fixed it in my post.
     
  18. Tals

    Tals Member

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    Jun 23, 2015
    @BJM Thanks a lot. How often should I check his sugar? The reading I get on the OneTouch device is what I enter?
     
  19. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Testing:
    1) Always test before giving insulin to make sure it is safe.
    For now, your no shot level is 200 mg/dL on a human glucometer (230 for pet-specific); this will lower as you collect data around the middle of the cycle to know how low he is going.

    2) Mid-cycle tests between shots - whenever possible, test around the nadir (lowest glucose level between shots) for your insulin, to see how low he's going. For Lantus, this often falls between +5 to +7 hours after the shot. Some folks do this on weekends or set a clock for the middle of the night to get this test done as it helps determine dose adjustments. This number should be at or above 50 mg/dL on a human glucometer (68 mg/dL for pet-specific).

    3) a before bed test is helpful in determining if you need to break out some higher carb food and steer the glucose level or go to bed with some peace of mind. Steering means giving 1-2 teaspoons of high carb gravy, waiting 30 minutes, and re-testing (repeating as needed) to make sure the glucose stays above 50 mg/dL.


    Yes, enter the value you actually get; no conversions needed. If you are not in the US, enter the data on the World page and it will automatically enter the US page via a formula (mmol/L = mg/dL / 18)
     
  20. Shiloh & Rhonda (GA)

    Shiloh & Rhonda (GA) Well-Known Member

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    May 9, 2015
    Tals...at least before every shot. EVERY SHOT! A plus 2 in the evening can be a good indicator of how the night will go. Much lower, need to stay up and test more. About the same, probably a level cycle. If it is higher, may be a good night to get some extra sleep. Plus 5 to plus 7 can help you figure out how low he is going on his dose.
     
  21. Tals

    Tals Member

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    Jun 23, 2015
    @BJM thank you. above 50 mg/dL on a human glucometer (68 mg/dL for pet-specific) ummm...not sure how much is that need to use your formula to convert. I"ll manage. Thanks again.

    @Rhonda Thank you. But I have no idea what +2 in the evening means or anything else that followed that sentence o_O so sorry. I thought +2 is the reading 2 hours after the shot as BJM said.?
     
  22. Brashworks

    Brashworks Member

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  23. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    She means getting a pmps +2, ie before bed, as it can be an indicator of diving if it has dropped a lot.
     
  24. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Our World version of the spreadsheet has 2 pages - a US page which you leave alone and a World page where you enter mmol/L. The US page updates automatically, at least for the first bunch of rows.
     
  25. Tals

    Tals Member

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    Jun 23, 2015
    @Brashworks that's just super! You are from Ontario :) So am I. I'm in Toronto...
     
  26. Shiloh & Rhonda (GA)

    Shiloh & Rhonda (GA) Well-Known Member

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    May 9, 2015
    Sorry Tals. I hope BJM explanation helped. And BJM, that was correct, wasn't it? Still new, so second guessing.
     
  27. Tals

    Tals Member

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    Jun 23, 2015
    @BJM got it. thanks again... whats diving? :)
     
  28. Shiloh & Rhonda (GA)

    Shiloh & Rhonda (GA) Well-Known Member

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    May 9, 2015
    Diving is heading low quickly from a preshot number.
     
  29. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Thing submarine - the glucose goes dive, dive, dive! (Obscure reference for old TV show) And you get to break out the high carb syrup and follow the protocol for intervening with low numbers. Test, see low number, give 1-2 teaspoons of high carb gravy or a couple drops of syrup, wait 20-30 minutes, re-test, and repeat as needed until above 50 mg/dL on a human meter, 68 mg/dL on a pet meter, past nadir, steadily rising, and no problems are observed.
     
  30. Tals

    Tals Member

    Joined:
    Jun 23, 2015
    @Shiloh & Rhonda & @BJM ok so lets see if I get this right...
    the chart is easy, I think I'll figure it out.
    So I should enter the reading the way it appears on a human device in the World chart here (no cat/human conversion?)
    I should check his sugar AMPS and PMPS and maybe sometimes at the peak of Lantus +5 to +7 during the day right?
    His sugar is always high btw... hopefully that will change with time.
    I should cut out his dry food entirely and keep him on wet only for now.

    When do I dive? :) still not sure what that is
    I'll start right away.
     
  31. Shiloh & Rhonda (GA)

    Shiloh & Rhonda (GA) Well-Known Member

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    May 9, 2015
    The dive is if his sugar starts dropping really low, fast. That is when you need to break out the high carb food and/or the syrup. You aren't doing the diving, his sugar is.

