New and getting ready to give first shot

Discussion in 'Lantus / Levemir / Biosimilars' started by DevilPup, Aug 11, 2018.

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  1. DevilPup

    DevilPup Member

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    Hi All, my 13 yo neutered male, dsh kitty, Spike was diagnosed about a month ago. The vet advised that his BG was over 400. I purchased a glucometer and started testing him at home. We decided to attempt to regulate him by changing his diet. We adopted Spike from a shelter almost 13 years ago. They fed him only dry food. He has eaten primarily dry food all his life. We are now giving him wet pate 3 - 4 times per day. I have reduced the amount of dry food and also mixed his usual dry food with some very low carb, high protein dry. He eats very little dry now. When first diagnosed I could not wrap my head around it, as he did not appear to be diabetic. No increase in drinking water, urinating or eating. He weighs 15 pounds.

    Since testing his BGs at home, he fluctuates a bit (probably because of the food and when he's eating). He is currently hovering around 220-260. Twice, he went over 300 (which I attribute to his rhinitis). He also has other illnesses which may be affecting his numbers. He has chronic pancreatitis, chronic allergic rhinitis/sinusitis, asthma and anxiety issues. He takes Flovent for his asthma, so no prednisolone is administered for that illness.

    Within the last week, more signs of his diabetes have surfaced. He is definitely drinking more water, eating more, and urinating more. He is always tired, sleeps a lot, does not play, and just not well. That is why I decided to start him on insulin. Today I purchased Lantus. The Vet suggested I start with 1 unit BID.

    My concern is that with where his numbers are hanging at, that 1 unit of lantus will be too much and I will have a hypo on my hands. I cannot test him by myself. Testing Spike requires two of us. I wanted to start tomorrow (Sunday) with his first shot. I will be able to monitor him all day. On Monday, I decided to stay home from work, but my husband will not. I will not be able to test him until he gets home from work.

    The attached spreadsheet tracks his numbers from the first day I started testing him.

    Would it be better to start him with maybe a one-half unit?
     

    Attached Files:

  2. Beth 73

    Beth 73 Well-Known Member

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    Hi ! Not experienced enough to give shot advise but will help if you add the question mark icon in front of your title to attract attention to your thread . Help will be along shortly :)
     
  3. Beth 73

    Beth 73 Well-Known Member

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  4. DevilPup

    DevilPup Member

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    Thanks for the assist, but I really don't know what you mean.... I tried to go back and edit my post, but it will not let me edit the "subject line." Is that what you mean by "title?" And where do I find the "icons?"
     
  5. Susan&Felix(GA)

    Susan&Felix(GA) Well-Known Member

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    Near the upper right corner of your post (to the far right of your title), click on Thread Tools, then Edit Title. Where it says "(No prefix)" is a dropdown, and you can select the question mark icon there, which will get more eyes on your thread. You can also edit the subject line (title) there if you want.
     
    Last edited: Aug 11, 2018
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  6. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    How much does he weigh?

    The starting dose is based on their weight, not necessarily how high their blood glucose is.

    The starting dose is usually Weight (in kgs) x .25.....so for example, a 10lb cat's starting dose would be 4.54kgs. X .25 = 1.14......which we would round down to 1U

    It will be important for you to get more tests in. Lantus dosing is also based on how LOW it takes them, not the Pre-shot numbers, so it's important to get tests mid-cycle or at least do weekly curves (but you should still plan on getting at least a "before bed" test at night since most cats do go lower at night) You don't want to wake up to a crisis.

    Here's something I wrote up for others for testing...maybe it'll help you too!

    It can be really helpful to establish a routine with testing. Pick one spot that you want your "testing spot" to be (I like the kitchen counter because it's got good light and it's at a good height....it also already blocked 2 escape routes due to the wall and the backsplash) It can be anywhere though...a rug on the floor, a table, a particular spot on the couch...wherever is good for you.

