i'm new here- increase dose????

Discussion in 'Feline Health - (Welcome & Main Forum)' started by dollsinmyeyes, Jan 23, 2012.

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  1. dollsinmyeyes

    dollsinmyeyes Member

    Joined:
    Jan 23, 2012
    Hey I'm a 26 year old nurse, with a newly diabetic cat.

    The vet prescribed 4 units of lantus BID, and after last weeks fructosamine level of 678, told me to start gradually increasing Satan's insulin by one unit every few days, and to do urine ketone tests to judge if it needed to be increased. I than asked if it would be okay to do blood testing. (AND I AM SO GLAD I DID)

    Last night was our first adventure in blood glucose testing on the cat. I managed to get a sample last night, and one this morning. THE NUMBERS CONFUSE ME
    last night his blood sugar read out as 42, I'm hoping i got a low test value because the strip was out for a long time, I know as a nurse in people if hte strip is out too long, it's not good anymore and reads low. So I fed him his meal, 1/3rd of a can of DM, and some saucy stuff to get him to eat it. and than attempted a few more times to get him to let me check his blood sugar, but poor kitty thinks i'm trying to kill him and doesn't want to come out of the bed except to cry for food.
    2 hours later i gave him 2 units of lantus, and left dry food out, went to bed, kitty slept on the foot of the bed fine all night.

    this morning at 6am his blood glucose was 102, so i'm going to hold his insulin, because i have to go out till 11-12am. bc i have a drs appointment.


    any advice on what to do would be great. the vet was clearly not quite right in the just increase his insulin levels more if his bs is in the 40s, or even 100, at meal times. i don't want to kill my cat. I am so glad to have found this message board

    thanks

    -melissa and satan
     
  2. Ann & Scatcats

    Ann & Scatcats Well-Known Member

    Joined:
    Dec 31, 2009
    Re: i'm new here and i could use some help.

    Hi


    You did the right thing of not giving him 4 Units of Lantus.


    Fructosamine of 678 is very high but if you have been feeding him dry food that could very much explain such high numbers.


    What has he been eating for menue so far up to becoming diabetic?


    If high carb dry food is taken away and one only feed low carb wet food or low carb dry food, the glucose level will drop significally, so you should go very easy on the insulin dose you are giving then.

    Others will come along and write more. I am in Sweden and can't advice you on good low carb food over there besides that you have a look at Binky's food list.
     
  3. Teresa and Poopy

    Teresa and Poopy Well-Known Member

    Joined:
    Dec 17, 2011
    Re: i'm new here and i could use some help.

    Welcome to the FDMB family, Meliisa and Satan (LOVE the name!)! cat_pet_icon

    I'm heading out the door for work so will keep this short. In my signature is a link for Janet and Binky's food list. We aim for at least <10 carbs for food. While Satan is eating the MD, great, but most cats quit eating it in short order (they just don't like it much). The MD can be returned to your vet if this happens (or if you decide to quit offering it - just tell the vet Satan wouldn't eat it).

    Going all wet canned low carb is best for trying to manage a diabetic kitty.

    A normal, non-diabetic kitty's BG will range from 40-120. The numbers you are getting do not call for insulin, but i'm sure other Lantus users will be along to help you soon.

    Have a great day and welcome again! cat_pet_icon
     
  4. Mystery

    Mystery Member

    Joined:
    Oct 4, 2011
    Re: i'm new here and i could use some help.

    Good morning Melissa and Satan, and welcome.

    Great news that you're testing his blood sugar at home and congratulations on successful testing! I'm certainly no expert in dosing, but readings of 42 and 100 are troublesome for that high of a dose. Four units of any insulin is a very high dose to start out with, and you might want to consider reducing it significantly until you get more data from testing that would indicate that high of a dose is needed. Most people on this board (and they have a tremendous amount of experience with feline diabetes, much more than most vets) recommend a starting dose of one unit twice per day.

    The Lantus advice givers will be along shortly, I'm sure. In the meantime, a little more information for them will be helpful. When was Satan diagnosed and how long have you been giving the 4 units twice per day? Have you changed is diet since his diagnosis? If so, how long after diagnosis? What brand and type of foods are you feeding? What type of meter are you using?
     
  5. Vicky & Gandalf (GA) & Murrlin

    Vicky & Gandalf (GA) & Murrlin Well-Known Member

    Joined:
    Dec 28, 2009
    Re: i'm new here and i could use some help.

    Hi Melissa,
    I'm very glad you are familiar with human diabetes because you are spot on about 4U of Lantus being too much to start for Satan. Thankfully you are hometesting already, even though I know it can be challenging to get Satan used to the routine.

    I can't spend a lot of time online this AM before work, but here are some links to get you started with using Lantus and keeping Satan safe.

    Information on remission in cats:http://petdiabetes.wikia.com/wiki/Remission#Proposed_Mechanism_for_Feline_Diabetic_Remission

    BG levels for cats: http://petdiabetes.wikia.com/wiki/BG_levels

    Protocol for tight regulation with Lantushttp://www.tillydiabetes.net/en_6_protocol2.htm

    Hope these help. Also, if you change diet to low carb, Satan may not even need 2U of insulin BID. 1U is much safer to start, even if he is an large or overweight cat.
     
  6. ohbell

    ohbell Well-Known Member

    Joined:
    Apr 21, 2011
    Re: i'm new here and i could use some help.

    Wanted to drop in and say welcome! I was ( my sugar Bean is in remission) a PZI user, so I will let the lantus folks do more advising. But, I will say that 4 units seems terribly high - wow!
    and if the diet has changed, so will the amount of insulin.
    Just wanted to say welcome and bump this thread up some!
     
  7. Hope + (((Baby)))GA

    Hope + (((Baby)))GA Well-Known Member

    Joined:
    Dec 28, 2009
    Re: i'm new here and i could use some help.

    Not a Lantus user but wanted to say "Thank God you were hometesting". Way too high a starting dose and by you immediately getting in to the hometesting you saved your kitty's life.
     
  8. nwnews

    nwnews Member

    Joined:
    Dec 11, 2011
    Re: i'm new here and i could use some help.

    HI Melissa, welcome to you and Satan. I'm a newbie myself (Sitka dx'ed in December) but wanted to welcome you. I also use Lantus and from everything I've learned its a 12 hour insulin more designed for long term glucose management. Everyone here (and fortunately my vet as well) advocates starting at 1 unit and staying with a dose for at least 4-5 days. I'm certainly glad you are home testing because as a nurse you know hypos are dangerous. Sitka's numbers the first three weeks were all over the map. I stayed with a 1 unit dose and now she is very consistent with numbers in the 150 to 250 range. So I think you need to lower the dose, hold it for a few days, see how Satan's numbers are running before changing the dose. There is a spreadsheet you can download and use so you can see how Satans glucose numbers are trending. Give your little furbaby a pet from me. Jan
     
  9. dollsinmyeyes

    dollsinmyeyes Member

    Joined:
    Jan 23, 2012
    Re: i'm new here and i could use some help.

    Hi, thank you everyone for your prompt attention,

    i should have been more clear,
    satan was diagnosed 12/23 after i noticed his thirst and increased urination. so to the vet we went, they were skeptical, and than said he was very much so diabetic, and that i should start him on 4 units of insulin, lantus bid, and to bring him back in a few weeks for a follow up blood test,
    after a month of lantus, on about 2 weeks in we switched to the purina DM wet food, this week i switched to purina dm dry food mixed with his old friskies dry food.

    satan pre-diabetes would eat 1.5 cans of food a day, pretty much anything, mostly friskies. and some dry food, maybe a cup a day. when i thought he was diabetic, i changed him to some of the foods listed on the diabetic cat lists (ex binkys)


    vet instructed to start him eating 1/2 a can a day + leaving out 1/4 cup of dry food for him. - 1/2 a cup of dry when i go to work at night because i am often gone 15 hours at a time. which sucks for regulating the cats blood glucose but i have to work.

    i started off giving him as directed by the vet 4 units of insulin when i could 12 hours appart, and on my own accord would give 3 on the doses that i knew the next one would be early, and 4 units when i knew the next dose would be late.

