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Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by Jill A, Feb 22, 2018.

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  1. Jill A

    Jill A Member

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    Feb 22, 2018
    Hi everyone, my 15 year old cat (Bam) was diagnosed with diabetes about a year ago. Vet started him on 1 unit of Lantus 2x a day at first and gradually built him up to 5 units 2x daily. After a few months we came home to find him disoriented and took him to the ER. They did a 24 hr curve and send us home with the dose of 1 unit in the AM and 2 units in the PM. Follow up with vet and over time (and many fructosamine tests) he ended up at 3 units 2X a day. Last week I cam home to find him disoriented and wedged between the wall and the dresser. Rushed him to the ER where he spent 4 days and had another 24 hour curve. He is home now and I found someone to teach me home testing. He had been eating Hill's Prescription Diet W/D dry food. We have switched him to a low carb diet (Fancy Feast Classic Pate) and he is now on 1 unit of Lantus 2x a day. We've been testing with a Relion meter for 5 days now. His numbers tend to be in the 300 range for the most part. We are becoming more comfortable with the testing, but understanding and interpreting the numbers is frightening. I will need some help with this as I go along. I know if his numbers are low, I should not inject. What is the cut off number for that? He had some very low numbers when he was at the ER (in the 50's, 80's and one time at 37) The lowest he has been at home was yesterday morning - he was at 183. I did inject the Lantus then. Highest so far was 458 and that was Wednesday night. Do I need to be concerned? I appreciate any help.
     
  2. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    First, hello and welcome to you and Bam. Those ER visits must have been very scary. :bighug: Good on you to start home testing and getting him on an all low carb wet food diet. Food changes can make a huge difference in the amount of insulin needed.

    There is lots of good information in the Sticky Notes in the forum. I would start by reading those. People here use a spreadsheet to track the blood sugar numbers, and it's a great tool to help us help you and figure out where to go with the doses. Instructions for the spreadsheet are here. We can help you with interpreting the numbers.

    We use one of two methods for figuring out how to change the dose. The first is the Tight Regulation (TR) protocol and the second is the Start Low Go Slow (SLGS) method. Take a read over the sticky notes for those two dosing methods and figure out which you'd like to follow. The cutoff numbers for shooting vary by method. Are you using a human meter or a pet meter? The numbers also differ by meter. For human meters, the 50's and 80's are still in normal blood sugar range.

    Keep on asking questions. We love to help here and all remember what it was like to be new.
     
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  3. Nan & Amber

    Nan & Amber Well-Known Member

    Joined:
    Mar 19, 2016
    Welcome!

    Wow, it sounds like you and Bam have really been through it over the last year :eek::bighug::bighug:.

    I do have two question for you, to help us understand what is going on with Bam.

    1) It sounds like the first ER trip was for a hypoglycemic episode (hence the reduction in insulin afterwards), but was that the case for the second time, when he was there for four days, or did the vet diagnose something like ketones or diabetic ketoacidosis (DKA)?

    2) How long ago did you make the food switch? Is he completely switched over to Fancy Feast now, and if so, for how long?

    So glad you are home testing! It's the best way to keep Bam safe and healthy. :)
     
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  4. Jill A

    Jill A Member

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    Feb 22, 2018
     
  5. Jill A

    Jill A Member

    Joined:
    Feb 22, 2018
    Hi, I am using a Relion human meter.
     
  6. Jill A

    Jill A Member

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    Feb 22, 2018
    I am having some trouble with the spreadsheet. I am doing this from work because my home laptop is busted. I could not retrieve the spreadsheet once I saved it to my file.
     
  7. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

    Joined:
    Feb 14, 2011
    I just want to say welcome to the group...this is the best place for you and Bam to be. I'm so sorry you have had a couple very scary hypo events. Now that you're home-testing, hopefully you'll never experience that again.

    You've already gotten some good starting info...as Wendy said, please ask anything you need. It can be overwhelming at first, but we've all been where you are right now so we know how it feels, and we will help in any way we can.
     
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  8. Nan & Amber

    Nan & Amber Well-Known Member

    Joined:
    Mar 19, 2016
    Very generally, we advise caution for new folks on shooting below 200. There's more detail about how to respond to lower-than-expected pre-shot numbers in the stickies Wendy mentioned (see the one on Start Low, Go Slow, for example). As you gather more data about how your kitty responds to the insulin, you can gradually move your personal "no shoot" number downwards, but it's always good to post and ask folks here for advice whenever you are uncertain how to proceed.

