Hi I'm new here, just started on 1ml Lantus 2x daily.

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by Duggles, Oct 5, 2018.

  1. Duggles

    Duggles New Member

    Joined:
    Sep 27, 2018
    hi there,
    My sweet little fluffy calico kitty, Kali, was diagnosed diabetic 2 weeks ago. She's been on 1 ml Lantus 2x daily. I switched her to canned Nulo chicken and turkey. She has been acting happier since being on the insulin, but without a BG meter it's been hard to tell where she's at. So I finally got a BG meter in the mail today, an Alphatrak. I tested her 2x today, once at around +4, I got 375 on the meter. Tested again at +9 and got 349. Now it's almost time for her meal and shot. The vet recommended feeding her two meals a day 1/2 hr before her shot. Other info I've found says it's better to feed several small meals. My question is should I feed here in between main meals or should I withhold food from her until her regular mealtime if her BG is high, like in the 300's?
    Thanks for any advice.
     
  2. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    I think you mean 1U.….1ml is 100 units

    It's actually not necessary for her to eat before shooting with Lantus....with older, harsher insulins, it was important, but with Lantus, it doesn't usually start to "kick in" for 2-3 hours after the shot, so you have time to feed.

    Most of us Test/Feed/Shoot.....all within about 5-10 minutes. You Test to make sure they're high enough for insulin at all, Feed to make sure they're at least willing to eat and Shoot. They shouldn't eat for the 2 hours immediately before shot times so that you get a "Pre-shot" test that's not influenced by food.

    Other than that, it's easier for the pancreas to deal with smaller, more frequent meals....just like human diabetics are told to eat smaller, more frequent meals, it's the same with our sugarcats.

    Sometimes it's better to feed most of their food in the first half of the cycle so you're not "slamming the brakes" on the insulin when it's starting to wear off, but some cats can eat throughout the cycle without any problem. It's something you'll learn about your kitty through testing.
     
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  3. Gill & George

    Gill & George Well-Known Member

    Joined:
    Oct 27, 2015
    Hi there and welcome,

    Good job on getting testing, it's the way you are going to keep your sweet girl safe.
    The feeding schedule your vet is suggesting is more appropriate for the faster acting insulins.

    Hope to see you around more, ask as many questions as you need to.

    You might want to take a look at the Spreadsheet we use for recording our sweet kitties BG's, it's really helpful in tracking the tests and allows you and others (should you need help with dosing) to easily see how well the insulin dose is working for her.

    How long has she been on the 1u of Lantus? What food were you feeding previously? When did you stop feeding that? If she was on a dry food diet that was high carb swapping her onto a low carb wet diet can have a major effect on her numbers, reducing the carb load can see BG drop significantly or even dramatically in some cats.
     
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  4. Sue and Luci

    Sue and Luci Well-Known Member

    Joined:
    Nov 3, 2017
    Welcome to the best internet forum out there to help your Kali get better! We'll be looking forward to seeing your Spreadsheet with all the details about testing, feeding...you can look at the hyperlink at the bottom of the replies you've gotten to see what other peoples SS looks like. If you need help with setting it up - just put that in the title of your post. There's a lot to learn and you'll feel overwhelmed at times (so much information)! But there's also a ton of help and support here as well. Hang in there! Looking forward to seeing your posts every day to let us all know how Kali is doing :bighug::bighug:
     
  5. Joanne&TinySole

    Joanne&TinySole Member

    Joined:
    Jun 19, 2018
    Welcome! You've found the right people to guide you through the maze called "diabetes." I'm new since May and am feeling a lot more confident than when we first had the diagnosis. I'm super grateful to be here and wish you and Kali all the best!
     
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  6. Amanda & Shmee

    Amanda & Shmee Well-Known Member

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    Feb 18, 2018
    Welcome :bighug::bighug::bighug:
    There are so many amazing and knowledgeable people here, you have come to the right place.
     
