? Insulin dosage ?

Hi, i have a question about insulin dosage. My cat Belle previously (last time was over a month ago) had glucose curve done at the vet, and they said his number averages at 400s. I was instructed to give him 4 units twice a day (that is 8 units a day), with Lantus.
Now that I learned I can home test him, I just bought the kit and tested him today at 530pm (I wasn't able to do the curves becos of several failures earlier today, his insulin was given at 1130am), and his number is 102 !!! so, i know i shouldn't be giving him 4 units any more, but what should be the dosage to give him?

 

Hi Helena and glad to see you over here from the Facebook group!! 102 isn't a medical emergency, so it's OK to go back and "edit" your subject line and remove the 911...our hearts skip a beat or two every time we see that!

4 units is a VERY high dose! It looks like your vet doesn't know how to dose when it comes to Lantus and Belle may very well be getting way too much insulin already!

Generally, we start out at .5 to 1U and go up slowly to make sure we don't go past what might be a "best dose" for each cat.

Cats that are only tested at the vets are under stress which can raise their blood glucose up to 200 points so it's great that you're learning to home test now!

What are you feeding Belle?? What meter are you using?

 

I'm sorry I don't give dosing advice but thank goodness you learned to test. I hope someone more experienced will be along soon to answer your question.

In the meantime, can you tell us a little about what Belle is eating? Did he start at 4 units or have they moved him up?

Also can you tell us what meter you are using?

 

My "do not shoot" dose was 250 when I first started. Later, after much data collection of his response to foods & meds, I was able to shoot lower numbers. If you decide to shoot, I would only do a very "token dose", such as the .5u that Chris suggested above, then test throughout the cycle to see where she goes. Data / aka knowledge is power.

 

Ahhh... I see from Facebook that you're feeding Purina DM...is that the dry or the canned?

The dry is too high in carbs for our diabetics...the canned is OK, but it's very expensive and no better than a lot of the foods you can buy at any WalMart or grocery store for a lot less money

 

In reply to Chris & China and Brashworks
@Chris & China @Brashworks

Belle had been on Purina DM (can and dry), and also getting some fancy feast lately (after i read from the FB page)
i know it's best if he only eats canned food; but he could not just be on canned , as he eats throughout the day, and i am not always there to give him food. And i am afraid he will go off and beg for food from neighbors.

A little background of Belle: he was an abandoned from neighbor, him and his sister came to me quite a few years ago ( (i just found out they are siblings from that neighbor who abandoned them) . But since i already have pets at home, i can only offer for him to stay in the garage at night. And he goes out during the day, which he wants to go out, he enjoys the sun and the grass. But the thing is, since he is with his sister Bailey, they eat together, and there are other cats who come to eat as well; it also becomes difficult to offer just canned food.

As for the meter, I am using the ReliOn micro.

His vet keep increasing his dosage, we started out with 2, then she increased it to 3, then to 4.

 

Hey @icesnow - my Billy is a grazer too. He eats canned food all day and night. He doesn't overeat or undereat so I just put out a 3oz can in the morning and a 3oz can at night. Sometimes he doesn't finish and the leftovers go to the dog. I have other pets as well, and Billy gets "freedom or food". He's always crying for one or the other. I sequester him for feeding during the day and give him freedom when I come home, and then at night I put his food in my bedroom and shut him in with me. I guess your guy is in the garage, he can have his canned in there? Find a spot separate from the sister or feed the sister canned too? You don't need expensive food at all. Friskies, Fancy Feast, and other low cost brands have low carb varieties (research these before buying, basically no gravy or shredded, only pate) and they're cheap. You can stock up on the large size cans when on sale.

 

It's so nice you are treating his diabetes despite not having room in the house for him <3 Good for you. Good luck!

 

OK...first, we use a spreadsheet here that is every bit as valuable a tool as your meter and insulin for helping Belle. Here are Instructions for getting the spreadsheet....if you have trouble, let us know so we can help you!!

As long as he's going out every day and can get into other foods, it's going to be MUCH harder to get his diabetes under control....you don't have to stay home all day to feed him (we have lots of tricks) but if he's able to get to dry food outside, you can be sure he's going to.

If I were you, I'd probably drop back in dose and start getting some testing in....ALWAYS before shots (the "Pre-shot tests") and then IF YOU CAN a mid-cycle test on the AM cycle (around 5-7 hours after the shot.....what we call +5 to +7) and a "before bed" test on the PM cycle. If you can't get mid-cycle tests on the AM cycle, then getting tests on the PM cycle are even more important.

