Little Boy's first BG home test - what does it mean?

ok so an Australian reading of the BG is 13.6 mmol/l

Have no idea what that means. We made a complete hash of getting the blood. went thru 3 strips and 3 piercings before getting blood. Husband was soooooo stressed. Cat was fine. Go figure! The pegs helped and then he must have been so amused by our ineptitude that he just went along with it. I will now work find out what it means myself but help would be appreciated muchly.

marilyn

 

I don't know the conversion - there are other beans on here that do - I'm thinking the Canadian Beans.

I'll PM Ronnie & Luna - she knows the conversions.

Have you tried some of the tricks to get blood - such as warming the ear, massaging the ear, kneading or milking the ear after the poke?

you may also want to experiment poking from the back to front of ear, as that may work better.

and you don't want to pierce, rather you want poke - if you are doing it freehand, without a device - I suggest you want to poke at an upward 45 degreeish angle.

here is a pic:



Are you poking the edge of the ear? Here is another pic of ideal poking location:

 

Multiply the mmol # by 18 and you get the mg/dl number. So for us your reading is 244.8 ... not too bad of a diabetic number. Is this a preshot reading?

 

I think the reading requires a multiplication of 18 which brings it to 244. He was due to get his nightly 3 units and he was hungry - so presumably that would make it as high as it's likely to go. The vet blood test print out says normal range is between 3.9 - 7.5. So 13.6 is nearly double normal. His official reading for diabetes was 21.4 so he's down from that 5 days ago. I guess he's still got a ways to go and only by testing regularly will we get an idea of where he's going. He certainly seems better in himself but very hungry. He's eager to eat every 2 (ish) hours. WE've been going lite on the 3 units - not sure if we are doing the right thing - as vet insisted on 3 units.

My kids in the UK (daughter and husband both doctors) tried to tell me about ketones on skype. Daughter didn't really know - but son in law thinks ketones suggests type 1 diabete's and no ketones is type 2. The only thing I've found on it is that it's a sign that the disease diabetes has progressed. I think I will google ketones next. The testing kit we bought requires a phd to set up - husband has phd but struggled. It tests for ketones but we didn't realise we have to buy different stips for it.

The pegs on the back of the neck worked great. He was really edgy till we tried those on him - after that he was a lamb. We didn't even have to leave them on - it's as if the process lifted his mood a lot. Very calming. I looked for the older pegs that had lost most of their spring. My husband thought I was crazy for going out in the dark and rain to gather clothes pegs but after he saw how much LB settled down he was convinced.

I cant imagine doing the testing every two hours as LBs ears look a bit sad by now. Part of our problem was the machine didn't work for the first two offerings. Not enough blood. We know what is required for next time. I will use a torch to check out the veins next time.

thanks all,
Marilyn

 

Congratulations!!!! :RAHCAT
You did great for your first hometest... yeah it took a few strips and pokes, it does for most people, but you got a number. It will get so much easier after you've done it a few times and know what to expect. So glad to hear that Little Boy was cooperative.

13.6 isn't that bad. It's not in normal non-diabetic range, but it's really not horrible. I presume you went to sleep before 5-7 hours had passed post-shot. Tomorrow, if you could get a pre-shot test and one somewhere mid-cycle, that would be useful to start to figure out how low he's going. To me, 3 units sounds like a lot as a starting point if he's at 13.6 pre-shot, but until we have more data it's hard to say.

(and yes, multiply by 18 to get the US version of the number)

Congratulations again!!

Odiesmom

 

Off to bed now. It's 10.30pm here.

244 pre his nite medication of 3 units and he was quite hungry (not sure if the hunger helps or hinders).

I don't really know what that means but wouldn't the 3 units reduce the level further into normal range?

Marilyn

 

Hurrah! Hurrah! So glad the clothespins worked. You may find that over time you won't need them - after he gets used to the process and is waiting for the treat.

So hope you got a preshot number in the morning. Be sure it is over 200 (multiply your # by 18) and safe to give insulin. Then try for a few tests during the day (between 5 and 6 hours after the shot would be good). You are trying to find his lowest point in the cycle (his nadir). That is the real marker for how well the insulin is working. That is the number that helps you adjust the dosage. (If he goes down real low, 3 units may be too much.)

Now that you have hometesting down, it is time to head over to the Lantus support group: viewforum.php?f=9 They all use Lantus and can give you dosage suggestions. Also be sure to read the stickies at the top of the page.

And start your spreadsheet. http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=16 It is a great tool to keep track of his bg levels. It is color coded and will start showing you patterns. You can add notes about food etc. Great way to remember what has been happening and to predict what make happen next.

About the food. Unregulated diabetics are literally starving. Their bodies aren't processing food well. So we find it is a good idea to let them eat more and eat more often - several times a day and night. With Lantus you do want to limit feeding closer to the preshots, but the support group page will explain that.

I know, I know. We are always giving you more work to do. You and your husband (and Little Boy) are doing great. You will have this sugar dance down in no time.

 

As Sue mentioned, until regulated they can't process food very well so they will eat a lot more than normal. Just let him eat. His hunger will reduce once his blood sugar is regulated and his body is able to process food properly again.

Yes, 3 units will reduce his blood sugar levels, you just don't want it to go down too low.

 

second reading (couldn't get the early morning one as I was out) was taken 4.5 hours after morning insulin - is 235.8. machine (optimum exceed). So far it seems that 3 units is ok for LB. We may try again in 2 hours but will see if husband has recovered this latest episode. He is not normally a stress head but this really upset him.

Does the two readings thus far suggest that 3 units is an ok starting dose in LB's case? Obviously will monitor and stop running to the board each time but I think we need to report in at this stage. I know I should go to the lantus board but it all seems a bit technical over there. Too many numbers I don't understand as yet.

marilyn

 

Well, this is the first time I've read your posts.........no info to add.........but have to say you have a wonderful sense of humour, especially where your husband is concerned :lol: It sures helps to be able to laugh when dealing with this disease and welcome to the board.

