Bella’s BG journey part 6

pmps BG 534.. wow

 

Ignore this black. It’s a bounce from the fast drop this AM.

 

Well, it’s not black. Keep 0.5 u today.

 

Something to keep in mind: your pet meter will read quite a bit higher at high BGs than your human meter. That's why you shouldn't get too fussed by a red or black. Those might be pink with the human meter. Focus on the low numbers. They're the ones that tell you what the dose is capable of. Novolin works in such a way that highs PSs are almost a given. Most kitties won't have a flattish curve on Novolin.

 

I’m gonna work really hard to get his insulin changed as soon as I can

 

If you decide (with the new vet's help?) to try Lantus, call a number of pharmacies to see if they'll sell you just one Lantus pen (out of the 5 pack they come in). It holds 3 mL (300 units) and would last a very long time at the low dose you give Bella. A full vial is too expensive and too much insulin. It'll expire long before you finish it and that's a lot of $$$ wasted.

It's possible the new vet might recommend Lantus and might sell one pen to you. It'll still be expensive but a lot less than a vial. One thing we caution against is buying Lantus that's been taken from a vial and put into another container in smaller quantity. It's too easy to contaminate it.

More stuff to think about ...

 

I also forgot to tell you, I left a snack down in case Bella needed it
Thanks for the info, didn’t you tell me it was cheaper if I bought it from canada

 

Yes, it is but you'd have to buy the 5 pack of cartridges/pens. They won't sell only one cartridge. That 5 pack plus shipping would be about $180 (CAD?). When some people want to try out Lantus before buying too much they sometimes buy from a person called Alan Hamman on the Supply Closet forum. No issues with insulin quality or shipping apparently. That's a possibility for you.

 

Just to give some more numbers, a single pen at one US pharmacy near me costs around $90. So, definitely more per-unit, but a single pen can last a long time if Bella stays on the kind of dose she's been on with Novalin. You can call around to different pharmacies to get pricing info-- not a bad idea anyway, as not all will sell a single pen.

 

Mind me asking if it’s a chain pharmacy

 

Wegmans-- supermarket chain in the northeast.

 

Nope we don’t have, thanks

 

PMPS 549

 

I see the black. I can't say for sure because you'd need to have mid cycle data but either:

1. he dropped quickly and fairly low earlier today and is bouncing back up with a vengeance OR
2. the dose is a little too low and he's lost duration.

In the interest of safety because you can't test in the daytime stick to 0.5 u for now. I suggest that any day you can't test during the day make a point of testing in the evening before bed.

 

Check pet pharmacies for lantus pricing as well. You will almost definitely be able to buy just one pen. So far my vet called in to a pet pharmacy about 40 min from my house. They were $107. After I bought the first one, I checked into prices at different places. I figured I could find it cheaper. I did find it cheaper, or so I thought.
I went to Walmart and explained my cat is a newly Dx diabetic and I was looking for cheaper Lantus. Somehow they came up with 3 pens costing about $250.
I'm thinking, "great, I'll get a script from vet and fill it here." You would think the ding-dongs working in the pharmacy would have told me they only come in boxes of five. When I went to get the script filled is when I'm slapped with over $400 for a box. It gets better (sarcastic). I don't have over $400. I only have one or two doses left. It's Friday at 2:45pm. The pet pharmacy closes at 4:00. My kid needs to be picked up from school at 3:45. I call the vet office and explain to the receptionist what happened and ask to have them call the script in for me. She told me they were short handed but would try really hard to get it called in asap.
Thankfully my husband was able to pick our son up. I headed to the pharmacy immediately. I figured if it didn't get called in, in time I would give them the written script and tell them I wasn't leaving without my cats Lantus even if they were ready to close. Lol it all worked out. The pharmacy called me while I was on my way there to confirm.

 

Kris, I contacted the guy u said about the lantus 48.00 shipped that's really good, also gave Bella . 75u as hubby will be home to test, I told him +4 hope that was a ok number

 

It’ll be very interesting to see that test. Because this is a dose increase I’d suggest a +2 first to see if he’s dropped a lot. A lot means 100+ points. He’d need a little snack if that’s the case. I know hubby doesn’t like poking Bella but that test is important.

 

He is testing now, should I have not increased?

 

I suggested two possible reasons for the blacks in my post #14. One was that the 0.5 u might be too low right now. Your husband is home to monitor today so trying the higher dose is fine - good data to have. If no one was going to be home today, I suggested sticking to 0.5 u.

OK. I see that red 404. Was it a +2? I ask because it's in the +3 slot on your SS. It's a large drop but still a high BG so my advice would be to not give a snack and test again at +4.

 

+3 +2 had already passed

 

OK. Then maybe a +5?

