4/03/13 Rags a beter day !

7:00 a.m. eastern AMBS - HI

He is eating

1.5 or 2 units ? I have to leave at 8:15 a.m. work, home by 1:30 p.m.

 

OK Rags AMPS was HI this morning even before any food.

So to continue last nights lesson from Carl , Rags needs to eat some food before he has insulin. He definitely needs more insulin not less because he is HI this morning already not less. So saying that I would go with the 2u not the 1.5u.

Do you understand why?

I have to leave by 8:00 myself this morning for work.

see below, I lost my bet. I owe you something. Maybe freeze dried treats fro Rags?

 

maybe it's too early but your second paragraph at the end really confused me.

Won't 2 units bring him down too fast ? He is only eating a can and 1/4. I hope he doesn't have hair balls again ! He is eating slow today. One bowl he didn't finish, he only ate about 1/4 of it. It might have been diff. food.

 

How much has he eaten already this morniing?

 

I just told you, 1 and 1/4. He looks like he would eat more. He is still sitting up waiting.

How may units ? I won't be home to catch him remember

 

Explanation to try to better explain why he needs more insulin this morning instead of less.

On 2 units Rags will drop fast but he is HI and can take this steep 200-300 point drop.

If he was only at 300, then 2 units might be too much this morning and he might drop 150 points

Then he would be at 50 points which would be a hypo situation.

It's a combination of knowing where he is a the preshot or right after he has some food on board and doing another test that determines how much to give him.

Like yesterday he was much lower in the morning at the AMPS test but had risen into the 400+ range after food.

You had done another test so that is why Hope had said it was safe to give 2 units. If you had not done another test and did not know what the number had risen to, then 2 units would have been too much.

Understand?

 

Morning Becki Just wanted to say hello & to have a great day :mrgreen:

 

so 2 units Right ? I'm gonna give him another 1/4 of a can if he will eat it.

 

Right 2u and more food is fine


At a HI this morning you are safe to shoot 2 u

Even if you are not around to monitor him.

I asked how much food because I was confused. :shock: :shock: and needed to clarify

 

Becki,

Yes, I agree it's WAY to early for some of those comprehension skills to kick in :lol: :lol: :lol:

and we are both on tight schedules this morning and need to get going

Please reread what I had said later and see if you do understand. If not, let us know so we can clear up the confusion.

Have a good day at work

I won't be back until this evening and then will be lurking.

 

Becki,

We are keeping paws crossed for a better day for you & Rags. cat_pet_icon

Misty & Rumpelteazer & the rest of the fur gang.

 

1:44 p.m. eastern BG HI

 

Okay...time to get him to eat a little...then give him 2 1/2 units....then let him eat however much he wants to eat between now, 2 p.m., and 5 p.m.

Little bit of a change and an increase of a 1/2 unit more today. Just make sure he eats first.

 

will 1/2 can be enough at first ?

 

Yes, and once he is through with that 1/2 can, then you can shoot him 2 1/2 units and then he can eat all he wants.

 

Becki, you will still need to wait a 1/2 hr. before shooting though. Always wait that 1/2 hr.

 

what if he won't eat after the inj. is that ok ? He didn't appear at first to be hungry that's why I'm asking.

Also he can't have inj. til 2:30 p.m. correct ?

 

Bj here; Hope needed to step away.

Please see how much he eats in that half hour and report back before shooting.

 

he ate 1/2 can, cause she said to feed him a little, then I asked her if 1/2 can was enough for now. he is waiting.

 

Re: 4/03/13 Rags - a better day !

Injection of 2 1/2 units @ 2:30

If he wants to eat more now, thats fine. He may have the rest of his mid-day meal. ( 3 meals per day, one before each shot)

We were wondering if you had contacted the vet yet.

 

NO, I have not contacted the Vet because Deb told me to wait.

Now, I'm really getting confused about the food. Hope said give him his unj. and he can eat as much as he wants until 5:00 p.m.

So are you saying he can only have another 1/2 until I test him again ? Deb said only 3 1/2 cans a day. He ate 1 1/2 this a/.m. and 1/2 at two.

 

Re: 4/03/13 Rags a better day !

You indicated he eats about 3 1/2 cans per day.

Divide this into 3 amounts - some for each shot cycle.

He needs to eat at least 1/2 can before a shot. More is OK, until 2 hours before his next shot.

 

NO, "I" said Deb said he can have only three and a half cans a day. So He eats more at breakfast, he gets 1 1/2 cans.

2:00 he gets one can.

9:00 p.m he gets one can.

The cat is starving.

This amount of food is what Deb said to feed him.

I just gave him his other 1/2 and he only ate about 1/4 of it. All his food has water added to it. not alot, enough to mmake it like apple sauce.