    Take him there as many times a day as you can and just give his ears a quick rub and then he gets a yummy (low carb) treat.Most cats aren't objecting so much with the poking..it's the fooling with their ears they don't like, but once they're desensitized to it and learn to associate a certain place with the treats, they usually start to come when they're called! Or even when they hear us opening the test kit!

    You also have to remember...you're not poking him to hurt him...you're testing him to keep him safe and understand what's going on inside his body. There's just nothing better than truly understanding what's going on inside your kitty's body and with this disease, the more knowledge you have, the more power you have against it. The edges of the ears have very few pain receptors, so it really doesn't hurt them. Also, if you're nervous and tense, it's going to make your kitty nervous and tense too. As silly as it might seem, try singing! It forces you to use a different part of your brain!

    It's also important to make sure his ear is warm. A small sock filled with a little rice and microwaved or a small pill bottle filled with warm water (check temp against your wrist like you would a baby bottle) works well

    For new kitties, using a heavier gauge lancet is also really helpful. A 25-28 gauge lancet pokes a bigger "hole" than a 31-33 gauge lancet does, so look for "Alternate Site testing" lancets that are usually a lower number

    Finding the right "treat" will be a great help too! Freeze dried chicken, bonito flakes, little pieces of baked chicken...whatever low carb treat you can find that he really enjoys will help him to associate the testing with the treat! China's Achilles heel was baked chicken, so I'd bake a piece, chop it into bite sized pieces, put some in the refrigerator and freeze the rest to use as needed. It didn't take long for her to come any time I picked up the meter!

    There are more testing tips here:

    http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/
     
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  7. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    The starting dose depends on which dosing method you would like to follow, we have two methods here. Tight Regulation, kitty must be on all low carb wet or raw, starting dose is based on cat weight. Start Low Go Slow, has a starting dose of 0.5 units if on all wet, 1.0 units if dry is in the picture. Since there is some dry food still in the picture, you must use SLGS, at least for now.
     
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  8. DevilPup

    DevilPup Member

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    Last edited: Aug 12, 2018
  9. DevilPup

    DevilPup Member

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  10. DevilPup

    DevilPup Member

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    Jul 10, 2018

    What damage is done if I start at .5 units? Am I hurting his progress? Will starting low prevent him from benefitting from the insulin? I am so very nervous to give him a full unit. It does not feel right in my gut to give him 1 full unit. My thoughts are to start with .5 for at least a week. Continue to check his numbers often. If it does not drop his numbers to appropriate levels, I can increase to one full unit. Thank you.
     
  11. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    You're fine if you want to start at .5

    Starting lower shouldn't cause any serious problems as long as there's no ketones in his history
     
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  12. Sue and Luci

    Sue and Luci Well-Known Member

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    Welcome to the group! You'll find lots of support and great help and advice here. Try to review/read the stickies at the top of the forum when you have time...it's a ton of info...a lot to absorb but oh so very helpful! I still have to go back and read them...and it's been 7.5 months for us...takes time...be patient...

    Hugs to you for helping your cat! :bighug::bighug:
     
  13. DevilPup

    DevilPup Member

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    Jul 10, 2018

    He got his first shot! I gave him .5 units. There have been no ketones present. I test his urine EOD. I will test him every four hours today, and again before bed.

    There is a lot of info to absorb. I make time to read it. I'm going to pick up a spare meter today and some cosmetic rounds and possibly some different lancets. Sometimes I have to try a few times to get blood. He doesn't like the "fussing" so if I can get him fast and get him the first time there will be less drama on his part and less start for Mom and Dad. Thank you!
     
  14. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    There is an overwhelming amount of information to absorb. That's the bad news The good news is that we're here to help and it will not take long for most of this to become routine. The sticky notes can be very helpful but please don't hesitate to ask questions.