 

+4 306

 

Hmmm ... interesting. He's coming down but in a much more moderate fashion. Any other tests hubby is willing to do would be good. No pressure.

 

When do you want it

 

I told you bella was crazy lol he doesn’t want to be like other cats, like nan said he likes different colors lol

 

How about +6?

 

I see the yellow 269 at +6. You can leave him alone until PMPS I think. So far this curve is a good shape (nadir about 50% of AMPS) but numbers are high. There's no drastic drop and that's good. I have no idea why a slightly higher dose is doing this but it is what it is. I'd keep this dose tonight (numbers permitting) but get at least a +2 this evening. You want to know ahead of time if he's going to surprise you with a dive.

 

I know this is stupid but what is ment by nadir about 50% of amps mean

 

Nadir is the lowest number during the cycle after giving insulin; or at the half way point. Ecid. That number should be half of the am blood glucose number. Say Bella is at 400 at amps, at nadir she should be at 200 bg. Baby usually has her lowest numbers at hour +7 so that’s her nadir.
I purchased my insulin from Allivet- it’s a pharmacy in Florida. They were the cheapest I could find for me. I looked up the price of a Lantus pen & its $97.99 there. Add shipping which shouldn’t be too much?!? Can’t remember but it would be close to you. It would last a long time at Bella’s dose.
But people also buy from the supply link here on the board a lot cheaper. I would trust that from Alan, no negative responses I’ve ever heard.
Just an FYI, for the pharmacy, my vet called in the script & then it was confirmed by e-mail. Plus they give you a number to call. There’s no promises in this sugar dance but I have a strong feeling that Bella would have better regulation. I know you’re struggling & I’m just trying to help. If Baby wasn’t already on prozinc I would certainly give Lantus a go, probably will in the future! It’s more expensive I know...but the results may be worth it. It wouldn’t hurt to call your vet & just ask what their opinion on changing would be. You can always decide at a later date... or let them know you’ll think on it.

 

Not stupid at all. When a curve or sequence of BG numbers in a cycle is being evaluated we look at how the highs and lows compare. It varies with the insulin so one like Novolin will give a significant difference but one like Lantus won't. For Novolin, a nadir BG that's about half the level of what the PS was is the right balance. That shows he dropped but not by too much. If all the BGs were shifted down a few notches so that the PS was low yellow and the nadir was low blue or high dark green that would be a set of ideal numbers.

 

Yes what she said!!

 

Well I’m ordering the lantus and going to vet sat, Kris you were probably right what you said about keeping in good with him
Becky, thank you so much for info

 

New vet or usual vet?

 

New

 

Great! Whole new world and a fresh start.

 

I think it will really help & hoping this is a very knowledgeable & kind vet! Keep us posted my dear! You’re the best cat momma! Kris too!!

 

Thanks and baby has an awesome mom as well

 

We are all awesome parents, this isn’t an easy thing and we love our little sugar babies enough we do whatever we have to do and the sound of that purr makes alllllll worth it

 

Pmps 488 dosage?

 

You could try 0.75 u again and get a +2 test. If that isn't myuch lower he should be OK overnight. If that worries you, go to 0.5 u.

 

What would u do

 

I was away from my computer so I'm only seeing this now. I see on your SS that you gave 0.5 u. That'll be fine.

 

I bought the lantus today from that guy today

 

Good. It's one pen, right? You can use the same syringes because Lantus is U100 like Novolin. It's best not to use the pen needle mechanism. Let me know when it arrives.

 

His numbers today are horrible +2 433
I,will let you know when it comes, yes pen

 

It's just one number. No stress required.

 

I’m just so hopeful with the Lantus for you! That’s all- can’t wait to see his #’s then!!

 

BG over 600 this am..OMG WTH

 

He'll come down-- at least he does show some response to the insulin, so there's that.

 

Can’t wait to see doc sat and get this insulin changed to lantus and see if that helps, I worry myself literally sick over this, these stupid numbers are gonna put me in the grave, I HATE DIABETES

 

I worry he will get a uti again the last time the vet said because sugar got into his urine and that caused it, so with his crazy numbers I worry it will happen again and he just got over one, very hard for me to keep up financially and always worry I won’t have the finances when something happens cause u never ever know, I started bella on uromax this am which he hates and I guess I’m doing the right thing I also pushed water on him, he is such a super trooper to let me do whatever to him, he trusts me 100% I read horror stories on here about cats not liking any of this and not cooperating at all so I’m truly grateful for his, I’m just rambling this am and frustrated, I want him to be better so so so much

 

I’m sorry this is so challenging. I think going back up in dose was right. I’ve read that some people here give a supplement called d-mannose to help with UTI problems. I think it’s related to a cranberry extract or something. Try putting that into the FDMB search bar in the upper right of this page.

