I'm a newbie.. Please help..

Please accept my apologies if i'm posting in the wrong place... My Tommy was diagnosed a few weeks ago with diabetes.. I thought he might have UTI.. took a sample of his urine in.. He does not like the Vet.. He did indeed have UTI.. was put on antibiotics for 2 weeks.. They found blood in his urine and said .I took him in for a BG curve for the whole day so they could monitor him.. His starting point was 568..I was initially told to give him 3U twice a day at 12hr intervals. He has not been back to the vet since..(Cost, Stress on Tommy and My vet believes 100% in Hills w/d.. After much research on the internet.. I do not believe the same as he does.. I am currently searching for a new vet.. one with more of an open mind to other options and who will work with me and not tell me it's this way or no way..Tommy is 14.. weighs 13 1/2 lbs.. Again after much research I have found this wonderful forum with people who love their pets as much as i do.. I bought a glucometer on Dec. 7th.. have been testing at least 3 times a day..
Here is my problem in a nutshell..
He is hungry all the time.. I am feeding him 3x a day at 3oz of wet low carb high protein food.. He was a "dry only" cat food eater for all of his life.. I understand to test before the insulin shot, but is it ok to test him immediately after he eats.. His afternoon numbers have been 151,90 and 68 so far.. all tests taken immediately after he ate and around 3pm.. and 5 1/2 to 6hrs after his morning insulin shot (humulin)..
I have been adjusting the insulin according to the readings i get..
Any advice would be very much appreciated..
Tommy and I thank you!
Lauren B

 

Oh wow! Where to start?

First, kudos for not sticking with the WD and 3 units twice a day to start...that is really poor advice from your vet because 1.WD is oldschool and very poor quality and 2. 3 units twice a day is a very high dose to start with. The only thing that likely saved your cat is the high carb content in the WD.

Please, what insulin are you giving and how are you adjusting the dose?

Jen

 

Agreed! You have done a great job so far.

With Humulin, it is okay to feed before the shot because it is a harsh insulin and he can drop fast.

Unregulated cats are literally starving so what you are feeding him is fine. It would be a good idea to leave out the food so he can snack during the day and night.

This is the place to post, but please take off the 911. It is used when cats are in danger of hypoing or are seriously ill. Your kitty is doing okay!

 

Sorry, I misssed the last part about Humulin N. What dose did you give him today? Those numbers are very nice, IF that is as low as he goes!

Jen

ps He absolutely has to eat prior to getting N

 

Welcome to the best site on the planet. You are right, we DO love our kitties. There is a wealth of information here as well as tons of experienced FD moms and dads who are, ready, willing AND able, to help you and Tommy through this journey.

Again WELCOME.
jeanne

 

Thank you to all of you for your initial responses and praise..By no means do i want to do anything to make it worse.. As far as what i'm doing with the doses.. today i am trying for very tight regulation and checking every 2 hours to see where he's at and when he might be peaking.. I don't know if peak times are different with PZI or is the cat that determines how fast the insulin starts to work. This morning he was 314 at 8:49am... 284 at 11:16am and i'm just now getting ready to go check again..
For the last 3 days i have checked 3 times a day and given insulin according to the protocol chart found at YourDiabeticCat.com which seems to be regulating it much better than the 2 doses every 12hours...
Dec.7th.. 568 in the morning..151 in the afternoon...354 at bedtime.. 3u breakfast...1/2u at lunch...3.5u at dinner
Dec 8th...248---90---408.... 2.5u--morning---nothing at lunch---and 3.5u at dinner
Dec 9th..198---68---253 2u---morning---nothing at lunch---3u at dinner
Dec 10th..314---3.5u.. when i checked him at 11:16 and it was at 284 I gave him nothing due to the fact he hadn't reached his peak yet..
Was i correct in not giving him any then or should i adjust the insulin every 2hrs when i check him (provided he needs it)
As far as leaving out food.. I have Tommy and Teddy in charge of the basement..
Teddy doesn't play well with the girls.. They are upstairs..
And isn't Tommy supposed to only have no more than 8oz of food a day.. I'm worried about the weight gain and i seriously think no amt of food i leave out will last more than a few minutes...
Thank you again all of you.. I'ts nice not to be alone in this..

 

Let me jump on the food thing....

FEED HIM

Give him all he needs, within reason.... his body cannot process the food to extract what he needs in nutrients so he's always 'hungry'.

My two used to eat tons before they were regulated.

Shadoe was eating maybe 24oz a day and is down to maybe 6 now... eats like a bird.
Oliver was up to maybe 30oz or more a day and is down to maybe 13 or so.

they are now fairly regulated and their needs have changed.
Look up some good low carb wet food from Binky's list and see what he likes.

Awesome you are testing, what insulin are you giving, and get a decent vet.

I am on the way out the door but wanted to say my bit on the foods.

Also, Welcome!!

 

Sorry, I can't help with that insulin. I have only Lantus and Levemir knowledge; they are longer lasting insulins, but the others can help you.

 

It looks like you are giving him insulin 3 times a day. Is that right? We would discourage that with a new diabetic. Humulin doesn't last 12 hours like milder, longer lasting insulins, but giving it 3 times a day requires some data in how it works in his body.

We have only a few people here using Humulin. It is a harsh insulin and doesn't last. But here is the protocol for using it: viewtopic.php?f=19&t=303

Don't worry about his weight until he is better regulated. With new diabetics, their bodies can't use the food and they are literally starving. One of things I do is to freeze the wet food and let it thaw while he munches on it. Makes it last a little longer.