    1 month fructosamine level of 678 was after following the above insulin schedule and the above feeding schedule,

    yesterday in the AM i had given him the 4 units, fed him as i have been, and took his blood sugar at 6pm(ish) got 42, fed kitty, gave 2 units at about 8, tested blood sugar again at 6 am. was 102, fed kitty, with no insulin.
    i am going . or have been trying. to get him out from under the bed now that i am back from my drs visit. kitty doesn't trust me. he was okay with insulin shots. but he's not into this ear pricking thing


    i hope i clarified everything.
     
  10. dollsinmyeyes

    dollsinmyeyes Member

    Joined:
    Jan 23, 2012
    Re: i'm new here and i could use some help.

    alright so 11:25am blood sugar 519
    he was probably very upset and stressed. because it took 3 or 4 ear sticks to get the test done. my poor kitty

    i am going to give him 2 units of insulin right now, and try and keep him on the 2 units every 12 hours as much as possible and as soon as i have a few days off, hopefully this wednesday i am going to do a curve, poor kitty is so unhappy with the ear sticks. he wont even let me pet him, and hes quite a cuddly cat.

    thank you everyone.

    any continued advice would be great.
     
  11. Teresa and Poopy

    Teresa and Poopy Well-Known Member

    Joined:
    Dec 17, 2011
    Re: i'm new here and i could use some help.

    It helps to give a special, low carb, treat that is only for pokey pokes time...something he will learn is special...just like he is! :D

    I also made sure I would pick Poopy up and love on him, even when he didn't want it and would turn away, so he didn't associate me picking him up as always being pokey poke time.

    He now comes to me and purrs during pokey pokes...he wants that treat! (And knows momma bean still loves him. ;-) )
     
  12. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Re: i'm new here and i could use some help.

    Welcome to FDMB.

    Sue/Oliver posted on the Lantus board that you were seeing some "odd" BG numbers for Satan and asked that some the us that are familiar with Lantus in cats stop by.

    First, I'm somewhat surprised that Satan will eat DM. Most of our kitties are not fond of the stuff. (Read the label -- it's primarily animal by-products.) While the carb count isn't awful (7%), you can do better. In fact, you could be feeding a premium, human grade quality cat food that's lower in carbs and costs less than the prescription diet. There's no magic with DM. Lisa Pierson, DVM has an excellent website on feline nutrition that you may want to take a look at. We also have food charts -- Janet & Binkys and this spreadsheet with nutritional values -- that can guide you through finding low carb food that Satan will like. While lower than 10% is viewed as low carb, most of us feed substantially below that. (I feed my guys Wellness chicken or turkey -- 4% carb.)

    With respect to dose, was Satan started at 2.0u BID or did you work up to that dose? If it was 2.0u, that's a large starting dose. It's not surprising that you are seeing wide swings in BG numbers. I suspect that once you get home testing under your belt, you'll see that Satan's numbers are dropping and then he's bouncing into high ranges. I would not do anything yet with his food until you feel a bit more comfortable with home testing. Many cats experience a drop in numbers if you reduce the carbs in their food. You may find it helpful to set up a spreadsheet so you can keep track of Satan's numbers. It will also help us if you want input regarding dose if we can see your cat's progress.

    Numbers in the 40s on Lantus are on the low end. When you see numbers below 50, a dose reduction of 0.25u is warranted. For now, I would not suggest that you give a shot if Satan's BG is below 200. Until you have a better sense of how his numbers are ranging, you want to be sure he will be safe after you give an injection and not risk hypoglycemia if you're not available to monitor. Because we typically make dose changes in 0.25u increments, you may want to look into getting syringes that are marked in half unit increments. Most of us order our syringes on-line or use Walmart's Relion syringes.

    With regard to testing, are you giving treats? The best way to acclimate your cat to getting his ear poked is with treats and lots of praise/affection. Many of us use freeze dried chicken or salmon, jerky style treats, or even cut up cooked or raw chicken as a treat. (Basically, anything that is pure protein works just fine.) Satan gets a treat regardless of whether the test is successful or not. The idea is to provide a positive reinforcement for his putting up with the ear poke so he associates the poking with a treat. Cats really will work for food! You want to make sure you are testing between the vein and the outer edge of the ear. If you poke the vein, you get a lot of blood. You also want to use a wider gauge lancet in the beginning -- something like a 28 gauge lancet. The wider lancet will make it easier for you to get blood with fewer pokes.

    Home testing and food are the best places to start on this journey. There is a great deal of information regarding Lantus in the starred, sticky notes at the top of the Lantus board. We follow a particular approach to dosing on that board (Tight Regulation) that has a very strong track record for getting a newly diagnosed cat into remission. It does require a bit more work than a "Start Low, Go Slow" approach. Which ever method of dosing you opt for once you've had a chance to get the basics down is fine. The support is here for you. The people on FDMB are extremely generous with their time and their information. If you have questions, please ask. We're here to help you and your kitty.
     
  13. dollsinmyeyes

    dollsinmyeyes Member

    Joined:
    Jan 23, 2012
    Re: i'm new here and i could use some help.

    again, thank you

    satans bs tonight at 6pm is 551,

    clearly his diabetes is out of wack.

    i have to go to work, and will give 2 units insulin


    for clarification: the vet had me start him on 4 units bid a month ago,

    i am going to cut back to 2 units, and work back up, because something was out of wack with the vets instructions,

    i will continue to do the low carb / dm food.

    thank you sue/oliver and sienne gabby, and everyone else who stopped by to offered advice and help

    i am quite a little bit of a nervous wreck with regards to kitty, who won't eat his post prick chicken. he's not my friend these days. and i feel a lot less alone in this cat diabetes mess. and i am reassured that he despite his blood sugars, looks and acts pretty normal. aside from the distrust.

    -melissa
     
  14. ThomasCat

    ThomasCat Member

    Joined:
    Jan 18, 2012
    Re: i'm new here and i could use some help.

    That is very odd your vet prescribed such a high dose right away. Curt was in the 400-500 range during his intial test and diagnosis at the vet last week and they only put him on one unit of PZI. I have not been home testing yet but he seems to have improved almost immediately despite being only 5 days into the shots. Although he still seemed very happy and playful, he was losing a lot of weight and drinking constantly. He tested 260 today about 6 hrs post shot and they told me that was very good. I imagine anything more than 1 unit would make him go too low. :( I also have to work 10 to 12 hours more at a time so Im not really home to observe him, which is really worrysome at times, so i understand. I hope Satan gets regulated soon.
     
  15. squeem3

    squeem3 Well-Known Member

    Joined:
    Dec 28, 2009
    Re: i'm new here and i could use some help.

    The dry food left out dyuing the day is probably why your cat's blood glucose levels are high. Even a low carb and/or grain-free dry food can keep blood glucose levels too high.

    Solution to long work days that most everyone here uses: a programmable timed feeder and fill the compartments with low carb canned food :thumbup canned food will be ok if left out all day. Some people add water to the canned food or freeze canned food into cubes to slowly defrost for meals later in the day. The PetSafe 5 compartment feeder is a popular one.
     
  16. ThomasCat

    ThomasCat Member

    Joined:
    Jan 18, 2012
    Re: i'm new here and i could use some help.

    Most cats like to graze throughout the day though... Curt eats 4 or 5 bites and then walks away... probably does that every 30 minutes throughout the day. Im not sure if I should stop this or if its okay?
     
  17. Karen & Pearl

    Karen & Pearl Member

    Joined:
    Dec 28, 2009
    Re: i'm new here and i could use some help.

    My opinion is that your cat was started on a huge dose and may now be in a chronic rebound situation. I'm not well versed in how to bring them out of that, but personally, I would totally drop back to 1 unit bid. I wouldn't shoot low numbers right now at all. I'd even be tempted to let that criteria ride a little high, like at least 250 before shooting so you can get out of this wild swinging.

    I would also get something he LOOOOVES to eat, deli chicken or turkey or bacon or something, and start plying him with that when testing. Not sure if you know how lantus works, but the cat builds up a shed and once capacity is reached, you can start getting some major action. He was soooo low and now has swung so high, it seems to be a matter of time before he starts crashing down again. With testing, you can figure out where to go with dosage, but I sure as heck would pull way back. Practice testing with treating and write those numbers down so you can see what is going on more specifically. I'd say you should talk to your vet, but I'm not really sure what this vet's experience with diabetes is considering the dosage. Once you get a handle on things, you could consider switching to a better low carb wet food from the list Sienne gave. He will be your friend again, and pretty quickly if you reserve that special yummy for testing time. Thank goodness you are testing.
     