Hang in there ...

 

Here's a link:
https://www.amazon.com/NOW-Foods-73...946&sr=8-4&keywords=d+mannose+powder+now&th=1
@Sharon14 and @Squalliesmom use it.

 

I ordered some

 

I don’t give it all the time, but when I do I give 1/8-1/4 tsp twice a day.
Lucy gives it to her cats daily I believe
HERES an interesting article

 

+5 184

 

What does coq10 help with in cats

 

Lol with as good as you guys are I forgot about looking up on google lol lol I found what it’s for

 

We are +t 184, no treat right

 

Coq10 is for arthritis I think. Cosequine

 

@Sharon14 - Thank you for the d-mannose advice & info! I got some for Baby just as a preventative.

 

This is interesting

 

Well it’s not what I thought! I thought it was for arthritis but this is for heart! Interesting & thanks for sharing- I’ll remember that now! Sorry for that! And bg too! My vet said Baby’s heartbeat was good & strong for her age. I was glad to hear that!

 

Did you see where it supports blood sugar balance

 

I don’t know if it helps, but it doesn’t hurt, so what the heck. Colin has acro and heart problems are one of the many complications. Also says it helps with gums and since he can’t have a dental (due to heart) I thought I’d give it a shot. THIS is the one I use. There’s a stronger one too, I think.

 

I've been out. Interesting supplements. I had no clue about d-mannose when Teasel was having bouts of sterile cystitis. His sister has the odd mild episode so it might be good for her.

That blue 184 today isn't bad.

 

Yes bg- blood glucose...amazing! That’s good stuff! I need some! Lol I’ll do the other first & see how that goes.

 

Stick with. 75?

 

Yes, I think that's a good dose for now.

 

He is over 600 again

 

It's hard but ignore those highs. He got down to 184 today and that was good. The low number is more important in judging the dose. Also you don't want to switch doses too close together - it can make for more erratic BGs.

 

Lantus will be here tomorrow

 

I was reading about the tight regulation protocol for lantus, is that what most people do or what you guys suggest

 

Tight Regulation means minimum three tests a day and doses are changed more frequently as numbers indicate. It's meant for cats that get NO dry food of any sort. The SLGS method requires a full curve about weekly and dose changes happen then if needed. TR means you give insulin on some low PSs and don't reduce unless BG is quite low. There's more of a margin with SLGS.

Ask yourself if:

• you can get three tests a day minimum (if daytime is impossible then a late evening test is essential)
• you're up for being more aggressive in dosing at lower BGs
• you can remove all dry food from Bella's diet - if not, then SLGS is the one to try.

You also have the option of starting one method and switching later on. I strongly recommend you try one and stick to its guidelines strictly to get the best effect. If it proves to be a poor fit for your schedule then try the other.

The Lantus forum is the best place for advice once you switch. There are a ton of experts there who can guide you every step of the way. It's a large, busy forum so that takes some getting used to but it's worth it, especially as you're learning the ropes. There are people there who post every day and have for a long time and there are others who drop in when they get stuck and need help.

 

TR is a bit nerve-wracking at first (you build up to shooting quite low numbers-- most people with well-regulated cats shoot greens most cycles!), but you do test enough to do it safely. Once you get going with it, it's an excellent method for acheiving good regulation and, in some cats, remission. The mantra for Lantus and TR is "shoot low to stay low"-- Lantus works very differently than the Novalin you've been using. Where Novalin is good at bringing numbers way down, Lantus isn't so much. What it is good at is bringing numbers down gently and then holding them. Once you find the right dose (either using TR of SLGS), it's possible for some cats to basically keep them in normal BG most or all of the time, helping the pancreas to heal. Between the two dosing methods used, TR is a bit more geared to this goal.

That said, I don't think I'd recommend jumping directly into TR if you continue to use the pet meter for testing. It can certainly be done safely that way, but most folks who will be giving advice are much more used to human meter numbers, and while people do make an effort to check what kind of meter you are using, confusion and just habit can lead to a lowered level of vigilance on pet meter numbers. So, just to start, while you're getting a feel for how Bella responds to Lantus, I'd either do the SLGS method if you're going to stick with the pet meter, or TR if you're going to use the human meter. [Note: SLGS strategies were also set using a human meter, not a pet meter so there will be the same difficulty in "translating" the method to pet meters. I just, personally, think that SLGS has a bit more wiggle room than TR, and is thus easier to port over to pet meter numbers]

 

Nan brought up the important point about meters that I forgot to mention.

