? 18/7-Do I shoot Jake tonight?

Discussion in 'Lantus / Levemir / Biosimilars' started by KittyCatJake, Jul 18, 2019.

  1. KittyCatJake

    KittyCatJake Member

    Joined:
    May 3, 2019
    Hi, I'm still pretty new to this and had it pretty much under control til Jake started on prednisolone for his cancer almost 2 weeks ago.....numbers have been hard to manage since then. Tonight, pre-shot he was at 10.9...in the past, vet told me not to shoot til he's over 12, so I left it an hour and re-tested and fed in between, but he went down to 9.9. It's now 8:20pm here, so if I don't do it now I'll have to skip his morning shot as I have to leave for work by 8 tomorrow morning. Would love opinions as to what I should do!
     
  2. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Hi.
    When you are stalling, don't feed any food and then test again in 20 mins to see if the numbers have come up. Once you feed the numbers are food influenced and that makes it hard.
    You don't mention in your signature if you are doing the TR or the SLGS method. As you are new and haven't a lot is data I will go with the SLGS method for tonight. So that says don't give any insulin if under 8.3 (150).
    If between 8.3 and 11.1(200) you can give nothing, give a token dose (10-25% of the usual dose) or test, feed as usual and test again in a couple of hours and decide on what to do.
    So probably you can skip or give a token dose....if you wait 2 hours it will throw you out with your timing.
    Are you able to test if you give a token dose of insulin tonight?
     
  3. KittyCatJake

    KittyCatJake Member

    Joined:
    May 3, 2019
    Thx for your reply! I'm not sure what method I'm using tbh. Vet had me giving same dose every 12 hours apart. I think his prednisone is throwing the numbers and making 12 hours worse than the other 12 hours. It's now almost 9pm....I could give token dose, but latest I can dose him tomorrow morning due to having to go to work is 7:50am....should I do it in those circumstances, or just start him again at 6am tomorrow? He had been at 7am /pm, but I'm hoping if I skip a dose it's ok to move timing up by an hour tomorrow and do 6am/pm again.
     
  4. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    If you skip, you can start tomorrow with the new times of 6 am and 6 pm. That might be best as if you gave insulin now, you couldn't give it at 7.50 am tomorrow.
    Looking ahead, are you able to do any tests during the day or evening cycles?....as Lantus is dosed on the nadir ( lowest point in the cycle, not the preshot. It is possible Jake dropped low today and then came back up to the 10.9 preshot but there is no way of telling unless you test. I know it is hard if you work but getting tests in during the evening cycle is good too. Always get a before bed test in to see if Jake is going to be safe overnight.
    Giving prednisone can stuff things around too.
    Do you have any higher carb food and honey in case of a low number?
    This might be helpful to read
    http://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216680/#post-2408690

    Also have a look at the sticky at the top of this Lantus page and see what method suits you, then pop your choice into your signature so we can see.thanks.. If you work long hours the SLGS method might suit better. Please don't just stick to the 2 units without taking into account the lowest point in the cycle. That will tell you if the dose needs to br increased, decreased or left the same.
    Ask lots of questions.
     
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  5. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    I think @Wendy&Neko gave Neko prednisolone so she may behave some tips.
     
    KittyCatJake likes this.
  6. KittyCatJake

    KittyCatJake Member

    Joined:
    May 3, 2019
    I so appreciate your help! I will dose him again at 6am. One of the reasons I haven't been testing much the last couple of days, is due to the fact that poor Jake is being grabbed and prodded and dosed over with numerous drugs and eye drops and ointments and insulin, over and over again all day and he isn't enjoying it at all. I'm not great at the testing and draw more blood from myself each time than from him.....and he struggles. Though he had a great week last week, he's battling the cancer hard again this week and not doing as well as I'd like. I hate upsetting him and want him to enjoy his days as best he can and feel like I'm ruining life for him by poking him all day. Sometimes I have to poke like 10 times to draw blood....I have watched the videos and read all the tips, but still struggle with it....I thought it might have been the lancing device I'm using, but saw a youtube video with someone else using the same one without a problem. I'll try to do some more testing on the weekend (easier then than during work week), but he also has his chemo appointment Saturday, which also involves a long drive. I put some whiskas food with gravy down for him about an hour ago but he wasn't interested. He got about a half tin of a/d syringe fed to him about a half hour after his pre-shot test. But the numbers still went down?! I will buy some honey in the morning.
     
  7. KittyCatJake

    KittyCatJake Member

    Joined:
    May 3, 2019
    Should have added, can't really test him much more tonight as I'm about to go to sleep....I'll test him just before I do....and then when I wake at about 5am should I do it again?? Or just wait til 6? Keeping in mind the poor guy's life is already pretty hard at the moment due to the cancer sadly.
     