I put your numbers in a sample spreadsheet so we could figure out what you are doing: https://spreadsheets.google.com/pub?key ... utput=html I wasn't sure when you were doing the midcycle test so I just put it in the middle of the day.

 

hi sue, i read the protocol for using humulin N.. and i'm wondering if it's the best for tommy.. should i change to another type. and is this possible without seeing another vet.. Like I said as of right now.. It's me my husband and Tommy on this journey ( and of course wonderful people like you)..
I was wondering if you had any input on the amt of food he should have or just feed as much until he's full.. I have read about the freezing of the food and will definitely be giving that a try.. The protocol you linked me to says to give food an hour before testing.. Is that necessary, Tommy has not thrown up and seems to be handling the injections just fine..
Also, I am giving Fancy Feast Classic.. and only seafood ones a few times a week due to the fat.. I have also looked and binkys page and will be trying some of those brands..
What am i doing wrong that his numbers are still high.. Or are they for being a new diabetic..
And from what i read and what you are saying.. I should no longer give him shots 3 times a day like i have been?..
Should i stick with the 3u twice a day.. Like the vet said..
I thought that doing home testing was a means of being able to adjust the amt.. and perhaps even one day have him off of insulin if that's possible for him..
Should i continue to test 3 times a day and give the 3u twice a day no matter what..?
I think my head is going to explode with all of the information.. I just want Tommy to be as healthy as he can while he's still here with us.. and i will do whatever it takes..
I am thank full for your insight and help so far..
Please be patient with me..

 

That protocol gives a reason for this:
"Always make sure kitty eats about an hour before his/her shot. This will insure that kitty has food on her stomach to counteract the typical fast drop of the bg's caused by N (some cats do not drop fast on it, which is, again, why hometesting is so important!). "

You want to make sure there is something for the insulin to work on; otherwise, you risk hypoglycemia.

 

Tommy is one of those cats that does not drop fast... his peak seems to be 5-6 hours after the shot.. that's why i asked if it was necessary to feed him an hour before hand.. I understand that all cats are different, just like people and i am trying to find out what's best for him.. I currently have no vet to rely on for any feedback as my vet of 11yrs feels differently about the methods used here in the forum and other places.. So i'm currently searching for another vet..
I just don't want to hurt my boy...He's been through a lot already..

 

I know it is really complicated, and difficult since so few people here use Humulin. I have asked for help from some previous users; hopefully they will chime in.

Humulin is harder to regulate with, but not impossible. You would have to get another prescription from the vet for one of the milder, longer lasting insulins like ProZinc, Lantus or Levemir (unless you are Canadian but I am assuming not?). They will cost more than Humulin, but they would be easier to use.

He did start with a pretty high number, but if he has an infection, that can raise the number. Once the infection clears, his numbers may go down. One of the problems is that you started on a high dose. We urge newbies to start with 1 unit twice a day. If you start too high, you can start a pattern of rebounding. It is a hard concept to get your head around, but it basically means that his body is producing more sugar because he is getting more insulin than he needs. This explains it much better than I could try to: Rebound

It is hard to know whether he is getting too much or too little insulin. You can "test" it by going back and starting over with one unit twice a day. You would probably need to hold that dose for several days to see how it works. But if you do that, you MUST test for ketones. And you would need to test often to see if he stays in high numbers.

If I were you, for now, I would continue to test often. Get a curve - taking a test every 2 hours during a day to see when he starts down, when he is at the lowest point and when he starts up again. Once you have some data, you can decide what to do. (And hopefully we will have some old Humulin users by then.) But I would not give him insulin more than every 12 hours until I had some data, and maybe not even then.....I am pretty sure the site you saw- YourDiabeticCat.com - is based on the idea of using ProZinc, not Humulin.

A spreadsheet like the one I included on my previous post will be vital. If you are fairly computer savvy, they are not hard to get up: Setting up a spreadsheet If you need help, just ask.

Where do you live - city and state? Maybe we have a member near you who knows a good vet.

 

As far as the food, when Oliver was diabetic (and he was a large Maine Coon) he got 3 cans of Fancy Feast daily. When we got him regulated, we cut back to 2-2.5 cans a day. The idea of feeding before the shot is that if the kitty throws up after eating, he won't have harsh insulin in his tummy without any food.

 

I have to say that yes it is a bit confusing at times given the wealth of information out there.. I thank you for talking with the other humulin users out there..
Why would my vet start me out at 3u twice a day if that was wrong.. Tommy's numbers seem to be a bit high given he is getting 3u twice a day.. how will that be better for him if i lower it to 1u twice a day..
Also, for today go ahead and continue with the testing every 2 hrs for 12 hours.. and feed him as much as he wants right..
Should i not give him the 3u at bedtime then..
Just so you know.. I have tested him 3times today so far...314 at 8:49am...then i gave him 3.5units...tested again 284 at 11:16am--and 161 at 1:30pm..i'm going to test again here in just a few..
By the way.. zipcode 63389, I live in Winfield Missouri which is in Lincoln county Near Troy Missouri and about 45 miles NW of St. Louis..
Thank you Sue and Oliver so very very much...

 

One more thing.. Yes that protocol on the website was for PZI.. Not humulin..
I saw your post also about the food.. Tommy Is going through at minimum 3 cans a day and is still ravenous...
I do have food freezing as we speak..
I also have a Main coon Named Abbey.. she is 3.. My first Main coon was Peeper.. They are a beautiful elegant cat aren't they?

