Help me with Mouzer Please

Mouzer has neuropathy, along with his diabetes. I have him on Zobaline.

May 12, 2017, on Friday - Mouzer's first ever reading was 463
Mouzer was on 2u of Lantus, for one week, as per vet instructions.
May 19, 2017, on Friday, After that week, Mouzer's reading was 371.
The vet took Mouzer's dose up to 3u.

I got into this forum with @Jill & Alex (GA)
I have lost my vet
I have to get things together to have a new vet.
I am wanting to do my own glucose curve, have all recordings, and be able to present to a new vet.

-----------------------------------

May 25, 2017, on Thursday - Advised to give Mouzer 1u
May 25, 2017, on Thursday at 7pm Mouzer was given 1u
And the dose is still 1u, twice a day.

May 27, 2017, on Saturday - I got my strips and meter all together, ready to use

May 27, 2017, on Saturday - Mouzer had 1u at 7am.
At 2:48pm - Mouzer's reading is 206

Would you continue with the 1u dose, for a solid week, before changing dose?
OR - What would you do now?

Mouzer is due a shot at 7pm. I will do a reading, before the shot, and return back here to see if anyone has any suggestions and to put in what the reading is, before the shot.
If I get no suggestions, I will stay at the 1u until @Jill & Alex (GA) or someone is able to suggest what I do.

Thank You

 

Are you using TR or SLGS regulation? I am new to this board to really. Like 5 months. But will try and help you. Deep breathe and good for you getting a new vet!

 

uummm I do not know what TR or SLGS regulation means???? *telling you with a question

I will have to go read all of my notes from @Jill & Alex (GA) 's information, to see if that is in there somewhere.
There is a lot to read and I have been reading but it is a lot and I have to re-read, so to learn.


EDIT TO ADD: I GOT IT!!!
"Start Low, Go Slow (SLGS) method

Mouzer has been on the diabetes diet since May 12, 2017. But it was suggested, for now, to let him have the dry food, if he wants it, if that is all I can leave out. But he hasnt eaten any dry food. He wants his canned diet haha And I am here to give it to him, anytime he wants it, unless it is in the middle of the night and I am sleeping.
So, technically, since we began the 1u, May 25, 2017, I cannot say he has not eaten any dry, in the night hours, but I tend not to think so. He is loving the canned food way of life

 

Hold the dose for at least a week:

• Unless your cat won’t eat or you suspect hypoglycemia
• Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
• That's from the yellow stickie at the top of the "Lantis Forum"

Do you have syringes that have half unit markings?

 

http://www.felinediabetes.com/FDMB/threads/lantus-levemir-start-low-go-slow-method-slgs.129446/
The link for slgs.. it's a good read and will answer most of your questions.

 

@Phoebes
Thank you

I do not have the half unit markings. @Jill & Alex (GA) is sending some to me, but they wont get here until Tuesday or so. I just have 1u markings, for now.

I have been meaning to ask, even when you have a half unit marking syringe, how do you know what 0.25 is on that syringe. Isnt 0.25 like a quarter mark? Or is that a half mark?

And I will go spend more time reading. I have been trying to read, in between doing chores, today. I will continue reading

 

Hey there Cherryl!

Congratulations on your first test!!! Sounds like it went smoothly!

To answer your questions: yes, on SLGS, you will hold the same dose for a week unless you get a reading below 90 (any time of day), in which case you drop the dose by 0.25U. Usually, you reassess a given dose every week by doing a curve (readings throughout the day)-- we'll talk about that when you get there.

The 206 you got is not a bad number for a diabetic cat! It's hard to connect that number to the insulin shot this morning because we don't know what his blood glucose was before the shot, but so far, so good.

Tonight, you have it exactly right-- test before shooting, post for help. It's best to keep that pre-shot number free of food influence if you can (no food 2hrs before). The main thing we want to know at pre-shot is, "is the number high enough to shoot?".