As long as he's eating dry food, the only method you can use is called "Start Low, Go Slow" . The usual starting dose is .5 to 1U....since he's been on 4 already, I'd probably suggest starting at 1 Unit. On SLGS, you hold the dose for 7 days and then do a "curve" (every 2 hour tests for 12 hours or every 3 hours for 18 hours) and then we decide if he needs to increase or not. If he drops below 90 at any time, we'd reduce his dose too!

Has he ever been diagnosed with ketones?

It'll also really help if you'll go ahead and add some information to your signature (if you look below my comment, you'll see the info I have in mine for China) Just click on your sign on name on the top right of the page and choose "signature"...a new box will pop up and you can add the information (and the link to your spreadsheet when you have it)

Some of the info to add is your name/cats name, age, sex, date of diagnosis, type of insulin, type of meter, type of food and any other health problems Belle has....a general idea of where you live is nice to know to!

 

@Kiara
my other cats are on science diet mature adult. they used to be on Friskies/Fancy Feast b4, but i was told those hv too much fat for senior cats. All of them are 10+

@Chris & China

thanks, i will look into the spreadsheet info in a little bit and reply again on that

i believe someone on FB from another post suggested the YoungAgain zero carb dry food. But it's very pricey.

as Belle is older now, he doesn't go outside the yard much anymore, he mostly stays inside the yard, but there are moments that i can't find him. so, in a sense, i don't think he goes outside to eat anymore, but i m afraid, if i don't hv food out for him, he might go.

i did tried to test him b4 giving insulin this morning, but failed (doing it 1st time...) couldn't get enough blood...

As you advice, i will lower his dosage to 1 unit starting tonite. However, someone (i think on FB) said something about the effect of insulin stays for 18 hrs, so his number of 102 might be an effect of his insulin as well?

i m not sure if he had been diagnosed with ketones, as least not that i m aware of

i will figure out on the signature later

 

Yeah, the Young Again is high, but a lot of people use it and say that the cats eat very little of it....You might call the company and get some samples...see if Belle even likes it first (they are happy to send samples!)

Another dry some people use that's lower carb is Evo Cat & Kitten...again, it's not cheap, but it's lower carb than other dry foods

You can leave wet out all day too! A lot of people just add extra water to keep it from drying out (which is also good for their kidneys...any extra water is good!) or you can make "food-sicles" by adding water to canned and freezing it in ice cube or mini-muffin trays. Most cats won't eat it frozen (although some will!) but when it thaws out several hours later, it's just like leaving out fresh food.

Another popular thing around here are auto feeders that you can set to open to offer food anytime you want them to have it like the Petsafe2 or Petsafe5

If you don't get blood, try 3 times and then take a break for a few minutes...it's going to be really important for you to always test before shooting because it's the only way to know if it's safe to give any insulin at all!! A doctor would never tell you to give insulin to a child without knowing what their blood glucose was first, and it's the same for our sugarcats.

Make sure to warm his ear a little before poking. A small sock with some rice in it and microwaved or a small pill bottle filled with warm water work well to warm the ear and bring blood flow into it

 

thanks.

it's a lot of overwhelming info to me right now... i m still reading the spreadsheet info...

the thing is, he is outside during the day, and with his sister there, and other cats coming to eat, if i leave canned food out, it will be gone in no time. he will eat any amount of canned food all at once... and with the auto timer feeder, he might not be around when it opens up and other cats might eat the food instead of him.

yea, (after seeing it in the group on FB), i used the rice sock and was able to get some blood from him finally at 530pm, but missed the morning time.. which i had 3 failures...

 

@Chris & China
One of the members in one of those posts on FB points out that the meter we used are for humans, and the readings are different from the meter from the vet. Pls advice.

she wrote: "I want to add one thing. Take your meter to the vet and compare. I was getting readings in the 100s, and wasn't dosing my guy. At the vet he started reading high. I brought my meter in to compare and the alphatrak was 361 and mine was 166. The next week, they ran on their other machine, the alphatrak, AND my monitor. Alpha trak said 320ish, blood test system said 332 and my monitor said 170-something."

 

Yes...human meters read lower than the AlphaTrak does, but the protocols here are all based on human meters so we're VERY used to them!

ANY meter can be up to 20% off....The FDA allows that much of a variance.