  18. Karen & Pearl

    Karen & Pearl Member

    Joined:
    Dec 28, 2009
    Re: i'm new here and i could use some help.

    It's true dry food makes regulating blood sugar harder, especially the higher the carb. I always left wet food down for Pearl though. And I fed her pretty much breakfast, a lunch, dinner and bedtime. It's way more about the carb count than having specific and strict feeding times. Pearl was never comfortable under 100 and she seemed to know that she needed to eat to feel better if she got low.
     
  19. akbahsMum

    akbahsMum Member

    Joined:
    Jan 17, 2012
    Re: i'm new here and i could use some help.

    When I put my cat on wet low carbs his insulin needs fell through the floor (from 3U twice daily to 0.25 at present). So removing the dry food might help.
    He wasn't happy with the ear testing (my first fortnight of it was miserable hell, or maybe that's how I'd describe Akbah)
    now we have a routine in which
    -i hold the warm sock to his ear and stroke him 30 times, I had to make him stay for that but he decided he likes it
    -then i prick his ear (after 10,000 pricks, his ears are easy to bleed now, so this has become suddenly easier for the rather grim reason of constant sticking)
    -then I hold his ear with the tissue and stroke him 20 times, he likes it more or less but is more interested in the next bit
    -then I give him a bit of low carb treat, which he loves more than the world. but I think i've discovered that the low carb treat has sugar and we have to stop with it and find another. sigh.
    -or sometimes instead of a treat i brush his cheeks with the brush. he absolutely loooooves the brush so this works.
    BUT it has taken a while for us both to work out this routine. I had to be pretty pushy for quite awhile and it involved a fair bit of dragging grumpy cats out from under beds and being avoided.
     
  20. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    Re: i'm new here and i could use some help.

    Welcome to the FDMB. LIke Sienne, I'm also popping over from Lantus Land.

    She explained that it appears Satan has been getting into very low numbers and then bouncing back up into high ones. This is caused by the liver reacting to numbers it is not used to and so, in trying to protect the body, releases counterregulatory hormones and glucagon into the blood to bring the BG back up to what it come to perceive as safe numbers.

    One of the things that might help Satan is if you put Neosporin with pain relief ointment, not cream, on his ears after you poke.

    Dry food is slow to raise the BG but then it keeps it elevated for quite a long time...every cat is different (ECID) and so it's difficult to know how long it would affect Satan's BG. As you slowly convert Satan from dry food and DM to low carb foods, you will have to be sure you can monitor/test him as his BGs should come down. But again....it is important for you to be able to test to monitor him before you make the switch. And we also highly recommend that you never shoot insulin without testing first.

    As Sienne stated and is important for you to understand, there are two protocols you can use for lantus but in neither do we raise or lower the doses by the increments your vet has suggested. By doing so, then you could easily be missing his "fitting dose" or the dose where you can get him into normal numbers of 50-120. Both protocols give you information on when to take him up, when to reduce, and by how much.

    In my signature block are links for Handling Low Numbers and Dealing with Low Preshots. As Sienne stated, for now and until you build up more data, you should probably not shoot any number below 200.

    We're all here to help so please let us know when you have questions.
     
  21. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

    Joined:
    Feb 17, 2011
    Re: i'm new here and i could use some help.

    just wanted to add my welcome, melissa. i'm also a lantus user that follows the Tight Reg protocol. you're surrounded by people who are glad to help you with whatever you need.

    first thing is getting the hometesting down. that's what keeps satan safe while using insulin.

    second is addressing the food issue - canned low carb is the very best. you can leave it out for hours and it will be fine. add a little water to mookie it up so it doesn't dry out.

    if you're techy enough to get the spreadsheet, it really helps. those of us who use lantus can "read" the spreadsheet numbers and trends and tell you what you need dose-wise.

    i agree with the "don't mess with the food until you're testing" because you don't want to cause a hypo incident from taking away the carbs without adjusting the dose simultaneously.

    we've all been in your shoes. we understand it's overwhelming. we understand that most vets aren't all that experienced with feline diabetes and the quirks of using lantus. some are, but many are not. we'll do our best to give you a hand. we understand feline diabetes - all of us do it 24/7 all year around.

    we'll teach you what you need to know to keep satan (ha - bet there's a story there!) safe and help him get back to feeling good.

    ask questions. and breathe - he didn't get this way overnight and it will take a while to help him recover. but now you're not alone in it. :YMHUG:
     
  22. dollsinmyeyes

    dollsinmyeyes Member

    Joined:
    Jan 23, 2012
    Re: i'm new here and i could use some help.

    Thank you again.

    I am at work, and I am printing out whatever I can. so i can read and figure out what is the best thing to do for now.

    I am going to attempt to set up the spread sheet when I get home, and I will feed him what he wants. and keep it to canned foods that are considered lower carb foods. When i go to work at night I am reluctant to leave no food out until i can get some sort of auto feeder, so ill continue to leave out some dry food, but just a little bit. he only ever eats the dry food if he is desperate anyway.

    I do think I put him into some rebound sort of cycle of hyper/hypoglycemia with too much insulin. Shouldn't have listened to the vet. I questioned the doses and the proceedures, and she poo-poo'ed it. But probably because she just doesn't know. But clearly you guys do. and I guess i will soon.


    Since is came up about his name, Satan is a 11 year old cat I've had since he was born, he was the run of the litter, all white except for his tail, one spot on his back, and his devil horn shaped spots, he is one of those sweet large cuddly devoted cats, at least until i started poking him with needles all the time. he's also a big cat! he weighed about 25 lbs prediabetes, and isn't too fat now at 20 lbs, the vet said he's not obese but not thin, but he's more scrawny than i've ever known him to be his whole life.

    I am very eager to have a day off when I can start testing his blood glucose all day long, and I think i will keep him on 2 units of lantus BID because his levels are too high, unless after reading both protocols i think something might be better.

    Im going to see what i can get as tasty low carb treats. the bacon idea might work. he likes meat. he won't eat freeze dried stuff though.

    how much do most people with 20lb cats feed their cat? I was probably over feeding him pre-diabetes, cuz i fed him whatever he wanted to eat. The vet directed me to start feeding him a lot less than i used to. and i feel like he's always starving. he always wants food. :x poor kitty

    and again thank you! hopefully soon enough ill get this all managed and sorted out. a few nights ago i debated trying to find him a new home, or
     
  23. squeem3

    squeem3 Well-Known Member

    Joined:
    Dec 28, 2009
    Re: i'm new here and i could use some help.

    There's a list of low carb treats here: http://www.felinediabetes.com/FDMB/viewtopic.php?f=14&t=9172 There are some non-freeze dried treats you can feed.

    The general rule is to feed about 20 to 25 calories per pound of ideal body weight. Since diabetic cats can't utilize food nutrients properly and are always hungry, you generally want to feed as much as the cat wants but without causing a huge weight gain. A 20 pound cat might need a 5 ounce can split into small meals throughout the day.
     
  24. Teresa and Poopy

    Teresa and Poopy Well-Known Member

    Joined:
    Dec 17, 2011
    Re: i'm new here and i could use some help.

    If Satan likes meat...cut up a raw chicken breast. I put about half a dozen 1/2" cubes to a baggie and freeze them, thawing one baggie at a time. I microwave one cube for 5 seconds to take the chill off. Each time you poke, Satan gets a cube. Poopy goes nuts for his raw chicken!

    Not only is it a yummy treat, it's good for their teeth and zero carbs! :D
     
  25. Brian

    Brian Member

    Joined:
    Jan 7, 2012
    Re: i'm new here and i could use some help.

    The massive size of your cat might explain the very high initial dose. Some protocols advise a starting dose of 0.25-0.5u bid per kg of ideal weight depending on how high the blood glucose is at the time of diagnosis. If your cat is not a major fatty at 20lbs (~9kg), then you've got a really large cat and 4u might not have been totally unfounded from your vets standpoint. That said, starting low and working your way up is definitely safer from a hypo point of view, especially if your work has you gone for long periods of time. Changes in food can have a big impact in insulin requirements, so careful monitoring is a good idea whenever you switch things up.

