? Help please did put this in wrong thread?

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Phoebes (GA)

Phoebes (GA)

Member Since 2017
I took phoebes evening 12 am bg was 308. Gave her a 1/2 can to snack on thru night. This am she had not finished it, husband got up gave her breakfast at 6. But she ate maybe 2 bites. Took her bs and she was eating new 1/2 canI got for her, it is 509 at 8. Gave her 2.5 units. She only ate half of that. And had 2 running poops thru night. We have been giving her 1 tsp of canned pumpkin a day with her food.
 
Hi!

This is the correct place for Lantus questions-- here is your previous thread in Health for those getting caught up on Phoebe's story.

http://www.felinediabetes.com/FDMB/threads/phoebe-newly-diagnosed-multi-problems.171739/

If you are in the eastern time zone, it's now about 2 hours after the morning shot (+2, in our notation-- we are all in different time zones here). If you can get a test now (or whenever +2 is for you), and then some more mid-cycle tests during the day, it will help people here figure out what is going on with the high BG numbers at pre-shot-- there's really no way to tell from just those pre-shot numbers, we need to see what is happening in the middle too.

I'm going to tag @Marje and Gracie to see if she can help you with the spreadsheet-- I think you said you are working mostly from your phone, which probably makes it harder to navigate, but it would be worth trying to get it set up anyway, it makes it much easier for people to see at a glance what is going on and to offer help.

If there isn't a life-threatening situation going on right now, could you take down the "911" part of your subject line? If you have specific questions, you can replace it with the "?" sign-- that will still get some extra eyes on the post, but won't give everyone looking at the board a heart attack!
 
Nan & Amber said:
Hi!

This is the correct place for Lantus questions-- here is your previous thread in Health for those getting caught up on Phoebe's story.

http://www.felinediabetes.com/FDMB/threads/phoebe-newly-diagnosed-multi-problems.171739/

If you are in the eastern time zone, it's now about 2 hours after the morning shot (+2, in our notation-- we are all in different time zones here). If you can get a test now (or whenever +2 is for you), and then some more mid-cycle tests during the day, it will help people here figure out what is going on with the high BG numbers at pre-shot-- there's really no way to tell from just those pre-shot numbers, we need to see what is happening in the middle too.

I'm going to tag @Marje and Gracie to see if she can help you with the spreadsheet-- I think you said you are working mostly from your phone, which probably makes it harder to navigate, but it would be worth trying to get it set up anyway, it makes it much easier for people to see at a glance what is going on and to offer help.

If there isn't a life-threatening situation going on right now, could you take down the "911" part of your subject line? If you have specific questions, you can replace it with the "?" sign-- that will still get some extra eyes on the post, but won't give everyone looking at the board a heart attack!
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Ty ban so sorry I was just panicking a bit with 2 running stools and her not eating that well. 2-3 weeks ago she went 5 days without eating and I want to try make sure that isn't what's happening. I am going to give her anti nausea, and will check her (+2 is 2 hours from insulin shot?) That would be 45 mins
 
Phoebes said:
Ty ban so sorry I was just panicking a bit with 2 running stools and her not eating that well. 2-3 weeks ago she went 5 days without eating and I want to try make sure that isn't what's happening. I am going to give her anti nausea, and will check her (+2 is 2 hours from insulin shot?) That would be 45 mins
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Nan not ban stupid phone
 
OK, let's see if the anti nausea helps. You definitely don't want her to stop eating again, you are right! And you want to be very careful with insulin if she isn't eating well-- very important to monitor her blood glucose while all this is going on. It's good that she at least ate half her breakfast, so that this morning's insulin isn't working on an empty stomach, but it'd be better if she ate some more small meals today as it (the insulin) is starting to work.
 
Nan & Amber said:
OK, let's see if the anti nausea helps. You definitely don't want her to stop eating again, you are right! And you want to be very careful with insulin if she isn't eating well-- very important to monitor her blood glucose while all this is going on. It's good that she at least ate half her breakfast, so that this morning's insulin isn't working on an empty stomach, but it'd be better if she ate some more small meals today as it (the insulin) is starting to work.
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She is eating on it again so that's a relief. Going to do +2 in 30 mins.
 
