First home BG reading - 229, start Lantus?

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KittyPurry

KittyPurry

Member Since 2014
After a few test runs on Trixie, we got our first successful reading on the ReliOn Confirm!!! Thanks for all the help, documents/links, and support. Her BG was 229. Today was her first day on an exclusively wet diet (ff classics from off the list) and the bg reading came about 3 hrs after her last meal.

Are we ready to start Lantus? She weighs 9 lbs and was originally prescribed 1 unit 2xday based on her blood test at the vet (in the 500s and still eating dry). Not 100% sure if I'll be able to test her bg again tomorrow but I can definitely keep trying.

Scarlett
 
if she is otherwise doing OK, I'd give her the day on low carb food and see how she tests.

If you were to give any insulin, I wouldn't start with more than 0.25 units! The syringes don't measure that finely, so you have to eyeball it. What insulin?
 
Hi Trixie and mommabean Scarlett.

We think you are using Lantus. Is that correct? If you could add more information to your profile signature, that would be helpful to us. You may have to consolidate some of your current information onto a single line and then add more info on additional lines. We are limited to 3 lines of data in our signature. It would be really helpful to see the insulin used, meter used, diagnosis date, any complicating medical conditions.

Hope you will consider doing this update.
 
@Deb & Wink I can definitely do that next time I'm at my desktop computer. For now all relevant info like that is contained within the post. But like I said, I will definitely update the signature later today.
 
BJM said:
if she is otherwise doing OK, I'd give her the day on low carb food and see how she tests.

If you were to give any insulin, I wouldn't start with more than 0.25 units! The syringes don't measure that finely, so you have to eyeball it. What insulin?
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I agree with BJ about holding off for another day or so. Plus, it will give you more time to practice testing. ;)

You can tell the diet has done quite a bit already for her to have dropped from 500s at diagnosis to 200s now without any insulin!
 
Congrats on your first successful home test! Glad to see her numbers are improving through the diet change alone (and no vet stress in the mix). Great progress!
 
Can we get you tracking the numbers on our spreadsheet? It'll help us give you better feedback.

Can we get you started using our grid to record your glucose tests? It will help us give you better feedback. Instructions are here.

Understanding the spreadsheet/grid:

The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning pre-shot test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
and so on.

Halfway across the page is the column for PMPS (evening pre-shot)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

It is merely a grid for storing the info; no math required.
 
@BJM I can start a sheet for her, where will these numbers go since they aren't really pre or post shot at this point? Just in the notes column?
 
Start feeding the main meal at the same time every 12 hours, and test before you feed. Those will go in AM and PM columns, 0 in units colums
Then use the +# columns to put the numbers with respect to when fed.
Note: if she grazes, leave the food out. If she's a scarfer, it'll help if you either split the meals for her, freeze part to be eaten as it thaws, or invest in a timed feeder.
 
We are feeding at 9ish am and pm, yesterday and the day before she had a little mid afternoon snack though because I was feeling guilty about her ravenous hunger.

She's definitely a scarfer right now, especially on the wet food. She thinks she's living the high life with her fancy feast.
 
Also, add 1-2 tablespoons of water (because uncontrolled diabetics urinate a lot and it adds volume) and spread the food thinly across a large plate to slow her down.
 
Good job on the spreadsheet. If you make the columns of the spreadsheet a bit narrower, the viewer may not need to scroll side to side to see a full day.
 
To calculate the starting dose (which could wind up around 0.5 units):
How much does she weigh?
How much should she weigh?
Take the lower weight (aka 'lean weight')
Convert to kilos (pounds/2.2) if needed.
Multiply by 0.25.
Round down to the nearest 0.25
 
Check my math - 9 lbs so 1 unit?

She weighs just under 9 which is too low for her, I'd say good weight is 10-11.
 
Yup.
9/2.2*0.25 = 1.02273, rounded down is 1 unit.
If nervous about him going low, you can start lower if you wish.
 
It can take several days to get the high carb food out of her system, but if she's running high, it might be good to go ahead and get her started on the Lantus

As long as you're comfortable with testing now and have all your supplies, it's probably OK to go ahead and start.