 

yeah, truly we should have video'd ourselves last nite and put it on youtube. we be nearly as entertaining as the bride who cut her hair off. We could have put our video up as "this is how not to home-test a diabetic cat! I am sure LB would have been given a prize for the most patient cat of the year! The second test was nearly as bad as the &^%$# machine wouldn't lose yesterday's reading. There we were with a great blob of blood, attained with hardly any effort or discomfort to LB and the *&^%$ machine wouldn't work!!! Yikes back to panic and dummy spitting from husband and me keeping my mouth shut coz how can me nagging on help the situation?? Just a bit unfortunate that our patients have to suffer thru our learning curve!

marilyn
ps yeah humour saves the day!

 

235 (13.1 -- I'm in Canada, I convert back to the other measure so they make sense to me :smile: ) is still a safe number. Did you manage to get another reading around +6 or so?

I'm not sure I understand what happened with the glucometer and the old reading, that seems a little strange. It will likely keep a history, but it shouldn't interfere with a new reading.
Usually, when the glucometer is off, you put in a new test strip, it starts up and is ready for a drop of blood. If for some reason it takes you too long to get the drop of blood and the glucometer shuts off, you just pull out the test strip and push it back in and it'll start again.

Next time though, if something weird happens like that, get the drop of blood transferred over to your fingernail. That way, you can let go of the cat and have all the time you need to fiddle with the glucometer.

Sounds like testing is still stressful, but it really does get a lot easier. In a week or so, you'll be soooo much more comfortable with the whole thing. You're doing great, really!

Odiesmom

 

ohmygod_smile

We should have saved the droplet of blood onto something e.g. a finger nail.

Didn't test 2 hours later. Too stressful. Will leave next test till 4+ hours tomorrow and then follow it with a 6+ hours. Will keep LB from getting fed up with our bungling. David will read your post about the meter - as he's not quite sure why it was showing yesterday's reading with the new blood inside. Those things are a bit temperamental.

Every cat is different but LB doesn't suffer fools gladly. He's a good boy but he has his limits - we feel our best chance is to start off doing the tests a couple of times a day and build up.

marilyn

 

Hey there Marilyn =) You're doing fine! Testing is hard for all of us at first, oh if you could have seen us the first few times!

My best tip is to find a special treat, something he'll do tricks for or at the very least that he'd follow you to hell to get Here we use freeze dried chicken treats which we can buy at Petsmart or Petco in the dog aisles. We try not to let the kitties know they are eating dog stuff, but I don't think they'd care even if they knew. I have two who will litterally climb my legs when I bring out the container (which is a well sealed plastic tub, kept behind a closed cabinet door!)

There are other flavors besides chicken but the chicken is the favorite around here. I call it freeze dried kitty crack :lol:

Once you find a treat he reacts to that way... ONLY give it for BG testing. Like someone said before, give it even if your test is not successful.

You can practice with your meter on yourselves to get the hang of it, might save a bit of stress on your Little Boy (I giggle when I read the abbreviated version of his name... bc around here a LB = Litter Box so I have to correct it in my head every single time. :lol: )

Have you tried using a warmed up sock with a bit of rice in it? I use a baby sock, put in a handful of rice and tie the top. Pop in micro for 15 seconds or whatever it takes to get it warm but not hot. Then use that to massage his ear flap. The warmth and the massage gets the blood flowing and it feels SOOO good LB should purr his way through that part. Then you can keep the warm sock behind his ear for stability while you poke to get the blood drop.

The thing that made it all the easiest for us though was for ME to CALM the heck down. Yep. I was stressed and nervous, which transferred to the cat and just made the whole thing harder. Once I took some deep breaths and started talking quietly to him in that special tone he loves so much... the fight ended. He came up and laid beside me and let me test him as if we'd been doing it perfectly from the first time. But I had to control myself in order for that to happen. Then give treats to make him a happy boy of course

I really should get hubby or the boy to video how we do it. Tugger is pretty easy going about it now, but I could use one of the civvies who aren't used to it so folks could see how to go about testing a cat who has never been tested. Those videos on youtube etc. all show nice calm, willing kitties. Which most kitties eventually do become but it's not really much help during the first week when kitty is more interested in escape than anything else. Maybe if hubby is not in a bad mood I can get him to try it this weekend (or next weekend, we're getting a new FD kitty next week, that might be the best time to record a vid)

Good luck!! Hopefully today will be easier =)

 

I should call him Litter Boy coz he's a walking litterer. We have white and black tiles in our foyer and he loves to roll in the dirt and leaves and come inside and drop stuff everywhere - not to mention muddy paws when it's raining!

I thought about treats for Little Boy but he's tuff on that one. Apart from a baby bird or a little mouse, I can't imagine anything I could tempt him with as a treat. But I've withdrawn Science brand cat biccies since 2 weeks ago. But I gave him ONE the last couple of testing times. (the human equivelant of a jelly baby?)

I will do the sock thing for sure. I am not sure about testing the machine on myself. Maybe! :sad: But I really am calm whilst trying to get blood. I am not squeamish coz I know it's helping him. My husband is usually the essence of calmness. This is a new side to him.

I should start writing down all the things we've tripped up over so that they can be covered in preparing newbies. e.g we didn't know that you had to get enough blood to make the machine go beap. We failed the first two times on that one. Poor cat had his ear squeezed 3 times while we learned from experience.

Anyway what a great site this is!!

there is something special about cat people. Anyone seen James Taylor show off his cat on his web site? He's a cat 'true believer'.

 

Hi Marilyn,

been off the board last couple of days so playing catch up.

Don't worry about going over to Lantus land yet. You need to really get your spread sheet up and running beore you do. As long as people who are giving you advice about Lantus actually know about how it works your fine.

That 235 is actually in my view a number that needs monitoring due to the 3u.