The biggest problem with the AT is that the strips you use in it can be over $1 EACH....when you test 4 or more times a day, that runs into a lot of money that most people can't afford...and that can cause them to not test enough (or go broke....lol)

The human meters like the Relion Confirm/Micro are only .36 cents per strip....and the Prime meter are even cheaper at .18 cents per strip (but the Prime takes a larger sample size and some people have problems with getting error messages with the Prime)

What we watch for mostly here are "patterns" more than the exact numbers....Is the dose getting them down into good numbers? That's what we want!

 

Thank you @Chris & China

did you see my other message b4 the last one ?
"the thing is, he is outside during the day, and with his sister there, and other cats coming to eat, if i leave canned food out, it will be gone in no time. he will eat any amount of canned food all at once... and with the auto timer feeder, he might not be around when it opens up and other cats might eat the food instead of him."

yes, i got the ReliOn micro becos it requires a smaller amount of blood, getting blood from Belle is so difficult, he moves around and won't stay still, can't get much blood out of him to start with, and then all the blood absorb into the fur on his ear...

thank you so much for figuring out the dosage for Belle, i will probably try to do the curve again after the holiday... but it might be challenging, since i tried to do it today, but failed, and was only able to get one reading

btw, if u look at the photo on the left, Belle is one in the lower right hand corner

 

Awwww...he's very pretty!!! How did a boy kitty get a name like "Belle"?

Keep poking!! As you poke more often, the ears grow new capillaries and make the ears bleed easier!

Not sure what you can do about the food problem if you are going to let Belle continue to go outside since there's no way to keep him out of food he shouldn't get into other than to try using one of the lower carb dry foods

1 unit may not be enough....we won't know until you start getting some tests in so we can see how he's doing. Lantus dosing is based on how LOW it takes them, so it's really important to get some tests in mid-cycle when you can

 

hello dear!!

Im also kind of new here on the forum. Im originally from Argentina.

About food, you will need I guess, to figure out how to feed him during the day. High glucose is bad, but low glucouse can be very dangerous, so food is very important. One good thing is that you changed the dose. This is very important, 4+4 units is too much. So now, this new dosing will be much easier.

On the other hand with high glucose probably the cat will come back requesting for food, since diabetes makes them feel much more hungry. Hope he comes back for food during the day so you can feed him and avoid low glucose.

You need to know when is his nadir (the peak of insulin effect, when glucos reaches the lowest number). Usually Lantus can have a nadir arround + 6 (this means 6 hours after shot). You will know this by doing a curve, this means testing every 2 hours.

And food change is the most important!! Im a raw feeder, since I live in Argentina and we don't have good quality low carb canned food, I use raw meat and bones. We call it barf (biologically apropriate raw food). But bear in mind that whenever you start givin low carb food, you need to be very carefull since insuline can be less necesary so you need to just be careful of testing your cat and checking on him.

I feed Markies with raw chicken, cow, pork, bones, etc.. I also make a home made pate that I can share the recipie with you. You may want to follow Dr. Lisa Pierson's web site, she is the great reference for all of us as regards food. Her site is www.catinfo.org

I wish you the best and wheneer you need help just post here or in the group. I know that forum may be difficult, it was for me, but if you feel for some reason scared or whatever happen, and if you still didn't learn how to use the forum, just post in the group asking for help. With the time you will learn how to use it.

Last thing, try to make your cat come back for food during the day or find a way to feed him at least arround nadir, be creative. If you have someone traveling to UK there is a great product that scans our cat and only opens the feeder door when the right cat is in. Let me find it and post it here.

In the meantime, just stick to what the girls from the forum say, they are awesome and they know a lot!!!

Never use dry food, even if it says "Diabetic" and the vet say it's prescription diet. That's simply BS and your kitty's glucose will get to the sky. Plus, dry food is not apropriate for an obligate carnivore as the cat is. Just follow Dr. Lisa Pierson's site, you will learn a lot about how to feed a diabetic cat.

Good nights!!

Silvi

https://www.sureflap.com/en-us/pet-feeder/microchip-pet-feeder

 

@Chris & China
When he first came (he came begging for food in the beginning), i thought he is a girl, and since he is fat--shape like a Bell, so i started calling him Belle.

Is Evo dry (u mention in previous comments) better (lower carb) than DM dry? If so, i might wanna try it, i just checked, it's on sale now at chewy.com & pet360.com (6.6 lb bag $18). DM is so insanely expensive.