Nan & Amber said:
OK, let's see if the anti nausea helps. You definitely don't want her to stop eating again, you are right! And you want to be very careful with insulin if she isn't eating well-- very important to monitor her blood glucose while all this is going on. It's good that she at least ate half her breakfast, so that this morning's insulin isn't working on an empty stomach, but it'd be better if she ate some more small meals today as it (the insulin) is starting to work.
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+2 is 461. And at nausea got in, with only minor scratched and growl.
 
OK, she's dropped 50pts or so in the two hours. Starting from the higher range of numbers, that could just be meter variance, but otherwise we may be looking at a so-called "active cycle".

The lantus will be starting to work now, we'd like to see how fast and far she goes down during the day-- can you do another test in a couple hours, at +4? And just in general, are you around all day to monitor? If so, it might be a good day to do a full curve-- BG readings every two hours-- to get the full picture of how the insulin is working for her. You don't have to do a curve every day, but the information you gather during one can be super-helpful in interpreting the spot checks you do on other days.
 
Nan & Amber said:
OK, she's dropped 50pts or so in the two hours. Starting from the higher range of numbers, that could just be meter variance, but otherwise we may be looking at a so-called "active cycle".

The lantus will be starting to work now, we'd like to see how fast and far she goes down during the day-- can you do another test in a couple hours, at +4? And just in general, are you around all day to monitor? If so, it might be a good day to do a full curve-- BG readings every two hours-- to get the full picture of how the insulin is working for her. You don't have to do a curve every day, but the information you gather during one can be super-helpful in interpreting the spot checks you do on other days.[/QUOTE

Omgosh her nose is cold and wet and she is laying in my chest!!# sobbing I know she feels better. I did a +4 all day yesterday. Can we use those, I did some fri as well. I think her ears are tender, she scratches them ever so often. I don't see bruising but she has black hair. I will do if have to. But was hoping to give her ears a break?
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Aww, I'm so happy she feels better!

It's good to do a full curve at some point but it doesn't have to be today. Maybe a test at +6 or +7, when she should be at her lowest point, if she seems agreeable.

For her poor ears, here are a couple things that can help:

-- put a little pressure on the poke spot afterwards-- lightly grip the ear between tissues to not only stop the bleeding but also prevent bruising.
-- put a dab of neosporin or polysporin (ointment, not the cream) on the ear afterwards, wipe off the excess later

They'll be feeling better soon, promise.
 
Nan & Amber said:
Aww, I'm so happy she feels better!

It's good to do a full curve at some point but it doesn't have to be today. Maybe a test at +6 or +7, when she should be at her lowest point, if she seems agreeable.

For her poor ears, here are a couple things that can help:

-- put a little pressure on the poke spot afterwards-- lightly grip the ear between tissues to not only stop the bleeding but also prevent bruising.
-- put a dab of neosporin or polysporin (ointment, not the cream) on the ear afterwards, wipe off the excess later

They'll be feeling better soon, promise.
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Been doing the tissue press after, as long as she let's me lol ty for neosporin heads up!! I have triple antibiotic ointment would that work?
 
Nan & Amber said:
Yep, that would work!
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OK so took +4 bg it's 376. It was not a true no food for 2 hours because she was finishing up breakfast. Taking bites here and there. It is now time for her lunch, and she's eating with joy, so hoping anti nausea was the answer. Does any if that make a difference for bg?
 
The midcycle tests are always going to have food influence of some kind, and that's fine-- it's really only the pre-shots we want to be sure we know exactly what we're looking at when we decide to shoot or stall.

So glad the anti-nausea seems to have helped and that she is now eating with gusto! Feeling yucky can definitely impact BG numbers-- we see it a lot when a kitty is in pain, numbers go up due to the stress. Hard to tell in this case.

History for today:

AMPS: 509, shot 2.5U Lantus
+2: 461
+4: 376

She's still quite high, though the insulin is definitely moving her numbers down. Another important question: are you doing any testing for ketones? Urine testing, can be done at home with little dipsticks (available at pharmacies). It's something to keep an eye on with a cat running in high numbers-- I don't see any indication that Phoebe is currently at high risk, but the "recipe" for ketones is: not enough insulin (high numbers), not enough food (poor appetite) and (usually) some kind of infection or other triggering illness that sets the whole thing in motion. Given that she's dealing with pancreatitis and occasionally goes off her feed, and she's not yet gotten the diabetes under control, I do think you should be testing for ketones if you aren't already-- it's the kind of health issue that is much easier (and much less expensive) to treat if you catch it early, and it can get very serious very quickly if you don't.
 