    If you are making a supply run, consider getting some "bigger" lancets -- 28 gauge or thereabout. (The lower the number on lancets and syringes, the wider the needle.) A wider gauge lancet is easier for you to draw blood in the beginning. The capillary bed in your cat's ear(s) will develop more as you continue to test and it will be easier to get blood. Until that time, if you have to poke twice (or more), try to poke as close to the original spot as possible. That way, if you get a small amount of blood from both spots, they will pool together. You can also scrape blood on to your fingernail if your kitty is getting impatient.

    Every time you test, successful or not, give your kitty a treat. In fact, take your cat to your testing spot, rub his ears, and give him a treat. If you start to associate testing and treats, chances are your cat will get the point and know that testing = treat. Most of us use freeze dried chicken for treats. Alternatively, cooked chicken also works. Basically, you want a no carb treat.

    I would strongly encourage you to ditch any dry food. If your cat has largely transitioned to canned food, that's great! Cats are obligate carnivores and only need a source of high quality protein (not primarily by-products) and certain nutrients, such as taurine, in their diets. If you've not seen Lisa Pierson, DVM's website on feline nutrition, it's very helpful. She also has a chart of most canned foods with nutrition information including carbs. You want to be feeding less than 10% carbs -- although most of us feed around half that % of carbs.

    Also, it will be much more helpful if you could use the spreadsheet template everyone here uses. Many of our members do not have Excel on their computers. The spreadsheet we use is color coded and has other bells and whistles you may find helpful (e.g., a page for your cat's lab values). I linked the instructions.

    Sorry for repeating a lot of what's in Chris' post.

     
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  15. Sue and Luci

    Sue and Luci Well-Known Member

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    Nov 3, 2017
    Skip the cosmetic rounds and get some baby sized socks.. fill toe with raw rice, tie it up, warm briefly in microwave to hold under kitties ear.. props up the place nicely for your poke.. warms it up so blood will flow too..

    On my cell. But I will tell you our story.. sounds just like yours!!!
     
  16. Sue and Luci

    Sue and Luci Well-Known Member

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    EAAD9991-F037-418A-8ED5-B761EB4B4EAE.jpeg 20CBDE06-BC33-40DE-A9E1-F22EF951016E.jpeg
     
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  17. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    Use whatever works best with Spike... cosmetic round, folded kleenex, folded piece of paper towel, or rice sock. Many cats won't let you get near them with a rice-filled sock! :rolleyes:

    Welcome to the group. Let us know how we can help.
    Hope to see you posting often!
     
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  18. DevilPup

    DevilPup Member

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    Jul 10, 2018
    Thanks, All. I had previously tried the warm-water filled prescription pill bottle. That didn't go over so well. So I tried the piece of papertowel. I can then fold it over to stop the blood before applying his aloe.

    I checked his BG at +3 and +6. This morning, I guess you call it "AMPS" was 235. +3 was 170 and +6 was 166. He really hates the testing. But we keep trying the treats and loves and kisses. He must have felt somewhat different this morning. He was wandering around all morning, like he couldn't find a comfortable place to sleep. He finally fell asleep in his "closet" after last test.

    I have been reading the files on this board every time I get the opportunity and have printed some documents out for handy reference. I have purchased my emergency supplies. I know this will get easier, but I'm so very afraid to hurt him. When I gave him the shot today, I didn't even think he got it, but apparently he did! I felt his fur and it was dry, so no fur shot! I know "NOT" to re-shoot with a fur shot or anytime I'm not sure if he got it or not. Better not to give than to overdose.

    I appreciate the support and welcome Spike and I received. Thank you! I will try to figure out the chart. I just couldn't handle it before. Between everything else and the shock and the stress, learning something else new at the time just wasn't in the plans.
     