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  7. Duggles

    Duggles New Member

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    Sep 27, 2018
    Wow Thank you all for the warm welcome and advice!
    Chris and China of course you were correct it's, 1 unit not 1 ml. It was late at night and I was sleepy when I posted that. Actually when she was diagnosed the vet technician mistakenly told me to fill the syringe to the 10 unit mark. I looked at it and thought that can't be right, my step father uses 20 or 30 units and he's a huge guy. So I made her go and double check with the vet. Good thing I noticed or it could have killed her.
    Anyway I just had a mini nightmare testing my poor kitty, I couldn't seem to get enough blood out of her ear to test so I kept poking... until suddenly I guess I hit the vein because blood started spraying all over the place, but then my tester was giving me an error code so it took 3 different test strips before I could get a reading. She seems really indignant about it, currently she's laying with her face on the floor drowning her sorrows in a pile of catnip. I'm sure I will get better at testing but right now it feels like I'm torturing my cat. Anyway she tested at 86 pre-shot this morning, which is a whole lot better than the 349 last night, but now I'm wondering if I should have even given her the shot... ? She ate quite a bit for breakfast so that should help, but as was mentioned she is on a very low carb food, like 1% to be exact, so should I be concerned about hypoglycemia?
    Thanks again for your help and advice.
     
  8. Camille and Cyclone

    Camille and Cyclone Member

    Joined:
    Dec 29, 2009
    Testing is almost always difficult and nerve-wracking at first but you'll both get better at it. Something you definitely should try is giving a treat immediately after - Halo freeze-dried chicken is zero carbs and most cats love it so much we call it Kitty Crack. The two diabetic cats I've had both would head right for the testing spot as soon as I got the treat container out. Another trick is to warm the ear for a couple of minutes before poking to encourage blood flow. But after a while the ear tends to bleed more easily anyway.
     
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  9. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Testing decidedly gets easier over time. As Camille suggested, treats help to deal with the indignant cat pouty face! There are a number of different brands of freeze dried treats and all you need to do is to make sure it's just freeze dried protein (chicken, duck, my cat like mussels).

    Depending on what gauge of lancet your using may also make the job easier. In the beginning using a 28 gauge (the lower the number the thicker the needle) will make getting blood easier. As the capillary bed in the ear develops, you can switch over to a thinner lancet (e.g., 30 gauge).

     
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  10. Duggles

    Duggles New Member

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    Sep 27, 2018
    Thanks again everyone.
    After doing 3 tests in the last day, requiring a few pokes each time, her little ears are looking quite bruised where they've been poked repeatedly so I'm hesitant to do it again until her ears can heal up a little bit. She seems like she's doing well with her insulin today, she was playing with some string a minute ago and now she's sleeping quite happily on the couch, cuddled up with her BFF, Lola the big tabby in the photo, and she's showing no obvious symptoms. So I'm thinking I'll wait a couple of days before I test her again, since it's a bit traumatic for us both.
     
  11. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    A little Neosporin with pain relief ointment (not cream) will help those ears heal quickly....also, make sure you hold something against the ear for a few seconds to stop the blood and prevent bruising
     
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  12. Duggles

    Duggles New Member

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    Sep 27, 2018
    Thanks Chris and China, the neosporin with pain relief is a great idea. Also maybe some aloe gel would speed the healing. For myself when I get bruised up I use arnica gel, as it really speeds up the recovery time and makes bruises disappear within a couple of days. I'm not sure if it's ok for cats though. Whatever I put on her ears usually gets licked off by her BFF, Lola, she likes to bathe her little friend :) As for the lancet, do you use the spring loaded pen type or do it manually with the lancet itself? I watched a bunch of youtube videos and I decided to just do it manually, but now I'm wondering if it would be better to try it with the spring loaded thing since I keep either not getting any blood or getting way too much.
    All the best
     
  13. Chris & China

    Chris & China Well-Known Member

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    May 10, 2013
    I just freehand it, but some people do like the lancet device. The biggest problem I hear of with the device is kitties being scared when it "goes off" due to the noise.

    What gauge are the lancets that you're using?
     