    How many calories per day depends so much on the individual cat that the ranges of calories per pound are really just crude starting points. I just aim for feeding a consistent amount each day and monitor the weight changes over a couple of weeks. Adjust the calories up or down accordingly.
     
  26. dollsinmyeyes

    dollsinmyeyes Member

    Joined:
    Jan 23, 2012
    Re: i'm new here and i could use some help.

    home from work. managed to corner kitty and do a glucose check, 346 at 10 am, which is 15 hours post his last lantus 2 unit shot.
    at least its a better number than 42, or 559. i will continue to do checks before every insulin shot, and tomorrow i will do a curve


    all your hints were very helpful...

    the neosporin with pain relief helped with the prick, as did not using a lancet device and just poking his ear. today we got our stick over with one try. yay. i also lured him near me with a little bit of ham.... he had a bite or two of his wet food. i am going to work on switching to some tastier choices than the DM. he's not such a fan of chicken. he's picky. he likes saucey cat food. that im sure isn't good for a diabetic cat.
    he still tends to eat almost anything i leave out. he's always hungry. oy vey. he's been known to steal cheese off pizza if you don't pay attention.

    and tomorrow i will work on the spreadsheet.

    you are all too kind. Thank you (everyone i can barely keep track) so much.

    i am much happier tracking his blood glucose. the way the vet wanted me to do things just did not sit right with me
    and i am glad you all agree.

    -m
     
  27. Ann & Scatcats

    Ann & Scatcats Well-Known Member

    Joined:
    Dec 31, 2009
    Re: i'm new here and i could use some help.

    Thank YOU for wanting to take care of your baby!


    We (Simba & I) don't do ear testing, we do paw testing and here is pictures of Simba being tested. http://www.kattdiabetes.se/70116292 His treat is to be held by me and cuddled and then he gets kisses and hugs. He is very tolerant as long as I use the left back paw and as long as he doesn't have to go to the loo :) He was easy to teach to sit and do this, since 1. the nurses at the hospital started him off with getting paw tested, and 2. this is how they sit when we cut the nails so he wasn't uncomfortable sitting like that.

    I was terrified in the beginning when given the first insulin shots and doing the blood testing, that he would scratch and bite me.

    Good luck with the testing and getting the spread sheat!
     
  28. Teresa and Poopy

    Teresa and Poopy Well-Known Member

    Joined:
    Dec 17, 2011
    Re: i'm new here and i could use some help.

    You're right, the gravy tends to be high in carbs, so good to have on hand in your hypo kit but not so good for regular feeding.

    I trick Poopy by adding water to his food to make "gravy". He laps it up!
     
  29. Julia & Bandit (GA)

    Julia & Bandit (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Re: i'm new here and i could use some help.

    According to the AAHA dosing guidelines, the max starting dose even when using a weight based formula should not be more than 2u: http://www.aahanet.org/PublicDocuments/AAHADiabetesGuidelines.pdf
     
  30. kim and simon

    kim and simon Member

    Joined:
    Jan 7, 2012
    Re: i'm new here and i could use some help.

    I hope things are going well! Hang in there.

    25 pounds...wow. When can we see a picture? :lol: (preferably next to some standard sized object to compare scale and size :D )
     
  31. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

    Joined:
    Feb 17, 2011
    Re: i'm new here and i could use some help.

    my felix, who we fondly referred to as The Moose, weighed 24 lbs at one point. poor guy was on a diet for the last couple of years of his life. 1/8 cup of dry food am and pm. and he always seemed hungry and never seemed to lose weight! i loved that "little" guy!

    btw, cats need to have very slow weight loss. i don't recall the percentage, but it's slow. their livers can clog with fat if it's too fast. usually newly diagnosed cats are starving. their bodies aren't getting the nutrition they are eating as long as their blood sugar is uncontrolled. his appetite should improve as his numbers improve.

    just reminding you to NOT switch completely over to low carb canned food until you've got the testing down. with lantus we are looking for 4 tests a day to keep the cat safe. one test before each shot to make sure it's safe to shoot - for a newbie we recommend not shooting under 200, and a test somewhere mid-cycle so we can see how low the dose is getting the cat. lantus dosing is based upon the low numbers of each cycle.

    sounds like you've seen both the Start Low Go Slow and the Tight Regulation Protocols. do you have questions we can answer for you?

    the way lantus works - it wants consistency. same dose, same time of day, 12 hours apart, mostly the same food & carbs. if you change things around you'll get wonky numbers and it's hard to see what the dose changes need to be. a late dose acts like a dose decrease and if you shoot early it acts like you've increased the dose.

    i'm not sure about giving a cat pork - i read somewhere that cats can't digest it. that's the reason it's not in any cat foods. i think i'd look for something else.

    good job on getting the test in today! wahoo! you're doing great and it only gets easier!!!
     
  32. Brian

    Brian Member

    Joined:
    Jan 7, 2012
    Re: i'm new here and i could use some help.

    Yep, and according to http://www.uq.edu.au/ccah/docs/diabetesinfo/link3.pdf (Marshall and Rand, protocol for an infrequently monitored cat), there's no mention of an absolute max starting dosage. I'd definitely agree that it was a scary high dose and a good thing Melissa was testing. I guess my point is it's not easy for a generalist vet to keep up to date on every new advance especially given how fast things change and that the expert specialists often disagree, and even often disagree with themselves a few years later.
     
  33. akbahsMum

    akbahsMum Member

    Joined:
    Jan 17, 2012
    Re: i'm new here and i could use some help.

    That's interesting, I'm glad you posted that link. I have wondered about paw testing but when I tried I didn't get any blood and I was scared to hurt Ak. I couldn't find any pictures of where people put the needle. My next question is, what angle to you go at? Straight down into his paw? Or across?
     
  34. dollsinmyeyes

    dollsinmyeyes Member

    Joined:
    Jan 23, 2012
    Re: i'm new here and i could use some help.

    unfortunately i can not help but give his shots off sometimes.

    i work 12.5 hour shifts as a nurse.and it takes me about 14-15 hours to get home. and if i work 2 nights in a row i am only home for 9 hours.

    i know this is not ideal but i can't afford to take care of myself much less the cat unless i work

    so off schedule i will be i suppose. and hopefully not killing my cat.

    15 hours post last lantus 2 unit shot. satans bs is 568. im giving him 2 units and feeding him half a can of food. i tried to feed him less yesterday but he ate it all and cried for more......... poor kitty likes to eat.

    ill give up the ham. - i went with ham bc someone suggested i fed him bacon as a treat, and i knew he was fond of ham-

    turkey is okay right? he seems to be sort of lured in with the ham.

    and again for clarification purposes...... i gave satan a month of 4 units lantus bid wiht out checking his blood sugar. and i feel rather guilty about not trusting my own gut that that was wrong. it seemed so not right to me. i should have investigated further....... thankfully he seems fine.

    tomorrow i will do my best to do a curve. and we'll be on q 12 hour shots whenever i can manage to get them done....... i wish i didn't live alone right now. so someone could help! hahaha. i need a cat sitter.


    on the spread sheet---- what does amps and pmps? is that hte blood sugar when you give teh shot??

    thank you all again. you are great!
     
  35. MommaOfMuse

    MommaOfMuse Well-Known Member

    Joined:
    May 26, 2010
    Re: i'm new here and i could use some help.

    amps = morning preshot before food or insulin
    pmps = evening preshot before food or insulin

    When I say before food that is before his actual meal, not his testing snacks...And yes turkey is great! A lot of the time I get a whole turkey when they are on sale and then cook it, debone it and freeze what I'm not going to use up in the next couple of days, and defrost the rest as needed for Musette's pokey treats. :D With 13 cats, who all want a treat when their sister gets her ears poked ...One turkey goes a long ways for very little out of pocket for mom.