As well as your preshot number can you get a test between +4 and +6? This is approximately when Lantus will be working hardest on the bg. Although you then had a high number next time you tested, he could have dropped really low. If this happens, cats have a natural body defence and the body releases glucagon into the blood stream to raise the bg.
If you don't catch this, people assume kitty not getting enough insulin and automatically increase dose again and the cycle continues. Eventuially kitty's body gives out, doesn't dump the extra glucagon into the blood stream and your facing a hypo.

Close monitoring is the only way to get the right dose.

You do need to be careful with the history of keytones.

I think it's in one of the stickies here in health, but see if you can find the one that says about setting up a profile. Knowledgeable beans will check this before giving advice. Otherwise they could advise you wrong because they don't know your story and/or confuse you.

It's important people know the keytone history.


Also, changing food to lower carb should mean a reduction in insulin dose.

Lucky was something like 482 at diagnosis. Wouldn't presecribe her insulin. Went home, came on here. Picked up her dry, dumped the HILLS M/D.Bought Felix wet and within a week her bg was 257. This was with NO insulin.Vet oprescribed insulin and promptly o'd her by giving 5u as an initial starting dose. I spent the night on here!!! Never looked back.I took a huge leap of faith, quicker than most, priobably because I live in a foreign country and had no one else to help me. Soooo very glad I did! :mrgreen:

Until you set up a spread sheet you could post a list of the numbers you have in relation to the time that you took them against giving insulin. So:
AMPS.....
+2....+4....
ETC
pmps
(that's am preshot and pm preshot). The date too

Then people can start helping you work out what is the way forward.

AS for reading up on keytones-WIKIpaedia, diabetic ketoacidiosis. Quite good and not too much terminology.
http://en.wikipedia.org/wiki/Diabetic_ketoacidosis
kEEP ASKING QUESTIONS

 

ok, I will try to set up a profile. I didn't get a pre shot level today. Damn. I was focusing on getting one at 4 hrs after and 6 hours after. Is there any point in doing it when he comes back from his morning walk? it would be 30 mins after insulin?

marilyn

 

Any numbers (and practice for Mom) is valuable. At this point, you are putting together a picture of what happens with his insulin. But do be sure to get a +6 so you have a idea of how low it is taking him.

Be sure you are keeping some notes on the numbers you have gotten, food given and when in relation to numbers, etc. Then when you put together your spreadsheet, it will already full of good info.

 

Hi,

I agree with Sue. Right now any numbers you can get will help show how the insulin is working for him.It's important to because of the dose he is on.

The ear pricking does get easier-honest :mrgreen:
You will still have your days off it taking more than one go (even I did after 10 months!)

You can post in tech forum for help setting your spreadsheet up-I needed it!!!

Your doing great :mrgreen:

 

We are keeping a diary but haven't set it up on a spread sheet yet.

Numbers for today a little worrying (I think). Insulin at 7.30 am plus food, more food at 9am. BG test at 1pm plus food. 309.6 (17.2). Food at 4.15pm. BG test at 7pm. 345.6 (19.2).

Do the human meter's read slightly above what cat meter's read? LB was 21.4 (385.2) for diagnosis with vet pathology reading. He's been on Lantus (3 units) 7 days x twice daily since last Monday nite. (Now monday nite where we live!) We have been giving him slightly under 3 units but last nite and this morning we made it exactly 3 units.

I'm starting to think that I did something wrong with this morning's injection.

Advice as to how long to wait before doing another BG reading. No probs getting the blood tests done twice today. Easy peasy for him and us! Gave Lantus at 7pm along with another meal.

Profile was difficult for retired professor of education husband - so yes advice from the tech people will help. We actually took a long bike ride today to destress. Gotta take care of the carers yeah? @-)

thanks in advance
Marilyn

 

Hi Marilyn

Please go to the following link. It will explain how to set up a spreadsheet and link it to your signature. viewtopic.php?f=6&t=16

This will be in the correct format that the members of this board can understand and help you. When you talk of blood testing we need to know it in relation to the shot. No good telling us the time, as everyone is on different timezones. So if you give the morning shot at 7am, AMPS is the test number before the shot (AM pre shot), then

+1 = 8am
+2 = 9am
+3 = 10am...and so forth until you get to your evening shot which should be 12 hours after your first.

The pre shot number then is called PMPS and then you start again +1;+2 ;+3 etc

From what I gather you did not do a AMPS and then tested at 1pm which would be +5.5 (from your post) and he was 309, then you did a PMPS and he was 345. We really do need more data. Try and test him, before the morning shot, then at +4; +6 +8 and then before his evening shot and again at +4; +6 if possible.

It is possible that you gave him a fur shot i.e. you missed and the insulin did not go in. Being a Maine Coon, all that hair can sometimes get in the way, and you think you have injected him and you haven't. Try to feel the site of the injection afterwards and see if there is any wetness. If by any chance you do give a fur shot (and it does happen to the best of us), do not give the shot again. You will never know how much actually got in, and you could overdose the cat.

You could describe how you inject here and we could give you some pointers

The procedure is always test,feed then shoot.
Also, try not to give him any food for at least 2 hours before his insulin or you could be shooting a rising number.
Hope this helps

 

You guys are doing great, Marilyn. It is often said here that this sugar dance is a marathon, not a sprint.

After you get some more readings and have data, it may be that the Lantus users may look at your beginning dose of 3 units. Usually kitties here start with 1 unit so their ideal dose is not passed by. But that is a decision that can't be made without more data.

You are doing fine. Keep taking your tests and writing your notes.

 

OK, will follow max's post testing time instructions today. done the amps then food this morning. he 15.9 (x 18) he's highish but its pre insulin. BTW he seems to enjoy all the fuss associated with the BG testing. Quite interesting. No need to give treats as he enjoys the attention.

thanx

 

(previous advice)::::::The pre shot number then is called PMPS and then you start again +1;+2 ;+3 etc
This is the best I could do since last posting. This morning's BG I did on my own. (fairly happy with that)
Yesterday (Tuesday)

PMPS 15.9 (286)
+4 12.2 (219.6)
+6 12.4 (223.3)
PMPS 17.7 (318.6)

Today (Wed)
PMPS 17.4 (313.2)

previous advice:::::The procedure is always test,feed then shoot.
Also, try not to give him any food for at least 2 hours before his insulin or you could be shooting a rising number.

