Need Lantus advice - cat's levels all over the place.

Discussion in 'Lantus / Levemir / Biosimilars' started by Kathleen Einwich, Dec 4, 2018.

  1. Kathleen Einwich

    Kathleen Einwich Member

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    Nov 3, 2018
    As you can see by Bet's spreadsheet, recently his levels have been up and down. Before that I thought he was on the way to remission just from the food. Then I found he was dehydrated and was constipated (he stuck his butt in my face and showed me what was stuck, little darling) and his levels shot up I had been adding water to his food at that point for 4 days. The next morning I found he had pooped by the back door to show me, and that morning's reading level dropped significantly. I guess I need to go out and get some laxatone. I've also thought of adding olive oil to his food if he'll tolerate it.

    I got the proper syringes for giving his insulin in smaller dosages (didn't know and I've been struggling to do that since 11/29. He has been a fighter with taking blood tests (blood everywhere) but he's getting better and is resuming his normal habits overall. He doesn't like having water mixed in his food and eats a lot less, so I'm going out today to get some chicken broth to try with that, as recommended by some...somewhere.

    I'd like some comments/recommendations on this situation. I have been tending to go back and forth between .5 and .75 since I stopped the vet's recommendation of 1 unit twice a day. I dose of late in reaction to how high his levels are, which I know is not good. It's just that a high reading, like this morning's, seemingly out of nowhere, scares the heck out of me. He looks normal, acts normal, but there's the reading... I know the dose supposed to be consistent.

    Any suggestions, recommendations?
    TIA,
    Kathy Einwich
     
  2. Joanne&TinySole

    Joanne&TinySole Well-Known Member

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    Last edited: Dec 4, 2018
  3. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Stick with 0.5 units for the moment. 0.75 units is taking him too low, and then he’s bouncing. When you see high in the morning, ask yourself if he went low the night before to cause him to bounce. Hard to say if there are no tests at night. A before bed test is a good one to get each night, as kitties often go lower at night. And we determine dose by the low points.
     
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  4. Kathleen Einwich

    Kathleen Einwich Member

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    No, he has no access to anything but what I put down for him. Thanks. He's never eaten people food. The only new thing he's had in the last few days is freeze dried chicken breasts. I was encouraged to get these as a treat since the glucose tests were such a trial for him. I give him one piece after each test.

    Thanks.
     
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  5. Kathleen Einwich

    Kathleen Einwich Member

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    OK, I'll stick with the .5 tonight. I won't be doing his shot and PMP test until 1030pm CST because I overslept the usual AMPS test and shot time by two hours this morning. Yesterday was exhausting - getting a new Lantus pen and other things. I'll be moving the shot due time back each day (?) by a half-hour until I get to his normal time of 9am.

    Bet didn't care for the chicken stock added to his food and didn't eat that much. I thought of olive oil too but I'm sure he'll hate that even more. I suspect it has something to do with the change in texture of the food done by mixing. Both of my cats ate the same food for almost all of their 14 years: Dynamite Specialty Super Premium Dry Dog Food, fed at will, plus a half can of 9-Lives Hearty Cuts with Real Turkey in Gravy, for the vitamin missing in the dog food - can't remember what. They were always healthy and with a good weight and shiny coat. One still is. But of course I stopped both foods in early November.

    Thanks so much for your thoughts and help.
    Kathy Einwich
     
  6. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Taurine....it's an amino acid that cats need for their heart and their eyes (it has other uses but those are the big 2)

    If he has problems with constipation, you might want to look into using Miralax….a lot of cats here are on it. It's a powder that's totally tasteless and you just mix it into their food.

    Usual starting dose is 1/8th teaspoon once or twice a day and then titrate up until you get the results you want.
     
  7. Kathleen Einwich

    Kathleen Einwich Member

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    The canned food contained the Taurine - right. I also used a special vitamin and also an enzyme from the same company to control the vomiting problem that Abby has (I think she is easily stressed). I just read that the enzyme, Catazyme, is successful with constipation but I think its 2nd ingredient, sugarcane molasses, might not be a good thing for Bet.

    https://dynamitespecialty.myvoffice.com/ShoppingCart/LNG/ENG/CatazymesC_SuppFacts.jpg

    I'll get some miralax. Bet has problems with his pate being mixed to mush and won't eat as much, but with him being fed at least 4 times per day we'll deal with it. Abby eats what he won't; separation has been an adventure. Thanks so much.
    Kathy
     
  8. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Right

    Nope...not good for a diabetic at all!!
     