    Mel, Maxwell, Musette & The Fur Gang
     
  36. dollsinmyeyes

    dollsinmyeyes Member

    Joined:
    Jan 23, 2012
    Re: i'm new here and i could use some help.

    turkey it will be for the next set of pokes.

    ahhh satan is back to his purring self. although still kind of scared of me touching him, i haven't heard him purr in days, when usually it just takes me calling him to set off a purr...

    one more question and than i have to go to bed. and stop obsessing over my cat.

    any one have any advice to avoid poking through cat ears? it happened with the lancet device, but i think i get better results free poking, but i keep piercing his ears. and it makes me feel terrible... maybe

    and i thought getting blood out of newborns heels was hard..... (i'm a l&d nurse) cat ears. oy vey. its torture for me and him still. his right ear will never bleed enough for the machine to not error. i'm using a bayer contour. i find it errors a lot. sucks up the blood and tells me its not enough. i think i'm spoiled by the accucheck we have at work that requires a massive amount of blood but you have 10 seconds to add more drops.


    thank you mel and brian, and so many other people who have offered their advice.

    spread sheet will be worked post my nap. i've been keeping a notebook so far.

    thanks again
     
  37. kim and simon

    kim and simon Member

    Joined:
    Jan 7, 2012
    Re: i'm new here and i could use some help.

    I started out free handing and now I've moved to the lancet device. I am able to have it on just the second shallowest depth now. Once I figured out where to poke, I could use a shallower poke. Also, toward the tips of my cat's ears is a thinner area, so I have poked through before. But on my cat, it's easier to get to the outside of the vein up higher (further from that foldy thingy!) so the shallow setting works nicely for us there. When I was free handing I was creating much larger bruises. I know that some people like each method, so you just have to figure out what works in your hands!
    Thicker gauge lancets, smaller number, may help also--you can get a better poke with not as much depth. However, I found the wider ones to be HARDER to freehand because they weren't as sharp and my hand was hesitant.
    Interestingly, I can also get a good stick on the opposite edge of the ear than is shown on any demo. Sometimes I do that now too. My cat has white ears, though.

    Look here for advice I got. Yeah, I was still figuring this out on Jan 11 so you will learn fast!
    http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=60857
     
  38. Jennifer & Saima (GA)

    Jennifer & Saima (GA) Member

    Joined:
    Aug 16, 2011
    Re: i'm new here and i could use some help.

    I have to second the 26 or 28g lancets. I had a terrible time getting any blood until I switched to those. I feel a little bad b/c I think they hurt a bit more, but then I was no longer poking her 20 times to get a drop of blood, so I think they were better overall.
     
  39. akbahsMum

    akbahsMum Member

    Joined:
    Jan 17, 2012
    Re: i'm new here and i could use some help.

    I have recently found that if I do a prick, and look and pause, nothing happens. But if I do a prick, then keeping the tissue behind the ear for a base, gently slide my finger along the edge of his ear from his head to the spot where I pricked, a drop of blood comes out. Ah, friendly drop!
     
  40. Ry & Scooter

    Ry & Scooter Member

    Joined:
    Dec 10, 2011
    Re: i'm new here and i could use some help.

    I use the Contour as well, and I wasted a lot of strips on errors at first. But you learn to distinguish the proper blood droplet size. The Contour uses .6 microlitres which is small. The blood has to touch the end of the sipping track. Older meters require 3-5x as much, maybe more. Just make sure you warm the ear up... a minute at least. A small amount of Neosporin or vaseline can help the blood bead better and not soak into his fur. And after you do the poke, gently stroke his ear towards the poke spot to help the blood bead up. I use the lancet device on the middle depth setting and I rarely put it through Scooter's ear any more, usually only if I push on his ear too hard. And even when I do, it doesn't cause any issues. You will get the hang of it. Just always remember to give him treats, even with the unsuccessful pokes.
     
  41. MelanieAndRacci

    MelanieAndRacci Well-Known Member

    Joined:
    May 19, 2010
    Re: i'm new here and i could use some help.

    Hi,
    I'm also a lantus user and Racci is a big cat (about 18 lbs). She was getting 4.5-5U bid but is in the process of changing to 4-4.2U bid BUT she started out at 2U of PZI at that time and was gradually increased by half units and switched to Lantus which has been much better for her. I am about to update her ss, sorry. I have crps/rsd so can't always type. but you can look at old history if you want on 2 ss's. I would start him on 2u given his weight and only bid given Lantus and it's way of building up as the experts have told you. You have been given great advice. I just wanted to let you know that large doses are not uncommon on lantus for big cats, just not a good way to start for the reasons already given. I agree with everything else you've been told, just don't think 1U will do much for him.

    Good luck & welcome!

    Melanie & Racci
     
  42. dollsinmyeyes

    dollsinmyeyes Member

    Joined:
    Jan 23, 2012
    Re: i'm new here and i could use some help.

    so i'm working on a spread sheet. i am much less tech savvy than i thought i was . i don't think my colors are showing up right in the spread sheet to highlight the doses. and how sad but i don't even have a clue how to make a signature on a message board

    a lot of my shots are given off schedule. on the nights i work back to back i am only home for 9 hours. so i am trying to figure out how i should adjust those doses. but i am just kind of lost. i am off until friday night so ill be trying my best to keep him on a schedule.

    i think satan needs more than 2 units of insulin? anyone else agree? or am i just totally wrong? do i need more data? tonight/tomorrow ill be doing as many tests as i can get kitty to let me. at least my testing skill is improving. tonight we got the test over in one prick.

    at the moment i am getting very overwhelmed by this all.

    think i figured out the signature at least. colors are still not showing up

    https://docs.google.com/spreadsheet/pub ... utput=html
     
  43. Teresa and Poopy

    Teresa and Poopy Well-Known Member

    Joined:
    Dec 17, 2011
    Re: i'm new here and i could use some help.

    It's ok to feel overwhelmed. :smile: We've all been there. :D

    I understand about your work hours. And it's going to be ok. :smile: Keep in mind, when you test later (like when you get home from a 15 hour stretch) the numbers will be higher because the insulin is gone or losing it's effectiveness. Hopefully other Lantus users can chime in about the staggered doses. If I understand Lantus correctly, the "shed" needs to be filled pretty close to the 12 hour mark. I haven't used it so I could be wrong. You might end up wanting to switch to ProZinc due to your schedule since it's more flexible.

    Bottom line, do what you can when you can. Something is much better than nothing, ok? :D

    Having more numbers, especially during the cycle, will help determine if Satan needs more, less, or the same amount of insulin. At this point, it's very difficult to tell how the insulin is working for him. :smile:

    Don't forget to breathe, and we're here for you. :YMHUG:
     
  44. dollsinmyeyes

    dollsinmyeyes Member

    Joined:
    Jan 23, 2012
    Re: i'm new here and i could use some help.

    as kim i believe requested, my fat pooky cat man


    rrr well that upload didn't seem to work. if anyone has any advice on how to post a picture. hahaha. i'll share one.
     
  45. akbahsMum

    akbahsMum Member

    Joined:
    Jan 17, 2012
    Re: i'm new here and i could use some help.

    They are big numbers you got there, I see em. I can give no advice about shooting your cat. I can advise you about the board: wait till some experienced voices kick in. Don't raise your shot without lots of consideration ... and normally people say to wait and get a decent amount of data before changing anything. And sometimes people see high numbers and call it "rebound", and suggest lower doses. So my main thought is, hang on and try to get more numbers in there. See if you can get numbers for the early, middle and late part of a cycle. This will help people to think about what is happening for puss.

    I see you've got your signature happening, way to go!!! You're doing so well to get this stuff happening, home testing isn't easy to learn, though its alright once you and your cat are used to the process. You should be proud of what you've achieved so far, its all well worthwhile.
     
  46. dollsinmyeyes

    dollsinmyeyes Member

    Joined:
    Jan 23, 2012
    Re: i'm new here and i could use some help.

    thank you....

    satans insulin is due in 1.5 hours, and his sugar was 400 2 hours ago, 500 now, and hasn't really had a meal since 11 am, since i missed whatever part of the curve with lows that would happen i think because i was asleep, i feel like he isn't on a big enough dose at 2 units. he's also starving. literally begging and crying for food. and he's gone back to drinking way too much water in the past few days since i lowered his insulin to 2 units instead of 4......

    i am going to feed him and than insulin is due at about 9:45pm, if anyone see this before than who knows more about it, would it be unreasonable to increase his insulin a touch? maybe 2.5 units, 2.25 units? sorry for so many questions....
    i'm also going to start investigating a vet nearby who has some diabetes experience.


    at least the ear pricks are going well now. being a nurse haha sadly only seems to help in being able to have skill with stabbing things or people with needles.

    everyone here is so kind and helpful. i really appreciate your time, knowledge and support. because no one wants to hear about cat diabetes.

    -m
     
  47. MommaOfMuse

    MommaOfMuse Well-Known Member

    Joined:
    May 26, 2010
    Re: i'm new here and i could use some help.