    Everything else, you nailed it!
     
  32. Brashworks

    Brashworks Member

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    Jun 21, 2015
    I'm just around the corner in London! There are quite a few Canucks around here.

    Isn't that funny we got the same meter? Mine came with a lancet pen but I do it freehand. Because of the type of insulin the vet gave me to start, I actually feed Genghis about a half an hour before her scheduled shot. While she is distracted eating, I rub her head and then poke her ear. She has been very patient with my novice and bungled attempts - and I think she actually associates the ear poke with yummy, yummy food. I took the cap off the lancet pen so it's easier to hold than just the lancet, but the pin is exposed. I have a permanent bandaid on my thumb and index finger to protect me (I spent a few days as a pincushion - who knew lancets were so sharp and ears so thin?) - Genghis was having none of a cotton ball or anything else against the inside of her ear. But the bandaids give me courage to make the kind of poke I need to get the sample for the meter. Bravo to you for getting it done with your aversion to blood! :D

    And listen, you are getting fabulous advice here. I know your mind must be reeling with all of this but, trust me, I can tell how devoted you are to Shimmi and I know it will all gel into something that truly makes sense. It's early days -- I've looked at some people's spreadsheets (click on mine below labelled Genghis SS) and I am so amazed at how devoted people are to their fur kids. We are among the most wonderful folks here!
     
  33. Brashworks

    Brashworks Member

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    Jun 21, 2015
    Shoot, and I meant to answer you about the meter. I am having Genghis' glucose curve done next week and will have the vet take tandem readings with my monitor for comparison. I will let you know when I know!
     
  34. Tals

    Tals Member

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    Jun 23, 2015
    @Brashworks you are so great! Thanks for everything, truly. How much does a glucose curve cost? what do they do exactly? poke his ear every hour?
    You made me laugh with your permanent banaid...that was a knee slap actually :)) Because the same happened to me...like exactly, you couldn't have described it better.
    I agree with you, people here are amazing. You have no idea how sad I was yesterday after the dose increase and the vet's visit...but folks here pulled me out of my horrible thoughts pretty quickly. When I fist registered, the morbid me, decided to first check the grieving forum o_O I don't recommend...today I feel much better and I got to chat with few more people including you and I feel blessed.

    thank you!
     
  35. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    A glucose curve is serial glucose tests from pre-shot to pre-shot, every 2 hours. An option to save money is to do the tests at home.

    Be cautious about changing doses based on a vet curve; those numbers may be from 100-180 mg/dL higher than at home.


    You don't dive; sometimes the planets align and the glucose level drops dramatically.
     
    Last edited: Jun 24, 2015
  36. Brashworks

    Brashworks Member

    Joined:
    Jun 21, 2015
    @Tals My vet said doing a glucose curve would be about $120 each time; yours may be different. He was very supportive about home testing but I'd rather have it done once there, at least, if only to find out the variance between his readings and mine.

    I'm glad I could make you laugh. I'm thinking I may do all 10 fingers for a Michael Jackson sort of effect :p Could be a look that's all the rage next year, like the FD Newbie badge of honour…

    @BJM Thank you, as always, for your advice - always invaluable. I plan on taking my spreadsheet into the vet's next week and would be hesitant at this point to change her dose based on one curve, especially when right now I have not exactly restricted her feeding but her numbers are looking pretty decent.

    Not to hijack Tals' condo but first, what are your thoughts on establishing the variance between his readings and mine, should I give him my meter to take readings at the same time? I was checking out the thread in Tech section about variances between pet and human meters and, while I'm not sure I understand all the statistics (no, I'm sure I don't!) is it worth doing to see how much of a difference there is for my particular meter? I have read your Glucometer Notes and don't want to be lulled into thinking her readings are "better" than they actually are. At this point I'm test to see trends and absolutely so I'm not shooting blindly, so I don't need the exact difference but I'd like an idea. Thoughts?
     
  37. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    You'll only have, at most, 14 paired tests, so there isn't a lot of data there to come up with a function of the relationship between the 2 testers. It won't hurt, but I don't know that it'll particularly help.

    It is more useful to give the vet the articles by Dr Rand of the University of Queensland where she provides some reference ranges with interpretations. Check this post for the article links.
     