Yes, Belle usually goes outdoors during the day, otherwise he will cry until he gets to go out. and he is difficult to keep inside the house as well, he has the tendency to sometimes poop outside of the box. I now have a heater on in the garage at night, will warm it up, it has auto turn off, and i will turn it off b4 i sleep at night anyway (to avoid any danger).

If 1 unit is not enough, should i give him 2 units then?

I will be busy starting tomorrow and throughout the weekend, so might not be able to test him again until after the holiday.

btw, a little story, Belle and his sister Bailey (top left corner in the photo). their original owner came up to me about half a year ago, and said "Oh, these used to be my cats about 10 years ago, and i got a new dog, so they ran away...and it's ok, ...that they found you..." i was gonna tell her "NO, it's not ok, I have cats and dogs myself, and getting a new dog doesn't mean you can abandon your cats (and never go look for them, they both had been homeless and was hanging around in the neighborhood for quite some time b4 they came to me). and it is also putting time and financial burden on me! "
anywayz, according to her, Belle's original name was Cooper.

 

Yes...it's still not great but it's better than DM dry

No...we go up slowly, in .25 unit increments, never a whole unit at a time, but it IS possible that we might suggest going up to 2U if his numbers get really bad...especially since we know he's already been on 4U...it's just too early to know for sure

Good for you for taking them in from this totally irresponsible owner!! I don't get it either....how do you just "throw away" a member of your family??

 

@Chris & China
Hi, i just checked Belle pre-insulin today @11am (his last insulin was given 1130pm last night, 2units), and his number is back up at 272. i gave him 2 units after the test. (sorry, i hvn't yet receive ur message when i gave him the insulin last nite). I will try to check him again throughout the day as much as possible, but can't do the full curve today since i hv family dinner n had to be out around 3pm.
hope the more testing will give more info for the right dosage. and what should i give him for now?

As for the canned food, should i give him DM or fancy feast? he gets both now.

 

@Chris & China
i checked her blood again at 130pm, her BG number is now 103
it was 272 at 11am, with 2 units of insulin given right after first check.

 

Im sorry Im not the best for this since I don't live in your country but I will copy what Dr. Lisa Pierson's say

http://www.catinfo.org/#Prescription/Therapeutic_Diets_

" If you have decided to start feeding your diabetic cat a low carbohydrate diet, please do not change the diet until you review my Feline Diabetes page - especially the STOP sign section - otherwise you will be putting your cat in danger.

Please also be aware that many veterinarians underestimate the favorable impact that a low carbohydrate diet has on the insulin needs of the patient and they do not lower the insulin dose enough. If the insulin is not lowered accordingly, an overdose of insulin will occur which can be life-threatening.

I strongly suggest that all caretakers of diabetic cats home-test to monitor blood glucose levels using a standard glucometer as a matter of routine. Careful monitoring is especially important when implementing a diet change.

Many veterinarians prescribe expensive diets such as Purina DM (Diabetes Management) and Hill's m/d but you can do much better for your cat (and your pocketbook) by feeding other more nutritious - and lower carbohydrate - canned foods. See the Cat Food Composition chart. You should aim for a diet that derives less than 10% of its calories from carbohydrates.

The less expensive foods like Friskies, 9-Lives, and Fancy Feast are also fine to feed."

Hope this helps. Check her Feline Diabetes section at the link above.

Silvi

 

I think you should keep on eye very close on him. YOu tested one hour an a half after shot time and he has a normal number.. If Im not wrong his clucose can go down, he didn't reach nadir. I will tell the girls on the forum so they can step in this forum now. Sorry, don't want to alarm but I think they should read this.

 

Are you still home and able to monitor for a little while longer? How long will you be out for? If Belle has continued to drop and you need to be out for a while, you might want to consider feeding a fair amount of high carb food to "abort" the cycle and make sure he stays safe. Will he free feed if you leave food out while you're gone?

 

Amy she is not home unfortunately. BUt you can find her in the facebook. I already called her attention.

 

Is someone home keeping an eye on Belle? If so, that person could feed the high carb food. If she has a smart phone, she should be able to access the forum from it, too, so she can see what's going on here.

 

I would simply add that there are conditions that cause a cat to need higher than normal amounts of insulin. Yes it's possible your cat is on too high of a dose. It's also possible that he needs more than the average amount.

The way to find out which it is would be to get the information you have in the spreadsheet so we can take a look at it. I'm not a fan of blanket reductions of the dose - if he really needs more insulin than average, that can be a disaster. My own cat arrived here on 3u of insulin and several people suggested I reduce the dose, but instead I got more tests in and we determined that he NEEDED that much insulin. One if 4 cats does need more. Instead, I would call the vet, get all the test information you can from the curves that were done, note on the spreadsheet what the insulin dose changes were, and let us take a look at it.