As for that, since you are just starting out, the usual recommendation is not to shoot anything below 200. Definitely post for help if you get a lower number-- under some circumstances we may say to go ahead (we don't like skipping shots), but don't shoot less than 200 without guidance.

One last note: because we are all in different time zones, we have a special way of describing times-- everything relative to the most recent shot. So, since you shot at 7am and took a reading at approximately 3pm, we'd say that the reading happened at (approximately) +9, meaning "nine hours after the shot".

I'll check back in later for your pre-shot. Hope you guys are having a great day, give Mouzer a scritch for being so good about being tested!

 

Congratulations on your first tests!! good to have you around

And that is a very good reading

 

Here's your Post from Health (here in Lantus Land, we like to have the link to the previous post so it's easy to go back and read what's been going on and the advice you've already been given)

You just have to eyeball it and try to be as consistent as possible......with syringes that have half unit markings, you know you need to get it "between the lines" ....that's why we like to have people use the ones with half unit marks....it's easier to get those tiny doses

 

I am not being a smart-behind or trying to correct - but 7am to 3pm is eight hours --- so did you add an hour for a reason that I do not understand? Or was that a booboo?
And do you mean, instead of saying 7am and 3pm, which I am EST --
I should say, a reading x amount of hours after shot - and that is good enough? No time needed then?
I am just making sure I understand.

And ok - No food two hours before shot/meal

For now, I do not have a half mark syringe. I just have the 1u mark. I dont know how to go .025 and I dont yet understand if .025 means half? Because it does look like quarter to me

And first reading was fun, except for the practice on me haha I had to stick me four times but I only had to stick Mouzer two times, which the first one, the lancing thing for the lancet needle thing needed to be set on another notch to make it go in far enough. And I had to come away from the rim of his ear. He really doesnt have much of a rim and I came in a bit and was able to get the blood on the second stick.
My reading for me was 128 - I am going to search to see if I am with a good reading



@Veronica & Babu-chiri
I actually had fun doing the reading. I thought to myself, well this might be fun, but I really hate that Mouzer has to have diabetes for me to have this kind of fun
I felt like I really did something big, because I was so scared, all of this time that @Jill & Alex (GA) has been giving me information. The information looks really scary to me right now

 

Hah! No, you are totally right.

The really embarrassing part? Usually I do these in my head but today for some reason I counted on my fingers-- and got the wrong answer. Ha!

 

Yes, that's exactly right.

We do this because it's too hard to convert back and forth between time zones, and it's just much much easier if you can just refer to times as +2, +3, etc. It's especially helpful when someone is in a crunch situation and needs prompt, accurate advice-- saves on the back and forth as people try to figure out the situation.

Don't you worry-- if you are giving a treat after tests, it won't take Mouzer long at all to learn that "test time" = "fun time", too!

 

OK - When I eyeball the syringe, it appears to me, I am able to get it half way in between 1u and 2u, so if that is what .25 means, I will do ok. But .25 looks like a quarter to me - so I want to make sure it is that .25 does mean .5 ??? .5 = half - just showing you that, so you can see what my mind is comprehending.

 

Mouzer did not mind at all
He just patiently waited and then I gave him his food.
I was worried he would get antsy, but he didnt

And ok on time + hours from shot thing - thank you

 

Oh! Dont get embarrassed with me! I am one big booboo
I just wanted to make sure there wasnt a reason for the extra hour, that I should know about

 

I was just thinking - .25 is between you guys half mark - I get it!
I have 1u markings - so in between 1u and 2u is half - I dont think I can do .25 because it is such a small bit in there but I can try to get as close to that by just being a little from where I view half to be, whichever way I am to go, up or down.