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  38. Tals

    Tals Member

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    Jun 23, 2015
    @BJM @Shiloh & Rhonda @Vyktors Mum @Brashworks guys, I'm sorry to bother you but I think I need your help.
    Shimi hit new heights today with his readings. I know I promised a chart, didn't get to it yet, was a stressful day so to speak. AMPS at 6:30 am was 20 or (360 in US measurements)
    he ate, I gave him 4 units. He slept for 7 hours, then I did a +7 check 30! (540 in US measurements) This is supposed to be the peak of Lantus...right? its supposed to be lower than in the morning?? I was watching him for the next 5 hours hoping he doesn't go hyperglycemic on me. i gave him a bit of wet food with Argenine...supposedly that stuff reduces glucose as well. Increased the dose to 4.5 units this evening, as I got scared 4 wasn't enough?? Whats going on with my Shimi? Do you guys know? I'm a bit scared.
     
  39. Shiloh & Rhonda (GA)

    Shiloh & Rhonda (GA) Well-Known Member

    Joined:
    May 9, 2015
    Tals, I'm not experienced enough to give dosing advice, but hopefully someone else will chime in. Those seem like really high numbers to me. What was his PMPS this evening? What is the lowest he has been on the insulin? Just asking so that everybody doesn't have to go through the whole convo to find out. And you might want to post in the Lantus forum with his numbers, just to get some other people looking at it. I will post a link in that forum to this condo and see if we can get you some advice!
     
  40. Tals

    Tals Member

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    Jun 23, 2015
    Hi Rhonda @Shiloh & Rhonda thanks for getting back to me...can you link me? I'm so not tech savvy. yes, those are indeed high numbers. I honestly didn't do a PMPS because I couldn't wait to give him a shot just to reduce this sugar as fast as possible...maybe the first vet was right? Maybe 5 units is what Shimmi needs?
     
  41. Vyktors Mum

    Vyktors Mum Well-Known Member

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    Nov 15, 2011
    NO 5 units is not what she needs posting more in a sec but don't shoot that
     
  42. Tals

    Tals Member

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    Jun 23, 2015
    The lowest he's ever been since he was diagnosed a month ago is 16 (288 in US measurements)
     
  43. Shiloh & Rhonda (GA)

    Shiloh & Rhonda (GA) Well-Known Member

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    May 9, 2015
  44. Vyktors Mum

    Vyktors Mum Well-Known Member

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    Nov 15, 2011
    Got to do a test be back in a sec with more info but please get onto the spreadsheet ASAP it is really really difficult to give advice without being able to see the picture.
     
  45. Tals

    Tals Member

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    Jun 23, 2015
    I didn't. But I did give him 4.5
     
  46. Shiloh & Rhonda (GA)

    Shiloh & Rhonda (GA) Well-Known Member

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    May 9, 2015
    @Vyktors Mum I'm trying to help with the spread sheet, created it, but the numbers that she gave me that I put in the world SS are showing up as very low green. Am I doing something wrong?
     
  47. Vyktors Mum

    Vyktors Mum Well-Known Member

    Joined:
    Nov 15, 2011
    Lantus is a depot insulin, you DO NOT dose based on pre-shot levels. Lantus likes consistency. To be able to see what a dose is doing you need to hold that dose for a few days and give it time to settle.

    Shimi was started on a very high dose @ 3 units and then to be increased by another 2 units is just nuts, as I mentioned earlier too much insulin can look the same as too little. How high the numbers are does not affect the starting dose of lantus. When we get your spreadsheet happening I'm going to call for some very experienced eyes to come take a look for you.

    Can you go ahead and link the spreadsheet into your signature (don't forget to allow sharing) so I can see what's happening and help you fix it up
     
  48. Tals

    Tals Member

    Joined:
    Jun 23, 2015
    Its says a world spreadsheet, but its not recording the numbers in my units of measure. I'll just use a converter and will convert the numbers myself. hopefully this will work.Doing it right now thank you ladies so much.
     
  49. Shiloh & Rhonda (GA)

    Shiloh & Rhonda (GA) Well-Known Member

    Joined:
    May 9, 2015
    Tals, I'm still here, I just don't know what else to do right now.
     
  50. Vyktors Mum

    Vyktors Mum Well-Known Member

    Joined:
    Nov 15, 2011
  51. Tals

    Tals Member

    Joined:
    Jun 23, 2015
    I think I did it! Can you please take a look and let me know if it looks ok? @Vyktors Mum
     
  52. Vyktors Mum

    Vyktors Mum Well-Known Member

    Joined:
    Nov 15, 2011
    Sorry I'm popping back and forward I have one requiring hand feeding and one in low numbers but I'll stay with you until we get it sorted - or die trying!
     
    Shiloh & Rhonda (GA) likes this.
  53. Shiloh & Rhonda (GA)

    Shiloh & Rhonda (GA) Well-Known Member

    Joined:
    May 9, 2015
    I am not sure either, but it looks like @Tals got it.
     