 

I know it doesn't seem to make sense that more insulin could mean higher numbers, but read the article on Rebound. I am not saying that it what is happening; it is just one of the possibilities.

I don't know about your evening dose; hope we have some more input by then.

Here is the spreadsheet of another new member who recently has done very well with Humulin N. (Hers is called Novulin - just a different trade name) https://spreadsheets.google.com/pub?key ... utput=html

I'll go ask on Community to see if there is anyone near you.

 

The scale at ydc was developed for pzi, and the place was full of some very scary people and a few decent people. Tight regulation is a term no longer popular because of many reasons...and for most cats is not possible on N. I applaud your effort, good numbers are good for your cat, but am a bit worried at how strongly you are pursuing this.

Jen

 

What are you worried about Jen.. I'm just trying to do what's best for Tommy.. In my earlier post i did say it was for PZI.. And i'm am just learning about the differences in insulin and what they do.. I won't be using that page anylonger.. which is why i'm here, to actually speak with people who are living this right along with me.. I just want the right answers and i'm sorry if i'm asking too many questions. but i will pursue this until i can make him better..Whatever it takes..

Sue, thanks for your response.. the more i listen to you and read other posts, the more i am understanding about this and i know it does take time.. I've only been testing him for 4 days now and i want to thank all of you for your concern.. I am a worry wart, I am anal about research, and i am a little scared..

 

Hi and welcome to FDMB.

I've used Humulin N in the past, and also in the past, I did TID dosing with PZI (currently using Levemir BID)

You need to do a 12 hour curve on Humulin N to see when it is gone from your kitty's system.
Our concern is that dosing at 8 hours (TID), you may be getting overlap of insulin effectiveness, and as a beginner, this can be a bit tricky to deal with safely.

Humulin N usually lasts 8 to 10 hours in a cat, so TID dosing is not necessarily bad. You may want to read the sticky posts in LANTUS Insulin Support Groups about "Becoming Data-Ready to shoot lower numbers". Keep in mind that some info may be specific to Lantus - but testing blood sugar and your kitty's response is relevant.

We consider a safe cutoff for a "newby" is 200 blood sugar at shot time. If your kitty's blood sugar is below this, then either skip the shot, wait until later and test again, or shoot a reduced dose. You can come post here for advice.

The 3u dose is for feeding dry food, and why your vet REQUIRES feeding dry food. It is a high dose for feeding the "right" low carb high protein canned food that our dear carnivore kitties need.

If you are feeding canned food, you will likely need a lower dose -- since you are testing - you will find out.

We recommend starting at 1u BID and gradually working your way up or down to the "right" dose that your kitty needs --- because every cat is different (ECID)

It is ok to feed extra food -- during the early stages of treatment, diabetic kitties are literally starving -- unable to get the energy out of the food and to their muscles. They won't gain weight unless something else is going on (my first diabetic cat had a condition called acromegaly that did cause him to gain weight - but that is another story).

When your kitty starts to feel better, his appetite will go back to normal.

 

Thank you Phoebe_tiggy_nortonGa..
should i continue with the 2hr intervals tonight.. I have tested him 4times today at those intervals--314-284-161-153..
Also, if he is below the 200 mark how long should i wait to check again and how much to give if it goes above the 200..
Just one more thing for now.. Do i start the 1U at bedtime.. or wait until the morning..
To finish.. You are saying that i should check him in the morning before i give the 1u insulin and not again until 12hrs later.
Do i continue to give 1u every 12 hours no matter what the number is as long as it's over 200..
Sorry for all the questions.. Don't want to screw this up..

 

What does BID and TID mean and where can i find an index listing all of the other abbreviations please..?

 

It doesn't look like Phoebe is still around. i'll try to answer and she can correct me when she comes back.

I would go ahead and get numbers every 2 hours today. Then we can see when his nadir was (the lowest point in the cycle).

if he is below 200 at shot time, wait 30 minutes and test again to see if he goes above 200.

Phoebe seems to be in favor of trying the 1 unit so you could start that with his evening shot, if he is high enough to shoot.

In the am, test. If he is above 200, give the 1 unit.

Since you are starting a new dose, go ahead and get several tests in tomorrow, especially around that nadir point. That info and the numbers you have gotten today will help guide you toward doses down the road.

BID twice a day, SID once a day. Here's the glossary: viewtopic.php?f=28&t=15885

 

Hi again -
No - usually a curve is testing every 2 hours for a 12 hour period. Don't have to test all night.

BID is every 12 hours, TID is every 8 hours or 3x per day.

When you have the curve data ... the time with the lowest blood sugar is the "Nadir" and we want to make sure that is not dangerously low (less than 50 gets an immediate snack - read up on the signs for HYPO and how to treat)

You can start 1u at your very next injection time -- since we are in many different time zones around the world, we don't post actual times -- but AMPS means morning pre-shot blood sugar test and PMPS means evening pre-shot blood sugar test -- and then the curve would have times like +2, +4, +6 etc for how many hours after the shot.

In the beginning when you are trying to find the best dose, you will need to test more often than later on.

With Tiggy, we usually only test at shot times every day, but he has been very stable and we have been treating him for nearly two years. We do a curve every 8 to 10 weeks just to make sure everything is still looking good.

So... was the 314 at shot time? If yes, then your data would present like this:

AMPS 314 shot 3u N
+2 284
+4 161
+6 153

This looks pretty good so far, and actually like the 3u dose might be ok. However since you started at 3u, there is no evidence to show whether 1u would be just as effective. So - let's find out. No need to give more insulin than necessary and risk Hypoglycemia (low blood sugar)

Typically, the nadir for Humulin N in kitties will be between +4 and +7.