 

I do have a human meter so needed I could switch it

 

I wasn't clear/complete here. Should really say: "SLGS method if you're going to stick with the pet meter, and consider TR at the beginning only if you're going to use the human meter"

 

When I switch to lantus do I not post on here anymore, I do it on the lantus forum? That freaks me out lol I’ve come to trust Kris, nan, Becky etc , but Nan I see you use it

 

I should say I want to use whatever method is best for bella not worried what all I have to do, I just want him more regulated and I’m willing to do whatever it takes

 

You can still post here! I'm actually mostly here, not the Lantus board (too busy for me, too!). If you post on Lantus, though, I'll be sure to keep an eye out for you!

 

Well so much for the TR as I’m not able to test like +3, +6 like it states so with that said will have to go for the SLGS

 

Ok, he goes to vet on sat can I start the lantus sat am before vet appointment and if so what dosage ,sorry I’m gonna have a lot of questions

 

Another clarification regarding where to post: you can still post here, but posting on Lantus will give you lots more eyes on Bella, at all hours, and as Kris says, many of the folks over there are quite expert. The thing to keep in mind is that, if you do post over there, you will want to keep all questions/discussions of insulin, dosing, BG, etc. over there (you can still post questions about other health concerns here). This is because not everyone there checks here, and it's really important to be able to see the whole story when giving advice-- you don't want one group of people advising one thing on Feline Health, and another set giving contradicting advice on Lantus!

 

HERES some good info for how to maneuver in L&L

 

Thank you, gosh sounds way more complicated than this one, a little intimidating

 

It's just because it's so busy-- they have to keep things organized. Some of the more active members may be following the progress of a dozen or more cats at once, it gets a little crazy!

 

Looks very busy
What does do u think I should start him on, I want to start sat. My vet appointment is not until 11:30 and he needs it before we go

 

0.5U would be reasonable.

 

Last question of the day lol
If you follow someone will you will be notified wherever they post a new thread if that makes since
Meaning if I post on lantus thread will the people following me know it

 

I started Diamond on Lantus. The Lantus forum intimidated the crap out of me. I didn’t head over there for almost a month. Even the format in which you need to start a thread had me worried. Lol But I had an urgent question one day and jumped into Lantus Land. I will say, posting there has helped me a lot. I actually test more and put more in my SS. I’m not going to lie, some days your thread will get buried. I have a few peeps over there who “keep an eye” on me. I have something important that needs to be addressed, they will reply. Or, I just tag them. I will keep an eye out for you.

 

I agree with Nan about: 1. trying 0.5 u as a starting Lantus dose and 2. posting on Lantus for all dosing advice. I visit that forum and comment occasionally but rarely give dosing advice there.

 

Thank you so much, yeah I was looking at the thread headings and thinking omg

 

Your cat weighs 23lbs wow would love to see a full pic lol

 

I compare the Lantus forum to a busy freeway. This forum is like a country road.

 

But I can stay here with you guys unless it’s something you guys don’t know or such right, let me get used to the new insulin first, I don’t want to be worrying about both lol

 

Yes, you can.

 

I turned around while I was preparing “snack” just now and was able to snap this shot. I am very excited to see him sitting up! His neuropathy has been so bad he usually can’t sit up for long. The other day I caught him pooping in normal cat posture too (normally he has to lay down to poop and pee). If you look closely at his front paws, you can see he is not totally on his foot.

 

Omg, so stinky cute, a butterball lol yeah I worry about neuropathy in bella but if it happens it happens we will deal with it, I might be asking something i shouldn’t but how does he get around, I’ve never seen a cat with neuropathy

 

It’s totally fine you asked. I guess it would kind of be like us walking on our knees. Thump, thump, thump is what he sounds like. Under the kitchen table I have bed for him. I removed the chairs from one side. My hubby is not thrilled. His food and water are about two feet away. I also have a litter box next to the table. Hubby is not thrilled about that either. But, it's box in kitchen or Diamond pees on the floor. He also likes to spend time on the stairs. Those are about 5 ft away. He figured out early on how to get down the first few as this is his “safe” spot now. I’m pretty sure he fell down them a couple of times too. Now he can make it all the way down if he wants to. He only does that if he gets scared or wants to use the box down there. Before Dx he would almost always hiss and run away at the sight of anyone but me. He hid in basement all day and would come out at night. In a weird kind of way, his neuropathy has been a blessing. He is way more social and less scared of everything. There is no way I would have been able to test him as often as I do if he was fully mobile.
In the beginning I would carry him from the stairs to under the table. Now I make him do it himself. I was totally shocked the other day when he made it all the way from the bottom. The past week or so I’ve noticed things finally starting to improve. I was told over and over when he starts getting regulated thing will start to improve. And wouldn’t you know, he is finally getting regulated!