    Yes you have some high numbers but you also have some very low preshot and late cycle numbers, which could mean that those high numbers are coming from his liver releasing stored sugars and counterreglatory hormones.

    With as few numbers as you have it is impossible right now to tell if it is too much insulin or too little insulin as they both look exactly alike without data to back it up...but looking at those low preshots and late cycle numbers I would be inclined to say he maybe getting too much, instead of not enough. Just my 2 cents based on what I'm seeing with limited data.

    With as erratic as your work schedule is you might do better working with the "Start Low, Go Slow Protocol" http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=61800 Sometimes throwing more insulin at a cat especially if you can't test often is like throwing gasoline on a fire, the numbers only get worse not better, or the cat takes a sudden dive and you have a full blown hypo on your hands.

    Personally, if Satan was my cat I would back off the insulin to 1u or less depending on what his level was when diagnoised and follow the Start Low, Go Slow. While testing as often as you can for Ketones. Satan didn't become a diabetic overnight and he isn't going to be 'cured' in a week either.

    Mel, Maxwell, Musette & The Fur Gang
     
  48. akbahsMum

    akbahsMum Member

    Joined:
    Jan 17, 2012
    Re: i'm new here and i could use some help.

    I have posted a question about this on one of the Lantus boards, hopefully they will come over and have a look at this predicament for you.
    Is your spreadsheet all up to date? I can't see the bit that would show "his sugar was 400 2 hours ago, 500 now"
    Head scratches to Satan. How is he? lethargic? thirsty? Okay?
     
  49. akbahsMum

    akbahsMum Member

    Joined:
    Jan 17, 2012
  50. Teresa and Poopy

    Teresa and Poopy Well-Known Member

    Joined:
    Dec 17, 2011
    Re: i'm new here and i could use some help.

    If that is Satan in your avatar, he's adorable! cat_pet_icon
     
  51. dollsinmyeyes

    dollsinmyeyes Member

    Joined:
    Jan 23, 2012
    Re: i'm new here and i could use some help.

    that is satan in my avatar :)

    i am going to leave the insulin at 2 units, he might be over compensating but i only got the one low blood sugar test, and that was when he was on 4 units of insulin. so i already halved it, tonight and tomorrow ill get as much data as i can. i need to be more patient. when i have my human patients who are diabetic on lantus. it's different. sliding scales and such. cats are different. ahhh.

    and someone asked - kitty is very thirsty. which he wasn't when he was on 4 units bid. which is why i was thinking it's not enough insulin. but i will wait and get more numbers. but he's not lethargic, or not acting any differently than usual. he ran around outside for 15 minutes. now he's stalking his food bowl.

    i think? i fixed the spreadsheet. i'm sorry i'm not so great at this yet. and i also can't for the life of me get the colors on my numbers to work? i'd do it manually even if i could. i know it should just fill in but won't.

    i'm working on getting ketones but he will only use the litter box in private. i set a second one up with nosorb stuff from the vet for that purpose but so far he wont use it either. (which i'm surprised about- he's used this setup in the past)

    i'm about to try and get the pm preshot and i'll be up till at least midnight so ill get a reading before then as well.

    thank you all again
     
  52. Blue

    Blue Well-Known Member

    Joined:
    Dec 28, 2009
    Re: i'm new here and i could use some help.

    Before you worry about a dose to give, you need to first sort out your work schedule because there lies your problem. Lantus works on a 12/12 shot schedule or very close to it. If you are shooting 2u at +5 and then again 2u 7hrs later, you are going to have nadirs clashing and no numbers are going to be true.

    Change your subj in your first post to ask about help with Lantus 14/10 schedule. There are some people who work odd hours and so they may shot 2.5u at the start of the 14hrs, then shoot 1.5u at the start of the next 10hrs.
    Get help with the scheduling first, once you know what times you can shoot, then you can figure out what to shoot am and pm.

    As for the food, let him eat. When the diabetes is not regulated, their bodies can't extract what they need from the food. One of my cats was eating around 30oz/day but once regulated he was closer to maybe 10oz.

    The colors on your ss you can do yourself; they don't need to be automatic. I add other info in the fields on my ss's so the colors don't work for me either. Just go to the field you want to color and select the color you want.
     
  53. dollsinmyeyes

    dollsinmyeyes Member

    Joined:
    Jan 23, 2012
    Re: i'm new here and i could use some help.

    thank you gayle.

    there was only one day when i gave him insulin that close together. and his sugar was too high not to give him anything i felt. and i had to go to work. and i had cut his dose in half the day before because of the low sugar. just to explain. i know it wasn't right. i just didn't know what else to do at that point, and it was before i knew about spreadsheets and how lantus was working exactly in cats. i know a little more now. i hope.
    i can not do anything to change my work schedule unless i get a new career.

    i will try asking about advice on a dosing schedule.... it makes sense, and when i was giving the 4 units. in retrospect, i was adjusting the dose to be a little higher when i left for work and lower when i came home. i have it all written on the fridge, but i wasn't testing his sugars, and,
    honestly. i don't know why i didn't think about that when i lowered his dose and started checking his sugars. so thank you for reminding me i could do this. i clearly needed the reminder

    and i will see about doing the colors. as i said. i apparently am way less tech savvy than i thought.


    so if anyone has any dose scheduling advice. i leave for work at 7pm and get home between 945-10am most days. there is no one around i could get to come in to dose him early. i only work 3 nights a week. so 4 days a week i can do 12 hour dosing.

    thank you!
     
  54. Blue

    Blue Well-Known Member

    Joined:
    Dec 28, 2009
    Re: i'm new here and need help w dosing schedules!

    What about sticking with a split schedule every day? It may be alot easier for you and your kitty to have a solid 15/9 routine. I wish I could help with it but I have no experience. I do know there are a few people on the board who have successfully made their routine work, and I am sure you can get a good one set up as well.

    It's like 6 of one, and half a dozen of the other; I think you will need to talk to the others if it's worth it to have a 15/9 for 3days, then switch to 12/12 for 4days. I think I'd want to stick with the same routine every day.
     
  55. Vicky & Gandalf (GA) & Murrlin

    Vicky & Gandalf (GA) & Murrlin Well-Known Member

    Joined:
    Dec 28, 2009
    Re: i'm new here and i could use some help.

    Hi again, Melissa. Gayle asked me to check in because of my experience with a wacky work schedule and arranging shot times.

    Is this schedule a 3 day in a row thing? If you can explain each day of the week in terms of when you leave for work and when you come home that would be help us help you with a schedule because how much insulin depends on what the shot schedule was the day before as well.

    My experience with schedule changing due to work requirements is with Levemir insulin. I feel Lantus and Levemir are similar enough insulins that what I have done should work with Lantus, but it may take some time and experience to develop a shot schedule that works for Satan. We say Every Cat Is Different or ECID. If you are willing to learn, we can help with this.

    I will just ask because sometimes people don't think of these things - is there anyone you trust who could come in and get a BG test and give shot closer to 12/12 schedule? Even a vet tech at a clinic is worth asking, they might live close enough to be able to do it for a small fee. Some petsitters will also give shots, but again there would be an extra fee and I don't know your financial situation. If someone could come in about 7AM and do his BG test, shot and food, that would help you out a lot and might well be worth the cost.

    And Mel "MommaofMuse" is right - he could be getting too much insulin even at 2U. She has good advice on that. Not having a reliable dose is a bit of a problem when doing unusual shot schedules, but our main goal is to keep Satan safe.
     
  56. dollsinmyeyes

    dollsinmyeyes Member

    Joined:
    Jan 23, 2012
    Re: i'm new here and need help w dosing schedules!

