?Dose Advice Needed, New to Vetsulin

Discussion in 'Caninsulin / Vetsulin and N / NPH' started by Really Riley, Feb 4, 2019.

  1. Really Riley

    Really Riley Member

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    I used to give Riley Glargine insulin, but switched vets and the new vet insisted on Vetsulin (plus I must use AlphaTrak2). Just started Vetsulin with the evening injection on February 2. When the vet gave me the insulin and syringes she didn't give any instructions other than telling me to give him one unit twice a day. I didn't "shake" the Vetsulin because you don't shake Glargine. I wasn't near any internet connection. If I had been, I would have checked here before starting. I gave him one unit twice a day morning and evening three times, watching his glucose climb higher and higher. I decided this morning to increase to 2 units because he's never had blood glucose this high for this long and increasing that much with Glargine in the past has not had a huge effect. I turned the vial over in my hand a couple of times because it seemed to be "cloudy". When I did this I mixed the ingredients so the insulin would have proper effect, but I didn't know it at the time. When I checked him mid-cycle, his glucose was 29. I gave him Karo syrup on top of some canned Friskies. After an hour he was OK. Now I'm not certain as to what to do this evening. I've read the information for newcomers regarding glucose and dosing levels, but this Vetsulin is evidently SOOO different from Glargine I'm having difficulty wrapping my head around it. Thanks for any advice.
     
  2. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Hi. That was quite the scare you got today. How long ago did you get that reading of 29 and have you checked Riley's BG since. If not please check it again now and let me know the reading. More to follow.
     
  3. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Was Riley showing symptoms of hypoglycemia before the reading of 29 or did you just happen to test at that time?

    I'm glad you treated him with karo and the Friskies but you need to keep an eye on him as Vetsulin can have another slightly BG lowering effect later in the cycle (around 8 to 9 hours post shot) in some cats. You also need to make sure Riley's BG is staying up on its own as the karo will boost BG but it won't last. The Friskies will certainly last longer but might not be high enough in carbs to keep BG from dropping again.

    Vetsulin is known as an in and out type of insulin whereas Lantus (Glargine) is a depot insulin. Vetsulin acts on the BG very quickly and can cause very dramatic drops in BG (what you saw today) whereas Lantus takes a couple of hours to start having an effect and it's much gentler at bringing BG down.
    If you did not mix the Vetsulin before previous shots, it's quite possible, even likely, you were not seeing the "real" effects of the 1u dose you initially gave. It's abundantly clear that 2 units is too high a dose.

    With the AT2 meter, normal BG range is 68 to 150. While using Vetsulin, you need to allow yourself a bigger safety margin than when you were using Lantus and with the pet meter, I'd suggest that right now it might be prudent to skip the shot if BG is below 250. That number can be lowered later but for safety purposes until you see how Riley reacts it's better to keep the no shoot number up a bit higher.

    That said, a low reading of 29 on the AT2 meter is very low and that can make kitty more sensitive to the insulin so I it might be prudent to skip the shot tonight but before we make a final decision about that, can you please tell me if Riley has ever had an issue with ketones or DKA (diabetic ketoacidosis).
     
  4. Really Riley

    Really Riley Member

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    He did not show any symptoms. I was testing at 6 hours, figuring that would be close to nadir. I did check him one hour after giving him the Karo and Friskies, and the reading was 150. I figured that he would continue to climb after that. I did not know that Vetsulin could lower his BG again later as I thought that once past the 6-hour period, his BG would continue to climb. Right now he is about 11.5 hours post AM shot. I have been watching him, but since he didn't show any signs previously, he probably wouldn't now. He's been nibbling at more Friskies, but I took it off him planning to not have him eating close to pre-shot testing. I did read about the fact that a serious low could make him more sensitive to the insulin and that had me concerned for tonight's dosing. He has not had an issue with ketones in the past. I used to test for that frequently but he was always negative so I haven't for a while. Hope I've answered all your questions - if not, let me know. Thanks.
     