1 unit is the correct starting dose, but a lot of times we'll want you to start even lower and work your way up.

You could go with .5 tonight while continuing to feed only the low carb and see how she does or start with the 1 unit the formula suggests

It's up to you which you're most comfortable with
 
@Chris & China since I'm not 100% confident on testing I feel like I should maybe start low (0.5 units). I just feel like I'm not testing enough yet to catch a bad situation if it were to happen and will be returning to work Monday so I won't be home very long after the am shot.

I'm afraid I won't be able to grab an amps every morning. I keep telling myself plenty of people shoot blind so it might not be the end of the world... (trying to manage my own anxiety) But if I want any help with dosing suggestions moving forward....
 
You do the best you can.
You might see if there is anyone you can recruit to give you a hand - perhaps a college or senior high school student interested in veterinary studies.
 
Couldn't get a reading on her yesterday. She's getting squirrely if I don't have someone to help me hold her.

Started her at 0.5 units of lantus yesterday - she got both shots but I wasn't able to test her.

AMPS is 138 this morning... shoot?
 
Stall 30 min without feeding and re-test.
If rising and over 150 mg/dL, you might give 0.25 units. I have a feeling you won't be using Lantus long.
Generally, you stick with the same dose every 12 hours.
For new folk, we don't want them shooting below 200 mg/dL for safety reasons. You've already got a significant drop to a decent number on 2 shots of 0.5 units, hence my suggestion to back off to the 0.25 (you'll have to eyeball this it won't be marked)
 
@BJM I was unable to stall and retest, had to leave for work. Did not shoot any Lantus though.

PMPS she is at 367. I can try and get a +2 test in this evening though. Since she's back up I feel like insulin is okay.
 
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Lantus builds up its effects over 5-7 days on the initial dose and 3-5 days on any subsequent doses.
Shooting late decreases the overlap between doses and may act as a dose decrease.
Shooting early increases the overlap between doses and may act as a dose increase.
As much as possible, stick to 12 hour intervals +/- 15 min per shot or a total of 30 min per day.
 
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Thank you for the information, so far I have been 12 hours each way. Yesterday was her first day on Lantus; and this morning I didn't shoot since numbers were low (for someone unseasoned, like me), and I wouldn't be home if she were to drop.

I gave her 0.5 units ~30 mins ago.
 
If she's too low again for you to feel comfortable giving a shot tomorrow morning, you might want to decrease the dose to .25u for a few days and see if that gives you a dose safe to shoot twice a day so she doesn't spike so high by the next day (which is what happens with Lantus when dosing only once per day).

There are no syringes with .25u markings so you have to eyeball it. It doesn't have to be exact; just consistent from shot to shot.
 
Sorry, I'm on the west coast so I'm not always around early morning. ;) If you're going to be around to monitor, you could always give .25u and test her throughout the cycle. Since you're still learning how to test and she just started insulin, however, I would probably suggest skipping the shot and resume tonight with .25u, expecting that she might be much higher again.
 
If Trixie keeps this up, she may not need insulin for long. Looks like that diet change is having a very positive impact on Trixie's BG (blood glucose) levels.

Go Trixie Go!
 
@KPassa I'm on central time here -- Nebraska -- so no worries. I appreciate that you are taking time to reply at all :) That sounds like a logical plan and makes sense to me. As you can see from her ss i skipped the juice this am because i wouldnt be around to keep testing. I will test her again in about an hour before food, shoot 0.25 (of course depending on her BG but it will probably be high) and test again at +2. My plan for the morning is to test AMPS, shoot if need be. Considering taking a long lunch so I could run home and test at +4.

@Deb & Wink heehee love the emoticon. I am glad to see that she is lower from the move to wet food -- even after my vet said it would be a bad idea. Also thankful for this forum and everyone who has reached out to help me learn to home test. Think if I had changed her food and was shooting 1 unit with no BG test?!? You say she might not need insulin for long... What is the ultimate goal range for her numbers?
 