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  9. Joanne&TinySole

    Joanne&TinySole Well-Known Member

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    I was trying to be humorous ...maybe not the time. My apologies. There is a freeze-dried chicken liver treat that 3 of my 4 (of course) go crazy over. I'll post the name tomorrow. You can give it with/without water - I do with water. I'm about to start some psyllium for one of my cats. Not sure how it will go, but...

    This forum is a wealth of knowledge with helpful people. You're in the right place.
     
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  10. Kathleen Einwich

    Kathleen Einwich Member

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    Oh, I thought it was a totally logical question! You never know. I of course can't have any plants in my place and it's been a bit of a problem through the years with a couple of roomies. Earlier this year I found Bet eating the dried spanish moss that one roomie had put under a crystal on display, years ago. He doesn't care what it is, as long as it was once growing! Bet likes to try to eat twist-ties and I find them in his food bowl all the time. He sniffs them out, wherever they are.

    I was surprised that Bet liked that treat. He hates every treat I've ever tried - except those. Would only eat chicken, hated fish. Contrary little bugger but easily spooked because he and his sister went through Katrina with me and 6 weeks on the road afterwards.

    Thanks for the info and it'll be good to find out about more treats for his Majesty.
    Kathy
     
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  11. Kathleen Einwich

    Kathleen Einwich Member

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    Are you sure it is good to remain at .5 dosage? It is the 2nd day in a row that Bet has high readings. Makes me nervous. I don't think he has constipation right at the moment. My instinct is to up it back to .75 on tonight's shot. I'll do a mid-day test to see where his levels go, but I think it'll be like yesterday, still high. He's not acting quite normal, just looks a bit off; the same last night.

    Also, Bet is drinking more. I don't know whether that's a function of my pouring a bit of the chicken broth (but not mixing) over his food or the return of the thirstiness of the diabetes. I keep a glass of water beside my bed and he is drinking from it again, first time in well over a month.
     
    Last edited: Dec 5, 2018
    Reason for edit: adding info
  12. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Yes, for now..remember, it can take up to 6 cycles to clear a bounce. We don't have enough data on him yet to know if he's going to be a cat that clears them faster or if he's one that needs the whole 6 cycles.

    I know we keep saying it, but it's really important to get at least 1 test on the PM cycle.
     
  13. Joanne&TinySole

    Joanne&TinySole Well-Known Member

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    Low BGs risking a hypo episode as worse than high BGs. A few cycles where the BGs may go a bit higher than where you want them will not change the chances of remission. There is a lot to consider and think about, but eventually the BGs will balance and become more stable.

    The dark green numbers are ideal, of course, but the blue numbers are good and the yellow numbers are ok, as they indicate an adjustment. I have found that patience and cautious regulation are our best friends when managing a sugarbabies diabetes.
     
    Last edited: Dec 5, 2018
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  14. Kathleen Einwich

    Kathleen Einwich Member

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    OK, I'll try my best. I'll test at least two hours after his shot at 1030pm. I was planning to do a test at 5pm, the mid-point. I had no idea about the bounce-clearing and the cycles. But what is a cycle, a day? I was looking through the site for a definition for that but can't find one.
    TIA
     
  15. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    A cycle is 12 hours...there's an AM cycle and a PM cycle
     
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  16. Krystina & Nelli

    Krystina & Nelli Well-Known Member

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    Hi Kathleen :)
    Regarding Taurine... I buy fresh chicken hearts from either a local, chicken farmer guy or at “a” meat market. You might want to try?...
    Are the best source of Taurine.
    OMG, kitties l.o.v.e them ;). Truly have never known any who didn’t. The fresh ones (in the blood, yummy :cat:) you can feed two+ a day... check out info online:)
    Nelli gets one chopped up (yuck! :eek:) one or two times a day.
     