  5. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Great! Glad to know ketones &/or DKA have not been an issue for Riley.
    We recommend withholding food for at least 2 hours prior to pre-shot testing so you can be sure the pre-shot number is not food influenced so I am glad to hear you removed food for that purpose.:)
    Are you using syringes or the Vetsulin pen to give injections?
     
  6. Really Riley

    Really Riley Member

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    U-40 syringes
     
  7. Really Riley

    Really Riley Member

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    I realize that I'm going to have to do a lot more testing. His ears are getting harder to get blood from. They still have a lot of little hard red spots from the last curve. That stresses us both out.
     
  8. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    When testing make sure you hold light pressure on the poke spot after testing for a few seconds. It will prevent bruising and ear soreness. You can also apply a tiny skim of Vaseline where you intend to poke to make the blood bead up rather than spread out into the fur.

    If you can test before every shot to make sure it is safe to give Riley insulin, and at least once again each cycle, you will be fine. This isn't about filling up the SS with readings. It's about doing appropriate testing to keep Riley safe and healthy.

    How far after this morning's shot are we now? (hours not time).
     
  9. Really Riley

    Really Riley Member

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    13 hours - This morning's shot was an hour earlier than normal because we had to leave for an appointment. I am going to test now to see what's happening.
     
  10. Really Riley

    Really Riley Member

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    His BG is 104. I don't believe I should be giving him any Vetsulin tonight.
     
  11. Really Riley

    Really Riley Member

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    Unfortunately tomorrow morning we have to leave again for another appointment and I won't be around to test him for at least 6-7 hours post shot. If I don't give him a shot tonight, his BG should be high enough for a shot tomorrow morning, but I don't want to spend the next 6-7 hours worrying about what's happening with him. The difference between his reaction to glargine and vetsulin is scary.
     
  12. Kris & Teasel

    Kris & Teasel Well-Known Member

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    No shot tonight if this is his pre shot BG level. He’ll likely be high tomorrow AM as you said.
     
  13. Really Riley

    Really Riley Member

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    One more question. The next time I do give him a shot, should I go with one unit or scale it back to 1/2 a unit and leave it there for a couple of cycles to see what happens? I'm just wondering if he now will be sensitive. The vet made a guess at one unit because of his weight and his resistance to the glargine I think.
     
  14. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    For some reason I didn't get notifications on your posts. :mad: Glad @Kris & Teasel was here to help you.
    Given that low today, I would be inclined to reduce the dose tomorrow to 0.5u and give it only if BG is 300 or above. After that low today, chances are his BG will be high and will remain so for at least a day and possibly a few 12 hour cycles but I wouldn't chance giving the 1u dose again until you can monitor thru the cycle. I am a bit concerned that the 1u dose might be too high as it looks to me like those black numbers could possibly be a huge bounce potentially from another low not caught with testing or just Riley's unfamiliarity with the lower PMPS of 190 on the 2nd of Feb.
     
  15. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    One request.......can you add a line to your spreadsheet to indicate you are using the AT2 meter and also add that information to your signature so anyone helping you will have that information. It plays a crucial role in interpreting the numbers on your spreadsheet and in making any suggestions about dosing. Thx. :D
     
  16. Really Riley

    Really Riley Member

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    Thanks for getting back to me. Your assistance is really appreciated. I made the changes - spreadsheet could use some work I guess. Just tested him and his BG was 497. Going with .5 because I have to leave him and won't be back for 6-7 hours. Hopefully his system can handle that. Another issue - do you have any advice regarding how to get him to have a normal bowel movement? He was totally backed up in November and needed an enema. The vet at that time put him on Lactulose - 2 ml twice a day. He has seen a specialty vet since then who kept it the same, and our new vet also agrees with that. But he is not having regular bowel movements - maybe every three days and only one or two firm ones. Had him to the vet last week thinking he needed another enema because he was straining and straining and producing nothing but some drippings. But she said the stool was soft. Only problem was that he didn't release any until she inserted her finger!
     