Maybe tomorrow, you could test at +5 and +7 to kind of "fill in" your curve with a couple more data points.

The goal is to find a good dose that keeps your kitty in comfortable blood sugar range as long as possible. You will probably find that at +10, your kitty's BG is back up to 300 -- which means no insulin is left, and your kitty is feeling kind of crappy. (typical of Humulin N)

That is why we like the longer-lasting insulins like Levemir or Lantus. Tiggy is on Levemir, and a small dose of 0.5u BID keeps his blood sugar in the normal range (75 to 140) pretty much all day and night. That is the dose that works for him, and we have tested and accumulated data showing that this is ok (the "data ready" to shoot lower numbers -- we know that it is safe to give Tiggy his insulin when his blood sugar is less than 200).

Questions are fine -- we want to help YOU to help your kitty feel better.

 

thanks sue, do you have a different idea on the 1U.. to start.. I'm open for any and all suggestions..
No matter if it's 250 or 400.. 1U is all i am to give.. Please explain how that helps to lower..
I have a question about humans.. Don't they check there levels many times throughout the day and adjust accordingly to keep there levels in the "Normal" range.. J
Just curious..

 

The long lasting insulins build up in the body and steady dosing is important.

The short-lasting insulins like Humulin N can have the dose adjusted more frequently, but in these beginning stages -- you need to a) let your kitty get used to a dose (we used to keep a Humulin N dose constant for a week before making adjustments)
and b) learn how much effect each dose has on your kitty.

Insulin is not "one size fits all". The dosing needs to be custom for your cat -- and to apply some generic dosing scale and sending you off and wishing you good luck -- well, that is dangerous.

Humans do test themselves several times per day -- but the newest insulins are One shot per day (Lantus and Levemir). I'll have to leave it to diabetic humans to answer more fully though.

Since cats have faster metabolism -- they need twice a day shots for Lantus and Levemir.

 

I think starting "over" again at one unit tonight is a good idea. You are testing so you'll be able to tell if it is going to work or whether you need to increase the dose over time.

Read that Rebound page. It will explain why we think the dose could be too high.

The motto here is "better too high for a day than too low for a minute.". One of the reasons we suggest you start low and go slow, increasing as you have data.

Take time to pat yourself on the back (and maybe get a beverage of choice...) You have absorbed a lot of info today!

 

Thanks sue,,, lol...
Actually as soon as i go test Tommy at 5:30pm I'm going to workout.. I have a ski machine here.. You all have been wonderful so far...

 

When an insulin dose is too high, the liver can protect the body by dumping extra sugar into the bloodstream.

This is called rebound.

I don't think that your kitty is in rebound, but how do we know that he might respond better to 1u than to 3u? The way to find out is by reducing the dose and testing.

Has your vet said anything about ketones? You may also want to read up on DKA (diabetic ketoacidosis) so you are familiar with the signs - because this can become an emergency in a hurry. Some cats are more sensitive or prone than others.

If you have a headache, do you take 3 aspirin because that works for your doctor's aunt? Or do you start with one and see if it works? Kind of the same thing here -- best to use the smallest amount needed to make your kitty feel better.

When we adopted Tiggy last year, he was eating dry food and given 5u PZI once per day. We reduced his dose and split it into two doses per day, and changed his food to low carb, high protein canned food. Initially, we gave him 1u BID. We discovered that he needed less. He now gets 0.5u BID and sometimes we only give him a half-dose because he is in a nice normal range. (the half dose keeps his Levemir "storage shed" from emptying)

 

No, i don't believe anything was said about ketones.. is that something i can check. because as of this post.. i have no vet.. i am looking.. My vet and i don't see things the same when it comes to how to treat Tommy.. He believes solely in hills w/d.. that it's the best food out there for diabetes...See my dilema? That is why i sought out and found this sight.. so i can make tommy better and the help and information that has been given to me so far has been invaluable.. Thank you for the layman terms about the aspirin... I do understand the need for less not more...So thank you again..

 

Here is the info on ketones: http://felinediabetes.com/ketones.htm You can buy the ketostix at the drug store. They are the same kind humans use. We have tricks for collecting the "sample".. Just ask.

 

i was just wondering if when i test him in a few minutes.. should i give him the 1u now or wait until 9pm tonight..(that will be 12 hrs since his last shot.)
Thank you..

 

Also, i am interested on the "tricks" used to check ketones.. i read the link about DKA and was wondering if any of you use a glucose/ketone meter by abbott..?

 

I would stick with the 12/12 schedule, if possible. I think it will help you with your data - comparing apples to apples.

Oliver would never pee while we were in the room. To collect a sample for ketones, we put aquarium gravel in the box and left him alone in the room with it. He would go and we would have a sample untaunted by litter. Some people come up behind their cat with a ladle and get a sample, but that didn't work for us. (Love the mental picture, though.)

 

Thanks sue, i love the image..
Funny though, that's actually how i got Tommys sample the first time.. I just happened to be down there checking on him when he was getting ready to pee pee and i had box with rubbermaids in it.. I grabbed one and held it under him until i had enough..
After i get the pee sample should i use a glucose/ketone meter or just get some ketostix.. and how often should i check for ketones..
I read that link that was sent to me and it said that if there is even a trace reading for ketones i should seek care..