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  17. Krystina & Nelli

    Krystina & Nelli Well-Known Member

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    ... just asking, don’t be offended :eek:... is the chicken broth devoid of any sodium?
     
  18. Kathleen Einwich

    Kathleen Einwich Member

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    I checked that just now. I did consider it and looked at the label, but it didn't register. It's:

    Chicken Stock, Water, Chicken Fat, Contains Less Than 2% Of: Salt, Yeast Extract, Monosodium Glutamate, Dextrose, Corn Oil, Flavoring, Hydrolyzed Soy Protein.

    I probably should have gotten the low sodium version but I was at a local country market. Try again....maybe not at all. He just doesn't like the texture of the pates mixed with anything - it makes it into mush, which I'll guess is harder for him to eat.

    I did a bit of research on this just now and I guess it wasn't such a good idea after all, even if I get low-sodium chicken broth to drizzle over the food. BTW, no chicken broth over Bet's 6pm or tonight's post-PMP feeding.

    Thanks for the pointer.
    Kathy
     
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  19. Kathleen Einwich

    Kathleen Einwich Member

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    What an interesting idea! Thanks!
     
  20. Kathleen Einwich

    Kathleen Einwich Member

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    When does this mean? I gave Bet his PMP test and evening shot at 1030PM. I am planning to give a test at 6am tomorrow, I hope. That's the best I can do. The other morning I knocked over a full water glass next to my bed turning off the alarm and did not even realize it until I woke up hours later. Sad...
     
  21. Idjit's mom

    Idjit's mom Well-Known Member

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    Kathleen, you could make your own chicken broth, if you think Bets would just lap it up by itself. No extra unwanted ingredients. When Idjit is pestering me for another meal, and it's too soon after he's eaten, I thaw a couple of homemade chicken broth cubes in the microwave for him and he's happy again.
    You just cook the chicken in water, a slow cooker is a good idea since you don't have to watch it to make sure it doesn't boil dry. Then strain out the chicken, let the broth cool, let it get cold in the fridge, then skim off the fat. I put it into ice cube trays and freeze it. Then the cubes get stored in the freezer in a ziplock freezer bag. You can then use the boned chicken for yourself in soups, chicken salad or casseroles. I save and freeze the bones also, then when I have enough I toss them into my electric pressure cooker and make delicious bone broth for soups. Idjit gets some of that too, if I haven't added any seasonings or vegetable scraps.
     
  22. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Is there any way you can move your shot times back some? I absolutely HATE mornings, but after trying an 11/11 schedule and having to stay up all night long with China when she dropped too low, I switched to a 6am/6pm schedule. I still hate dragging my butt out of bed at 6am, but I can almost always go right back to sleep for a few hours.....and it lets me test until at least midnight on the PM cycle without staying up all night long.

    If you can at least get a +2, that could help because in a lot of cats, it can almost predict what's going to happen later in the cycle. If it's lower than the Pre-shot (by more than the meter variance) that can be an early warning that kitty might be going a lot lower later in the cycle and that it's truly important to get more tests in later to keep them safe.

    For people who have a hard time waking up to alarms, I suggest getting one of these Sonic Alert alarms....LOL
     
  23. majandra

    majandra Well-Known Member

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    The chicken stock has dextrose and msg - the homemade like Idjit's mom suggested may be a better option, and cheaper too!
     
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  24. Krystina & Nelli

    Krystina & Nelli Well-Known Member

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    I thought of this when you mentioned his thirst. MSG is definitely not good :eek:... I buy chicken breast quarters- lightly, slowly cook, boil them for Nelli. She loves :cat: the softly cooked chicken and I’ve got my own non seasoned broth :bighug:
    Happy to pipe in ;)
     
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  25. Krystina & Nelli

    Krystina & Nelli Well-Known Member

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    She l.o.v.e.s them... the liver too :eek:
     
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  26. Krystina & Nelli

    Krystina & Nelli Well-Known Member

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    IMHO... I bet it’s the chic stock :eek:.
     
  27. Krystina & Nelli

    Krystina & Nelli Well-Known Member

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    ;):cat:
     
  28. Kathleen Einwich

    Kathleen Einwich Member

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    Well, I do have a slow cooker that I've never used, and it's an oval one. I'll look for some kind of recipe for that since I don't really know how to do that or how long it takes. But that is a good idea. Bet often seems to be hungry too soon after he eats. And he'll love the chicken itself as treats, I think - yes, unless I don't get to it myself first.