See my signature link Glucometer Notes for reference ranges using human and pet meters.
On a human meter, 50-130 mg/dL if on insulin; 40-120 mg/dL off insulin.
 
Hey! You already have her down to 0.25U, eating low carb wet food, on lantus which is a good long lasting insulin.

Looks like Trixie may be bouncing a bit. It takes time for some cats to "settle" into a dose. It's also possible that Trixie may be going lower at night. I haven't been following your posts closely so don't know your whole backstory. Still trying to learn how to use the new board format.

One suggestion for you. You may want to try get in at least one test every day in the PM cycle. I have no idea what your work, life, family commitments are, but some testing in each cycle if possible would be helpful. You likely work during the day, so can't test in the AM cycle every day. But perhaps on your day off?

Is Trixie cooperative with the testing?
 
This cat momma bean is stressed out, frustrated, and discouraged. :( :( :( Struggling in every way possible. Here is her condo from yesterday. Today her AMPS was super high again. Numbers are crazy right now…

This home testing thing is killing me! I’ve read all the how-to’s, tips, and tricks documents, watched a bunch of videos, etc. etc. I know everyone is doing their best to help me with some piece of wisdom often overlooked by stressed newbies, but I’m doing everything I’m “supposed” to be doing. I know exactly what I’m supposed to do. I could pass the theoretical exam with an A+, I promise, but I’d fail the practical.

I’m pissed, she’s pissed, and I hate starting AND ending my day a shaking ball of tears. Her little ears are bruised because I haven’t been shooting in the right place (either hitting the vein, or on the inside of the marginal vein not the outside which is what I’m aiming for) and she’s getting kind of bitey when I try to test, probably because of the bruising.

She is initially cooperative. She will come right over to the testing spot, will let me sit her down. She will usually try to dart away a few times throughout the process, but I can gently guide her back to sitting position. She purrs while I warm her ear and scratch her chin/head/other places she likes. As soon as I try to manipulate her ear by folding it over (shooting on the inside helps me a little since it’s not so furry and dark) she gets a little wiggly. I try to position the lancet device and my finger on her ear, and she will yelp and nip me. Same after I lancet, yelping and attempts to bite and get away. Does NOT like when I try to “milk” her ear, which is why I kind of gave up on aiming for the outer edge of the ear, since I never get enough blood there.

I know that I need to test her more than just AMPS and PMPS, I *know* that, but right now I just can’t make it happen. Especially since I live alone. I can manage the whole thing a lot easier when my boyfriend stays over at my apartment because he will hold her for me, but I can’t just rely on having another person there. He doesn’t live with me. It’s just me. I know that someday she will need a curve but I can’t even IMAGINE trying to test every few hours. Her ears still hurt from the time before so she isn’t having any of it.

Now I’m second-guessing myself on the process of giving her insulin at all, the ONE thing I felt easy enough. The first few days/times, she didn’t even notice or care about the injection. The last two times, however, she has actually fought me a little – last night she jerked to run away from me before the needle was out and same thing this morning. She ran away from me right off of the needle.
 
I'm sorry you're so frustrated. I swear I was in the same boat the first week or so we were attempting to home-test. Lots of tears, and Henry's ears were bruised and I felt awful. I posted on your Facebook yesterday that for whatever reason--either his ears just "learned" or I got the hang of it, or some combo--something just clicked one day and it became much easier. A couple of things that worked for us were 1) the Neosporin with pain relief: we smear a little on both before the test and after. His ears look SO much better, even though we are testing more. And 2) are you using the clear cap on the lancet device? We removed that right away and find it much easier to see what we're doing/aim without it. Some people freehand with just the lancet, but I've never tried that. (I think I'd hesitate and that would be worse.)

As far as the insulin goes, from what I understand Lantus can have a bit of a sting. If you inject with the numbers on the syringe facing up, that supposedly helps position the needle for less "drag" and thus less pain. Henry's halfway through his OTJ trial right now, so we didn't give insulin very long, but I also noticed he reacted a lot more when we tried it in his sides vs. the scruff of his neck. I know there's some discussion about which area absorbs better, but the main thing is getting it into the cat, so you have to do what works for yours!