  8. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    It's hard when other things are going on.
    Do you have some higher carb food as well? The fancy feast gravy lovers are higher carb.
    Re the testing. What size lancet are you using.? When you first start out, it is best to use a size 26 or 28 gauge lancet as it will bleed easier.
    Also are you warming the ear first before poking? Get an old sock and fill the toe with rice and warm for a few seconds in the microwave. Make sure it is not too hot, then place on the ear to warm it. You can also milk the ear......gently rub the ear one way to help the blood go up to the tip. Hold the ear gently with a cotton ball after testing to stop bruising
    Are you testing in one spot each time? And giving a treat every time, even if there is a no blood. I used to give Sheba a small treat in her bowl and test her as she ate it. That way she was distracted.
     
    Sue and Luci likes this.
  9. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    There is no need to test tonight if you haven't giving any insulin.
    Then test at 6 am
     
  10. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Do you leave food out for him at home when you go to work?
     
  11. KittyCatJake

    KittyCatJake Member

    Joined:
    May 3, 2019
    Just woke and tested him....he was at 19.6....so I reduced his dose back down to 1.5 today. Yes, I do leave food out for him while I'm gone, but sadly, due to his cancer, there are days when he isn't interested in eating off a plate and he relies on a/d being syringe fed. He ate off the plate for about a week (for the first time in over a month) after starting the steroids, but the last 2 days he isn't as interested. He goes back for more chemo tomorrow and I hope they can give it to him as I fear his tumors are growing back.
     
  12. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Sending many vines that the cancer is responding to the chemo. Poor boy. It is a terrible disease. Please keep us posted.
     
    Krystina & Nelli likes this.
  13. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    No, Neko could not have prednisolone due to her heart condition. She took budesonide, and steroid that acts locally in the GI, so not an option for Jakey. I hope it's prednisolone he's getting, not prednisone. The two are formulated differently and it's prednisolone that cats should get, the other is for dogs.

    I see you notice lack of interest in food. Is he getting anti nausea medications? Both Cerenia and ondansetron are good, though Cerenia is more for vomiting it also helps anti nausea. Neko ended up on both.
     
    Bron and Sheba (GA) likes this.
  14. Figaro's Liz

    Figaro's Liz Member

    Joined:
    Jun 18, 2019
    I'm so sorry that Jake is having such a hard time right now. It sounds like you are doing so much to help him to feel better, and that is amazing!
    My Figaro was diagnosed a month ago with diabetes and it has been a challenge, I completely understand not wanting to poke your precious kitty. Truly it does get easier. I couldn't even test at all, just a few weeks ago, and now I can multiple times a day, and Figaro will be better for it.
    One thing I have read is that cats don't actually have lots of nerves on the edges of the ear, where we poke, but many are of course irritated by being touched on their ears. So when I started out testing Fig, I would rub his ears as part of his petting sessions (outside of test time) to get him more used to it. Treat after has been important for Figaro, if Jake doesn't have an appetite for food treats, is there some other reward like pets or praise?
    Another thing, some people sing to their cats at test time to loosen their own nerves and calm the kitty as well. They can sense when we are nervous, so remember to take a deep breath and remind yourself that you are doing this for him, and go in confident (fake it til you make it!!).
    Just generally, maybe you could prescribe yourself a set amount of uninterrupted quality time with Jake as part of his treatment... whatever he likes best, whether pets, or watching the birds, or you singing to him... just non-medical time, no reading articles about cat health or texting. Could just be 10 or 15 min. It's been important for me and Figaro.
     
  15. KittyCatJake

    KittyCatJake Member

    Joined:
    May 3, 2019
    Bawling hysterically here....just had to prick Jake at least probably 50 times to get any blood, though plenty of blood came out of my own fingers. Warmed them nicely before hand so I don't know why the hell they won't bleed. So upset cause I think he thinks I'm torturing him. Tried to get a better lancing device at the chemist a few weeks ago but they had no idea what I was talking about. Will try some more chemists tomorrow to see if I can find a chemist who knows what I mean. Can't thank u enough for your help. Between this and managing his cancer I'm starting to feel very overwhelmed.
     
  16. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Count me in as one of those who cried a lot to start.:bighug: Then there is my squeamishness about blood. :oops:

    What size lancets are you using? To start, the larger lancets, smaller number, as easier to use. Over time and as more capillaries form in the ear, you can go to thinner lancets.
     
  17. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    I’m sorry it is hard for you.
    It’s not the device you need to change but the little blue lancet. Ask for size 26 or 28.
    Keep trying. It will come.
     

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