So far not managing to regulate his diet. He eats before shots. He has usually eaten an hour before giving him insulin. As time goes by I will try to stop him from eating up to 2 hours before. Sorry I don't have more results. Some of the BG tests go smoothly and others cause us a lot of stress. Cat no problem - still mastering our technique.

I know that you would like more results but I am happy with how much we are achieving in a little over a week since diagnosis. The figures above aren't suggestive of a hypo event are they? We are doing the full 3 units of Lantus x 2 daily. Lots of small meals throughout the day. Little Boy seeming to be better in himself.

thank you

 

Great job on the curve! Another FDMB task accomplished! The numbers are pretty flat and mid range. (Hypo is below 40 US) Safe, but not getting to regulation.

My guess is that you need to lower the dose, but you really need to take your numbers and history over to the Lantus Support group and see what they say.

It does seem complicated over there at first, but so did this forum, right? Read the stickies on the top of their page. They do post a little differently than here. They do "condos" which help the responders keep track of your numbers daily. You can read some of the posts to get the idea of how things work. They are patient with newcomers and will help you out.

And they will want a spreadsheet. (It is actually kind of cool to see the color coded bg levels. Makes it real easy to see what is happening.) Any chance hubby is into computers and would see this as a challenge? ( http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=16 How to set up a spreadsheet.)

You are all doing great - sliding down the end of that steep learning curve.

 

Good job, look how much you've accomplished in one week! You guys are doing great, really! :RAHCAT

No, in "your" numbers, the worrisome numbers for hypo are below 4, so you're far from there.

Odiesmom

 

The spread sheet is gonna have to wait. Husband is away and I can't walk and chew gum at the same time. Husband tried to set up the profile (following advice on here - but couldn't do it - so it's on hold too). Husband is a semi retired academic - so it can't be all that easy to do this stuff. I'm keeping a diary of tests and shots.

I will start to read the Lantus board. Thanx to all who've helped set us up.

Our vet said that research tells us that cats live an average of one year after diagnosis of diabetes. He said he's had them live longer but the world average is one yr.

The thing that I had not figured on is how satisfying it is to tackle this disease. It must appeal to our nurturing side. There is such a feeling of accomplishment. We are being very dedicated to trying to improve Little Boy's quality of life. He seems to comprehend that we are taking care of him too and is being a very well behaved patient.

Thanx for all the help here,
Marilyn

 

Hi,
I would guess your vets information is based on how vets tend to treat diabetes. I.e they don't achieve regulation because they start them on the wrong doseage and seemingly cats appear to do o.k, when in reality they are not. Their bg's are above renal threshold and thus continue to cause damage to kidneys and other organs.

On this board, in my experience, cats are living a lot longer than a year with diabetes, quite a few have been going 7+ years. Others have passed after several years because of other illnesses such as sarcoma, not the diabetes.

Just want to clarify-are those preshot numbers when Little boy hasn't had any food for at least 2 hours?
Likewise with the other tests?

I'm still not a fan that your dosing at 3u without having worked up to that dose. Would like to see some +6's. This is when insulin workig hardest.

Other thing with Lantus, builds up a shed. When this gets full, overflows and can have big big impact on bg numbers.
Are you testing for keytones?

Your doing good with getting the tests, just need those +6's :mrgreen:

 

:::::::::Just want to clarify-are those preshot numbers when Little boy hasn't had any food for at least 2 hours?
Likewise with the other tests?

Hi,

Little Boy has food pre shots. I am free feeding him and he wakes me up for food from 5 am onwards (3am 2 nites ago). I am not sure that making him wait is good. What is the advantage of making him wait till it's 7.30am to just before his shot? He tends to get distressed if he is hungry.


::::::I'm still not a fan that your dosing at 3u without having worked up to that dose. Would like to see some +6's. This is when insulin workig hardest.

I'm not thrilled about it myself but LB's figures aren't great on 3's.

I did 3 tests today. Tried for slightly different times. Pre shot for the day was 313.3. +5 was 266.4 and +9.5 was 262.8. No pre shot measure tonite as LB expressed pain on last two tests (doing it on my own as Husband away).

I don't know what the results mean. From my simple understanding his numbers are too high still. He's been on lantus 9 days. Pls tell me what might go wrong at this point. Does it start working better after a while. There may be things I am not prepared for. Yes I am nervous about 3u x twice daily - but what about the damage that is occurring at the BG current levels.

::::::::::Other thing with Lantus, builds up a shed. When this gets full, overflows and can have big big impact on bg numbers.


HAVE NO IDEA WHAT THIS MEANS

We did one urine ketone test (no ketone on vet supplied tester) - need to buy special strips from the pharmacy for blood ketone testing.

I am curious to know whether rubbing his neck after the insulin shot is a bad thing? The vet said not to shake the vile of insulin incase we break the hormone - just to turn it a few times carefully. Could I be damaging the insulin after it's been injected by rubbing his neck by way of showing my approval??

Marilyn

 

Kate said:
> Just want to clarify-are those preshot numbers when Little boy hasn't had any food for at least 2 hours?
> Likewise with the other tests?
and Marilyn replied:
> Little Boy has food pre shots. I am free feeding him and he wakes me up for food from 5 am
> onwards (3am 2 nites ago). I am not sure that making him wait is good. What is the advantage
> of making him wait till it's 7.30am to just before his shot? He tends to get distressed if he is
> hungry.

When your cat eats, the BG numbers go up. So if he eats before you do the BG tests, his BG numbers are artificially inflated. I don't use Lantus, so I can't say whether / how long he should be off food before testing.


Kate also said:
> Other thing with Lantus, builds up a shed. When this gets full, overflows and can have big big
> impact on bg numbers.
and Marilyn replied:
> HAVE NO IDEA WHAT THIS MEANS

Please read this sticky about the storage shed from the Lantus forum. It takes time to fill up the shed and, once it's filled, you can have hypos or rebound. Neither are particularly healthy for your cat.