    Thank you for chiming in, i was thinking about pming you on Gayles suggestion

    If i could start this all over I'd have never given him 4 units bid. he might be in some horrible rebound thing, but my gut feeling is that he's not on enough insulin right now because he's thirsty and peeing a lot more again. but i don't know. i'm willing to just try and wait it out a few days,

    i think i want to just feed him how he wants to be fed as long as it wasn't more than he was eating pre-diabetes (or when i think he became diabetic, or symptomatic) until i get a feel for how his sugars are on the 2 units of lantus, unless someone strongly strongly feels its too much insulin. it might be. i clearly do not know enough about this.
    but i need more data, and the more i read, and look at others spreadsheets the more i think i am learning.

    my schedule is erratic, my 3 days in a row are not the same, for example i am off work now until friday night, leave at 7pm and come home 930 saturday am off saturday / sunday, work monday night 7pm-10am tuesday (takes longer to get home on weekday mornings). and than i am off 2nights, than on 2 nights in a row, sometimes i work 3 nights in a row but it is rare, because it is hard on me to do. my schedule changes every week, and i really don't have much control over it aside from requesting 4 specific nights off a month

    occasionally, very infrequently, i get sucked into staying late. due to the nature of being a nurse,

    satan gets his vet care so far at a clinic in my town, with some volunteer techs, but they are mostly all teenagers and i would be reluctant to let them into my home at 7am, my mom and sisters live out of reach for coming in, and the only neighbor i really know is an elderly lady who would probably do this if she could. i'm pretty sure wrestling my cat and doing blood glucose checks, or even giving him a shot is beyond her. especially at 7am.... but i'll keep my eyes and ears about it...... theres another lady i talk to occasionally whos dog loves my yard, but she doesn't usually walk lily until 9 or 10 am, and than she's usually half asleep in her pjs. i do live in a friendly neighborhood. but i feel like its a really big task to ask of any of these people. i'm wrestling the cat to do the ear pokes currently. but we're getting them over faster now at least. and as many people report. one ear gives lots of blood now. poor bruised ear. :sad: but he likes getting his turkey treat :)

    sorry if i wrote a lot.
     
  57. Vicky & Gandalf (GA) & Murrlin

    Vicky & Gandalf (GA) & Murrlin Well-Known Member

    Joined:
    Dec 28, 2009
    Re: i'm new here and need help w dosing schedules!

    Melissa,

    Here's a tentative schedule based on your working those hours on 3 consecutive days and staying with 2U.

    regular shot schedule should be 10PM/10AM

    Day 1 non-work day
    2U at 10AM
    2U at 10PM

    Day 2 work day 7PM to 10AM
    1.75U at 10AM
    1.75U at 7PM before leave for work

    Day 3 work day 7PM to 10AM
    1.5U at 10AM
    1.75U at 7PM before leave for work

    Day 4 work day 7PM to 10AM
    1.5U at 10AM
    1.75U at 7PM before leave for work

    Day 5 non-work day
    2U at 10AM
    2U at 10PM

    Day 6 non-work day
    2U at 10AM
    2U at 10PM

    Day 7 non-work day
    2U at 10AM
    2U at 10PM

    Day 1 non-work day, start schedule over.

    The reason to lower the dose twice during the work period is because of Lantus' accumulative effect that you may see referred to here as a "shed." I am afraid it might build up too much so I think it should be lowered prior to each +9 shot except for that first work day. Also, giving shots earlier than 12 hours since the previous shot is like a dose increase itself, so you have to lower the dose. The formula I had developed for Gandalf was based on my determining that a 12% decrease worked OK. If Satan's dose needs to be 2U that is very easy mathematically.

    I will be honest that without knowing how effective 2U truly is for him, that makes this whole schedule kind of a guess. It is what I would suggest for a cat who was somewhat regulated on 2U. But at the first sign of 2U being too much, like another low, we need to rethink this schedule and dose. From what you're saying I feel OK about 2U for him at the present time.

    I just read your newest post. The somewhat erratic schedule complicates things only a bit more. Basically you want to reduce not just the earlier shot but also the shot before that one. If you want to try it for yourself with next week's schedule, write it out like I just did and we can make sure it's OK. There really isn't much you can do to extend duration in this case because the very next shot after going 15 hours between has to be an earlier one.

    I hope this gives you a little more control and helps you feel better about everything.
     
  58. dollsinmyeyes

    dollsinmyeyes Member

    Joined:
    Jan 23, 2012
    Re: i'm new here and need help w dosing schedules!

    thank you so much vicky for your time and knowledge,

    when i am a little more awake i will write out my time just like you did.
    and what you say makes sense. and i guess it will take some experimenting, and maybe some trial and error.

    i'm sorry i don't have better data yet. still figuring this all out

    but you have made me feel like this is more manageable. and i really appreciate that. and satan does too. even if he thinks i'm torturing him still.

    i overslept on the 9 hour test but i got a 10 hour test, of 216, which wasn't such a low drop, ill get the 11, and the amps.
    i am realizing that the low usually comes at 5-9 hours for most cats, so i will try to get readings in that range today, and tomorrow if at all possible.
    but it doesn't appear that most cat's go down that much lower than the 10 hour, but i don't have enough data to assume anything.

    everyday this will get easier. that is my mantra, and that's what i keep telling the cat man
     
  59. Teresa and Poopy

    Teresa and Poopy Well-Known Member

    Joined:
    Dec 17, 2011
    Re: i'm new here and need help w dosing schedules!

    And how right you are! You're doing great, so keep up the good work!
     
  60. kim and simon

    kim and simon Member

    Joined:
    Jan 7, 2012
    Re: i'm new here and need help w dosing schedules!

    To add your picture, click on the blue upload attachment tab at the bottom of your post window that you're working on. Click choose file-->navigate to the file on your drive---> select it--->click add file---> add caption if you like---> position cursor where you want image---> click place inline. This works for me at least!
     
  61. dollsinmyeyes

    dollsinmyeyes Member

    Joined:
    Jan 23, 2012
    Re: i'm new here and need help w dosing schedules!

    the picture upload thing isnt working, but ill try again sometime.

    today went better than yesterday with regards to glucose numbers, nothing in the 500s, or even 400s

    all wet food, most of it low carb, while going over binkys list in depth today, i discovered a lot of what he eats was low carb, so we're going to switch to the low carb friskies flavors, some DM mixed in to use up what i have left, we're going to start on wellness, for variety, because he seems to really like it.
    http://www.petco.com/product/112955/Mer ... -Food.aspx anyone feeding their diabetic cat this?

    i haven't gotten to type up the plan for the insulin shots, but i have an idea in my mind, and hopefully have a few minutes in the morning. its been a long day of errands and chasing kitty and i am falling asleep
     
  62. akbahsMum

    akbahsMum Member

    Joined:
    Jan 17, 2012
    Re: i'm new here and need help w dosing schedules!

    Those numbers look better Melissa. And you've done a BG curve, go you! Or maybe half a one, I still don't know if they're meant to be 24 hours or if one cycle is enough. Anyway, good work. There's not a huge curve in them I notice. Most curves I've seen have more of a dip in them, in the middle somewhere. I wonder if a curve will appear as Satan settles down into 2U.
     
  63. dollsinmyeyes

    dollsinmyeyes Member

    Joined:
    Jan 23, 2012
    Re: i'm new here and need help w dosing schedules!

    my gut instinct is that he needs more insulin but i will wait a little longer before doing a dose increase. maybe tomorrow,

    I was going to get at least a 1 cycle curve if it killed me yesterday. part of being a nurse gets me very ocd about these things. and the ear pokes. we have a whole system already. i tackle the cat, one or two pokes a treat or some petting and we're good to go.

    his 11+ is 412 now and he hasnt had anything to eat since i went to bed since he's gobbling up every crumb he can find, and than i catch him licking the empty bowl... he drank a lot of water yesterday too...i am trying to get him 2 decent sized meals and 2 snacks every day. plus the testing treats which have been turkey cold cuts or a nibble of his favorite food (some FF food that is pieces of fish. i forget what its called)

    i will post in a few minutes my tentative work insulin schedule

    i think i've decided that i will do my best to seperate the doses as much as possible before hand, with 15 minute changes.
    when i have to give late doses that are due for a decrease i will give 1.75, early doses due for an increase i'm going to stay at 2, but maybe give a fat 2. am i right? am i wrong? lantus TR protocol says
    "Random Notes:
    Because of the cumulative nature of Lantus and Levemir:
    An early shot = a dose increase.
    A late shot = a dose reduction."

    so last nights shot was given at 9:45 pm 2units
    friday am: 9:30 2u
    friday pm 7pm 2u (early dose increase?)

    saturday am should be home by 930, 1.75u (late dose decrease)
    saturday pm shot 7pm (have to go out- working on changing my plans so i can give the shot later) 2u

    sunday am, shot, 12 hours post saturday night shot 7:!5am? 2u
    sunday night 7:30 hours post, 2u

    monday morning 12 hours post sunday night shot - aiming for this being at7:45 2u
    monday night shot 7pm 2u

    tuesday morning 9:45a 1.75u (late shot = dose decrease?)
    tuesday night 9:30pm 2u on time shot.

    wednesday morning 9:!5am 2units on time shot.
    wednesday night: 7pm 2 units early shot - increase.

    thursday am 9:45/10am 1.75 units late shot. decrease
    thursday pm 7pm 2 early shot increase


    friday am 9:55am 1.75 units? late shot decrease.
    friday pm 7pm shot 2 units early
    sat am shot 12 hours post friday night shot.



    i have a good idea of what i am going to do....... i will use your dosing advice for now vicky, and try 12% changes when i need to increase or decrease, and ill ask for advice. i have a feeling his dose will need to increase, but today i am staying on the 2 units.

    as long as i am interpreting the early increase, late decrease i think i am doing okay... but vicky had reduce reduce......

    aaaah this is so stressful. i will jsut do the best i can do. and hopefully it will all settle down better. he will never be as well regulated as i want him to be i guess but what can i do. just keep checking his numbers?
     