 

He is starving because he is not regulated; the insulin does not last long enough.

1) how much food do you think he needs each day?

2) Divide that into 3 amounts; 1 amount for each shot cycle

3) After a pre-shot, put down at least 1 can

4) temporarily pick up the food when he walks away

5) wait 30 minutes

6) give his shot

7) put back down any remaining food for that period

8) pick up the food 2 hours before the next test

 

Got an appt. with Dr. Ritter Saturday April 06, 2013 at 11:45 a.m.

 

Hi Becki,

How much did Rags weigh before diabetes?

How much does he weigh now?

Does he look skinny, like he needs to put on some weight?

Carl

P.S. - GREAT NEWS on the vet appointment

 

from her post on March 20th, 2013, 3:46 pm
"He was 16 Lbs., now. /13 lbs."

 

that is correct ! he looks thinner now. His skin is all white flakes, and his 4" long hair is in knots all over his poor body. I try to brush him, but he doesn't like it a whole lot.
Today when I got home I cut a HUGE matt out of him. He doesn't like that either. I feel so sorry for my boy, can't wait to get him on new insulin and I pray it won't be had to regulate him !! I just don't think his ears can take much more !!

I'm going to check his BG (relunctantly) at 4:30 cause of the new amount he got. If he got 2.5, it's soooo hard to measure.

Carl, how about his picture, is it hard or difficult to do ?

 

Becki,
Do you have a picture you can email to me? I will send you a PM with my email address. I can then shrink the picture and send it back to you with instructions on how to put it on the side of each of your posts like my pic of Bob and his guitar.

 

4:30 BG 332, he can have a little to eat can't he ? Hope said until 5:00

 

Yes.

What do you think he should weigh? 16 pounds?

 

B, I have no idea how much he should weigh. Hid coat makes him look heavier. I thought he looked a little overweight at 16 lbs., but now I think he looks bad.

He just bate 1/2 can ff with water and wants more. I don't want to give him anymore cause his sugar is finally coming down.

I'm gonna try to get his picture on here so you can see how big he is. This is when he had the weight on.

I'm feeding the other kids now, I'll be back.

 

3.5 cans of FF is around 280-300 calories depending on flavor

per Cat Info
"Required calories per day = [13.6 X optimal lean body weight in pounds] + 70"

which gives us
288 calories for 16 lbs
247 calories for 13 lbs

So 3 1/2 cans would be about right for a normal cat.
Since Rags is diabetic and unregulated, you might give up to 50% more over the day, except in the 2 hours before the next shot.
That would be 3.5 + 1.75 = a maximum of 5.25 cans, spread out among the 3 shot cycles.
So you may feed between 3 1/2 cans to 5 1/4 cans per day.

If he does not want to eat that much, don't force it.
If he were truly ravenous, he'd probably scarf 'n' barf - eat it so fast that he then vomited back up.

If you can feel his ribs and his hip bones easily under the fur, he's underweight.
If you can feel his ribs or his hip bones with some pressure, he's close to his ideal weight.
If you cannot feel his ribs or his hip bones even with slight pressure, he's overweight.

 

am i keeping him on his regular schedule ? 9:00 p.m. test, feed and a half hour later shoot what ? 1.5 0r 2 units. depending on test results, right ? He has been HI most of the day. he did eat 1/2 can at 4:45 p.m. of course he wanted more, but I wouldn't let him have anymore because of that. I just do not like him HI !!!!

Now when I go to Dawn, Dr. Ritter, what kind of insulin do i want, the Lantus, right ?

 

Yup. sticking to schedule. Dose based on pre-shot.
How's he behaving?

We think it may be easier for you to use ProZinc, as it is similar to what you are using, but lasts longer. That way, you'd only have 2 shots each day.

 

Re: 4/03/13 Rags - a better day !

Just checking - did you give him his mid-day shot?

 

yes, he got his shot @ 2:30 p.m. but at a higher dose, 2.5 instead ig 1.5 because he ran HI most of the day.

I thought Lantus was the BEST one to have him on ? that's all you spoke of. I don't want him to get the same insulin if it isn't going to do much better. I want to get him reg. and off some day, ya know ??? I'll see what Doc says.

 

Becki,

Lantus and Prozinc are much better insulin types than what you are using now.

And as far as the "best insulin?" The way I have seen it posted on the board is this:

The BEST insulin is the one that works the BEST on YOUR cat.

There are studies that show that Lantus has the highest rate of remission. That is true, but with this condition - that you follow the Tight Regulation Protocol for Lantus. But even if you don't follow that protocol, it's still a great insulin.

I have seen cats go "off insulin" with Lantus, with Levemir, and with Prozinc. There are benefits to each type.