  17. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Thanks for adding the meter into your signature. :D

    On the BM front, I thankfully have little experience with that problem so I suggest that you post a question over on the Health Forum where there is more traffic and you will get more eyes on your query. One thing I've seen often recommended is adding plain pumpkin (not pie filling) to the food. It seems to work for both loose stools and constipation. Sometimes constipation can result in leakage of watery stool so I wonder if there is some hard stool a little further up than the vet was able to examine.
     
  18. Really Riley

    Really Riley Member

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    With all the straining he was doing (and everywhere, even when I was holding him in my lap), when I saw the watery stuff coming out I figured there was something blocking the way. But the vet said he had a good, normal movement after the "inspection". Which could be the absolute truth or not (I wasn't invited into the exam room and that always makes me suspicious). I'll try to put something "intelligent" together and post on the Health Forum.

    Anyway, just checked BG and it's gone up to 551. Did you say he may have highs for a couple of cycles? I would suspect that his pre-shot this evening BG will be even higher. If so, temptation is strong to go with the one unit dose. Maybe this experience has made his body resistant to the Vetsulin as it appeared to be with the glargine. Funny thing happened once with the glargine when I could not dose him for 2 cycles. When I was able to again give him insulin his BG was a little higher than it should have been (of course), but in the 12-hour period after that injection he dropped lower than he had been for quite a while (not too low, just right). And I thought at the time that his body was "surprised" by the insulin after having not had any for a spell, and therefore did not fight back against it.
     
  19. Kris & Teasel

    Kris & Teasel Well-Known Member

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    That black is very likely part of the rebound after the lime green. That can last a couple of cycles.
     
  20. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    That is not unexpected after the seriously low BG he dropped to yesterday and the reduced dose of insulin this AM. Let's see where he is at PMPS before making any decisions about dosing tonight. How many hours till his shot is due?
    He could drop off more if the bounce starts to clear or he could remain high for a few cycles. If he is having problems evacuating his bowels, that too could be causing some of that BG elevation.

    While it's an interesting theory that his body was surprised by the insulin, it sounds to me like whatever dose he was on was likely too high. By not giving insulin for 2 cycles, you had drained the depot that glargine leaves behind after each shot to some degree and so you saw a better cycle based on what would be essentially like a slightly lower dose of insulin. You had Riley on a large dose of glargine and while there are cats that need that much and more (my cat was at one time on 16u twice daily), it's usually due to a high dose condition of some sort or a very high carb diet.

    To be honest I was surprised the vet had suggested only 1u of Vetsulin given the dose of Glargine you had been giving but yesterday's reaction seems to support my theory that the glargine dose was too high. The interesting thing about insulin is that too much insulin can look exactly the same as too little and without small incremental dose increases of 0.25u usually and definitely no more than 0.5u except in some exceptional cases, it's very easy to totally bypass the right dose and end up with worse rather than better BG numbers and to think that the dose needs to be increased even more. :eek:
     
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  21. Really Riley

    Really Riley Member

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    His next shot is due in about 5 hours. Would so love to see the BG a little lower, but we'll measure then and go from there. Does the Vetsulin create a depot? Or is it just that it lasts longer for some cats than others?

    I so wish I had figured this out then.

    Just FYI - The U-40 syringes that the vet sold me don't have any 1/2 unit markings so I hope I'm getting the correct measure at .5 The U-100s I used for glargine had half unit markings but I couldn't find them anywhere and the vet always ordered them for me.
     
  22. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Ok I will check in a half hour before shot time. You are on the same time as me I think... EST.

    Vetsulin does not leave a depot behind. It often doesn't last a full 12 hours in cats.....some it lasts 8 hours some 10 and others get the 12 hours out of it. While there is no residual insulin still at play after a cycle, there is more of a propensity toward bouncing because of the faster and sharper drops in BG. The curve with Lantus looks like a smile while the curve with Vetsulin will look more like a broad spike.