  54. Vyktors Mum

    Vyktors Mum Well-Known Member

    Joined:
    Nov 15, 2011
    I can access it yes, it will be more convenient for you to have it set up so you can just enter into the world sheet and have it convert itself though. Did you follow the instructions from the link I just posted or do it some other way?
     
  55. Tals

    Tals Member

    Joined:
    Jun 23, 2015
    oh my lord. Thank you so so much. Shimmi means the world to me. I don't want him to hurt or to suffer. take your time @Vyktors Mum I'm not going anywhere and @Shiloh & Rhonda, you are amazing. Thank you for your help
     
  56. Tals

    Tals Member

    Joined:
    Jun 23, 2015
    I followed the link BJM instructed to use yesterday. I don't mind using a converter. I really don't. The numbers in black are scaring me. what does it mean?
     
  57. Vyktors Mum

    Vyktors Mum Well-Known Member

    Joined:
    Nov 15, 2011
    Have you entered all the data that you have? Do you have any of the vet's data?
     
  58. Vyktors Mum

    Vyktors Mum Well-Known Member

    Joined:
    Nov 15, 2011
    The black is a high ugly number but don't panic about that, it's just one number. Lantus takes a little time to settle in, it's not a quick fix. Insulin is a hormone not a drug so it doesn't work like a dose of antibiotics or something like that.

    be right back got to test
     
  59. Tals

    Tals Member

    Joined:
    Jun 23, 2015
    no...that's all I have apart from the very first day on June 5th when I took Shimi to the vet and I already knew he has diabetes, because of his acetone breath
    When I first brought him in, his BG was 612 they kept him for 30 hours and started him on 2.5 Units at first and increased to 3 Units right after while he was getting electrolytes via IV for the next 30 hours. When I took him home, they said his BG will drop to 216...I dont' remember when I checked but I did once between June 5 and 19 and it was 288, thats all the numbers I have.
     
  60. Brashworks

    Brashworks Member

    Joined:
    Jun 21, 2015
    @Tals I'm watching this post but I'm afraid even with the spreadsheet I lack the experience to make any dosing recommendations.

    All I can think of is that too much insulin can sometimes cause high readings - Genghis' initial reading was almost as high and she was started on only 2 units (mind you, it was a different insulin and all cats are different, but 5 units seems like so much, even with my limited experience)

    It is also possible that your meter (same brand as mine) gave you a wacky reading - do you think you can get another reading, just to be sure you're not reacting to a false number? Did you ever test yourself with your meter to ensure your strips are okay? Maybe something got on the tip and threw you that high number? Just thinking out loud. I know you hate blood and hate poking Shimmi, but I promise you his ears don't hurt.

    Breathe!! You guys will get through this!!!
     
  61. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Welcome to FDMB.

    You initially mentioned that the dosing suggestions from the vets seems to be random. The reality is that there is good, published research regarding the use of Lantus in cats. BJ gave you the link to the German websites where Lantus was first being used (and the moderator of the website was involved in the published research.) I'm linking the journal article where this research first appeared. The article may be something you want to share with your vet.

    The initial dose of Lantus is based on a weight-related formula: initial dose = 0.25 x ideal weight in kilograms. Your cat would have to be very large to be started on 3u. Most cats' initial dose is in the neighborhood of 1.0u.

    I would strongly discourage you from changing the dose. You typically want to hold the dose for at least 3 days in order for the insulin depot to stabilize after a dose change. If you change the dose too often, you end up with wonky BG numbers.

    With regard to testing, as others mentioned, it's essential to get pre-shot tests. I tend to like data and test frequently. (I also have a cat who likes to dive early in the cycle so I test frequently during those early hours.) I would encourage you to get some additional tests during the cycle. The minimum number of tests that are recommended is four -- your pre-shot tests and at least one additional test each cycle (2 cycles -- AM and PM -- per day).

    You may also want to read the sticky notes at the top of the Lantus board. There is a great deal of very helpful information in those notes.

    @Shiloh & Rhonda - the link doesn't work.
     

    Attached Files:

  62. Vyktors Mum

    Vyktors Mum Well-Known Member

    Joined:
    Nov 15, 2011
    OK - I'm going to call along some others to confirm (or deny) but my view is you were started too high, you have insufficient data to be adjusting the dose and you should basically start all over from the appropriate starting dose for Shimi's weight.

    This will sound counter intuitive to you because of the high number readings that you have but you really need to trust the experts here because I'm calling your vet out on knowing jack about lantus and how to use it - that doesn't mean he's a bad vet, vets can't be across all the treatments for all the ailments across all the species that they see.