Can't answer your questions on Lantus dosing or handling, as I'm not a Lantus user.

 

I used to free feed too because Tugger gets stressed out when his dish is empty but if LB has food in the two hours just before his shot the number you get will be influenced by food. Food gets to work pretty quickly in their system (which is why we feed when they are dipping too low, food brings the numbers up) and if he has eaten in those two hours you could be shooting a number you feel is safe, but it's only "safe" because there is food behind it. Also, if you aren't sitting there watching you don't know if he ate five minutes before the test or an hour before the test...

Really, taking up the food two hours pre-test is what you want to do.

My suggestion would be to get a timed auto feeder if you can. There are types that turn to allow the food to be eaten and then turn at whatever time you set it, making the food unavailable or for the next feeding. I don't use one but there are lots of folks here who do and can explain it better.

For us, I fed a snack before I went to bed then I just had hubby or son pick up the food if there was any left when they got up for work/school (6am) then I would test/feed/shoot two hours later. Tugger wasn't thrilled about it, none of 'em were, but they have all survived Nobody has even lost weight lol. If I happened to wake up early enough I could give a snack about 2.5 hours before his shot then pick up any leftovers at the 2 hour mark. (this is where an auto feeder is handy)

You can take a look at Tugger's spreadsheet if you like, you can see how much of a difference food makes. I kept notes of what time he was fed/shot and what he was eating. Doing that, I learned that he is pretty sensitive to carbs and I was able to control his numbers even better by keeping his diet 5% or less and I also learned that I didn't have to pull out the really high carb stuff when we were dealing with hypos... a nice 10 or 11% brought him up just fine.

Not a huge concern right this second but another thing, you want to get the BG test before you feed and shoot. Sometimes, you will get a low number and need to keep an eye on him to see if his number is rising or falling. You can't know this if there is food on board. So you'd test and see a low number, wait a bit and test again and if it's going up you could *then* feed and shoot. I made that mistake a few times early on, just test, then throw the food at the screaming hoards to shut them up so I could finally get to the coffee only to turn around and realize "OH CRAP, that was a low number, is it safe to shoot?" I'd come running here and they'd all say "DONT FEED YET, we need to know what that number is doing on it's own before we can decide what to do" ohmygod_smile . Again, lots of info in Tugger's ss feel free to look it over and look at other kitty's spreadsheets too. Lots to be learned in them =)

If you need help setting up the spreadsheet, just let me know. I'm not the most computer literate person but I managed to get it done so I might be able to walk you through it.

 

Yikes, so much to know. I confess to being overwhelmed again. It's late here and I'm needing to sleep. No point scaring myself about all this at this time of nite. Just have to try to get my head around how this is going to pan out.

thanks again - and yes I will be reading everything suggested and trying to understand it.

marilyn
ps decided to do a little light reading because I wasn't feeling upset enough.... http://yourdiabeticcat.com/protocol.html
LB is on Lantus which i assumed was the best. this person makes a good case for PZI. How many people are using PZI for their moggies?

 

I know. You just get some of the stuff figured out and we throw you some more.

Lantus and PZI are both long lasting, gentle insulins. Cats here have been regulated and got into remission on both. There are some differences but both seem to work. Since you are on Lantus, and haven't yet "experimented" with dosage, I would stay with it if I were you.

We use an automatic feeder. It's called the PetSafe5 and we love it. You can set the feeder to go off 5 different times during the day and night. We put frozen food in for the early morning feeding. With diabetics, it's nice if they can eat several small meals during the day and night, and the feeder lets you do that easily. We got ours at PetSmart but you can also find it on the internet. So maybe you could feed LIttle Boy at 5am, take your time with the poke about 7ish and give him the insulin after. (For us, it has had the added bonus of not having to wake up earlier in the morning as we are retired.....)

Do read the stickies on the Lantus page. They will explain the shed.

Rubbing his neck shouldn't hurt anything but is not necessary. You could always rub another spot that he enjoys after the shot!

You got a nice +6 shot yesterday. Besides the preshots, try for another today to add to your data.

 

Marilyn:

I spend the majority of my time over on the Lantus board. Sue asked me to stop by.

Once you have your SS up and running, it will be much easier to get the big picture of LB's response to Lantus. I believe that Max's mom asked if you could list out your results. (Also, the morning pre-shot test is AMPS and the evening pre-shot test is the PMPS.) It will be much easier for us to look at LB's numbers if we have everything consolidated in one post until you have your SS completed.

I'd also like to give you some "homework." This is the link to one of the sticky notes (permanent notes) on the Lantus board that provides information on Tight Regulation Prototocols. Linked within the note are the "formal" protocols -- one from the German Lantus forum, the Tilly Protocol, and one from Jacqui Rand, DVM at the University of Queensland, who is doing the leading research on Lantus in cats. You will note that the starting dose of Lantus is based on ideal weight so unless LB is huge, it's likely that 3u is too large of a starting dose. We like to work up to a dose since that is far more safe than starting high and working down.

I also want to point out that your vet is incorrect about the lifespan of a diabetic cat. Gabby has been diabetic for a year AND when she was diagnosed was critically ill due to the diabetes. She's very healthy. While cats have a shorter lifespan than humans, some people live with diabetes quite literally for all of their lives. As long as the diabetes is regulated, you can expect LB to live a long and happy life! I don't want to undermine your confidence in your vet, but I do think you need to do more reading and decide how knowledgeable your vet is on this subject. Many vets are not terribly familiar with diabetes management and even fewer are as knowledgeable about Lantus as you will find on this Board. For vets, diabetes is one disease out of many that that deal with in a broad array of species that they treat. All we do here is deal with feline diabetes.

Also, I didn't catch if you noted what you are feeding LB. I'm hoping you are feeding him a canned, low carb diet. There is also a great deal of information on feline nutrition that is important to diabetes management.