    You should be able to get U100 syringes at any pharmacy (Walmart Relion brand are often used and reasonably priced) with half unit markings. You don't need a script in PA from what I can see unless the laws changed again since 2009. Ask for 3/10ml syringes, 31 gauge 8mm length needle (6mm is fine too but some find them more prone to furshots) with half unit markings. Walmart staff don't know they have syringes with half unit markings so ask to see what they have to check. You can use the U100 syringes with a conversion chart for the Vetsulin.
    The other option is to order from ADW diabetes. They have U40 syringes with half unit markings. For now, you could use a used syringe to draw up some coloured water at an eyeballed 0.5u dose and use it for comparison when drawing up a half unit in the future. The dose doesn't have to be 100% accurate but consistency is important.
     
  23. Really Riley

    Really Riley Member

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    I am EST. How long before shot time should I be checking his BG?

    I tried a CVS pharmacy when I first needed the U-100s and they gave me a serious run around so I gave up and let the vet charge me for them. I will check ADW - just started ordering AT2 test strips from them. Where can I find a conversion chart? I've got lots of U-100s with the half unit markings if I just knew how much one unit in a U-40 meant in a U-100.
     
  24. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    With Vetsulin, you should test about 20 to 30 minutes before you intend to give the shot. Test, feed Riley, and then wait until shot time. The point of this is to have the food entering his bloodstream by the time the insulin starts taking effect which with Vetsulin can be almost immediate. It also ensures you don't end up in a scarf and barf situation having kitty throw up right after you shoot.

    HERE is the conversion chart. Any questions, just holler.

    I imagine some pharmacies might give you a run around but from what I read, you are allowed by law to buy them without a script in PA. It was changed in 2009 I believe to try to avoid drug addicts using dirty needles etc. and perhaps for other reasons.
     
  25. Really Riley

    Really Riley Member

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    624 is pretty high. Do you think he could still be reacting to the overdose?
     
  26. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Absolutely. This is not unusual at all and part of the problem is that Vetsulin pushes the BG down fast that it has a tendency to cause some bouncing in many cats too. I think you best to stick with the 0.5u dose tonight and it would be very helpful if you could test Riley again at +2 post shot to see where he is heading. It a really good idea to get a test in at night even if it's just one before bed. It helps to fill in the picture and offer some clues as to what is going on at night.
     
  27. Really Riley

    Really Riley Member

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    OK - .5 it is. I will test him at +2 to see what's happening. After that, he is probably good until morning, right? Unless his BG goes down real fast. If his BG is still high tomorrow morning, should we up the dose then?
     
  28. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Assuming Riley doesn't do anything too dramatic, yes he should be fine till morning. I'd like to see if those numbers drop some on the smaller dose right now but it's a two edged sword. We never know how much of those numbers is normal BG elevation from the diabetes and how much is from the bounce. Let's play this step by step right now and see where he is at +2. Hopefully that might shed some light on how the 0.5u dose is working for Riley.
     
  29. Really Riley

    Really Riley Member

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    We're at 649 this morning.
     
  30. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    When can U monitor today?
     
  31. Really Riley

    Really Riley Member

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  32. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Ok. That is good to know. The depot left over from the Lantus should be pretty much gone at this point in time. I think the depot contributed to the massive drop the other day. And now we are seeing high numbers for a number of reasons.
    I'd suggest you try either 0.75u (if you found your U100 syringes) or you can try the 1u. Either way, I'd definitely want to monitor the cycle to watch what is happening.
     
  33. Really Riley

    Really Riley Member

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    I went with the 1 unit. What are the best times to check? I'd love to do every 2 hours but I only have about 15 test strips left until a new batch gets delivered Friday (hopefully). So I can't really do every 2 hours, but you probably know which time periods will give the best info if not doing a curve.
     
  34. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Here's the basic testing routine we recommend:
    1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
    2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
    3. do extra tests on days off to fill in the response picture
    4. if indicated by consistently high numbers on your spreadsheet, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
    5. post here for advice whenever you're confused or unsure of what to do.
     
  35. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I'm a bit concerned about you only having 15 strips left till Friday. You need 4 of those just to get pre-shot tests before the order of strips arrive leaving you 11 strips for mid cycle testing. If you use 1 strip per cycle, till order arrives, that only leaves you a supply of 6 strips should Riley decide to do anything dramatic. For future I would suggest you try to keep an extra vial of strips available at all times. A lot of us leave an extra vial in our hypo kits.
    So let's check the BG +2 and then based on that reading, decide when to next check. I'll check back in around 11:30am to see what Riley is up on the 1u dose.
     