If I go after her in the litter box there will surely be an adversion. If anyone of us is in the room when she goes to the box we have to freeze and pretend to not notice. Or she will walk away. We have 2 litter boxes one in back of apartment one in the front. I was hoping with giving her the fluids and water in her food she wouldn't have that problem. Did I see something about stuff you can put in litter box to tell? Or any tricks, I know of the ladle but if I even went to get it. Litter use would go out the window. She is so skittish, because when I became disabled I lost my home, was homeless. My friend offered us her 2nd bedroom. She had 3 cats that did not like phoebe in their territory. We tried to get them together slowly over time. Needless to say her and I lived in that bedroom behind closed doors for 4 years while waiting for SSI and disability. Only then was I able to move her into her apartment. For 2 1/2 years we have been "home". Sorry off topic, but that has made her skittish.
 
Her sugars were in the 600s at vets. Would not come under 500s. So we have gotten further with it. Vet said maybe we would need to lower it to 2 units, sometimes kitties will do better with less lantus. I know Jan 7 was the last time she had 200s. But can't remember if she was on 2.0 or 2.5 units. I did mark Jan 8th as 2.5 and she had 200s from 7am to 8 pm. On the 9th at 830 she was 330. And hasn't been back down to the 200s. Vet said at least if we can get her under 240 we will celebrate.
 
Phoebes said:
If I go after her in the litter box there will surely be an adversion. If anyone of us is in the room when she goes to the box we have to freeze and pretend to not notice. Or she will walk away.
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Yep, I have one like that! Here are some tricks to deal with a shy litterbox user:

-- put some plastic wrap in the litter box in one of her "favorite" spots. The ketone sticks only need a very little urine, a drop or two, so even if just a bit splashes onto the plastic, that will be enough
-- swap out litter for aquarium gravel (or anything similar that is non-absorbent), collect the pee, rinse and reuse.

They also sell meters that test for ketones in blood, but I don't know that I'd get one of those immediately. Pluses: easy to use (you've got the testing down already), and they give an immediate answer as to ketone status. Minuses: while I think you can sometimes get the meter for cheap (list price is high), the strips are super-expensive, so it's not great for everyday testing compared to the urine dipsticks. But something to remember if ketones ever do become a problem-- it's a nice thing to have in reserve to be able to get an instant answer if you are worried.

Your vet is correct that sometimes the answer is less insulin not more. Here's what happens: when the insulin brings the BG down, the cat's body reacts, releasing more glucose from the liver and sending the numbers shooting up again. That's why we recommend the midcycle tests-- if you only see the high numbers at morning and evening preshots, it could be because the numbers never went down during the day and more insulin is needed, or it could be because the numbers did go down during the day, too far, and actually less insulin is needed.

We like to say around here that getting all this figured out is a marathon, not a sprint, and it's really true. There are a lot of moving parts to have to account for!
 
You don't know how much you guys are a relief to me. Thank you from the bottom of our hearts. So ketones strips same as humans use? I like the plastic idea she always goes on edge. That would be perfect. Not sure she would like the aquarium gravel. But might be worth a shot. Thank you again.
 
@Phoebes .....I can set up your spreadsheet for you if you'd like.....I am sending you a Private message so you will need to look in your "Inbox" for it (on mobile "conversations" should be to the right of the word "Forums" ....there should be 3 horizontal lines ....click there and choose "conversations")

In the meantime, it would help if you'd go ahead and fill out your signature (if you look below any of our comments, you'll see our "signatures" that give basic information about our cats)...that way we don't have to keep asking the same questions over and over again

To fill out your signature (on mobile) click on your sign on name (top right) and a box will pop up....Choose "Signature" and a new box will open for you to enter details.

Generally we like to see stuff like:

Your name/cats name, age, sex, date of diagnosis, type of insulin, type of meter, type of food, any other health issues? and maybe a general area you live in. When you have your spreadsheet link, it will go into the signature too
 
Nan & Amber said:
Yep, I have one like that! Here are some tricks to deal with a shy litterbox user:

-- put some plastic wrap in the litter box in one of her "favorite" spots. The ketone sticks only need a very little urine, a drop or two, so even if just a bit splashes onto the plastic, that will be enough
-- swap out litter for aquarium gravel (or anything similar that is non-absorbent), collect the pee, rinse and reuse.