 

I don't know what happened to my last post.. so i will try again..
I finished the last test for the evening 6 tests-2hr intervals starting at 8:50amps with a reading of 314.. then i gave him 3.5u
after that...test numbers of 284-161-153-250-340.. should i expect the number to be much higher in the morning given that i have been giving him more insulin at night than the 1U i will be giving him at bedtime tonight.. and how many days do i continue with the 1u twice a day? and how do i adjust accordingly.. is there a means by which this is calculated with humulin N?
I know his body will need time to adjust to the different dose.
Thanks all and have a great weekend..

 

There are only a couple meters that will test for both blood blucose and ketones, and the ketone strips are very expensive. I would go for the ketostix.

You can test once a week or so, unless his numbers are running really high.

High ketones can lead to DKA, which can be deadly and usually requires a vet's care. http://petdiabetes.wikia.com/wiki/Ketoacidosis

I would try the one unit for a few cycles.

Homework: Set up a spreadsheet to keep track of all this data you are collecting.

 

Since the Humulin is all used up in less than 12 hours, I would not expect him to be higher than the 300s you saw today. There are some informational "sticky" posts at the top of the Humulin / Vetsulin / Caninsulin Insulin support group - "The N Primer" is probably the most important.

Some of your mid-day tests were 151, 90, 68 -- well, 68 is at the low end of normal, so you assuredly don't want to increase Tommy's dose.

It would be best if you could change to a long lasting insulin like Lantus or Levemir. Unfortunately it requires a prescription to purchase unless someone nearby will sell you a cartridge/pen. (they come in 5-packs)

 

Hi photosquirrel,

Welcome to FD! You will see that finding this site was the best thing that has happened re Tommy.

You are getting great advice from Sue and Phoebe. If you take a look at my cats Sara's ss, you will see what lantus has done for her. She is down to 1/2 Unit BID and doing great. Not eating like a horse anymore, or drinking and peeing a lot. Lantus worked great for her.

I appauld you for getting the right information re Tommy and sticking to your guns. I hope you find a vet that will work with you. Bacically you need them to perscribe the insulin and the syringes, although I don't know the laws in your state.

Glad it's going to be easy checking Tommy for keytones. That is vital to know. Hometesting is also very important in managing your cats diabetes. So glad your doing it. Putting the informatin in a spreadsheet, makes it easy to track his progress. I believe someone gave you a link earlier.

Good luck with Tommy and keep us updated.

jan and sara

 

hi photosquirrel,

i've been off and on here the past week... my lulu was on humulin n... sounds like you are doing great and getting some really great advise. setting up a spread sheet looks like the next step... this will help you visually see tommy's curve and also let us help too.

my experience with humulin was just ok. lulu is trying to hold his own currently, but honestly if he needs to go back on insulin my vet and i have decided to try levemir... but lets see what we can do with the humulin since that is what you have and you are still vet shopping. i think there are links around here about talking with vets and finding one's that will work with you on all of this... they are out there.

our vet started us at 1u and the beginning was a mess.. he had a bad tooth infection and he was literally starving. his apatite has returned to normal and now leaves food in his dish... before he would eat all he could eat when ever he could eat it. by home testing we started to see that he might need less insulin and he just kept improving once the infection cleared up.

if i can help let me know. you are doing great and tommy is lucky to have so much love!
amanda

edited to add spread sheet link: viewtopic.php?f=6&t=18207

 

Update? What numbers are you getting today?

 

Hi sue, Sorry i haven't updated today.. i just got home a while ago..My mother was admitted to a care facility yesterday after her 2nd fall at home in a couple of months.. My father's 77 and this time he just couldn't help her up..She is 73..and the greatest mom in the world... I live about 35miles from them.. She has middle stages of alzheimer's and my dad just cant take care of her needs anymore. GOD love him for trying this long..I know he did the best he could for her. None of us wanted her to have to leave her home.. I miss her so very much and my husband and i went to see her this morning..
Sorry i went on..
Tommy's numbers amps..363 at 830am.. and 261 at 2:51pm.. I have only given him 1u today so far per the advice given yesterday.. and i have left out frozen food for him as well as fresh.. I am going to check again around 5pm...
Yesterday he was at his lowest around 3:33pm---153.. so i'm a little concerned that the number today hasn't dropped much since the shot this morning.. but i will give another 1u this evening and see where we are tomorrow morning..
Yesterday he had around 12-14 oz of food...
Thanks for checking up on Us..
That really means a lot..

 

Sorry to hear about your mom. It is hard when the children become the caregivers instead of the other way around. My mother is 93 and blind; I know what you mean.

That are pretty good numbers. You will need to give it a couple complete cycles before you decide what to do next. Just keep collecting data.

 

thanks for the concern.. I'm sorry to hear about your mother too.. Yeah it sucks pretty bad.. I just want the rest of her time here on earth to be as good as it can be..My husband and i will be visiting her regularly.. She is staying at a place called Delmar Gardens in O'fallon Missouri.. It is an absolutely beautiful facility and from the staff that i spoke to today.. She seems to be in good caring hands.. We'll see.. It's wonderful to see her face light up when she sees us..

As for the numbers.. they aren't too bad? I guess i just want the numbers to be somewhat normal right this second.. I keep forgetting that's it's not even been a week since i started testing and got him on wet food.. I will keep you posted and thanks for the confidence builder...

 

We have an annoying saying here - Diabetes is a marathon, not a sprint. Patience....