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  36. Really Riley

    Really Riley Member

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    His BG is 638 - doesn't look like he'll be going too low. Could it be that what he ate after his shot this morning is still influencing the reading?
     
  37. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Yes the food "bump" could still be in play but most of that number is not a food bump. Riley is still in a bounce and he's not moving much. I think we can hold off until +5. Hopefully by then we'll see a little more movement downward and unless it's a substantial drop, you can then probably hold off until the pre-shot tonight. I'll check back around 2:30pm to see what he's up to.

    In the meantime, if he asks frantically for food or starts to act oddly, test again. He took a very sudden and huge drop the other day so just be vigilant for any suggestion he might be experiencing a dramatic drop again.
     
  38. Really Riley

    Really Riley Member

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    He's at 475. Do you think the bouncing is over and that his BG will continue to be lower? Not too low, but closer to where it needs to be?

    On another note, tomorrow afternoon I am leaving my hard-wired internet access behind. I really like accessing the net via laptop where I can actually see what's on the screen without a million advertisements. And using the laptop keyboard for messaging is also a good thing. Plus there's that reception thing when you are wireless in a remote area. I won't be able to access the spreadsheet (well, I could access it but changing anything on it might be a problem). I'm going to have to try and see if I can communicate with you on FDMB by way of cell phone.
     
  39. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Ok it looks like Riley is safe for this cycle. Get a pre-shot test as usual. I do not think the bouncing is over. It may be breaking but without more testing over the course of a few cycles it's really difficult to guess how much of Riley's BG readings are being affected by any particular dose of insulin vs bounce wearing off. I'm certainly glad to see the BG coming down a bit but it's still far too high.

    There are lots of folks here that use their phone for communicating and looking at their spreadsheet. I'm not sure if anyone is updating their spreadsheet on the phone because the small screen definitely does make it harder. The SS is vital for us to be able to visually see and track what is going on with Riley. Will you be able to access Internet with your laptop in any way......ie at a library or another public WIFI spot nearby?
     
  40. Really Riley

    Really Riley Member

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    I will be back by Monday. In the meantime I'll try to find some way to update the spreadsheet before then, but not sure if I will be able to.

    How long do you think he is going to continue to bounce? Could his being constipated again cause high BG?
     
  41. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Constipation can definitely cause an increase in BG. As far as the bounce is concerned, it could break at any time but in some cats it can take 3 days to completely clear.

    So the lack of hard wired internet will only be a temporary issue?
     
  42. Really Riley

    Really Riley Member

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    Yes, only temporary.
     
  43. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Ok so while you are away, you can just put the readings into your communication and then update the sheet when you get home. I was a bit concerned it was going to be a permanent thing which could hamper seeing what Riley was up to long term. ;)
     
  44. Really Riley

    Really Riley Member

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    And now he is at 628. I don't think I need to worry about him going too low tonight. It would be good if I get a reading in 3-4 hours, but if I sleep through that, I don't think he is in any danger.
     
  45. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I agree. I'd go with the 1u dose. Check once more tonight just get some more data.
     
  46. Really Riley

    Really Riley Member

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  47. Really Riley

    Really Riley Member

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    Am I coming through?
     
  48. Really Riley

    Really Riley Member

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    Yesterday's pmps 697 overnight 551 . this morning 705. Vet office called and said to increase by one half unit
     
  49. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I agree an increase in dose is needed. Is Riley with you? When do you come back home?
     
  50. Really Riley

    Really Riley Member

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    Riley is with and I hope to test every 3. He went from amps of 705 to 576 in first 3.
    Sunday probably
     
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  51. Really Riley

    Really Riley Member

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    His 6-hour was 662. He did eat in between the 3 and 6 hr check. The vet office said I should only feed him at shot time with nothing in between. He has always been a grazer. Not sure if he can learn to eat as much as he needs twice a day.
     