    I can see your linked spreadsheet in your signature-- it's blank, but hey, partway there! We have people who can fix problems and get things set up for you, but I'll take a stab-in-the-dark at a possible problem: make sure you are accessing the spreadsheet through your Google Drive (your personal copy), not through the link in your signature (read-only). I've done that a few times myself when I had the read-0nly version open because I wanted to see how something looked on a different device, then panicked when I could "no longer enter data" :rolleyes:.
     
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  9. Ella & Rusty & Stu(GA)

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

    Joined:
    Jan 11, 2010
    Hi and welcome to you and Bam. Good job on setting up the spreadsheet. Now you can start filling it in! Go back to when you started keeping his test numbers and start with that date. The + numbers indicate the hours after the AM and PM pre-shots (AMPS; PMPS). We have members all over the world, so we don't give our local time, just the hour in each cycle (AM and PM) when we tested.
    I think @Nan & Amber is correct about accessing your spreadsheet. You have to go to your Google Drive Home and call it up from there. The spreadsheet we can see when clicking on "Bam's Spreadsheet" in your signature is the read-only copy.

    Welcome!!
     
  10. Jill A

    Jill A Member

    Joined:
    Feb 22, 2018
    Okay, that is my problem. I made a copy of the file, but now I don't know how to access it. How do I get to my Google Drive Home?
     
  11. Ella & Rusty & Stu(GA)

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

    Joined:
    Jan 11, 2010
    Go to your Google account and find "My Drive". Click on it and you should see a list of your files in Google Docs. The spreadsheet should be there. Click on it and you should be able to enter data into it.
     
  12. Jill A

    Jill A Member

    Joined:
    Feb 22, 2018
    Found it. Thank you! Now I need to look at the notes so I know how to fill it in.
     
  13. Sue and Luci

    Sue and Luci Well-Known Member

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    Nov 3, 2017
    Welcome to you and Bam! Sounds like you've had some hairy times - at least you caught him in time! And now home testing! You'll love the 'control' you will get when you start to get a routine of testing - so you'll know what his numbers are looking like historically.

    Luci and I use the human ReliOn meter too. Luci was diagnosed last November but we didn't start Lantus until early January - because her numbers weren't low enough quite yet...but they got there...and now Luci and I test about every 2-3 hours - I'm having a really difficult time getting her regulated. Fortunately both times she went too low I was here with her and testing frequently so I was able to respond with High Carb Fancy Feast with Cheddar or Gravy - to bring her numbers back up. This group is really wonderful to help you through all the rough spots - it's quite a bit of a learning curve for you and Bam! There's a lot of information but you'll get it in time - get yourself an emergency kit - your High Carb foods, keep karo syrup or honey in the cupboard - and know where it's at - for when his number goes really low - it'll freak you out - and you need to know where your high carb things are - to get that blood sugar back up to normal range.

    Best of luck to you - I'm still learning so much every day - but at least have gotten her through a couple of situations without having to go to the Pet ER. You can do it too! With the help and support of the experts on this group your Bam will be fine :)
     
  14. Judy and Boomer

    Judy and Boomer Well-Known Member

    Joined:
    May 23, 2014
    Welcome to Lev and Lantus Land!
     
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  15. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Welcome to the group!

    If you're trying to sort out the spreadsheet (SS), AMPS and PMPS are your AM and PM pre-shot test values, respectively. The "U" column is for the dose of insulin (i.e., units of insulin) you're shooting. All of the other numbers are how we tell time. +1 is an hour after shot time, +2 is two hours after your shot time, etc. We don't use the time on the clock because we're all in different time zones and it's actually more meaningful to know what the test value is in relation to when you gave Bam his last dose of insulin.

    If you've not had a chance to investigate the meter, it stores information. That means if you've been testing for the past 5 days, the information should be stored in the meter. You can transfer that information to Bam's spreadsheet.

    Please let us know if you have questions. The people here are incredibly generous with their time and knowledge. We're here to lend a hand.

     
  16. Jill A

    Jill A Member

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    Feb 22, 2018
    Thank you!
     
  17. Stacy & Asia

    Stacy & Asia Well-Known Member

    Joined:
    Oct 2, 2017
    Welcome, Jill and Bam!

    How scary to come home to your cat in such a state! Now you have the tools to ensure that doesn’t have to happen. :bighug:

    Read the stickies, ask lots of questions and try to post once a day and keep your SS up to date and I think you find Bam is looking and feeling a lot better soon. In the manual for your meter, it should tell you how to access previous readings and you can add them to the SS. Be sure to always test before giving insulin to make sure it’s safe and if you can get a couple tests in between shots, that will help you figure out what to do next. :cat:
     
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