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  14. Bellasmom

    Bellasmom Well-Known Member

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    Feb 12, 2018
    Welcome, everyone is awesome, couldn’t ask for better people on here, when in doubt, just ask:bighug:
     
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  15. Duggles

    Duggles New Member

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    Sep 27, 2018
    Thanks for the welcome :)

    I think the lancets are 28 gauge. It doesn't say on the package but in the listing on amazon where I bought the BG meter kit it says that it comes with 28's.

    I'm going to restart the testing today, but I think I'll try the pen thingy since doing it freehand has been difficult, I think I may be hesitating and doing it too slowly which probably causes more pain than a really quick little poke. I've been clicking the little pen near her and then giving her a treat so she doesn't jump wen it goes off.
     
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  16. Sue and Luci

    Sue and Luci Well-Known Member

    Joined:
    Nov 3, 2017
    Have you had a chance to watch the video on how to test your cat? It's very well done - made a world of difference for us. The only thing I do differently is to use a little sock with some uncooked rice in it - I tie it into a little ball - and warm it in the microwave for a few seconds - I use it to support Luci's ear - and keep my fingers away from the lancet. Not all cats like the warm rice sock idea - but it's been a real charm for us - Luci gets a 'warm sock massage' before getting her ear pricked...she purrs away while I rub that sock on her back...I think she thinks that's what the whole thing is about now anyway - getting her back rubbed with a warm sock...she doesn't seem to mind the rest and lays quietly on the towel while I poke her ear - freehand - I couldn't see what I was doing with the little lancete holder....do what works best for you :)
     
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  17. Ella & Rusty & Stu(GA)

    Ella & Rusty & Stu(GA) Well-Known Member

    Joined:
    Jan 11, 2010
    Hi Duggles, Welcome to you and Kali,

    I used a damp baby washcloth to warm the ear (neither of my cats liked the rice sock: too bumpy). Put the washcloth into the microwave for 15 seconds or so (test it on yourself first to make sure it isn't too hot). Then put the warm, damp washcloth into a small plastic baggie. Fold it over the ear to warm. Talk to Kali and tell her how wonderful she is.
    When it is time to do the ear prick, I put a small gauze square behind the spot on the ear where I intend to poke and hold it there with my thumb. I put a little pressure on the ear with thumb and forefinger (on the other side of the ear) just below where I intend to poke. This causes the blood to dam up and encourages a good drop to form. With your thumb and gauze still behind the ear, position the lancet device where you want it (near the edge of the ear) and do the prick. Put down the lancet device and hold the meter to the blood drop. If Kali is antsy, you can simply get the blood drop onto your fingernail and test with the meter from there. Immediately after the test, fold the gauze pad around the ear and apply pressure. The pressure keeps the ear from bruising. Finally, put on a little Neosporin with pain killer. AND, give the freeze-dried treat!!

    This all sounds cumbersome, but it is really quite easy and Kali will get used to it very quickly. Both of my diabetic cats--Stu and Rusty--always came to the "test site" at the times I usually tested. It becomes part of a cat's routine, and cats love their routines.

    Good luck! Welcome to your new adventure!!

    p.s. I always used a lancet device because it is so much faster than I ever was freehand. The one that I liked the best is the "One Touch Delica". I used it with the OneTouch Delica 30-gauge (fine) lancets, sometimes with the 33-gauge (extra fine) lancets.

    p.p.s. I don't think I would use Arnica gel. I love it for myself, but you never know what might happen if one of your cats ingested it.
     
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  18. Bron and Sheba

    Bron and Sheba Well-Known Member

    Joined:
    Feb 21, 2015
    Hi and welcome.
    I noticed you said you got an 86 Preshot a couple of days ago with the Alphatrak. That is pretty low. I would not shoot that low a number at this early stage. I would stall, not feed and post for help. Put a large HELP in the subject line.
    I would always test before every insulin shot to make sure it is safe to shoot. And another test at about +5 helps us see how the insulin is working.
    Bron
     
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  19. Kylee and Her Mom Renee'

    Kylee and Her Mom Renee' Member

    Joined:
    Sep 20, 2018
    Hi and welcome. Me and my girl are newbies too. Everyone has been so helpful. You were so smart to catch the 10units. My pharmacy gave me the syringe that was bigger. My vet told me 2units 2x's a day. I didn't even think or look at the syringe. I was giving her double the insulin. She went into hypo, but thanks to this board and my knowledge of sugars I gave her honey and food and she was fine. But I was afraid I had lost her. I posted about the syringe and I think it was Chris who asked me to post a picture of the syringe. I bought the correct size and and only giving her 1unit 2x's a day as needed. So be sure to read about low blood sugar and kitty going hypo.
    I am glad you and everyone are here.
     