 

just to update the last bg... 414 @ 5:17pm...
That's not so good is it..? Could that high a number be because i haven't fed him enough so far today or not enough insulin.. and how does one tell.?
It appears that over the past 5 days i've been testing the peak is about 5 1/2 to 6hrs after the morning dose...
Just FYI...
this one at 5:17pm is the highest it's been since the 8th of Dec at 9:20pm..
Should i still stick with the 1U... Also, i don't need to check him anymore today do I?

 

Is your 414 your evening shot number? I would give one unit.

Did you miss that marathon thing? You may have to give it a while. We suggest that when you have 2-3 days of data, then you decide if you need to increase the dose.

But know, I am not a vet or any kind of expert. I am using the method prescribed here. He is your cat. You decide. If you are uncomfortable with his numbers, increase the insulin by half a unit. Or if it is not shot time, wait to see if Phoebe comes back on and what she says.

What we are concerned about is that if you dose high, and the change to wet food and the insulin suddenly decides to kick in, he can go too low. It's that "better too high for a day than too low for a minute" thing.

There are no absolutes, and no firm rules to follow. Each cat reacts to insulin differently. Your job is to figure out how your cat reacts. I do wish it was easier and less scary. Does it help to know we were all confused and unsure? Because every poster here is or was....

 

Hi there.. Yeah i know you all were in my place an one point.. and yes i'm a worry wart when it comes to my kids..
No, i saw the marathon funny :smile: I know you're not a vet, i just thought that number was a bit high is all.. and no, he doesn't get his shot until 8:30pm..
I've been looking at some of the spreadsheets that have been recommended to me and it looks like most of them had spikes of high readings in the beginning..
Thanks again for keeping it lighthearted and keeping me focused on what matters most... MY TOMMY!!
Keep you Posted...

 

Tight regulation is still being actively promoted in Lantus currently [if not what the entire Lantus group is dedicate to], and you are right - it IS very scary.

 

Actually Gator I am not referring to the lantus group rather ydc only. I cannot comment on lantus nor would I without knowing a heck of a lot more before casting judgement. Perhaps you could take your concerns there.

 

Hey Sue, if you're out there, i've got Tommy's spreadsheet done.. Would you take a look at it if you get time.. I feel like we're going backwards.. Let me know If the link worked please.. Thank you again..

https://spreadsheets.google.com/ccc?key ... ewJA#gid=0

 

Hey there, I'm not sure I've seen Sue post in a couple days.

What I can tell you is that I cannot access your SS. So you need to log out of Google then try to click on your link. If you can access when you are logged out of google then we should be able to see it too. Help can be found and asked for in the Tech Support forum.

Or you can try PMing me if you would like more help with your SS.

 

i would love to take a look at your spread sheet but it's not visable for us. sue (oliver) is the resident expert at getting that just right for you.
if on the 1 unit you are having higher numbers it is likely time to raise the dose. perhaps at .5 units at a time.
i'm just wondering if i read correctly you had a nice curve with the 3 units...usually a high dose but still a nice curve...don't know why rebound was considered. i probably missed something in all the reading.
i'll wait to see you SS/.
Lori
and tomtom too!
i love your enthusiasm to learn and do the very best you can. you will do very well here.

 

Welcome back! I am out of town and just checking in occasionally. And my Ipad won't let me help with the spreadsheet. Take Gator up on his offer. On his reply, pick PM on the bottom of the page and see him a private message. You are almost there. You just need to publish it so that everyone can see it and Gator can help with that.

As soon as you get it up, why don't you start a new topic and ask for Humulin advice. I asked Phoebe to watch for you so hopefully she will see it.

 

Hi - willing to help -- you need to take one more step with the spreadsheet - right now it is still "private", so we get "permission denied" when we click the link.

you need to "Publish" it so we can look.

very close!! hang in there,
phoebe

 

HELLO EVERYONE.. Thanks for all the info.. found the place where it said to publish.. have done so..
On the Tech forum page for publishing it does say that i am not supposed to change any privacy settings that would allow users to view without signing in. So i have left it private.. Please let me know if the publishing worked.. Talk with you all soon....

 

one more thing.. if anyone has a suggestion on how to shorten the link...................I am allllllll ears!!! ha ha ha...

 

http://tinyurl.com is one way to shorten URLs

As for your signature, [for security reasons] phpBB will not translate html [the "<a href=...> <a/>" stuff. So if you just past your link into your signature then phpBB will automatically recognize it as a link.

Also, if you remove the last "&output=htmltarget=blank" from your link your SS will have enhanced functionality.

Good news is that I can now access your SS if I copy and paste the link.

 

good morning Gator.. Are you referring to the link in the address bar or the one that comes up when i open up the "publish to web page" and then there is the very very long link that i was told to copy and paste and put into my signature.. looking at the links you guys have for your kitties.. are much shorter than that..
Thanks I'll wait to hear back...

 

It looks like you are getting 6-7 hours before the insulin starts wearing off, which is decent for Humulin N. It is odd to see the few black and red numbers and I'm not certain why they are popping up when the rest of your preshots are in the pink. As for expiry, some people found that they could use the humulins past expiry, others found it started losing effectiveness. See a few more days of preshots before you throw it out....

I wish there was something else that stuck out that would explain his behaviour...it could be simply that he needs more insulin...

 

Great - I can see the spreadsheet now.

Humulin N's expiration date is more of a "sell by" date. Always check this when you buy a new vial, so they don't give you one that expires real soon.
Humulin N, if refrigerated and handled carefully, should be ok for the entire vial.

Humulin N is NOT like Lantus or Levemir, which must not be mixed.