    The high readings that you have could be from too high a dose, bouncing (when the cat drops too fast or goes lower than it's used to and springs back up high again) or just because the lantus depot hasn't had a chance to settle yet - especially with all the dose changes.

    Lets see if others agree @Sienne and Gabby @Wendy&Neko @Marje and Gracie as it happens Marje is also a spreadsheet expert so she may be able to help you get that right :)

    ETA: I see that Sienne has just been - Sienne do you think she should hold the high dose or start again using the weight based formula and hold that dose for the appropriate time?
     
    Last edited: Jun 25, 2015
  63. Vyktors Mum

    Vyktors Mum Well-Known Member

    Joined:
    Nov 15, 2011
    I would also pick up some ketodiastix from the chemist so you can test his urine for ketones regularly until his numbers come down.
     
  64. Tals

    Tals Member

    Joined:
    Jun 23, 2015
    @Sienne and Gabby. Hi and thank you for joining this conversation. Shimmi was in a bad stage when I first took him to the vet. he is 12 lb now, so according to your formula his dose should be 3 at the very most. and that's exactly what it was since June 5 to June 23. But poor cat started to drink and pee like a human, his sugar was too high and I didn't know about this group...so what do I do now? step by step. I'm ready to do what it takes to make him better. Can I see one normal reading before dropping the dose? Look what happened when I lowered it to 4 units. My vet has 40 years of experience, but I'm not on his side here. I'm on Shimmi's side. You guidance is greatly appreciated and thank you in advance.
     
  65. Tals

    Tals Member

    Joined:
    Jun 23, 2015
    What sticks? I dont' know a chemist, is it something I can buy at a pharmacy? Please guide me. I'll try it
     
  66. Vyktors Mum

    Vyktors Mum Well-Known Member

    Joined:
    Nov 15, 2011
    Tee hee sorry in Australia they're chemists - same thing as a pharmacy :) they don't cost too much

    If kitty is overweight the weight based formula is usually done on ideal weight

    Hmmm I forgot he'd been on the 3 units for so long either, based on the spreadsheet I thought just a short time, that may change things a little but it's very hard to know without the data. I might lean towards 3.5 units with that info but lets see what the others say. I notice @julie & punkin (ga) is on the board too.

    Edited to change errors - needed coffee and a shower!
     
    Last edited: Jun 25, 2015
  67. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    I honestly don't want to second guess the vet. It sounds like Shimi was in DKA if the vet was giving electrolytes. Lantus is typically not used to manage DKA in a newly diagnosed cat. (Usually, a faster acting insulin like Humulin N/Novolin/Normal insulin is used along with a rapid acting insulin like Humulin R to manage the numbers.) Once the crisis is over, the type of insulin can be switched to an insulin like Lantus which is much longer acting.

    With many cats who have experienced DKA, you need enough insulin to keep the ketones in check. I would be very reticent to suggest dropping the dose in a cat that is recently out of the hospital. I don't necessarily disagree with Serryn it's just that I would not want Shimi to be back battling with ketones.

    Tal -- are you still feeding W/D? If so, it may be contributing to the high numbers. Canned W/D is 25% carb. I have no doubt that the dry is even higher in carbs. (We consider a low carb good to be under 10%.) Is Shimi eating well? Food is also a critical factor in a cat that is post-DKA. This link to Lisa Pierson, DVM's site on feline nutrition is a wealth of information and there are charts listing the carb content of many varieties of canned food.

    Did your vet happen to suggest that you test for ketones? You can get Ketostix at any pharmacy. You dip the stick into your cat's urine and it will give you a color coded reading on the paper end of the strip that tells you if ketones are present and if so, how much. I would test Shimi daily until you are sure the ketones are gone.. Also, once you smell acetone, it's a pretty good indicator of DKA. You want to catch the presence of ketones well before ketones turn into DKA.

     
  68. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Actually, the dose calculation should have been around 1.25 - 1.5u. You didn't convert from lbs to kilograms (initial dose = 0.25 x ideal weight in kilograms).
     
  69. Tals

    Tals Member

    Joined:
    Jun 23, 2015
    @Sienne and Gabby, Oh my...he is getting too much insulin and seems like I took him to the vet too late...
    He is a tall cat so to speak. He was always a bit large? but then he lost weight along with the rest of the symptoms. On June 5, he was 11.6lb and now he gained a bit of weight and looks more or less normal again. he is now at 12.2lb he is always hungry. So I guess its the insulin that makes him hungry. I don't know what to do...keep 4 units? 4.5?
    I'l start checking his BG 4 times a day as much as I hate that, he jerks when I poke him and I think its causing him pain. then I stare at the poked ears for a while and hate myself for hurting him. But that's not whats important.
    Whats the plan for the next few days? Should I keep him at 4.5? and try to get a normal reading?
    As with food, why would they write on the can that its a special food for diabetic cats if the carb content is so high? I still have 24 cans of that glorious stuff. What should I do?
     