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  20. Duggles

    Duggles New Member

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    Sep 27, 2018
    Hi everyone,
    Thanks all for the advice, I just did a PM pre shot test and got 509... Yikes. I used a lancet pen this time and found it much easier, but I am quite concerned by the high number.
    I tested myself just to make sure the meter was working and got 145, which seems about right after some pasta and a beer.
    She was acting pretty hungry throughout the day so my girlfriend fed her a few small spoons of low carb canned food. However one of our other cats is still finishing the bag of dry kibble we have left over since switching to canned food, and she may have eaten some of his food.
    What would you guys do if your cat was testing that high pre shot? I don't want to up the dose, especially since she was at 86 pre shot the other day. Should I restrict her food intake? Only feed her twice a day at shot time? I wasn't sure what to do so I gave her the 1u shot as usual and fed her a slightly smaller amount since she ate throughout the day and her BG was super high.
    I will definitely be testing more often in the future now that I've learned to use the lancet pen, it's much easier for me than just sticking her by hand. I used the rice sock method, she was pretty good about it and I didn't hit a gusher like the last time :)
    One question I have, is it ok to feed her salmon? Where I live in Alaska salmon is actually cheaper than cat food, if you can believe that. it's one of the only things that doesn't have to be shipped in by boat or plane.
    Thanks again everyone, I had no idea there would be such a nice community of cat-loving folks in the same situation as me.
     
  21. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    If she got into dry food, that's enough to send the blood glucose skyrocketing.

    Most of us get totally rid of all dry food …..our sugarcats are geniuses about getting into it no matter how hard we try, so it's just much easier to throw it all out and feed everyone low carb canned so if they get into the other guys food, it doesn't matter.....and it also helps keep the other cats from developing diabetes!

    Yes, it's OK to feed her some salmon, but it's not a complete diet. Most of us limit the amount of seafood we feed due to the problems with mercury and other heavy metal contamination and fish is generally higher in phosphorus due to the bones that always end up in "fishy" foods. Fish can also be very addictive and if you want/need her to eat something else, she may not be willing to.
     
  22. Duggles

    Duggles New Member

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    Sep 27, 2018
    Thank you so much for your help. We were thinking of giving away the rest of the bag of dry food we have (or feeding it to our chickens, they absolutely love it) but our other cats have developed a bit of the runs since switching to canned food so we've been trying to switch them over more slowly. However after seeing that number I think the chickens will be getting a big treat for breakfast :)
     
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  23. Duggles

    Duggles New Member

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    Sep 27, 2018
    Kitty is definitely showing symptoms of high BG, she is drinking a lot of water and peeing frequently. I really wish I had some ketone test strips about now. Is there anything i can do except to not feed her and hope her shot kicks in soon?
     
  24. Gill & George

    Gill & George Well-Known Member

    Joined:
    Oct 27, 2015
    You should not withhold food just because her BG is high, feed her her usual meal.

    The high number you got could be due to a kibble raid, but equally it could be a 'bounce' she has dropped lower than she is used to and that has triggered the liver to dump glucose into the bloodstream.
    With the 86 AT you got the other morning, on friday this dose is obviously capable of getting her into low numbers so a bounce is a real possibilit.