Hang in there. It really, truly will get better.
 
I can poke any-old-place on her ear and get blood, I just can't get it where I'm supposed to :( I have some of the Neosporin w/pain relief but haven't been religious about using it. Have used it more as a treatment after instead of before.

The lancing device I'm using is the one that comes with the ReliOn meter - there is the solid blue cap that adjusts depth, and then the clear one for 'alternate site testing'. I have been using the solid blue one because it seemed like the clear cap might make it go too deep and I'm not comfortable free-handing it, especially trying to hold her myself. So you are use the device (with the automatic "poke" action) just without the cap? Agreed, aiming is pretty hard - with the solid it's hard to estimate where the actual poke will be happening, which I'm sure is contributing to me putting it too far inside her ear (by inside I mean moving towards her head, instead of towards the edge).
 
There is a woman in my town who has offered to come over and help me learn, but I'm not sure if Trixie would let a stranger get near her or not. And again, of course it's much easier with a second person, but more often than not I won't have a second person to help me.
 
KittyPurry said:
I can poke any-old-place on her ear and get blood, I just can't get it where I'm supposed to :( I have some of the Neosporin w/pain relief but haven't been religious about using it. Have used it more as a treatment after instead of before.

The lancing device I'm using is the one that comes with the ReliOn meter - there is the solid blue cap that adjusts depth, and then the clear one for 'alternate site testing'. I have been using the solid blue one because it seemed like the clear cap might make it go too deep and I'm not comfortable free-handing it, especially trying to hold her myself. So you are use the device (with the automatic "poke" action) just without the cap? Agreed, aiming is pretty hard - with the solid it's hard to estimate where the actual poke will be happening, which I'm sure is contributing to me putting it too far inside her ear (by inside I mean moving towards her head, instead of towards the edge).
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Anywhere near the edge of the ear you can get blood is fine; don't sweat the "supposed" too much. I hit the vein last week for the first time, and yikes it was a lot of blood, but with a few seconds of firm pressure it stopped. If you're getting enough blood to get a test, you're doing it right! Try applying a bit of Neosporin beforehand and see if that makes a difference in Trixie's response to the poke. It will also help the blood bead up instead of soaking into the fur.

I use an AlphaTrak pet meter but actually still use the lancet device that came with my original CVS human glucometer (probably quite similar to the ReliOn). And yep, you've got it exactly right: I use the device, just without the cap. Occasionally I go all the way through the ear by accident, which is less than ideal but doesn't really seem to bother Henry any more than any other time. He's just eager for his treat!

ETA: I hear ya on the stranger issue; Henry would not deal well with that either. I am married, but I do all the testing solo because Henry is a mama's boy and much calmer with me. My husband basically sat on him for the first couple of tests/shots and he did not appreciate that. Now I can just hold Henry on my lap, facing away from me, and he stays pretty chill throughout...but that took some time!
 
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KittyPurry said:
This home testing thing is killing me! I’ve read all the how-to’s, tips, and tricks documents, watched a bunch of videos, etc. etc. I know everyone is doing their best to help me with some piece of wisdom often overlooked by stressed newbies, but I’m doing everything I’m “supposed” to be doing. I know exactly what I’m supposed to do. I could pass the theoretical exam with an A+, I promise, but I’d fail the practical.
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I think the only thing you're missing is that it takes TIME. You just need to be more patient with yourself. :bighug:The bruising is also completely normal the first couple of weeks to a month. This is because their ears are "learning to bleed" (growing more capillaries). I was freaking out the first few weeks because Mikey's ears looked terrible! They were bruised with petechia and every time I poked him, a new spot would appear. Then suddenly, the red spots started to disappear and new ones never formed and now, 2.5 years later, you can't even tell I test him. Make sure you apply pressure after every poke as this helps stem the bleeding and reduce bruising during those first few weeks. You're both learning: you are learning the best technique for you and Trixie is learning how to be patient and sit through a test.