  64. dollsinmyeyes

    dollsinmyeyes Member

    Joined:
    Jan 23, 2012
    Re: i'm new here and need help w dosing schedules!

    i'm getting all stressed out now that maybe lantus is no good for satan because of my schedule. i don't know what would be better.
    the vet didn't think my work hours mattered. i'm sure she'll think i'm getting far too involved in my cats diabetes. i just told my friend i have to come late to her birthday party because i have to stay home to give the cat a shot... i can only imagine the eye rolls going on over there.

    le sighe.
     
  65. Vicky & Gandalf (GA) & Murrlin

    Vicky & Gandalf (GA) & Murrlin Well-Known Member

    Joined:
    Dec 28, 2009
    Re: i'm new here and need help w dosing schedules!

    Hi Melissa,

    First off I think you might be confused about this:
    It doesn't mean that you want to give a dose increase if the shot is earlier, it means that an early shot acts as if or is equal to giving an increase in dose.

    "Early shot" means a shot given less than 12 hours after the previous shot. So if your last shot was at 9:30PM and you want to give the next shot at 7:30AM, that is an earlier shot and as such you need to DECREASE the dose at 7:30AM. You also need to have decreased the 9:30PM shot in my experience so you don't create too much "shed."

    A "late shot" means you gave the last shot at 7:30PM and can't give the next shot till 9:30 AM a full 14 hours since the previous shot so the shed is being drained, but it isn't safe to give an increased dose in that case. You just have to be aware that the draining shed may cause higher BGs over the next couple cycles and not react to those by giving more insulin.
     
  66. Jennifer & Saima (GA)

    Jennifer & Saima (GA) Member

    Joined:
    Aug 16, 2011
    Re: i'm new here and need help w dosing schedules!

    I can't help with dosing but I know people here feed their kitties Merrick Before Grain. If you look at the food lists, one of the flavors (maybe the quail? I can't remember) is high in phosphorus--bad for kidneys--but I know at least the turkey is considered pretty good, or was last time I checked.
     
  67. dollsinmyeyes

    dollsinmyeyes Member

    Joined:
    Jan 23, 2012
    Re: i'm new here and need help w dosing schedules!

    thank you vicky,
    and thank you for the food info. salmasmom!

    learning learning learning.
     
  68. akbahsMum

    akbahsMum Member

    Joined:
    Jan 17, 2012
    Re: i'm new here and need help w dosing schedules!

    Yesterday I left a birthday drinks gathering for a friend early because I had to get home and test my cat. Its a bit like that isn't it. And today I'm starting him on five meals a day but I have no automatic feeder, so we are arriving a bit late for my great-nephew-in-law's first birthday party, and leaving a bit early. I don't know how this will work for the future but at the moment it actually suits me, I have a big deadline for my phd and so I needed an excuse to get home, one that other people can't tell me to reschedule.
     
  69. dollsinmyeyes

    dollsinmyeyes Member

    Joined:
    Jan 23, 2012
    Re: i'm new here and need help w dosing schedules!

    i guess everyone else will just cope.
    i'm part of a young active social circle in nyc. and i live outside nyc. so its going to take some adjusting of my schedule less going out. but thats okay i'll deal


    here is my update/corrected
    cat insulin schedule the timing is kind of off, i put my goal shot times from getting home from work, sometimes it'll be 9:45-9:50am. but i fugre the closer i can stay to 12 the better?

    friday am: gave 2, should have been 1.75
    friday 7pm 1.75u
    sat 9:30am 1.5 u
    sat _pm 2 u 1.75 if early
    sun _am 2 u 12 hours post last
    sun _pm 2 u 12 hours post last
    mon _am 2 un 12 hours post last (goal to have this one be at 7:15 or 7:30)
    mon 7pm 1.75 units
    tue 9:30 am 1.5u
    tue 9:30pm 2units
    wed 9:30am 1.75 units
    wed 7pm 1.75
    Thur 9:30 1.5
    thur 7pm 1.75
    fri 9:30 a 1.5
    fri 9:30pm 2
     
  70. dollsinmyeyes

    dollsinmyeyes Member

    Joined:
    Jan 23, 2012
    Re: i'm new here and need help w dosing schedules!

    sooo maybe this wasn't the right thing to do wiht lantus sheds and everything but i gave 1.75units instead of 1.5 units. because satans amps was 561 after 14 hours post his last insulin shot.
    i'll do 1.5 or 1.75 if the next shot has to be a little bit early. this scheduling is so tricky. and stressful. and maybe i am just venting...... satan seems okay at all these different blood glucose levels. but they make me nuts.

    his numbers are overall too high for my comfort level..... how do i get his numbers down!

    is it time for an increase? do i just need to be patient?

    i want to pull my hair out. i'm going to try and pay my little sister to come and maybe do 10pm shots for me when i am at work but she is reluctant.
    (THIS WAS HER TEENAGED YEARS CAT- that i got given responsibility for when i moved out)
     
  71. Cheri & Patriot

    Cheri & Patriot Member

    Joined:
    Dec 28, 2009
    It's been a lot of years since Patriot and I did the insulin dance. He's a wonky cat and we got creative to deal with it. Sounds to me like you are doing just fine and as time passes and you have more testing data you will be better able to assess potential tweaks to your dosing routine.

    I was admonished not to micro manage but for me that is what worked, I was a testing and tracking-aholic. In retrospect I wouldn't change my style but I would change my stress level and concern I could be doing more or better. Just by changing diet to wet only and administering insulin you have addressed the two major components to kitty feeling better.

    Patriot was the type of diabetic that experienced large swings in glucose level and it was a trick and half to figure out what we needed to do. I think they feel better if the drop and rise in a cycle is not too extreme so even if the numbers are a bit higher than you like, working toward a smoother curve is just as important as reducing overall BG.

    I'm hoping you have completely gotten away from leaving any dry down when you have to be away at work and wanted to point out that you can put extra wet food down and it is fine to sit there all day. I would also freeze wet food and put the frozen out as well so there is a fresher food supply.

    You are doing well and you have lots of experienced Lantus users to help you make adjustments as time goes on and you have variables under control and trends noted from testing. Good luck!
     
  72. dollsinmyeyes

    dollsinmyeyes Member

    Joined:
    Jan 23, 2012
    hey cheri
    thanks for checking in

    ive been freezing food in ice cube trays and leaving that out when i go to work. no more dry food. i gave it all to my mom who will feed it to her cat regardless if its bad for tabs

    i will let him settle into this dose longer. i am impatient. must learn patience with regards to this

    satan seems good. the peeing too much has settled back down.

    thanks again everyone!
     
  73. hmjohnston

    hmjohnston Well-Known Member

    Joined:
    Dec 30, 2011
    good to hear the last bit. Sneakers started peeing less in her last week on the humalin. It started up a bit more when we switched to PZI but has decreased by another 25% since then- almost 2 weeks.

    I, too, have two late nights but not as bad as yours. And, no, it isn't bad that you leave to go give satan a shot- I did that a lot today and the response I got the most was "Cats can get diabetes? Who knew!" And anyone who is a diabetic knows it is important whether the person is a two leg or a four leg.

    GOOD LUCK!!!
     
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