    Going forward do you think you could record the readings you've been getting on the Spread Sheet we all use. It's a great way of tracking BG and is also really helpful to anyone trying to help, giving advice without seeing all the numbers is impossible or very risky at best.
    Here's the link for the SpreadSheet instructions http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
    And here's a link explaining how to record numbers and use it http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

    Great job on catching the Vet Tech error! Not the first time we've heard about that happening.:rolleyes:
    FWIW I find using the lancet device easier than free handing it, George doesn't worry about the click noise it makes.
    The Crime Scene moment, I've certainly been there. Yes you probably hit the vein, have you seen the picture of the sweet spot? [​IMG]
    Lots of great advice on testing this posthttp://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/



    Initially you may struggle a bit to get blood until the capillaries form. We haven't got neosporin available here in Europe, so what I did, a member here recommended, was to hold a cold cotton pad firmly at the puncture site, I used to count slowly to ten, that seemed to reduce the bruising considerably, infact you couldn't tell I had been poking his ears at all, and if you look back at the begining of Georges spread sheet , linked on my signature, you can see I tested a lot. It will get easier, hang in there.
    :joyful:
     
  25. Duggles

    Duggles New Member

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    Sep 27, 2018
    Ok thanks much, we'll let her have the rest of her meal then.
    We gave her less than usual because of the high reading, but I guess that's not the thing to do.
    This all seems very complicated, hopefully it will get easier to manage. The last test I did was much easier than the one before, although using the lancet pen seems much easier for me than freehanding it. I will for sure be testing again in the morning before her AM shot. Now is just after midnight here and time for bed.
    I will start using the spreadsheet tomorrow, thanks for the links.
    Best wishes
     
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  26. Gill & George

    Gill & George Well-Known Member

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    Oct 27, 2015
    The issue with diabetes is that the kitty is not able to make use of the energy in the food, because they are lacking in insulin, which is what allows them to make use of it.
    That's why our FD kitties, when unregulated are hungry all the time and loosing weight even when they are getting fed plenty. My George started developing a taste for blueberry jam on toast just before we got him diagnosed.

    Additionally it's important that a FD kitty is getting enough calories, as not enough calories can contribute to them developing DKA, especially if BG is unregulated and something else starts going on like infection/inflammation.
     
  27. Duggles

    Duggles New Member

    Joined:
    Sep 27, 2018
    OK, that makes sense.
    I've been reading as much as I can find but there's more to this whole thing than I ever imagined.
    Thank you everyone for your help and advice.
    The testing is getting easier now as we're developing a protocol and the cat is getting more used to it. This morning she was 349 pre shot, a little better but still quite high. I'll be testing again at +5.
    I've been recording the date, time and BG numbers of the tests and I'll be starting a spreadsheet soon.
    Best wishes
     
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  28. JoyBee&Ravan

    JoyBee&Ravan Well-Known Member

    Joined:
    Feb 17, 2018
    Here's another pic of the "Sweet spot" for testing

    [​IMG]
     
  29. Jill & Jade

    Jill & Jade Member

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    May 29, 2018
    It's super overwhelming in the beginning, but like others have said, you found the best place you could find here in this forum. If you ca, do get rid of the dry food in your home. It's loaded with carbs and seems to be something that most of us have fed our cats before they were diagnosed. It can't be a coincidence.
    The people here helped me many many times with Jade. Day and night. No question is silly, just ask.
    Best of luck!! Will be watching!
     
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  30. Duggles

    Duggles New Member

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    Sep 27, 2018
    I started a spreadsheet for Kali. It doesn't look that great for her so far, although the testing is getting easier and I will be testing a lot more often from now on which should help in figuring out how to regulate her.
     
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  31. Duggles

    Duggles New Member

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    Sep 27, 2018
    PM pre shot was 343. hmm. Still pretty high. So far it doesn't seem like the insulin is doing a whole lot, but then again I have no idea what her BG would be without it. The food I'm feeding is one of the lowest carb foods you can get, Nulo turkey and chicken, only 1% carbs according to the chart. It seems like I should be seeing better results... but maybe wishful thinking, I don't know.
     
  32. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    It takes time....you'll see us say "It's a marathon, not a sprint" a lot around here

    It was 4-5 months before China settled into anything close to a "pattern".

    Now that you're more successful in testing, it'll really help to see what's really going on!
     