 

Marilyn,

Please check your private messages. (Look at the top of the page by your Logout (Anyname) 1 new message

I think I have helped with your spreadsheet problem. (I hope so!)

Sue

 

> Yikes, so much to know. I confess to being overwhelmed again.

Yeah, we all feel that way; it *does* become easier, I promise!


> decided to do a little light reading because I wasn't feeling upset enough....
> http://yourdiabeticcat.com/protocol.html LB is on Lantus which i assumed was the best.
> this person makes a good case for PZI. How many people are using PZI for their moggies?

My Gwyn was on PZI-Vet for years, and I absolutely loved it. That said, if Gwyn were diagnosed today (and if I knew what I know), I'd probably opt to try Lantus or Levemir first. My reasons -- the first two of which are specific reactions to things that happened with my Gwyn and I don't expect anyone else to follow the same logic -- would be:

1. (personal preference) I personally prefer manufactured insulins to compounded insulins. Of the various forms of PZI that are easily available in my area, most are compounded.
2. (personal preference) Gwyn had a *long* history of presenting illnesses with atypical symptoms and of having atypical reactions to medications, including insulins. Because of this, I would prefer an insulin that's been on the market for a longer period of time over an insulin that's been on the market for a shorter period of time, so that more of those one-in-a-million side effects that might show up would be identified -- 'cause Gwyn *did* have a few of those one-in-a-million side effects over the years. The one type of manufactured PZI that's available in my area is ProZinc, and it's been on the market for less than a year, while Lantus and Levemir have been available for several years.
3. I'm fairly certain that there are also more Lantus users on these boards than either Levemir or PZI users, which would give me a wider pool of folks to get dosing advice from.

All of these reasons may be moot in your case. ProZinc was approved for use in the US last fall, and it may not be approved for use in Australia yet. I'd assume you can get a compounded version of PZI in Australia, but I'm not sure what else might be available. If you're seriously thinking about trying some form of PZI, I'd check what options are available in your area and work from there.


Also, a note: the YDC folks practice a thing called Tight Regulation. That means trying to keep your diabetic cat's blood sugar levels as close to non-diabetic numbers as possible. The YDC protocol was developed with PZI insulin and they've continued to focus on it pretty much to the exclusion of other insulins. So I would add one thing to what they say on their site:

Practicing Tight Regulation is possible with all of the longer-lasting insulins on this site (Lantus, Levemir, and PZI). If you head over to the Lantus forum, there's a sticky at the top for Lantus and Levemir users labelled "LANTUS & LEVEMIR - DATA READY TO SHOOT LOW NUMBERS?" (you can find it here). That's the sticky that will start you on tighter regulation with those insulins.

Please note that you should *not* try Tight Regulation until you have a lot of data to work from. Giving insulin when your cat has low-ish numbers is *NOT* a good idea until you have a *very* good idea of exactly how your cat will react to the insulin. You're currently still collecting that data right now.


Finally, I agree with the others that your vet is wrong about the possible lifespan of a diabetic cat. My Gwyn was diagnosed at age 15 and lived another five and half years after diagnosis -- and she had to have insulin injections every single day of those 5+ years. And Jojo's Bunny was an active diabetic for 14+ years.

I would suggest that your vet's opinion is formed by the information that he's developed on diabetic cats over the years -- and that *that* information is tainted by the treatment policies he advocates:
1. he starts at too high a dose of insulin, which immediately increases the risks of hypos, increases the damage to the pancreas and makes it less likely to achieve remission, and makes it harder to regulate the cat;
2. he advocates not-great-quality high-carb food, which decreases any possibility of remission, while simultaneously increasing the severity of the diabetes;
3. he doesn't suggest home blood-testing of BG levels, which is the best chance for any parent to gain control over their (human or fur-baby) child's diabetes; this also means that most folks won't recognise a hypo when it happens, may not recognise it as a medical emergency and, by the time they seek medical attention, it may be too late for intervention;
4. for unregulated / under-regulated cats, he didn't suggest testing for ketones at home, which means that (*IF* your cat develops ketones) once again, by the time folks recognise there's a problem, and recognise that it's an emergency situation, it may be too late for intervention.
Every single one of those issues has the potential to decrease the lifespan of a diabetic cat.


You've been learning a *lot* about feline diabetes in the past couple weeks. I'd suggest this as an opportunity to help your vet update his practices. And, yeah, you can evangelise all you want, doesn't mean he's going to listen to you. Many of us converted our vets by showing them how well our cats were doing following the advice advocated on these forums.

Hope all of you are doing well!

-- Jean and her Gwyn

 

Sorry your feeling overwhelmed. Everyone wants to help and because you only have words with no tone etcmakes it hard to always convey things the way they are meant.

Take your time. Kitty is doing ok so far.

I'd stick with Lantus (at least for now).Many have had excellent results.

Although you might have a hungry cat, making him wait is the best way to work out how ell the insulin is working.
Although it might take you a little while-you could do a post with all your results in, then keep copying and posting that link in your subsequent posts and keep editing it, to add new numbers.

Lucky was a free feeder but she wasn't very carb sensitive (plus used very low carb food), so I would leave just a bit down to see her through the night, safe in knowledge she wouldn't have eaten in the 2 hours before I got up to do her test.
We can then see the difference in preshot number and the +6-that will guide as to what dose is best.

If you give cats too much insulin they can rebound (which think I mentioned previously), however Lantus doesn't really seem to have this effect, but can get the sudden drop in numbers.

The shed-imagine a petrol tank. Fill to full, keep filling before it's empty-overflows. Where does the fuel go? Well in kitty, that spilt fuel goes into bloodstream and works on the glucose there-hence suddenly more insulin than there is glucoseto 'mop'it up and bg number drops very low.
Atmo, no way of knowing if this is happening in your cat.

Lot of cats stay in high numbers at the beginning-remember your kitty isn't just a number. How does he look? how is he acting? peeing/pooping/preening/eating? These are all guides too.