    Thanks so much.
     
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  29. Kathleen Einwich

    Kathleen Einwich Member

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    I don't know. I keep track of when and what I feed Bet and I only used it in the later, maybe 2, feedings of 12/4 and the first feeding of 12/5, about a tbp or two each time. That was it. Maybe that was enough.
     
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  30. Kathleen Einwich

    Kathleen Einwich Member

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    Thanks. Once I get back to my 9 and 9 time, I'll be able to do at least a +2 PMP test. Things went so well at first with all of this...the cats woke me up in the morning and we did our thing. But I have become so exhausted by everything, can't quite explain it, partly having to go out every day to get things related to the diabetes when I usually never leave the house and the rest?? Last night I set the alarm for 6am for a mid-test after Bet's shot at 1030pm and it never went off. I checked it and it was set for 6pm! I appreciate knowing that a +2 will be good and I won't have to get up at 3am to test. That I can do.

    It's near impossible for me to get back to sleep once I am up. I wish...
     
  31. Kathleen Einwich

    Kathleen Einwich Member

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    Nov 3, 2018
    I found this recipe. I can get a whole chicken at the local market and will do this recipe with the chicken and the water only. Great idea! I can get the ice trays at the local Dollar Store. Thanks so much!

    http://www.kitchme.com/recipes/slow-cooker-chicken-noodle-soup
     
  32. Krystina & Nelli

    Krystina & Nelli Well-Known Member

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    OMG! Been there :woot:!!! Sad/sorry to say... it makes me feel good to hear I’m not the only one :-|
    I get soooo mad at myself when I screw up >at Nelli expense :mad: :(
     
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  33. Joanne&TinySole

    Joanne&TinySole Well-Known Member

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    :eek: and "yuck" is right, but if they like 'em... alrighty then!
     
  34. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    As for the recipe you found, no onions or garlic for kitties. They can cause anemia in cats. Cats also have no need for vegetables in their diet. Veggies = carbs and cats are carnivores. I would eliminate all but the chicken and put the chicken and water in your slow cooker and then follow the directions. Also, you can use chicken wings or chicken legs which are likely less expensive.

    If you've not had a chance to look over the two methods we use for dosing, Tight Regulation Protocol or the Start Low Go Slow method, they may be helpful guidelines. With either method, it's important to get at least one test during the PM cycle as Chris was suggesting. Getting a +2 test may let you know if you need to continue to test. (If the +2 test is lower than your pre-shot test, it may indicate that numbers are heading down and you need to monitor.) Some of this comes with getting to know how your cat responds to insulin. Some cats also respond differently during the AM vs PM cycle. In addition, if you don't get tests during the PM cycle, you're missing half of your data and you have no way of knowing whether Bet's numbers are lower than may be safe.

    You are absolutely correct in that the learning curve for managing Bet's diabetes is overwhelming and exhausting in the beginning. It really does become more second nature. Like Chris, I moved Gabby's shot time to early -- 5:00 AM and PM. In part, this was because I work full time. It also allowed me to get some tests in before I left the house to make sure Gabby was safe since I was going to be gone throughout the day.
     
  35. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Here's Dr. Becker's DVM Bone Broth
     
  36. Kathleen Einwich

    Kathleen Einwich Member

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    Nov 3, 2018
    Hmm, interesting idea about the chicken legs etc. That's a nice alternative in case the market doesn't have the whole chickens. Thanks for that.

    I am retired and am here all of the time. Before this crisis I used to wake up naturally early in the morning around 8am and went to sleep around 10pm...but no more! It seems like time goes by so fast. Right now I'm waiting for mail delivery. I am expecting the syringes (recommended and linked by someone here) and glucose strips that I couldn't get locally, but ordered last week. Nearly out of the syringes - got the wrong type locally, twice. A very kind local lady gave me 10 of the proper syringes she had left over. I sure hope they get here today. No tracking by ADW Diabetes.