I've also gone to people's houses and helped them test their fractious kitties. Since I've been testing Mikey for so long, I'm no nonsense about it and have been able to test even those difficult kitties. It's like when some difficult kitties go to the vet: they're hissing, fighting, crying and then the vet gets a hold of them and they turn possum (Mikey is like this). So, you might think Trixie won't let someone else test them, but you'll probably be surprised. ;)

As to lancing devices, the first meter I bought was an AccuChek (expensive test strips!) and it came with a lancing device. I also tried the ReliOn lancing devices, but they're very primitive in comparison and a PITA. I ended up switching back to my AccuChek FastClix and it made a dramatic difference for the better for us; I just had to get used to the off-centered hole where the lancet comes out...which actually makes it easier to use on the edge of the ear because you can do it by feel instead of by sight.
 
Scarlett, This is exactly the kind of information we needed to know from you, that you are having difficulties in testing and giving the shot.

Let's see if we can come up with some ideas for you to try in giving Trixie her shot. Let's concentrate on that step first.

1. Where to give the shot is not as important as getting the insulin into Trixie. If the scruff is easier, than use the scruff. If the sides are easier, then use the sides. If she doesn't like you to pinch up a bit of skin to insert the needle into, then don't. Just poke the needle into the scruff. It's not the ideal way, but it works. Some cats are more cooperative than others. Sounds like Trixie is a bit tricky and you need to slowly gain her confidence.

2. Distraction aka bribes. Does Trixie like any sort of meat like grilled or rotisserie chicken or maybe a little bit of pork or beef? I cat sit for another diabetic kitty several times a year. This kitty has severe fear aggression with strangers. But, he'll let me get close to him once I sit quietly in a kitchen chair next to his food dish and dangle some pieces of grilled chicken in front of him. It's the only way to get the shot into him but it works almost every time. Well, he has pulled away from me a couple of times just as I stuck the needle in, so probable fur shots occasionally. Do you think something like that food bribe would help you to give Trixie her shot?

I know it's frustrating and hard at first. I remember those days well. I was doing deep breathing exercises constantly to help calm me down and be less nervous about the whole process. My nervousness was being communicated to Wink and he would get jumpy and snappy too.

We know you are trying your best. It won't all come in one day or one week or one month. It will get easier. You will develop a routine and ways that work for you.

{{{{{HUGS}}}}}
 
ramonaghan said:
Anywhere near the edge of the ear you can get blood is fine; don't sweat the "supposed" too much.
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That's the thing, I'm not really near the edge at all... if I want to get enough blood the first time, I end up poking further in. I'm trying to make her ears 'learn' but so far there just hasn't been near enough at the edges.

KPassa said:
I think the only thing you're missing is that it takes TIME. You just need to be more patient with yourself. :bighug:
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I appreciate this, and the hug. Much needed. I feel like I (and everyone here who is helping me) needs more information than just the am/pmps tests, but I'm so lucky if I even get THOSE. You'll have to explain what you mean on the "by feel" with the hole on the accucheck device. Right now, I'm struggling to guess where the poke will actually take place with the one I'm using now, which is probably contributing to why I'm so far inside her ear instead of near the edge (that-- and the edge doesn't bleed enough :/)

@Deb & Wink I can't even figure out what I did differently the first couple of times to now! :confused: This morning she took the shot just fine, no running away or struggling. The vet never discussed alternate injection sites, only the scruff by making the tent, so I haven't practiced anywhere else. Scruff seems easiest if I could just figure out what I'm doing that annoys her sometimes! She's loving the purebites chicken pieces she gets after testing (or testing attempts...) so those could definitely be used to bribe. I've been doing it while she's finishing off the last of her wet food so she's already occupied/thinking about something else.
 