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  19. DevilPup

    DevilPup Member

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  20. Sue and Luci

    Sue and Luci Well-Known Member

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    I have to share with you - I was a zombie the first week or six after Luci's diagnosis. I felt overwhelmed, undereducated and terrified...all rolled into one giant ball of incompetence.:arghh::arghh::arghh: I was sure I was going to get bitten or have my eyes clawed out by my Luci - she's been a rather hellish cat, aka Luci stands for Lucifer because she's not what one would call a 'cuddle bear'...hasn't ever been a big one for a lot of petting or handling...just a strange cat like that...and NOW we have to do WHAT? Hold her in place and stab her in the ear to get a drop of blood!!! ARE YOU KIDDING ME??? I figured I'd give it a try - or kill her trying - I mean what was the option? Euthanasia?? Hold on a minute! I'm going to TRY to help my girl...even if she is kind of a hell cat...she doesn't know what's going on...so why not? Vet prescribed Novalin which I took home and put in the fridge - read the board some more and they said no shot until she's over 200 ... fortunately for about two months she was under 200 when I finally got a drop of blood from her ears...only with DH helping to hold on to her could I ever get any blood...felt awful when we first started - stabbed her 3 times - we were sweating and crying and scare and tired...what a mess...she just thought we were crazy and would walk away...so we'd feed her...leave her alone for a while and try again once we all recovered..this went on for a while...no shots yet...(never did give her Novalin)

    Then we went to Florida and although Luci was eating she was losing weight - I decided in January she NEEDED to see a vet - she was sicker than she looked and sicker than the BG's I was getting at home indicated...the vet there was very supportive and kind...prescribed Lantus and off I went to Costco to get it - fell over when they said $275...:eek::eek:had our other supplies already...

    So now not only were the two of us trying to hold on to Luci to test her - we had to get together to give her a shot - he'd hold her and I'd jab her...she didn't seem to really notice the injections...:cat:

    After a while...she was ready and waiting in the morning for her FOOD...for her it was always about the food...and one day I just picked her up and held her (she didn't realize I was all by myself!) she stood still, I tested her, fed her, shot her...and from that point forward I do 90% of the testing and jabbing...DH does it at night because he doesn't mind being up late...I get up early...so there we have it...7.5 months later and Luci although not regulated...maybe never going to be regulated...but she's healthy and happy and getting fat (uh oh)...think I'm going to have to watch her portions (mine too for that matter! ha ha)...and she actually PURRS when I put her on the testing towel...she sits there and waits for me to finish whatever I'm doing...and then she gets a treat - usually a little LC FF (low carb Fancy Feast)...she's a sucker for food...:woot:

    So know you're not the only one with this trying time...but you'll be able to become a pro at it in no time at all...your kitty will settle into the routine and will cooperate too...:smuggrin:

    If someone had told me that Luci was going to behave the way she does these days I would NEVER have believed them...Luci does everything her way...always has...but she is a different cat. I think she knows we're only trying to help her... at least I hope so...otherwise it truly is all about the food...:rolleyes:
     
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  21. DevilPup

    DevilPup Member

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    Thanks! Loved getting to know Luci....I'm glad she finally surprised you and provided some cooperation. LOL. I hope Spike sees the light, too. If he doesn't, we will continue to motor on. It's my watch and mutiny will not be tolerated! :nailbiting:
     
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  22. Beck and Philly

    Beck and Philly Well-Known Member

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    Hi! I don't have any words of wisdom, but just wanted to say what a great kitty mom you are. You so obviously are taking the time and making the effort to learn all you can and make the best decisions for Spike. Don't get too overwhelmed. You're doing an amazing job, and Spike is lucky to have you.
     
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  23. DevilPup

    DevilPup Member

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    Jul 10, 2018
    Good Morning! Thank you, I appreciate your kind words and support. This illness seems to be like none other I have experienced with my kitties. I think it's because of the power of the insulin. It is powerful and one must be ultra careful and vigilant. We have got thru shot #3 of this new ride this morning. He didn't fight as much....we'll take it. I won't question it. I will do what I have to do for him....I've added his picture as my avatar. I can't resist that face. He's a big chooch.:kiss:
     
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