Since he's out during the day and you can't test him then, you would want to either do a curve once a week - keep him in the garage for the day and test him every 2 hours for 12 hours or every 3 hours for 18 hours.

 

Oh, and you're not getting blood because the capillaries haven't grown yet. As you poke him, it will stimulate the growth of more capillaries. After a couple of weeks you'll get blood every time - in the meantime, hang in there and keep trying. You're still doing some good with it.

 

103 is still a normal number and if I'm reading the times right, it was 272 at AMPS (at 11am) and 103 at +2.5 (1:30)?

That's a pretty big drop for so early...if you have someone who can feed Belle, have them feed him something higher carb than DM or Fancy Feast since you can't be there to test

The wet D/M is low carb but it's no better in quality than the Fancy Feast (and a lot of cats get tired of it)...it's also very expensive for what it is. It's the DRY D/M that's high carb

 

Im so glad you are here helping Belle. Im leaving now. Bye bye!

 

Thanks everyone!!
I just got home and will catch up reading the comments above.
sorry, i was not able to access the forum when i was out, i was either driving or at family dinner.

@Chris & China
I just tested him again @ 9:15pm, and his BG is at 249, with his last insulin give at 11am, his per-insulin number was 272, and @ 1:30pm, his number was 103.

He is due again for insulin tonite at around 11pm, what dosage should be given to him?

@Amy&TrixieCat yes, he had the dry DM bowl available to him while i was gone.

@Silvina Thank you

@julie & punkin (ga)
He is out mostly during the day, but he mostly stays in the yard now, so most of time i can find him and test him. but if i intend to test him, i will mostly choose to keep him in the garage.

 

As long as you can test tonight, I'd go with the 2U again

Don't forget to put the numbers into your spreadsheet...do you understand how to use it?

The AMPS is the AM Pre-shot (test immediately before feeding/shooting in the morning) and then we use the "+ system" since we're all over the world here and your 10am isn't necessarily my 10am

+3 is 3 hours after the shot...+5 is 5 hours after..+9 is 9 hours after..etc.....until you get past +11 and then you're at PMPS (PM Pre-shot) and the whole thing starts over

The spreadsheet color codes itself, but if you put numbers in at a time other than an exact hour (like +2.5) you'd put (for example) 103 @ +2.5 in the "+2" cell and then click on the little icon at the top that looks like a bucket of paint tipping over. Choose the color that goes with that number....in this case, the blue

Of course in the U column is the number of units of insulin

 

@Chris & China
I can probably test him again b4 i give him insulin tonite, but will go to bed soon afterward, so won't be able to test him again 2 hrs after.

i will figure out about the spreadsheet.

sorry, things had been overwhelming recently. my most beloved cat passed away couple weeks ago to pancreatitis, and vet's wrong treatment. another cat was just diagnosed with hyperthyroidism. and belle's sister is also having a limping leg... i m emotionally exhausted.

 

Can you at least set an alarm and get a test at +2?

That can tell you a lot about if it's REALLY important to test later in the cycle or if you can probably go to bed without worry

 

OK, maybe i can give him his insulin now, and test him in a couple hours. he usually gets it 1030 at night anywayz.

 

Most cats go lower at night...I'd just really hate for him to go too low when you're not able to test and help him if he gets too low

How long until his PMPS?

 

Well you don't want to give it too early either....Lantus really craves consistency and needs to be as close to every 12 hours as possible BUT if he's high enough, it can be OK to give early

We generally try to keep our shots at every 12 hours....and if we need to adjust, do it 15 minutes per cycle so it doesn't cause too much of a problem

 

i gave his insulin to him @ around 1015pm, and his BG was 249 @ 915pm (call it PMPS?). and will test him again quarter pass midnight.

now i hv to give medication to my 2 chinchillas... yes, i hv 2 chinchillas on long-term medications as well... :~(

 

It's sometimes considered crazy what we'll do for our furkids....but the people here will all just say you're a very good mama!!

 

just tested again 2 hours after 2 u insulin, his BG is 198

 

just tested him this morning per-insulin, 1130am, his BG is 300

 

Helena,

When are you going to be able to do a curve?

I usually do it at least for one cycle (12 hours) testing every 2 hours.