  70. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    12 / 2.2 *0.25 = 1.36, rounded down to nearest quarter unit is 1.25 units.

    Return the food and say he won't eat it.
     
  71. Shiloh & Rhonda (GA)

    Shiloh & Rhonda (GA) Well-Known Member

    Joined:
    May 9, 2015
    Not going to address the dosing issue, but as to why they would put on the label that is a special food for a diabetic cat? $$$$ That is the only answer I have. Most vets, if you tell them they won't eat it will take it back and give you a refund.
     
  72. Tals

    Tals Member

    Joined:
    Jun 23, 2015
    @BJM :) HI!! Thanks for checking in on me. yes, it seems everyone is saying the same thing. I"m afraid to drop the dose from 4.5 to 1.25 right away though...not with todays readings. that is the goal for sure. I'd like his insulin dose to go down as well as his sugar.
     
  73. Vyktors Mum

    Vyktors Mum Well-Known Member

    Joined:
    Nov 15, 2011
    It's the diabetes (lack of insulin) that causes weight loss.

    Are you giving low carb treats after each test? Most kitties adjust very well and end up focussing on the treat rather than the test ;)

    I have to go now but I'm sure some of the others that I tagged will be along to give advice and we can find some sort of consensus before Shimi's next shot is due..

    I also recommend that you start posting Shimi's numbers regularly (daily is good) in the lantus/levemir insulin support group forum at least until you know what you're doing - and no mucking with his dose without advice :)
     
  74. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    The nadir for Lantus is often between +5 to +7, although it can and does vary day to day. Aim to get tests during that period in case his ability to compensate fails and his glucose dives. Make sure you have the hypo instructions printed out and Karo syrup in case you need it.
     
  75. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

    Joined:
    Feb 17, 2011
    wow, you've had a rough time. You're getting a lot of conflicting information and your kitty isn't doing well.

    I've skimmed through this long thread, trying to get just your posts so i can get the story. Can you clarify, is Shimmi still eating any dry food? Eating dry food can really increase the amount of insulin needed.

    We need to sort out if you have a high dose kitty, one that has a condition like acromegaly, which my punkin had, or if Simmi's high numbers are caused by too-high of a dose, or from eating dry food.
     
  76. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

    Joined:
    Feb 17, 2011
    I want to give you a couple of things to read:

    Bouncing - second post in this thread
    When a cat is overdosed, his body will put out counter-regulatory hormones to keep the cat alive - the result can be constant high numbers. If the dose is reduced, it can take maybe 3 days for those hormones to clear out and the blood sugar to drop.

    3/8/11 Punkin
    When we arrived at FDMB, our vet had switched us from Prozinc, a U-40 insulin requiring u-40 syringes, to Lantus, a U-100 insulin requiring U-100 syringes. Only he hadn't switched our syringes - so the dose was actually 2.5x as large as we thought it was. Libby laid out some things for us to consider as we moved ahead. Your situation isn't exactly the same, but the choice is the same - should you drop the dose to see if he's overdosed, or should you hold this dose and move ahead.

    Take a look at these and answer the question about dry food in the previous post, and let's see if we can help you figure out how to proceed.
     
  77. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    I also don't like lowering a dose when the kitty has had DKA until we see if that's what they actually need. Since you reduced to 4.5u, I'd suggest you just leave him there for now and let it settle so we can see where the numbers are.

    I've never heard of an aggressive form of diabetes. I suppose he could be talking about acromegaly that Julie discusses. But that's not our first thought....we need to just get a consistent dose and see where he is.

    If you need help with your SS, I'm more than happy to fix it. Click on "Marje and Gracie" on the left and select "start conversation" and it will send me a message so I can get some info from you.

    Lastly....take a deep breath. :) We've all been scared to death, too. We've seen our kitties become starving, lethargic, lose weight, high numbers, etc. so we totally understand your distress. But we've helped a lot of kitties and caregivers here and we will do our best for you and Shimi. There have been cats on this board that have lived with diabetes for more than 14 years.
     