 

I was just writing an explanation of the half-unit thing--but you already figured it out There are various ways of measuring super-tiny doses, but I think the main thing is to be consistent. Someone suggested to me that I draw marks on a piece of paper and line the plunger up with those, so I could be sure I got the plunger to the same place every time (even if my guess about whether that was .25 wasn't quite correct, at least I'd be giving a consistent dose). Some people use calipers! But to me your plan sounds fine--it'll be easier when you get the half-unit syringes in a few days!

Congratulations on starting your testing adventure!

 

I do not have a printer. Mine broke.

I am going to have a lot to try to remember from this area...

START LOW, GO SLOW METHOD (SLGS)WITH LANTUS OR LEVEMIR
FOR DIABETIC CATS
http://www.felinediabetes.com/FDMB/threads/lantus-levemir-start-low-go-slow-method-slgs.129446/

 

OK - I think the eyeball will be good
I probably couldnt mark a piece of paper to match the syringe up with, anyhow.
And thank you. I would hope my adventure leads to Mouzer's remission with no return of it.

Mouzer was given a depo-medrol shot, around August of last year, and then again around September.
This shot can cause diabetes, but it usually is over time, before diabetes is caused, however, if Mouzer was borderline diabetic, at the time of the shots, the shots could push him on into full blown diabetes, which would appear, to me, is what has taken place. The vet, we did have, said, if it is the shot that caused the diabetes, the better his chances of going into remission. So, I am hopeful this would be the case for Mouzer.

 

Yes--come on, Mouzer--you can get past this whole diabetes thing!!!

 

Congratulations to you and Mouzer! It seems that you've figured out some key things. There are lots of people on this forum to help.

 

@Squeakycats - I do hope Mouzer gets past this. This is wearing me out


@Kris & Teasel - Thank you and I hope I have something figured out, at least.

I am reading and the future to come does appear even more exhausting hahaha
http://www.felinediabetes.com/start-low-go-slow.htm

I am saving everything to a folder. I do not have a printer, so I am saving the entire pages to one folder and I can rush to them in emergency.

 

I did just add to my first post, in case it matters...

Mouzer also has neuropathy, along with his diabetes. I have him on Zobaline.

 

Don't feel bad about it we all have been there and it feels seriously good when you get your first test, is a really big thing ¡¡¡ and the first step in helping Mouzer

As for the information keep asking any doubts you have little by little you will get the hang of it

 

You could add it to your signature together with some extra information like his name, the protocol you will be following ( once you get the hang of it ) the food he's eating that way everyone knows and you don't have to remember to mention it

 

Funny you just mentioned that! I was just looking at @Meridith and Zeke 's signature and wondering if it would be helpful for me to put any information in about Mouzer, as a signature. I do not know how to do a signature, but my guess, it probably is in my preference area and I will look.

By what protocol I will be following - do you mean like the SLGS regulation?

 

Yes the protocol will be SLGS .

To edit your signature go to your profile that appears in the top right part of the page, when you click it a menu (drop down) appears with a list of options click in the one that says "signature" and it will open a window where you can edit what will appear in your signature every time you post something

 

Three test strips
I could not get blood from his ears...

It is time for his shot..
Mouzer's reading is 156

Do I continue to do the 1u ?
Or dont do a shot?

I am scared to do a shot - it is below 200!!

Is this 911? For Help
He is waiting to eat but I dont want to feed him until I find out to skip shot, do shot or do what now?

@Phoebes @Nan & Amber @Veronica & Babu-chiri @Chris & China @Squeakycats @Kris & Teasel

 

In this case: don't shoot now, stall and don't feed.

Take another reading in a half hour. If he's moving up then, we'll think about shooting, but not yet.

 

Wont this change his shoot time? I mean, the 7am and 7pm time?

OH God I hate to have to tear on his ear again. I made a mess trying to get this blood this time.
And he wants to eat NOW ---- I have to tell him no??? hahahaa

 

Yes-- if that's a problem, I'd just skip tonight's shot, especially given his +8 reading.

 

It is also possible that the 156 was a bad strip/error, but I didn't want to suggest a re-test immediately because I figured both of you could use a little break from the pokies .