KittyPurry said:
You'll have to explain what you mean on the "by feel" with the hole on the accucheck device. Right now, I'm struggling to guess where the poke will actually take place with the one I'm using now, which is probably contributing to why I'm so far inside her ear instead of near the edge (that-- and the edge doesn't bleed enough :/)
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The hole where the lancet comes out is raised slightly so you can feel where it is (here's a picture of it). Then, when aiming on the ear, I line up the bottom of the device with half of it off the ear and the half with the lancet hole on the ear just until I can feel the start of the hole on the edge of the ear. That gets it right on the edge in the sweet spot almost every time. So all I have to aim is the big, round bottom of the lancing device instead of aiming a teeny little hole or lancet.
 
KittyPurry said:
his home testing thing is killing me! I’ve read all the how-to’s, tips, and tricks documents, watched a bunch of videos, etc. etc. I know everyone is doing their best to help me with some piece of wisdom often overlooked by stressed newbies, but I’m doing everything I’m “supposed” to be doing. I know exactly what I’m supposed to do. I could pass the theoretical exam with an A+, I promise, but I’d fail the practical.

I’m pissed, she’s pissed, and I hate starting AND ending my day a shaking ball of tears. Her little ears are bruised because I haven’t been shooting in the right place (either hitting the vein, or on the inside of the marginal vein not the outside which is what I’m aiming for) and she’s getting kind of bitey when I try to test, probably because of the bruising.

She is initially cooperative. She will come right over to the testing spot, will let me sit her down. She will usually try to dart away a few times throughout the process, but I can gently guide her back to sitting position. She purrs while I warm her ear and scratch her chin/head/other places she likes. As soon as I try to manipulate her ear by folding it over (shooting on the inside helps me a little since it’s not so furry and dark) she gets a little wiggly. I try to position the lancet device and my finger on her ear, and she will yelp and nip me. Same after I lancet, yelping and attempts to bite and get away. Does NOT like when I try to “milk” her ear, which is why I kind of gave up on aiming for the outer edge of the ear, since I never get enough blood there.

I know that I need to test her more than just AMPS and PMPS, I *know* that, but right now I just can’t make it happen. Especially since I live alone. I can manage the whole thing a lot easier when my boyfriend stays over at my apartment because he will hold her for me, but I can’t just rely on having another person there. He doesn’t live with me. It’s just me. I know that someday she will need a curve but I can’t even IMAGINE trying to test every few hours. Her ears still hurt from the time before so she isn’t having any of it.
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First of all, big time congrats for home testing- so many people don't test at all, so give yourself a big pat on the back for doing it! :bighug::bighug:Are you offering treats? My kitty Tiger loves Pure Bites- they are crunchy like a kitty potato chip. Being that you are alone(so am I!), you could try the kitty burrito wrap, but this never worked for me. I let Tiger eat a bowl of food while I was just getting started testing, except 2 hours before shot time. But now I don't even have to do that, she wants those Pure Bite Treats so bad, she gets the test overwith in a hurry. The other thing is, kitty can feel all of your stress, what was helpful to me was to sing the Hokey Pokey song, yes, you feel so stupid, but it makes you laugh, your cat will laugh at you too! :rolleyes::smuggrin: Read this thread: http://www.felinediabetes.com/FDMB/threads/hokey-pokey.112041/#post-1183858 Feline Diabetes is a tough disease, it is overwhelming,but you have to laugh and relax a little bit- and that's what we're hoping to help you do!
 
She just barfed up her purebites!!!! That's never happened before!!! She just walked around the room, barfed twice, and barfed foam one time. Please tell me this is just a cat barf situation and not something FD related that I need to be concerned about
 
Actually, talking about cat barf is a sign you're no longer new. ;)

I wouldn't worry too much just yet. Probably the beginnings of a hairball or maybe she took too big a bite of a treat and it got lodged. I have a saying for myself: "once is chance, twice is coincidence, three times is a pattern."
 
No problem. We discuss anything and everything. And when the feces are properly formed and passable, we're happy about it!
Sometimes, a cat will eat too fast - we call it scarf 'n' barf. There are some medical conditions which may cause barfing. See my signature link Secondary Monitoring Tools and read the dehydration checks.
 
Sigh... another barfing event. Ate 90% of her ff then barfed it all up. She hasn't done that once since the switch to wet food, when before wet food always meant there was a chance she wouldn't keep it down.
 
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