I think you have alpha track? Don't need to get keytone strips for this. Can go to pharmacy and get 'ketodiastix'-urine strips that you pop under pee stream.Count to 15-30 secs whatever it says and then look what colour the strip goes. There is a chart on the side of the vial that tells you what the colour means. Yes may mean you have to stalk kitty, but only need to do this once a day (if reading all good).

Sounds like a lot of hard work, but honestly once you get into this, it's like 5 mins here and there in your day.

Keep asking questions and we will try not to overwhelm you.

Sleep well :mrgreen:

 

Lot's to work on thank you.

The only thing I can say in my vets defence is that he said to change to a high protein diet. I will try to convert Vet but I can't do that until I know much more - a little knowledge is a dangerous thing. I mentioned once before that I went thru something similar with breast cancer in my mother. I was passionate about the subject and I have a very good memory for medical information ONCE I understand the deal. I was amazed how much I came to know and how many basic mistakes were being made with women all over the world (1998 - 2003). I wouldn't trust any doctor to make decisions if I got breast cancer and likewise I won't trust our vet to understand the nuances of diabetes in LB. But I am free sailing at the moment because knowledge takes time to acquire. The thing I feared has turned out to be quite easy for me. Doing the blood tests. I seem to have less success with insulin as this morning I fed LB 2 hours before his insulin and then the needle was faulty so I lost some of the insulin on the way in. Numbers later today will be affected. Pre shot, no food in previous 2 hours BG test was 15.7 x 18. Rushing to go out now.

Little Boy is a lot better in himself. He was yowling at the shadows out the window last nite which he hasn't done for ages. He is bright and looks a lot better. STill drinking from the pool. I know we have a lot of work ahead of us to feel confidence of what we are doing. But thanks to everyone's detailed comments and advice (and Susan's help with a spread sheet) I am feeling optimistic again.

If I am quiet for a while I am following thru on all the information. Yes we down loaded the Qld protocol a few days ago.

Marilyn
ps I love people who love animals!!!!

 

ps LIttle Boy had very high cholesterol. Anyone else's cat have this?

 

Just in case you have not read this I am posting it............
PROPER HANDLING OF LANTUS and LEVEMIR


Lantus and Levemir should be inspected visually prior to administration and should be used only if it appears clear and colorless.

Never shake or roll your vial, cartridge, or pen.

In-use and unopened Lantus and Levemir should be stored in the refrigerator between 36 to 46 degrees F (2 to 8 degrees C).

Be careful your refrigerator is not so cold that the insulin freezes. Do NOT use Lantus or Levemir if it has been frozen.

Never reuse syringes. You'll run the risk of contaminating the whole vial/cartridge/pen.

Do not inject air into vial and especially not cartridges or pens. Cartridges and pens are designed to work on a negative pressure principle.

If you draw up too much insulin in the syringe... squirt excess either into the air dramatically like they do on TV or into a paper towel... anywhere but back into vial/cartridge/pen. There is a silicon coating inside the syringe. It can contaminate the insulin vial with silicon (this is probably what makes "floaties", it forms a white precipitate). Better to waste a drop than ruin whole vial, cartridge, or pen.

Pre-filling Syringes with Lantus (see page 3) is NOT recommended.

Lantus and Levemir should not be diluted or mixed with any other insulins or liquids.

Patches(GA) lived for 4 quality years with diabetes. '90 to 94'....long before much of anything was available for info.

Baby (GA) was diabetic for 5 1/2 years and passed away from heart at the age of 18 1/2+ ( she could have been older)

Hope .....well......she was diabetic for close to 4 1/2 years then went into a remission and we have no clue as to why other than she was dx'd with Restrictive Cardiomyopathy. She's doing great and it will be 8 years in Sept.

Mishka is doing great also and is coming up on 7 years in Oct. of being tested and shot every day.

Vinnie .....his saving grace was at the shelter they at least started him on Glip and canned food. In the process of waiting for transportation, Claudia, one of our members fostered him for two weeks and she started him on Lantus. He went into remission within 2-3 days and is still OTJ.

Your vet has a very negative approach as to lifespan so hopefully down the road you can help educate.

 

Yikes, we are doing it totally wrong! we reuse needles up to 3 times after opening new syringe. We also pull out 5units and squirt it back to 3 units to get to correct amount with no air bubbles. The insulin we keep in the butter compartment of the fridge. We have polluted the vile by using a reused needle on numerous occasions. Our Vet told us to do it the way we've been doing it. The vile is still pristine clear but I did wonder about injecting it into LBs skin and then into the vile again next time and then next time etc.

Does everyone use a new needle every time? And also does it mean I have to throw out a whole vile of current Lantus? Cats have a very high immunity to germs in comparison to humans. They lick their butts! :shock:

***
I am still doing GB tests and writing them down but I haven't shown husband the work he has ahead to set up the SS. I am saving it for when he's recovered from his trip.

marilyn
ps my vet said he has cats live longer than a year with diabetes but the world average is one year. it's not him being pessimistic it's a world average. There are folks like yourselves who provide quality of life and years on the life of your cat with diabetes but also a lot of people failing to manage diabetic cats properly, possibly because they don't belong to this site and get pushed back on track every few days until they work out WTF they are meant to know and do to keep kitty alive and healthy!!! :mrgreen:

 

Okay, can someone help us out? I set up a spreadsheet for Marilyn and Little Boy. Marilyn, can you access it on Google and make changes using the passwords I gave you? https://spreadsheets0.google.com/ccc?ke ... vZXw#gid=5 . Marilyn, I hate for your husband to start over again if he doesn't have to.

If I were you, I would start a new thread and ask specifically for Lantus help about the reusing of syringes. It may be that you will need a new cartridge of insulin, but maybe not. Lantus users should know.

 

> Does everyone use a new needle every time?

I always used a fresh needle for each injection. That included when I needed to give multiple shots at the same time (for example, if I needed to inject insulin, steroids and B-12 at the same time, I'd use a different syringe for each shot). There's some info on re-used syringes here' FWIW, I've seen re-used syringes that looked even worse than the ones pictured here.