  52. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    That is common advice but you will find that 99% of us feed our cats several times a day. There is no reason to withhold food midday or during the night. The main thing is to be sure that Riley eats a decent amount before each shot and that food is not given in the 2 hours leading up to the pre-shot tests. Diabetics are not able to metabolize their food efficiently so they are often always hungry., Giving them snacks through the day helps them feel more satisfied and less frantic for food at shot times and it's easier on their pancreas which we are trying to heal by treating with insulin.
     
  53. Really Riley

    Really Riley Member

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    Thanks so much for that. I would never be able to explain to him that he has to eat as much as possible right now because he isn't getting fed for 12 hours. And he has kidney issues. Looking at Tanya's website the other day and I believe it mentioned being careful if trying to switch your cat to low phosphorus food - you don't ever want to starve them in order to force them to eat what you want.

    His BG is 680. Cannot see how Vetsulin is any better. And I don't think he's feeling that great. His BG has been pretty high for a while.
     
  54. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Vetsulin sometimes causes kitties to feel poorly because of the dramatic ups and downs it causes in BG. If you are noticing Riley more lethargic and subdued than when on Lantus, you might want to reconsider going back to Lantus. A lot of cats start out on Vetsulin and some do very well but I've also seen a fair number end up switching to Lantus just because it is gentler and doesn't generally make kitty feel so out of kilter.
    It may be that he needs a higher dose of the Vetsulin but because of the quick drops, it also causes more bouncing which again can make kitty feel poorly.
    You may want to revisit the choice of insulin with your vet. I'm not sure how quickly the dose was increased while Riley was on Lantus but it's possible you went right past the right dose by making dose increase too large at one time, and that unfortunately can look the same as too little insulin. Insulin is not medicine like aspirin....it's a hormone and therefore doubling the dose isn't usually then answer to high BG numbers.
     
  55. Really Riley

    Really Riley Member

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    His BG 3 hrs post was 580. 6 hrs was 522. His amps was 727. I gave him 3 units (U-100) of Basaglar and he is now at 410. I'm not going to keep working with the Vetsulin. It may work fine after putting some time into it, and if he was younger and didn't have kidney issues, we would.

    Now I wish I knew where to go with dosage on the Basaglar. Hold him at 3 units for 3 days and see where his numbers are I'm thinking.
     
  56. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Sorry I've been out all day and am just seeing your post now.
    While Vetsulin does work for some cats, it is very unusual to see folks switch from Lantus to Vetsulin and as you witnessed the action of the two insulins is very different although I think some of that seriously low BG at 2u of Vetsulin was likely influenced by the Lantus depot. I think switching to Basaglar which is generic Lantus, it a good idea. Given the dose of Lantus Riley was on previously 3u seems to be a logical place to start dose wise. It may be that Riley does need a higher or lower dose but a slow methodical approach to dosing in 0.25u increments will keep you from jumping over a good dose for Riley.
    Perhaps when you get back home, you can review the SLGS and TR approaches to using Basaglar and decide which method would be most appropriate for you and Riley.
    The other thing I would encourage you to do is to test Riley for ketones when his BG numbers are so high. Ketostix are readily available in the pharmacy and
    some folks can just hold the strip in a stream of urine while others can catch a sample in a ladle place under kitty's butt in the LB. If Riley is shy about his bathroom visits, then crumpling up plastic wrap and placing it in the litter box where he normally likes to pee, can catch a few drops of urine to test. It only takes a few drops.
     
  57. Really Riley

    Really Riley Member

    Joined:
    Oct 12, 2017
    Thanks again for the info. Much appreciated. I want to let you know how much I appreciate all the advice and support you've given me. Riley appreciates it too - he gets nervous when I'm freaking out. Thank you again for being with me through this. Of course the work of getting him on the right path isn't finished. Hopefully someone from the Basaglar group can help.

    I do have some test strips that are combo ketone-glucose for urine. They are past expiration date but the strip did pick up the sugar in his urine - no ketones. I'll get some new ones to be sure.

    How can I save a copy of our correspondence? You gave me some good links and great general advice that I'd like to keep.
     