That will tell you how your cat is doing with that dose of insuline. Also will tell you at what time he has his nadir (the time when the insuline has it's strongest effect, this will be shown by the lowest glucose number during that cycle). Whenever you know when is his nadir you need to be able to feed him for sure, arround that time.

I guess you should keep giving your cat 2 units every 12 hours. Testing everytime you dose (AMPS and PMPS) and asap making a curve to see if that dose is correct for him.

The rest will help you better with this.

REMEMBER SOMETHING VERY IMPORTANT. Never dose before +12. If you dosed at 13:00 hs. (1PM) then you dose at 01:00 (1AM) never before that time, unless someone tells you to do it and how (there is a protocol to follow whenever you need to dose before +12).

Hope not to creat confusion with my bad English.

 

just tested him again 2 hrs after insulin, 130pm, his BG is 287

 

ok great, keep track of this testings and complet the spreadsheet.
let us know if there is two digits number or high numbers for example (more tan 400) so the fórum can see and help you through.

usually we write down the tetings in the spreadsheet so we can all see what is going on. Messages isolated in the thread may not help see his glucose behavior so if you can, complete the ss. It saves automatically and we can see almost online.

You want to try now so i can tell you if it Works?

 

sorry, I saw you already completed the ss with the last testing!!! SUPER!!!

 

@Silvina
i won't be able to do the complete curve until after the holidays, on monday

 

Ok if you can't do the curve but you are able to test at least once in the cycle, try to test at +6 (instead of +2) or + 5
othe day at +7

this is better than +2 since Lantus has nadir arround +6

Happy Thanks Giving!!!

 

@Silvina
i was only able to do +2 cos i was heading out afterwards

@Chris & China
I tested him PMPS tonite 11pm, his BG is 317 !!
https://docs.google.com/spreadsheets/d/1HCmV232LV07IPtUzEIBbEry53soidx7omsrfjf-MWzQ/pubhtml

 

I see you upped the dose tonight to 2.5, I assume based on the pink preshot. The thing about lantus, being a depot insulin, is that you never adjust the dose based on a preshot number. Lantus (and levemir) doses are based on how low the dose is taking the cat not on preshot values.

Now that you have your spreadsheet set up I would encourage you to start posting in the lantus/levemir support group forum which is where all the experienced lantus users hang out. We will help you and the very gorgeous Belle get on track with all this

 

I tested him AMPS 11am, his BG is 314 !!
tested him again 2 hrs after insulin @ 1pm, his BG is 266

https://docs.google.com/spreadsheet...soidx7omsrfjf-MWzQ/edit#gid=361360320&vpid=A3


@Vyktors Mum
yes, i am concern about his raising BG numbers, and no one is online for the holidays to advice about the dosage.

 

Hi Helena!!

It's important that you TRY to ignore the high numbers at Pre-shot....and believe it or not, 314 isn't TERRIBLE...we've seen cats that sat in the 600+ range for much longer

Lantus dosing is based on how LOW it takes them with only a little consideration going to the Pre-shot numbers.

I know you have special challenges, but it really is very important to try to get those tests on the PM cycle too...we've seen cats go from 400 to 40 and back to 400 in the same cycle....without those tests, we'd never know that the cat was getting too much insulin!!

What's your current shooting schedule? Is there any way you can move it so you'd be able to always get at least a +2 or +3 on the PM cycle? I HATE morning....always have!!...but when I moved China's shot schedule to 6am/6pm, although I still hate to get out of bed that early, I can usually go back to sleep in the morning and it lets me get tests on that PM cycle that are so important.

It's important for you to HOLD each dose for at least 3 days (6 cycles) but since you've increased to 2.5, go ahead and stay there for now. Looks like this morning's dose was cycle #2 so just hold that same 2.5u dose for at least 4 more cycles and try to get some tests sprinkled in at different times.

I'd like to go ahead and invite you over to the Lantus Forum too. Everyone there uses Lantus or Levemir so you'll get the most experienced eyes watching out for you and Belle!!

 

@Chris & China

thanks chris, will keep that in mind.
so, what dosage should be given to him after 4 more cycles?

yes, i will check out the lantus forum when i get home later tonite

tested him again 2 hrs after insulin @ 1pm, his BG is 266
and the Evo dry food just arrived, so i hv replaced the DM dry, hopefully that would also help him a bit too

i will try to do one more test cycle PM after insulin (i tired last nite, but failed, not enough blood)

 

Are you heating his ear before trying to poke? It can make a big difference in whether you get blood or not. A small pill bottle filled with warm water or a small sock with a few teaspoons of rice that you microwave for 20 seconds or so can really help!!