 

I just checked on Mouzer. He is fine. He is on a towel, in the bathroom, cleaning himself.
I spoke to him and told him to hang on, give us just a bit of time.

I will test in ten minutes and that will be 30 minutes from last test. That wont change his shot time. Dont I have up to two hours shot time play? The vet, I did have, said, I can go two hours either way, but when reading here about Lantus, I got the impression you might not can do that with Lantus, but I am not sure.
I could have misunderstood.

I just could not get blood to come out of his ear. He has a left ear tip, so I try to avoid that ear because not much room for poking. I was thinking about doing his arm but I didnt want to hurt him. I just hope this next one goes easier with getting blood. I did keep using hot water on a cosmetic cotton thing to warm his ear. Poor guy! Stupid mommy stickin the poo out of him. He sure was good about it all though

 

We try to keep Lantus dosing on a 12hr schedule-- early or late shots can act a little wonky (not the end of the world, but it's easier to interpret patterns in BG if the dosing is consistent). If you have to move a shot time (like tonight), to get back to your preferred time it's best to do it in stages, 15mins shift each shot. So if you do end up shooting at 7:30pm tonight, you'd plan on shooting at 7:15am and 7pm tomorrow.

It will be interesting to see where he is on this next test. That 156 was quite a surprise!

 

You want to shoot as close to every 12 hours as possible....2 hours late might not be a problem (but then you'd want to shoot 12 hours later and work your way back to your chosen schedule) but shooting 2 hours early could very well be!! An early shot can act like a dose increase!

Try a wash cloth with warm water and then put it inside a baggie.....by using a wet cotton pad, you could add water to the sample as well as making the blood wick into the fur easier. Or find a small pill bottle and fill it with warm water and use that to warm up the ear. A lot of people here also use a little bit of rice in a sock....You microwave it to warm the rice and then hold it against the ear.

 

He is 184 now

Shoot or dont shoot?

And I called everybody on that one post because I freaked out over 156

I did have to do three pokes but I used a wash cloth. I will try the rice in sock next.

 

Do you have plenty of supplies, like High Carb food (Gravy Lover), Karo, syrup or honey, and plenty of test strips?

If you do, I'd shoot the 1U but you'll want to test at +1 and +2 so if you need to intervene, you can do it early

He is coming up, so the last shot is wearing off

 

Cherryl, if you were to shoot tonight, you would have to be prepared to monitor, possibly very late. You'd also want to make sure that you had emergency supplies (plenty of testing strips, high carb food, karo or honey). How do you feel about that?

 

Ohhhhh - I dont want to have to intervene. I am not ready for that.
That might make me have a nervous breakdown.

I have Karo syrup and honey and some friskies foods with gravy in them but I really prefer not to have to intervene - at least not yet - that is too much of a trip on my head.

I cant be up tonight. I have to be somewhere tomorrow and I will have to get to bed.
So I will let him go high. And with that, I can also do the 7am shot, if test shows he did continue to climb, right?

And wow - I am already going to have to buy more strips, if this is how it goes, with getting blood

 

Yes, if you can't monitor tonight, it would be safest to skip.

Assuming he doesn't throw another curveball for AMPS, you should be good to do a 7am shot.

 

That's why I suggested the early testing....186 is close to 200, but it's the lowest you've shot

The only thing you really have to be prepared to do is feed.....most cats LOVE the "gravy" part of the HC foods and it works pretty well to bring their numbers up

Do you think you could do something like .5 tonight? That would give him some insulin, just not as much....but I'd still get the +1 and +2 tonight

If you're not ready, don't push it....Skipping is OK until you have more data on Mouzer and can learn more about it

If I could guarantee I'd be able to stay with you tonight, I'd really encourage you to go ahead, but due to severe storms in the area, I can't

 

OK - Skipping tonight's shot and going to feed Mouzer.
I will test before going to bed and see what is happening but if it doesnt go over 300, by the time I go to bed, he is ok to wait for 7am normal shot time, I am taking it ?????