  58. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    You are very welcome. :DGlad to hear you tested and found no ketones. :)
    The thread will stay here so you could just bookmark it for future reference in your browser, you could print it out or save it in your browser as an "htm" file that I believe you could still open offline.
    How is Riley doing?
     
  59. Really Riley

    Really Riley Member

    Joined:
    Oct 12, 2017
    Riley is very, very tired. He only pestered me once last night to eat. This morning at the country place with no internet but plenty of birds, he was sitting in his favorite chair in front of the window he uses to watch birds at the feeder. Only he wasn't watching because he was sleeping and that's strange. On the way back to the city he didn't complain once. He usually gets tired of the drive fifteen minutes before we arrive. When we got here, he went back to sleep and didn't ask for any food (which he usually does). He seems weaker when he walks. He can still jump up on chairs and beds, etc. But when he walks he kind of zigzags. And I do believe he lost some weight. He has lost quite a bit of weight since being diagnosed, but if there was any left to lose, he just did.
     
  60. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    I'd try to get as much food into Riley as you can and you may need to be a little more aggressive about the insulin in the days to come. Sounds like Riley could be developing some diabetic neuropathy which will cause some weakness in the hind quarters but sometimes in the front too. The best treatment for that is to get his BG down to better numbers. Many folks also give Zobaline which can be ordered online as a supplement to help with the neuropathy. Definitely keep checking for ketones and any lack of appetite is a concern. It's important for Riley to get at least his normal amount of food everyday but if you can get extra into him, it will help. Diabetics cannot efficiently use the food they consume so feeding them more until they are regulated is often needed to keep them from losing more weight and to keep their energy up and ward off ketones.
    When you can, get the spreadsheet updated so we can see what Riley is up on the Basaglar. :)
     
  61. Really Riley

    Really Riley Member

    Joined:
    Oct 12, 2017
    I shouldn't have given him the Friskies after his injection yesterday evening, but he loves it, and he wasn't eating much yesterday. He ate a 5.5 ounce can overnight. Even though it does not appear to be a high carb food on Dr. Pierson's chart, it has in the past increased his BG levels. So just when it looked like there was some consistency at the 3U dose of the glargine, we are back up again. And now that he got a can of Friskies out of me, he is going to hold out until I give in again. I used to cook chicken for him and he LOVED it. And now he won't touch. When he was in remission he ate nothing but Tiki brand canned flavors that have zero carbs. And now he won't touch.
     
  62. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    He may have dropped a bit lower last night and be bouncing a bit. Try to get a test before bed every night so you get some idea of what he does at night. Otherwise you're only getting half the picture and our kitties often go lower overnight for whatever reason.
    Some cats are more carb sensitive than others and some react to certain ingredients so perhaps a different flavour in the Friskies would suit his tastes but also keep the carbs/his reaction under control.
    Right now, if the Friskies is what he likes and will eat, I'd let him have it to ensure he is getting the calories he needs. Insulin dose can be adjusted accordingly but eating is not optional. :)
     
  63. Really Riley

    Really Riley Member

    Joined:
    Oct 12, 2017
    We need that test during the night, I know. Since his evening injection is about one hour before bedtime it doesn't provide enough info doing another test an hour later. If I'm going to get any good info from a test after evening shot, I set the alarm clock for 4, 5 or 6 hours post. I took last night off but shouldn't have. The alternative would be to change injection times
     
  64. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Finding a schedule that accommodates all CG needs as well as kitty's can be challenging. If you can grab a +4 to +6 during the night as much as possible that works just fine. I agree a +1 usually doesn't tell you much. Some folks drink extra water before bed so they HAVE to get up while some others set an alarm. I had the luxury of moving shot times periodically to accommodate social engagements etc. but when one is working, it's a lot tougher to figure out. :)
     
  65. Really Riley

    Really Riley Member

    Joined:
    Oct 12, 2017
    Do his numbers look like it might be time to try an increase?
     
  66. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Yes, you should increase. I think you’d be better off posting on the Lantus forum. Lots of expertise there and they can give you really good advice.
     

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