What size are the lancets you're using to poke with? Most of the lancets are 33 gauge which is very tiny...it will help to buy some for "Alternate site testing" that are 25-28 gauge since they make a bigger "hole".

Another trick that some people use is to poke quickly twice in the same place on the ear.

It depends on which protocol you're going to use with Belle. The Tight Regulation Protocol gives cats the best chance at remission but it's VERY important that you're able to get at least 4 tests per day (and there are times you'll need more than that to keep him safe) On TR, dose adjustments are made as often as every 6 cycles and they don't earn reductions in dose until they drop below 50 on a human meter. It's an aggressive protocol, but it's backed up by a scientific paper that's been published in a veterinary journal. ONE IMPORTANT NOTE....to do Tight Regulation Protocol, Belle MUST be on canned or raw food only...NO dry (which I understand is a problem for you)

The Start Low, Go Slow method is your only option as long as dry food is in the picture. The main differences between TR and SLGS is that on SLGS you'll hold the dose for 7 days (which means you may have to accept higher numbers for a longer period of time) and reductions are earned if they drop below 90. On SLGS, after a week at the same dose, you'd need to run a curve....testing every 2 hours for 12 hours or every 3 hours for 18 hours and then make decisions on whether you should continue with the same dose for another week or increase. It's still always important to get the PS tests in and if at all possible, a mid-cycle on the AM dose and a "before bed" test on the PM cycle

The one BIG problem is the dry food...although you're right that the Evo is lower carb so it's much better than DM, it's still dry and that means it's not possible for Belle to be on Tight Regulation.....but we've had some cats on SLGS get into remission too

 

Dear, did you buy dry food?
Please, dry food is not at all what your cat should eat. That will keep his glucose high. You need to feed wet, canned or raw, but NEVER DRY.

 

@Silvina Helena doesn't really have a choice about including dry food in her circumstances so she has bought a very low carb one. It's not ideal but everyone just needs to do the best that they can in their circumstances - but I love that you're looking out for this with people - definitely keep promoting that message

 

Oh Im trully sorry about that, I didn't know that part.
Well, do you know if dry can be mixed with little water? I read it somewhere and some people do, but the recipient then after the cat eats has to be cleaned up immediately, not leaving any leftovers, since they will get bacteria.

But if the cat is willing to eat dry with little water that will help to his kidneys and also with glucose.

 

thanks everyone.
one of the reason i hv a schedule of 11am/11pm insulin time is becos sometimes i get home late at nite, and don't want to miss his insulin time.

i just tested him PMPS (11pm), and his number is 221... even lower than his 2+ of 266 ! (1pm)... is that not normal?
PM +2.5 (130am) is 165

@Chris & China yes, i heat his ear with rice sock everytime. and use 30 guage. but he keeps moving around a lot. he keeps turning away so i cannot get to the blood... blood came out...then soaked by his fur... ... ...

i have been trying feed him more canned food now, but can't really totally take dry food off...

 

do you have some Neosporin with pain relief ointment? Or some plain Vasoline? By applying a very thin layer before you poke, the blood will "bead up" instead of soaking into the fur

 

For dry food, if you must use it, check out Young Again 0 Carb online (about 5% calories from carbohydrate as we calculate it) or Evo Cat and Kitten Dry found in pet specialty stores (about 8% calories from carbohydrate as we calculate it)

 

this morning AMPS @ 1130am is 208
thanks for the advice, will try using Neosporin next time, let me go find/buy it
i just bought EVO per chris' advice, someone else also suggested young.again, but chris said EVO is better, and also price is lower than young/again. used to be on DM dry
(now i m mixing DM and EVO to slowly do the switch)

also, can someone tell me what is the normal BG number range (for cats on human meter) is?
thanks!

 

Evo isn't any "better"....just usually a little cheaper than the Young Again Zero Carb....but BOTH are much better (carb-wise) than the DM!!