The reason that we are thinking "Prozinc" is because we think it can work for Rags, and just as importantly, that it can work for you. The way it works is similar, but better, than the way N works. You would be giving two shots a day instead of three. It lasts longer and doesn't make the numbers drop as quickly as N.

But yes, none of us are vets. So of course, talk to Dr. Ritter and see what she thinks. Most importantly, find out which types of insulin she has experience with. And ask her why whichever type she suggests is the one she prefers you use.

And before you give her one penny for that prescription, please let us know what she says, and what she suggests as far as a starting dose goes.

 

Becki, I am so glad you got a vet appt on saturday. That is such great news!! I am so excited to see how Rags will do on a better insulin! Goodluck on saturday!

 

Carl & Bob did you get my boys pictures ?

 

Yes!
I just mailed one back

 

why did you mail it back ? didn't you like it ? ha,ha

Are you on with me tonite ? Til 10:00 ?

 

Carl, Haven't you done another shift change and you have to be to work really early this week?

 

10 pm is my curfew this week.

 

Yes Deb, my alarm is set for 4:30am. The ONLY good thing about it is that I get to see the sunrise!

 

I do bird banding in the spring and fall. Capture birds in a mist net, put a numbered band on them, take measurements and let them go. Been doing that for ten years now,on a volunteer basis. I'll be getting up at 4:30 myself to be out there at dawn. In the winter I bird band at a Mass Audubon sanctuary. Use traps that time of year, but boy!, do my hands get cold taking those birds out of those traps. It's worth it though.

Good thing Wink went OTJ for me. I was thinking I might not be able to do the bird banding this year.

I hate mornings! But the sunrise over the Merrimack River and the drive out onto the Parker River National Wildlife Refuge is awesome. I'm only volunteering one day a week at this point but it's a lot of fun. I get to teach other people how to handle the birds safely, teach them to take the birds out of the mist nets, and process them. I love seeing the birds up close so yes, I'll get up in the wee hours to do it.

We catch mostly the passerines migrating through, warblers, thrushes, robins, chickadees, woodpeckers, vireos, and other birds like that. Some days out there can be really quiet and then we sit around the banding shed talking and listen to the waves from the Atlantic crash on the shore. Nice!

 

I have to say, Rags has the most beautiful tail! Bob, being without tail, is extremely jealous! :lol:

 

I have used both Lantus and Prozinc.

Dose adjustment is different between them
With Prozinc, you may adjust the dose based upon both the pre-shot and nadir tests.
With Lantus, you adjust the dose after 3 - 5 days at the same dose, mostly based on the nadir, with some consideration for the pre-shot

Sliding scale use
Prozinc lends itself to sliding scale.
Lantus, because the effect builds up over several days, is rarely used on a sliding scale

Scheduling
Lantus shots must be as close as possible to 12 hours apart every day and changing the schedule needs to be done slowly to avoid complications from dose overlap.
Prozinc shot schedules are a little more flexible as it does not build up in the body.

I found the Prozinc to be more flexible, especially since Spitzer had a variable appetite, plus vomiting issues.

 

Deb, what an awesome volunteer job! We have one end of the island that is designated as a bird-protected zone, mostly due to the passing through of piping plovers. The two most popular birds for visitors are the brown pelicans and the painted buntings. People go crazy over the buntings.

I know just what you mean about the sound of the surf! If I sleep with the windows open, I can hear that from my cabin. Pretty sweet!

 

9:00 p.m. eastern BG 587, now what, I know feed him and shoot him, but how much ??

 

I think 2 units, Becki.

Go ahead and feed him and the others will most likely give their suggestions by the time his shot is due.

 

hello, is anybody home ?

 

We just jumped to page 2, becki. My answer is right above your last post.

2 units.

 

2 units

 

thank you Carl, why has he been runnuning hI the last two days ? food hasn't changed, this is what Im have a hard time understanding.

 

Becki,
This insulin just isn't doing the job. It doesn't last long enough. But we can't just keep increasing the dose because then it might push his numbers down too far too quickly.
What he really needs is an insulin that will last longer and on lower doses. And that's what we hope will be happening after Saturday's vet visit.

 

Hope, thanks, did you see Rags has an appt. this Sat. at the new Vets ?

 

So I should ask for the PZI ?

 

Becki, I've been here and checking all day, when I can, but we work out who is on to respond to you.

Prozinc would be easier right now for you to deal with, especially after using N. Lantus is dosed differently and you might have a much harder time understanding it and much more learning of that insulin.

Prozinc basically works like N.....preshot number, feed and you can shoot while he is eating....and then maybe do a spot test at +5, that can all be worked out. He won't go down fast and shoot back up. Duration is so much longer and much gentler on Rags body.