    Last edited: Jun 26, 2015
  78. Sue484

    Sue484 Well-Known Member

    Joined:
    Apr 25, 2015
    @Tals Have a look at my spreadsheet. After a failed year on Caninsulin, my specialist vet put my Frankie onto Lantus and started him on 3 units, then upped it to 4, then again to 5 and I was seeing much higher numbers than you. After finding this site, I realised he was on far too much and started taking control of him myself. I changed his food against the vets wishes and I get dosing advice from here. He has been slowly reduced and is now on 2.75 units twice a day. Admittedly, the last decrease failed and I will be going back up to 3 units tonight, but my spreadsheet did look very much like yours (or what there is of it) at the start. Trust the advice you are given here, they really do know much more than the vets!! Plus it is a slow process, you won't get results from a few shots. It can take 3-4 days to see what a consistent dose will do for Shimi.
     
  79. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    If you're worried about testing and how Shimi will adjust, take a look at Gabby's' spreadsheet and Marje & Gracie's. We're testaholics! You kitty will catch on that this is the golden road to treats (lots of us use freeze dried chicken) and that what you're doing helps him to feel better.
     
  80. Tals

    Tals Member

    Joined:
    Jun 23, 2015
    @Sue484 @Marje and Gracie @julie & punkin (ga) @Sienne and Gabby Good morning guys. Thank you for joining this thread and for your advice. Shimmi is off the dry food. I stopped it, only wet cans and this morning I gave him a mainly protein can, not a W/D can, but a Signature can I had from before he got sick. his AMPS was super high though. 498.6 and a 4.5 unit shot followed. Sue, Frankie's story sounds very similar to mine. I looked at your chart. Poor Frankie :( his sugar is all over the place. Are you not afraid to drop the dose form 5 to 2 in a day in some cases? I saw that on your chart.
    Julie, I Googled acromegaly and I don't think Shimi has that. There might be another explanation for the super high numbers....a tumor....but I don't want to think about it right now. I just want to see his sugar drop at least once.
    As for treats :) Do you freeze cooked chicken pieces? My cat doesn't eat anything raw...never had, but he loooooves roasted chicken!
    A million thanks, people. I was telling my friend last night about how I stumbled upon this forum and how amazing the people in here are. I truly appreciate the time you take out of your day to care for Shimi.
    Tals,
     
  81. Sue484

    Sue484 Well-Known Member

    Joined:
    Apr 25, 2015
    @Tals I only halved his dose when he had a particularly low pre shot number. That was also the day after I changed him to an all wet low carb diet. I would rather he had too little insulin than too much. At least that way I know he was safe. I am doing things the hard way, starting high and reducing, I was a bit like you at first. I had advice to start afresh as he was overdosed, but couldn't quite get my head around it. It is better for them to have high sugars for a little while than be too low for a moment
     
  82. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    Tals

    Keep in mind that Sue also uses a pet meter and so the numbers will appear higher than you would see with a human meter.

    One thing we say here and believe firmly is "every cat is different" or ECID. If you'd like some hope on how much things can improve, check out Cooper's Spreadsheet.
     
    Millie and Cooper likes this.
  83. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    You can use roast chicken as a treat. Freeze dried chicken (and other proteins) are in the treat aisle at any pet food store. Many of us buy the "dog" version since it's cheaper than the cat version even though they are exactly the same. This is a link to one brand, PureBites, that's available.

    I'm also giving you a link to the food chart that most of us use. If you look through the multitude of food available, you want to select food that's less than 10% carbohydrate. That's what we consider low carb (LC). I feed my guys Wellness Chicken or Turkey (it's around 4% carb so it's well below the 10% limit.
     
  84. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Hi Tals - and hello from another Canadian, but from the hot west coast. I see you are using the World version of the spreadsheet but entering data on the US side. If you look at the tabs on the bottom of the spreadsheet when you are editting it, you'll see the second one is World mmol/L. If you grab that tab and move it to the left, it'll end up being the top tab when you open the spreadsheet. You can then enter all the data in mmol/L as you see from your meter, and it will automatically do the conversions for the US tab.

    My Neko was also a high dose kitty and has acromegaly. Over 50% of acromegalic cats cannot be identified by looking at them. Neko's main symptom was being crazy hungry, including for inappropriate foods like banana bread. But otherwise didn't really have any visible symptoms. Later on I found out her eye tearing was also a symptom. Four years after that first symptom, she still here and fairly happy. Acromegaly is a benign tumor on the pituitary. I'm not saying Shimi has that, just that it's a little trickier to say one way or the other.
     