Normal numbers on a human meter are 50-120

 

tested him again +2 @ 130pm, his number is 120

 

That's a pretty big drop for so early in the cycle

You might want to go ahead and give him a snack of his Fancy Feast and retest now

 

i was out for the day , and just got back home, tested him again @ around 9pm, and he is 106 @ 9+
just gave him his dinner. n i saw that he ate some Evo dry when i was out

 

Just a little something to remember for "next time"....We've seen that +2 be a lot like a crystal ball in a lot of cats, so it's a good test to get to get an idea of what might be going on later in the cycle

If the +2 is about the same as the Pre-shot, usually they're going to have a fairly "normal" cycle...slowly dropping to nadir and then slowly heading back up until the next PS

If it's higher than the PS, that can indicate the beginning of a bounce and those are the cycles where you can usually get by without testing as much

If the +2 is lower than the PS, that's your "early warning"....those are the cycles where it's important to try to get more tests in...but if you can't, you might want to leave some higher carb food down for him....it sounds like he may have "helped himself" today by eating the Evo

 

so, in a normal cycle, the +2 should be higher than the PS?
his testes indicates that he always have a lower +2 than the PS, which is not a good sign?
does that mean the dosage is too high?

 

It's really too early to say what Belle's "normal" cycle is going to look like

No...if the +2 is about the same as the PS, that's usually a more normal cycle

On 11/26 AM cycle...his +2 is about the same number as his AMPS (remember, all meters are allowed a 20% variance)....but again, since he's so new to the sugardance, he's not going to have really "normal" looking cycles yet.

Now last night, when he went from 221 to 165 in 2 hours, I would have tried to get another test in at about +4/+5...that's a pretty significant drop (as was 11/25's AM cycle and this morning's)

For now, you just want to hold this dose for 7 days (unless he drops below 90 at any time)...as he gets further along and you get more data, you'll start to learn to watch for certain patterns that are unique to Belle

 

@Chris & China
i just tested him his PMPS, his BG is very low, 77, (despite he just had dinner 2 hrs ago), should i skip his insulin tonite ?
afraid he might go hypo at night

 

Since you're doing SLGS, that drop to 77 earns him a reduction in dose....down to 2.25

If I could stay up with you tonight, I'd encourage you shoot a reduced dose, but my internet connection has been lousy tonight

It'll be safer for Belle to just call it a "furshot' and start over tomorrow morning but at the new 2.25U dose

 

thank you , what is a "furshot" ?
i would not be able to stay up with him, so should i skip tonight? and start tomorrow.

 

test AMPS 1230pm, his BG is 281,
the syringe i hv goes up per unit, so when i was giving him 2.5, i kinda go between 2 & 3
now, i just gave him 2.25, bit above 2

 

A furshot is what we call it when we try to give a shot of insulin, but it doesn't all go INTO the cat...like if the cat moves as you're pushing the plunger. Even if you know you gave a furshot, you never try to go back and shoot over again though since there's no way to know exactly how much insulin actually got into the cat

Sometimes when we skip the dose on purpose, we'll just say "call it a furshot"....either way it means you either didn't shoot at all or you're not sure how much might have actually gone into the cat so you just hang in there and wait for the next shot time

When you skip on purpose, you can put N.S. into the U column on your spreadsheet...that means "No Shot"

It'll help with those ".25" doses if you'll get some syringes with half unit markings. We all wish they'd make syringes with .25 unit markings, but half unit is as low as they go

 

I want to invite you over to the Lantus Forum too. Now that you have the basics down, it'll be best for you to start posting over there so you get the most experienced eyes watching over you and Belle.

Each day (I'd start today if you have the time) you start a new post with the date, cats name and the AMPS number in the subject line....so for today your subject line would read

11/29 Belle AMPS 281

As the day goes on and you get more tests in, you "edit" the subject line and add the new test results (if you look at other posts in the Forum, you'll see what I mean)

In the body of the post you first put the link to the prior day's post (so it's easy for people to quickly go back and read what's been going on with Belle) and then just add information about how Belle is doing overall.....We call it the WCR (Whole Cat Report)

If you have a question, you'd also ask it in the body of your post...and if your post includes a question that day, you can use the ? "prefix" in your subject line so the people who scan the board will see that your post that day includes a question

Spend a little time reading others posts and you'll quickly pick up how we do it...and probably learn some things too!!

 

thank you for the explaination of the "furshot"

the syringes i can get here doesn't have the half unit markings, they strictly requires prescription here, i can only get what is prescribed + what is available

 

@Chris & China
i posted to the Lantus forum, pls let me know if i m doing it correctly

 

just tested him again +2 @ 230pm, his BG is now 170,
looks like a huge drop again

Belle was pretty mellow, but now he gets very angry about BG testing, and will put up with a fight

 

thanks,
tested him again +4 @430pm, and his BG is 85,
does it mean he earns another reduction?

 

replied on your new post

It's best to just stay there now that you've moved over to the Lantus forum