Lantus is not a guarantee of remission...quite a few cats have gone into remission on Prozinc. Too many people come on and want remission and do everything possible, everything correctly, but no remission. If remission is going to happen, it will. If not, diabetes is treatable and not a terminal disease like cancer. I have always considered a remission in a cat as a gift to be thankful for.

 

Becki, We want to see the pictures of Rags, now!

But it's getting close to your PM test, feed, shoot cycle so we'll have to be patient.
You could put a link in your post to your online account where you have your pictures stored.

Click on the URL symbol in the list where you compose your messages for step one.
Open a second tab on your computer to where your pictures are stored.
Highlight the web link address in the upper right hand corner in that long rectangular box by clicking on it.

Hit the ctrl and c keys on your keyboard at the same time.
Go back to the tab where your feline diabetes message board is open.
Your cursor should still be in the middle of the URL brackets [ ].
Hit the ctrl and v keys on your keyboard at the same time.
That will paste the weblink address in the middle of your brackets.
You have done a cut and paste from one web page to another one.

Preview the message before you send it. You should see the website link address underlined and highlighted in blue. If it looks good, you can submit your post as usual.

 

Deb,
Becki sent me three pics of her kitties. I shrunk one down and emailed it back to her with instructions on how to add it as her avatar.

Becki,
Did you get the email, and did the instructions make sense?

Would it be ok if I posted the two I didn't use so everyone can see your babies?

 

Becki,

sounds to me like prozinc will be much easier to use.

I asked Carl the difference between the N and PZI and here is what he told me.

Love seeing that longer duration with PZI. Sounds like a lot fewer variables in using the PZI then you have with lantus. Gosh, reading some of those condos over on the lantus tight regulation board, it sounds like people are jumping through hoops to deal with the lantus. Very, very complicated. I was lucky, only needing to be on that insulin for such a short time and being able to diet regulate.

Some of the people using lantus are feeding their cats mini-meals 10- 14 times a day, sometimes more. I wouldn't want to keep up with that type of schedule. Learning how to steer the numbers with food, new dose wonkiness, that very very rigid dosing schedule, the frequent overnight hypos, bouncing, many more tests to see where the numbers are going, having nadirs that can vary from day to day, shooting low, clearing bounces, new dose wonkiness, having to change your shot times for daylight savings time/standard time clock changes, and a ton of other things I know I have forgotten to mention. Holding the dose for 3 days, changing the dose and having it not work, having to change back to the last good dose.

It was mind boggling.

All this and sometimes cats are still not regulated on the lantus let alone achieving remission.

I think I'd stick with the PZI.

 

Sorry to bump yesterday’s thread, but these are common misconceptions about Lantus so I felt a need to respond.

First, Becki, I understand why they are suggesting PZI for you and your cat, and I think it is an excellent suggestion for you and Rags. I’m only responding to the generalities about Lantus use (and the reason I am responding is because I think there are others who believe the same thing).

Every Cat is Different, and Every Caregiver is Different too. On any of the Insulin Support Groups you will see people and cats at almost every level of Feline Diabetes treatment. There are people who are new and just learning, and there are people who have been here a while and are looking to take things a step further.

There are people on the Lantus ISG who “jump through hoops.” For the most part, they are people whose cats are challenging, for one reason or another, and the caregiver wants to improve the numbers so they are trying different things to make that happen. That is their choice, if they want to do it. If they want to post about it to get more sets of eyes and more ideas, they are welcome to do so. Brainstorming through challenges is a great way for us all to learn new things.

There are also a lot of cats, like Deb’s, who come in and go off the juice quickly, before we even get a chance to get to know them. That’s great too!

The people in between, who get their cats well regulated on the protocol, are not as visible on the forum because they don’t need help anymore! Those folks do not tend to post threads every day because they don’t need to, and they don’t tend to stay around much unless they are staying around with the intention of helping others.

I can see why people who just look through the Lantus ISG would think using Lantus is complicated, because that is what is most visible on the forum, but really it is not difficult and can be very flexible.

Not all cats will be regulated, no matter what insulin they choose. Hopefully one day we will get there, but for now we all just do the best we can do for our cat.

 

Libby I was not saying that all users of lantus need to jump through hoops. I was explaining that there are many factors to consider and learn if you want to use lantus.

What I wrote was more of a 'worst case scenario' then what every lantus user can expect. Without a crystal ball there is no way to know if Rags will be one of these worst case scenarios.

I know that many users of lantus, never even find this board. If they do, they may never post. If they do post they may ask a few questions and feel they can manage on their own. They may be one of the caretakers to have their kitty diet controlled after a short time on insulin. ECID

Also, EOID or every owner is different. Some can manage the complexities of using lantus if required. Some have work schedules that make PZI a better choice. Some are fearful and never learn to hometest. We are here to provide options.