They also sell meters that test for ketones in blood, but I don't know that I'd get one of those immediately. Pluses: easy to use (you've got the testing down already), and they give an immediate answer as to ketone status. Minuses: while I think you can sometimes get the meter for cheap (list price is high), the strips are super-expensive, so it's not great for everyday testing compared to the urine dipsticks. But something to remember if ketones ever do become a problem-- it's a nice thing to have in reserve to be able to get an instant answer if you are worried.

Your vet is correct that sometimes the answer is less insulin not more. Here's what happens: when the insulin brings the BG down, the cat's body reacts, releasing more glucose from the liver and sending the numbers shooting up again. That's why we recommend the midcycle tests-- if you only see the high numbers at morning and evening preshots, it could be because the numbers never went down during the day and more insulin is needed, or it could be because the numbers did go down during the day, too far, and actually less insulin is needed.

We like to say around here that getting all this figured out is a marathon, not a sprint, and it's really true. There are a lot of moving parts to have to account for!
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+6 326
 
It's OK-- you'd expect the numbers to start climbing again at this point. You can back off on any more tests until the next pre-shot, though, we've gotten all the info we're going to out of the curve. I see the spreadsheet has been started and a bunch of other information put in your signature-- well done! Once you get as many of the past tests as you have into the spreadsheet we can start to look for patterns.

You are going back to the vet soon, correct?
 
I am calling her tomorrow with the values from the weekend. And will go buy some ketone strips tomorrow as well.
 
Sounds good! Doubt from what we've seen today that a dose reduction is in Phoebe's immediate future, but remember, marathon not a sprint! It's good that she is definitely getting a response from the insulin (509-326 is a pretty good-sized drop), and it looks like a pretty normal pattern for lantus with a low-point around +6, so that is good to know.
 
Nan & Amber said:
Sounds good! Doubt from what we've seen today that a dose reduction is in Phoebe's immediate future, but remember, marathon not a sprint! It's good that she is definitely getting a response from the insulin (509-326 is a pretty good-sized drop), and it looks like a pretty normal pattern for lantus with a low-point around +6, so that is good to know.
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That is a relief, thank you. Will talk to vet tomorrow to see where to go from here. And see if you all agree. I do love my vet she has been our vet for about 15 years. Alot if experience with sick kitties. And knows we do not have Alot of money. I love her.
 
Nan & Amber said:
Yep, I have one like that! Here are some tricks to deal with a shy litterbox user:

-- put some plastic wrap in the litter box in one of her "favorite" spots. The ketone sticks only need a very little urine, a drop or two, so even if just a bit splashes onto the plastic, that will be enough
-- swap out litter for aquarium gravel (or anything similar that is non-absorbent), collect the pee, rinse and reuse.

They also sell meters that test for ketones in blood, but I don't know that I'd get one of those immediately. Pluses: easy to use (you've got the testing down already), and they give an immediate answer as to ketone status. Minuses: while I think you can sometimes get the meter for cheap (list price is high), the strips are super-expensive, so it's not great for everyday testing compared to the urine dipsticks. But something to remember if ketones ever do become a problem-- it's a nice thing to have in reserve to be able to get an instant answer if you are worried.

Your vet is correct that sometimes the answer is less insulin not more. Here's what happens: when the insulin brings the BG down, the cat's body reacts, releasing more glucose from the liver and sending the numbers shooting up again. That's why we recommend the midcycle tests-- if you only see the high numbers at morning and evening preshots, it could be because the numbers never went down during the day and more insulin is needed, or it could be because the numbers did go down during the day, too far, and actually less insulin is needed.

We like to say around here that getting all this figured out is a marathon, not a sprint, and it's really true. There are a lot of moving parts to have to account for!
Click to expand...
When you say put plastic wrap in litterbox could be more specific? Like under the clumping litter or just lay it on top?
 
Not entirely under the litter, you want it somewhere where it will hopefully catch some urine before it gets soaked up. You can put it right on top if you think Phoebe will go on it, or another strategy is to put a little litter on top to disguise it (not enough to soak it all up). If you crumple it a little it will make little depressions for the urine to pool in. You only need a couple drops for the sticks, so the way you do it doesn't have to be fancy-- anything that works!
 
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