  33. Gill & George

    Gill & George Well-Known Member

    Joined:
    Oct 27, 2015
    When I look at Kali's numbers my eyes keep going back to that 86 you got on am Oct 5.
    and then that black you got on 10/7, I'm suspicious that she is bouncing, so in other words the insulin has dropped her into numbers that she is not used to and that has resulted in her liver 'panicking' and dumping glucose into her blood stream in an attempt to keep her safe from a perceived low. How low she may have gone is impossible to say, that 86 might have been the lowest or not.
    Bounces take up to 6 cycles to clear, so I would be looking for her to clear it sometime tomorrow, or even tonight.

    When the bounce clears you may see her drop back into green again.
    I know it's been a steep learning curve with the testing for all of you and you are doing a great job of getting up to speed. I would strongly recommend that you try to get a midcycle test (any time between +1and+11), that means in the pm cycle too, cat's BG often goes lower at night.

    A lot of us will grab a test just before bed, for me that was a +4 or +5 (11-12pm).

    When I first started out I was shooting at 10am and 10pm but it soon became clear that a 7am-7pm schedule was going to be better since it was the early part of the cycle that was going to be the most important to monitor, with lantus, for most cats, they are more active in the first 6hours after giving the shot. George used to Nadir at +5 usually, but it also wasn't uncommon fro him to nadir earlier, especially when he got to a good dose and then started earning reductions.

    If you get this in time perhaps grab a test in 10/8 pm cycle even if that's a +10 when you get up. We want to see how low he is going when he clears the bounce and when it comes to making a decision about dosing it would be much easier on the nerves if there are no gaping holes in the data.

    If she is yellow or blue in the morning if you are home, grab that midcycle test a little earlier, +2 is a good one to grab since that coincides with onset in most cats and if you find it is lower or about the same as amps it can be your early warning signal for an active cycle.
     
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  34. Duggles

    Duggles New Member

    Joined:
    Sep 27, 2018
    My girlfriend and I had a miscommunication this morning and we missed the AM shot. It was due 3 hours ago. Should I give it to her now and then wait until 12 hours has passed (after midnight) for the next one? Or should I skip it altogether and give her the PM shot at it's normal time? I tested her and got 300 but I thought my girlfriend did the shot and she thought I did it. We just realized now that neither one of us had done it. I'm thinking we need to have a better protocol since it's one thing to miss a shot, but another altogether to accidentally give it twice.
     
  35. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    I'd just wait and give it on time tonight
     
  36. Rebecca.garfie

    Rebecca.garfie Member

    Joined:
    Jun 25, 2018
    Try this idea I read earlier if 2 people are shooting in the household put 2 syringes in a cup. Color code them with tape or something. Let's say red is am black is pm. If 1 goes to shoot at am and am syringe is gone you know it was done. This helps with missing shots or double shooting at shot time. Double shooting is meaning 1 person gave am shot and 2nd person goes oh shot time in am and gives 2nd am shot.. Hope you understand what I mean
     
  37. Catacular

    Catacular Member

    Joined:
    Jun 25, 2018
    I wouldn't test less than 4 times a day. As long as you rotate sides and ears, your cat can handle 1 prick a day across 4 "sides." It helps to angle the needle and get the cat in a very good secure position. I hold my kitty on the counter for ear pricks, and because he knows he's about to be fed, he's happy. So my timing was always:
    1. ear prick,
    2. measure BG,
    3. mark BG in SS,
    4. put down food,
    5. draw insulin & shoot while cat's face is in the food bowl,
    6. enter insulin shot into SS.
    Once you get this routinized, it takes very little time, and my cats love being on a regular feeding schedule enforced by the insulin. Ha-ha. Before our kitty went into remission, on working days, we did AMPS at 7:30am, BG test +6 at lunchtime 1:30pm, PMPS at 7:30pm, and then a final BG test +4 at 11:30pm. It took us 46 days to start getting consistent good numbers. We stopped giving insulin after 80 days of treatment, and our kitty has been doing pretty good with no insulin now for 25 days. Slow and steady wins the race, and consistency and measurement are key! If we have to go back to giving insulin, we'll be ready and able. Anything is better than the neuropathy (very weak hind legs) and other problems the diabetes was causing for our kitty.

    Good luck!
     

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