  85. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

    Joined:
    Feb 17, 2011
    Tals, I think the thing that would be most helpful in helping us figure out how to help you move ahead, is for you to hold this dose for the next few cycles, and get at least one preshot and one mid-cycle test in both morning and evening. Sometimes there are hidden low numbers in there and a cat will bounce (I linked you some info on it above) and then remain high for the next 3 days. The most helpful pm cycle test is probably just before you go to bed. During the day, I think anytime between 3 and 8 hours after the morning shot would be good. Because we have people here from all over the world, we measure time in + hours counting from the last test - so if you shoot at 6am, then +3 is 9am and +8 is 2pm.

    If you can get 4 tests a day for 3 consecutive days while you hold the dose constant, we ought to be able to tell from those tests if you need to increase or decrease the dose.

    Is that something you might be able to do?

    While he is high it's also important to test him frequently for ketones. Here is a good information post on them. Since he had DKA at diagnosis, the risk is present for him to develop ketones again and that's a dangerous situation we want to avoid. If you see a trace of ketones, please post immediately and ask for help. Trace ketones can be dealt with at home - more than small requires a vet and can become a crisis in a matter of hours.

    I'd also encourage you to post on the Lantus/Levemir Insulin Support Group. That's going to keep your sweet Shimi on the radar of those who all use Lantus and Levemir, and many people there can help you. Don't worry about the lingo or the subject lines - for now I'd just encourage you to post there so we can keep an eye on how Shimi is doing.
     
  86. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Hi Tals,

    I'm still going through all the notes on this thread to catch up (late to the party!:rolleyes:), but wanted to let you know that I am another Canuck and quite possibly a neighbour. I too live in Toronto. I am in the west end near 427 and Rathburn. Where are you?

    I have been at this battle a smidge longer than you and can appreciate your frustrations although mine are for totally different reasons. ECID is sooooo true. I have a zebra who is not following the rules and refuses to read the manual.:cat::banghead: I will continue to follow your posts to see how you are managing. Cheers!
     
  87. Tals

    Tals Member

    Joined:
    Jun 23, 2015
    Hi Everyone.

    Shimi's sugar dropped from he highest cliff! at 3.6 (or 64.8 US) @+7
    I gave him a tea spoon of sugar and some high caloric food. now what?? what am I waiting for? when do I check him next?
    Whats happening to him?
     
  88. Tals

    Tals Member

    Joined:
    Jun 23, 2015
    @MrWorfMen's Mom Hi Linda, I'm in Distillery and currently totally scared...my hands are shaking as I'm typing. I've never seen his numbers that low.
    Is 1 tea spoon of sugar water is enough?
     
  89. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Ok. BREATHE
    Are you using a human meter? If yes, he is safe.
     
  90. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    If you are using an AlphaTrak or other pet meter, he is borderline. Give 1-2 teaspoons of high carb food or several drops of syrup/honey/sugar water.
     
  91. Tals

    Tals Member

    Joined:
    Jun 23, 2015
    Hi BJM, trying to breathe.... it is a human meter yes. should I give him more sugar? food?
     
  92. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Nope. He's right around his nadir (or even possibly past it) and that is a beautiful number!
    Wait 30 minutes and re-test.
     
  93. Tals

    Tals Member

    Joined:
    Jun 23, 2015
    ok... I will check at 4pm. beautiful number? ok...ok
     
  94. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Saw you were posting in Lantus, too, so answered there.

    I need to pop out for a bit to help a friend, so keep posting on this post in Lantus, ok?
     
  95. Tals

    Tals Member

    Joined:
    Jun 23, 2015
    yes...will do for sure. Thanks so much
     
  96. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Oh Tals,

    I'm so sorry I didn't see your message until now but I see BJM got to you pretty quickly and others have since chimed in. That's the beauty of this board.....there's usually someone around to help. I checked the message in the Lantus section and see that Shimmi's numbers have started rising . You are getting a great nadir number but I understand how scary that must have been. You must have been going nuts when you got that low number. I'm shaking just thinking about how you must have felt. Sending you a big HUG! :bighug: You should go do something nice for yourself now. You earned it!

    In the Distillery district.....so you are in the heart of Downtown. That's one of the few places the old buildings with their remarkable architecture have been preserved in this city. I love going for a stroll through the area although I haven't done it for years. I need to put another stroll down there on my ever growing ToDo list.

    I will keep an eye out for any more unwanted "excitement" but hope that's over for you today.
     
  97. Tals

    Tals Member

    Joined:
    Jun 23, 2015
    Linda, thank you for the hug...much needed. If you do end up strolling down here, let me know. Would love to have a coffee with you.
    Thanks again for your support.
     
    MrWorfMen's Mom likes this.
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