Humulin N should be gently mixed before drawing up the shot -- because the insulin (white particles) settles to the bottom of the vial. I used to gently turn the vial about 10 to 15 times to mix it up. (now using Levemir)

Lantus is a fragile insulin that does tend to lose effectiveness after a couple of months.

If you think of your Humulin N insulin as being like tiny ice crystals -- if you shake too hard, the insulin molecules will break and no longer work.

The curve that you did on 12/10 shows that the insulin is completely gone by +10 (BG same as preshot)

This is typical of Humulin N, and it means that your kitty has no insulin for 4 to 6 hours every day.

That is why so many are using Lantus, Levemir or PZI. All these last longer in cats than the Humulin N.

Is dosing / injecting every 8 hours an option? That might help Tommy get some better insulin coverage from N.

phoebe

p.s. with BCP PZI, they label with the manufactured date and guarantee effectiveness for 6 months from that date.

 

Currently the link in your signature reads:

Code:

<a href=https://spreadsheets.google.com/pub?key=0AnMURR6ic-MNdGM2d21oU19iOWlEdlg5ZHlHWmV3SkE&output=html target=_blank>tommys spreadsheet</a> 

If you shorten it to:

Code:

https://spreadsheets.google.com/pub?key=0AnMURR6ic-MNdGM2d21oU19iOWlEdlg5ZHlHWmV3SkE

The board will automatically recognize it as a link and even do further shortening. If you want a REALLY short URL then you can use TinyURL and feed the link above into it. But that's more fancy than most need here.

If you wanted it to read "Tommy's SS" and be linked to your SS then you would put this in your SS:

Code:

[url=https://spreadsheets.google.com/pub?key=0AnMURR6ic-MNdGM2d21oU19iOWlEdlg5ZHlHWmV3SkE]Tommy's SS[/url]

Then it would look like Tommy's SS

We have to use "BB code" and not HTML code on this board to achieve simple HTML tasks [for security reasons].

 

Thanks for all the advice everyone.. yeah i've heard conflicting stuff about insulin and the exp.. date.. i'm going to use it for a little longer.. I think his UTI might be back.. He's consuming a lot more water in the past couple of days too.. but still acting all right.. I haven't shaken the insulin.. I roll it like you do Phoebe..
I also spoke with another vet in our area the other day and was told that PZI can no longer be shipped across state lines.. So i would have to find it here in Missouri.. Do you know if this is in fact true..
Also, I could definitely try the 8hrs 3x a day.. I could do 8-4-12 and see... how would i break the doses down then... right now i am giving him 2.5U 2x a day... doesn't seem to be lowering his numbers like it should... Would you recommend i try to find a vet that carries PZI or levemir. One of our regular customers owns a vet clinic here in Troy Missouri and my husband has had many conversations with him.. Seems like a good man.. I just need someone that will take the time and actually care about my babies.... What do you think.. I've read that i should not change insulin type without having Tommy checked for other problems.. Is it quite possible that the reason for his numbers being high still is that his UTI could have come back.. and there is no way for me to check that is there... I would need to take another sample of his urine back to the vet?
One last thing for now, Gator.. where would i paste this on my ss : Tommy's SS Thanks again everybody..

 

Success! your spreadsheet is now linked in your signature.

When I went to TID dosing -- I started by splitting the total daily insulin (for Tommy 2.5 +2.5 = 5 u ) and divided into 3 equal shots.

since 5/3 is kind of hard to do -- I would go with 1.5u TID

Start on a day that you will be home -- as high as Tommy has been -- give 2.5u in the morning as usual.

At +8, test his BG. If over 200, then shoot 1.5u and continue on from there with tests, meals and shots every 8 hours. (you can make the meals a bit smaller to give 3 also -- with N, it is important to feed when they get the shot and they need to eat about a spoonful ~1oz)

I would suggest that you call BCP Vet Pharmacy about shipping PZI. I don't know of any changes that restrict the shipment -- however shipping costs are significant -- maybe your vet had some problems getting it or just didn't like the cost.

www.bcpvetpharm.com
Toll Free: 800-481-1729
Toll Free Fax: 866-PET-CHEW -- you do need to fax a prescription -- and ask that it be written for a year's supply (several bottles -- you can choose U40, U50 or U100 strengths in either 5ml or 10ml vials)

U40 is popular for giving tiny doses using U100 syringes (U40 is dilute so 1u fills a U100 syringe to the 2.5 mark)

U100 is the same concentration as Humulin N

It would be good to check for infections -- they can aggravate blood sugar.

Check out the new vet. Most do not know about using Levemir.
There are a number of articles about FD / Lantus published.
print out the info here --- and the 3 main reasons that I prefer Levemir to Lantus:

1. Levemir and Lantus are both gentle long-lasting insulins good for cats with BID and low carb diet.

2. Lantus has an acidic base liquid and stings when injected. Levemir does not - it has a neutral base.

3. Lantus is fragile and breaks down after 5-6 weeks -- requiring that you discard and start a new cartridge. Levemir is not as fragile, and I've been able to use the entire 3ml cartridge -- never had to throw away any from loss of effectiveness (using Levemir since 4/2009.