And based on what you have said, I am going to say, he is ok to wait til 7am.
I am trying to be confident in what I am doing, so just saying it, like I know for sure.
If I am incorrect, let me know.

I cant even stay up tonight. I have to be somewhere in the morning.
Even a +2 would be too late. I wont be awake.

 

Not sure what you are asking, but the choices for tonight are, skip or shoot the 0.5U Chris recommends now. Don't give a "before bed" shot because of numbers you see-- we really want to keep on the 12hr schedule as much as possible. A before bed test would be good data to have, though!

 

Ok - Test before bed just for knowledge... But no shot



@Chris & China - When you said 186 was the lowest shot -
I am not sure if you saw that he was at 156 and then 30 minutes later the reading was 184.
At +8 - he was 206. I could not do any earlier because the strips had not arrived.
I did it as soon as the strips arrived.
And I am not sure if you mean something else.


And thank you both for being here. I freaked out over just this much!!
Thank You!!!

 

Chris means the lowest pre-shot number (that you know of). As you gather more data, your cutoff for shooting/not shooting will get lower and lower. It seems scary at first to shoot numbers in the 100's (or even lower, for our really experienced caregivers!), but it's a really good thing to do with Lantus because Lantus is good at holding BG numbers low and producing "flat" curves over the course of a day. That means the caregiver can hold the cat's BG in "normal" (pancreas-healing) numbers for most of the day-- exactly what you want to do!

It is, however, something to work up to. Especially at first, you always want to have the ability to monitor extensively when you shoot low, just in case the BGs drop too much. It usually doesn't take much food intervention to bring them back up, and (after the first time, which is always nerve-wracking!) it can feel kind of powerful to know that you have that tool to keep your cat safe!

 

Sounds like you are wrapping things up for the night, so I just wanted to say, well-done on your first day of testing!!!!

In the morning, you'll want to start a new post (Lantus is a very busy forum, so the rule is 1 post/cat/day to keep things organized). Include the date and Mouzer's name in the subject, and then in the first post, link back to this thread so that anyone who wants to can follow the history back.

See you in the morning, have a great night!

 

I see you already have a plan and it looks ok, always safety first, you will retake everything in the morning with both of you rested and more relaxed, as many have said this is a marathon and takes time.

Patience with the testing it gets easier for both of you with time.

Also as you get more data and practice you will be able to shoot with low numbers

I use a small wet cloth that I warm in the microwave and put inside a bag (so that it won't mix water with the blood) to warm his ears before the testing

 

Thank you!!

I will end this thread with the numbers for today.

May 27, 2017 - Saturday -
AM Shot Given - Strips had not yet arrived
-----
Strips Arrived -
+8 / 206
-----
PM Pre-Shot / 156
30 minutes later / 184
PM Shot Skipped


And I hope I am putting that all in a way that is understandable.
And again, thank you for being here

 

Just checking in to see what the morning number was-- have you shot yet?

 

heehee I wasnt sure if I am to create a new thread every single day or just when I need help, so I have messaged @Jill & Alex (GA) to ask her

The AMPS was 447 and the shot was 1u

I want to test again at +2 which is in about ten minutes

What do you think about that 447?

 

Yeah, you're supposed to create a new thread for each day-- I just got impatient and I couldn't wait so I replied to this one !

As for the 447, it's high, but not unexpected. He'll come back down.

When you get the +2, probably best to go ahead and start a new thread rather than adding to this one.

 

Yes, new thread every day. Check the format we use by looking at the thread titles on the Lantus forum main page. That AM number is high-ish. Had Mouzer eaten in the 2 hours prior to the BG test?

 

No - He did not eat. He was very hungry and I did his read and shot 30 minutes before I wanted just so he could get his breakfast.

 

Ok I will go do read now and come back with new thread