    Had to pay a young fortune for the strips at Wallymart on Tuesday. I had to buy 100 strips cuz that was all they had. I think I'll buy a cheaper meter/strips when I run out of these, though in a test comparison video the FreeStyle lite was the most accurate of three meters. The test was not done by the mfgr. The readings varied wildly. Does it matter?

    I've read the write-ups on the two different methods, but I really don't know what to do with until Bet's levels settle a bit. I have a feeling that the significant drop in his levels at one point were the result of an insulin...pocket, pod, what is it? I made it worse with the chicken broth maybe, because I never saw him drink any water and it scared me. I couldn't make a tent in his skin and he appeared to be so dehydrated. He's putting on weight, finally, though. I can see it, using the cat silhouette chart. No constipation either. I can make a tent now.

    Now that I know I will be testing +2 both in the morning and evening. I now know that it doesn't matter if he's eaten between shot times except for two hours before the AMP and PMP - that has made a difference. I thought he couldn't eat 2 hours before all tests.

    Thanks so much for all of your suggestions and help.
    Kathy
     
  37. Kathleen Einwich

    Kathleen Einwich Member

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    That is the coolest! Thanks so much!
     
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  38. Joanne&TinySole

    Joanne&TinySole Well-Known Member

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    Many people here are TR proponents, I follow SLGS because I allow grazing on low carb (4%) kibble (Young Again Zero and Dr. Else's Pure Protein).

    We had a Vet that recommended:
    1. We don't test frequently :woot:, and
    2. We feed a balanced prescription kibble :woot:

    I quickly learned how dangerous #1 was the first time I tested and Tiny was really low, and how ridiculous #2 was when Tiny's BGs shot up in the 200 and 300s!

    I can't tell you how happy I am to be here in this group, as Tiny has gone from 3.5 U (At those times) to 0.1 U recently.

    I don't feel like I know a lot, or even enough after 7 months of being here - its a lot to learn, chew on digest, REMEMBER and apply, but these kind and mostly patient people truly are like angels repeating all we newbies need to know over-and-over again, as much as it takes to help.

    The door of patience and loving kindness must be swung back and forth gently as we all move forward...singing kumbaya together! :rolleyes: ;) LOL...but I'm serious too!

    Hang in there. You are in the right place! ❤
     
    Last edited: Dec 7, 2018
  39. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Please let me make sure I was clear -- the +2 test is a "signal" that in some cases that numbers will drop. It's not a "rule." You still need to get some additional tests. It takes a while to get enough data so you have a reasonable feel for how your cat responds to insulin. If you look at Gabby's spreadsheet, you'll see that she had an early nadir. Her numbers could drop starting at +2 and her nadir was often at around +4. Her numbers could also dive very low. I knew to test a lot early in the cycle because of this.
     
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  40. Kathleen Einwich

    Kathleen Einwich Member

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    Nov 3, 2018
    Thanks. Ok, I'll try my best, at least getting more tests during the day. I made a mistake and bought the Consumer Reports best-rated FreeStyle Lite meter in the beginning and its strips are expensive (min $55 for 50, never in stock at Walmart). I just got 150 and that will last for a while. I'm moving Bet's tests back slowly to 8am and 8pm or further so I can fit more tests in. Any earlier is pretty much impossible - I've tried. I have a hard time getting to sleep if I stay up too late (3am last night and yes, I know, why didn't I do more tests?) but I'll do the best I can.

    It was so weird that Bet's levels dropped to normal for a while. I was so hopeful.

    I am really looking forward to making Chris&China's suggested bone broth for Bet tomorrow!
    Kathy
     
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  41. Kathleen Einwich

    Kathleen Einwich Member

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    Nov 3, 2018
    I'll wait for maybe 2 more days and test as much as I can. Bet's levels have been too high for too long. It scares me. I quit giving him any chicken broth on the morning of the 5th, and I see no further drop. No constipation. I think he needs to go back up to .75. I hate the new syringes. The marking on them is crooked. Oh well.
     
  42. Joanne&TinySole

    Joanne&TinySole Well-Known Member

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    Jun 19, 2018
    I don't think any syringe has perfect or the same markings because they are made in different batches. Even drawing the insulin is nearly impossible to get the exact dose every time...it might come close, and that'll do!

    We do the best we can and you are doing great!
     
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