 

At +8, test his BG. If over 200, then shoot 1.5u and continue on from there with tests, meals and shots every 8 hours. (you can make the meals a bit smaller to give 3 also -- with N, it is important to feed when they get the shot and they need to eat about a spoonful ~1oz) HI PHOEBE.. THANKS AGAIN FOR ALL OF THE INFO..This sentence i don't quite understand...
Just so you know... Tommy has no problem eating at all........... i can't seem to give him enough.. and he definitely eats before i give the shot..
Are you saying if he is under 200 not to shoot at all?.. and then check again at bed and then shoot..? and that every morning he should be given 2.5u or just the first morning.. and when you said make the meals a bit smaller to give 3 also... what does the 3 reference?
Will i need to do a bg reading 3x a day all the time.. before his shot..
I also think it might be a good idea to have him checked for any other infections.. Like i said earlier, i'm afraid his UTI is back...
Oh and i just checked him about 20min.. ago.. reading up to 438 tonight....arrrrrrrghhhhh!!!
Thanks again Phoebe, I'll keep in touch..

 

Ok - yes, you got most of it ---- test before every shot, and give food with every shot

If you test at +8 (new shot time), and blood sugar is over 200 -- give 1.5u

some mid-cycle tests would help out too --- test at +4 or so.

IF..... BG is less than 200 at the +8 shot time -- then wait 30 minutes and test again. If Tommy's BG has increased by AT LEAST 20, then ok to shoot.

When I was shooting Norton TID -- about every third day, he would be in the green at shot time - so we would delay that shot

So... he ended up getting shots kind of like this:
Day 1: +8 +8 +8
Day 2: +8 +8 +8
Day 3: +12 +9
Day 4: +8 +8 +8
and so on

we were testing between 4 and 6 times per day

Another thing to consider that works for HUMULIN N or PZI ONLY --- NO Lantus or Levemir (warning to other readers) ---
developing a sliding scale for Tommy
A sliding scale is for adjusting the dose based on BG at test /shot time. So -- if BG is high - give a bigger dose. If BG is low - give a lower dose.
!!!This possibly frequent changing of dose does not work for Lantus and Levemir!!!

The sliding scale is developed by examining Tommy's spreadsheet and seeing how he responds to insulin -- and defining doses accordingly.
If you are interested in trying this, we can work out an initial scale.

Or if you want to start with TID for a week or two and see how that works -- that is great too.

 

Question...why TID dosing of when when there are other easier insulins available that require only BID dosing and less testing? I have never thought that TID dosing would feel great for the avg cat...

 

Though I have not done TID myself, I think the idea is that spreading a day's dose over 3 doses vs two doses can actually be more gentle. Just like spreading a day's dose over two shots than one is more gentle. Judging by the recent TT topic this may not be an advisable idea at this juncture with Lantus or Levimir. But with PZI/ProZinc it has worked wonders on occasion - including leading to remission.

Now whether or not the additional testing is fun for the cat is another topic.

 

@Jen
we're discussing what she can do NOW to help her cat feel better.

Not everyone can walk out the door and buy a different insulin.

We have to have a prescription for Levemir or Lantus (vet visit), and it costs more here than in Canada.

My vet refused to prescribe Lantus or Levemir for years because she didn't know enough about it. When she got a new patient already on Lantus - she finally did her homework and realized it was good stuff -- in 2009.


I agree - it would be terrific if she could get Tommy started on one of the L's, but it takes a bit of time to coordinate -- even if someone lives up the street and hands her a free cartridge.

 

Fair enough on the not necessarily being able to switch

Gator, I do not think that N is as nice to do TID with as PZI...quite a different action altogether. depending on the cat, might work well (overlap) or not (rollercoaster)

 

hey Phoebe, I was just checking in and wanted you to know that Tommy was 258 this afternoon so i gave him 1.5u.. No matter what his number is tonight, i should give him 1.5u right? That's going to make 5.5U for the day..
I'm not to give him 2.5u tomorrow morning am i?.. That was just for Day 1.. Just wanting some clarification..Sorry again if i'm sounding like such a dope..
And given my schedule i don't think it will be possible to always test 4-6 times a day..
We'll be taking Tommy to a new Vet next week to find out what's going on and to hopefully get his insulin changed to Levemir.. I saw what you said about not doing TID with that one.. but i am going to try and TID with the humulin until then.. keep you posted..

 

HEY EVERYONE, JUST LOOKING ONLINE AT LEVEMIR PRICES AND WAS WONDERING IF $180.99 FOR 3ML X 5 PENS IS THE NORM..?

 

Hi - agree - from now with 8 hour shots -- stick with 1.5u but do please post preshot numbers and try to get some mid cycle tests - like +4 or +3 or +5

If you need to increase the time -- let's say go back to 12 hours for a few days -- increase the shot accordingly
so the daily total amount is similar.

With a prescription, you can order Lev from Canada online for cheaper than buying in the U.S.
There is a thread in the SUPPLY CLOSET about ordering from Canada.

I live close enough to drive (35 miles from border), so I can buy at their pharmacies -- last two purchases were $120 and $110 for a 5 pack of Levemir. I have taken along my prescription "just in case" I get questioned about it at the border.

When ordering from the Canadian pharmacies, they only charge $10 shipping, so that is not too bad.

Since Levemir does not go bad -- one 3ml cartridge of 300 units lasts Tiggy several months, so a 5 pack is enough for about a year and a half.

I'm sorry - I forget -- did you post your location? (city/state) maybe someone nearby can sell or give you one cartridge.

 

By the way - in case it wasn't clear ...

with TID dosing, we will be taking advantage of overlapping the effective time of the insulin.

So - today, Tommy went from 451 to 258 and you gave a little shot at 258 before he is back on the moon.
this next cycle, he may go 258 down to 100 and back to 250 in 8 hours --

please post, ok? Maybe start a new thread because this one is getting very long