I usually got my syringes at WalMart, where it was roughly $12 for a box of 100, so cost wasn't a factor for us. You may want to check around on prices in your area, and also see if there are online / mail-order places that might have better deals.


> And also does it mean I have to throw out a whole vile of current Lantus?
> Cats have a very high immunity to germs in comparison to humans.

Folks who actually use Lantus can correct me, but I *believe* the concern isn't about infection, it's that by re-injecting into the vial Lantus has a greater probability of 'pooping out' faster. Lantus is a relatively 'fragile' insulin in that and some other respects.

Since you're doing BG testing, once Little Boy is regulated, you'll be able to tell when it starts losing it's potency (your numbers will change). When you open your next pen/cartridge/vial, you'll want to re-read the care&handling of Lantus sticky; you've spent a lot of money on the insulin, why make it go bad faster than it needs to? (I'm not sure what you've read or not, but you should also consider whether you want a pen, cartridge or vial when it's time to get more Lantus.)


> I am still doing GB tests and writing them down but I haven't shown husband the work he has
> ahead to set up the SS. I am saving it for when he's recovered from his trip.

Didn't Sue & Oliver send you a PM on this? I thought she got one set up for you folks ...


> LIttle Boy had very high cholesterol. Anyone else's cat have this?

I don't remember. It's entirely possible that Gwyn had cholesterol problems, but she had a lot of issues and cholesterol wouldn't have made even the top 30 things I worried about -- nor the top 80 things I needed to keep track of. If you don't get any responses in this thread and it's something that concerns you, you might consider starting another thread on the subject as the current thread title ("first home BG test") won't necessarily bring in anyone who knows anything about cholesterol.


> my vet said he has cats live longer than a year with diabetes but the world average is one year.

That might be. I'm not sure how widely available the longer-lasting insulins are elsewhere, and I know some countries severely restrict the types of insulins that can be prescribed for animals, which undoubtedly skews the percentages.

But, while your vet may have had diabetic cats live longer than a year, I still disagree with some of the courses of action he's recommended. But please know that I mean that with a lot of respect: he knows more about more diseases in more types of animals than I ever could or will. And diagnostic tests, medications and treatments are changing so quickly that it's literally impossible to keep up to date on everything. I'm not blaming your vet, because the folks here have a luxury he doesn't -- the only thing we need to care about is diabetes in cats. We don't need to know anything about symptoms of different forms of scaling disease in fish, causes of lameness in cows & horses & sheep, what ringworm looks like in dogs, nor the types of surgery needed to correct a parakeet's malformed beak. Our only focus is diabetic cats.

*shrug* Anyway, it's easy for us to spout out our opinions on things. Whatever you decide, we know that you're doing the best you can in balancing the torrents of sometimes contradictory information coming at you from multiple directions, and that you only want what's best for Little Boy.

(ear scritches) to Little Boy, and I hope things are settling down for you a bit --

Jean and her Gwyn

 

Hi Marilyn

Please read the following and all the links in this document:

New to Lantus link: viewtopic.php?f=9&t=157

Lantus is a brilliant insulin but it's fragile and needs to be handled specifically. Please do not re use needles as they blunt easily and can contaminate the vial.
When you fill the syringe take in more than he needs, then take it out the vial, add some air and then tap the syringe to get rid of air bubbles. Do not inject Lantus back into the vial, again this can contaminate the bottle. Point the needle upwards and adjust the volume in the syringe to the correct amount. You will throw away a few drops of Lantus doing this, but it's the safest way to do this.

Sue has set up a spreadsheet for you. Please can you start to use it and post on the Lantus board.

 

Yes Sue did set up the spread sheet for me but I didn't try to do it coz I'm really hopeless on computers. I was waiting for my husband to come home. I can't make this happen any faster than I'm doing.

I've been contaminating the vile for 10 days by reusing the needle up to 3 times per syringe (I would gladly have used a new one each time had I known I should). I will now use a new needle each time but the vile with about 2 months worth of lantus insulin to go is contaminated. Personally I think LB's numbers are still too high. I did an 8+ today 280.8 - obviously higher than that first thing today.

I know you want the spread sheet and you want me to post on the Lantus site. I won't post again until I can do those things.

Marilyn
thanx for help.

 

You can still post here; it's just that the spreadsheet will help folks see what's been going on quicker and easier than text.

Lantus users will have more experience with this, but you said you'd only been contaminating the vial for the past ten days? If so, I *think* it would take longer for the insulin to start pooping out, so that's not something I'd worry about immediately. (Folks who have actual experience with Lantus should feel free to correct me.)

 

Hey Marilyn, since Sue set up the spreadsheet you really don't have to do much. Just open it up, go to the boxes, click in the one that says AMPS and type the number you got. Hit enter. The box will change color for you automagically =) Same with the +2 etc and if you scroll all the way to the right there's a box where you can type comments/questions, like if he's not eating well that day or if you think you did a fur shot or whatever. Easy peasy =) Oh, I forgot, if Sue didn't fill in the dates you will want to put the date in the box before the AMPS number and in the box where the "U" is you'll type how much insulin you gave. You don't have to do anything else, it will save your data for you. If you run into trouble, holler, we'll help =)

Note to Sue, I clicked the link and it wouldn't let me see the SS so you might need to share it or something? I know Marilyn hasn't used it yet, I clicked to see how the columns were set up because I've already forgotten which comes first... Tugger has only been OTJ a very little while but I had to refresh my memory lol.

Back to Marilyn =) On the Lantus... I did some of the exact same things you've been doing. The air injecting into the vial, keeping it in the butter door etc. It does cause the insulin to poop out a little more quickly but I'd think that with just ten days of use you shouldn't need to replace the insulin right away. I did all that stuff for nearly 4 months while using the same vial. I'm not sure when it started pooping out because I was also feeding dry food during that time so that was causing some high numbers, and I wasn't handling his increases properly so I had him up to 4 units BID. Then I switched insulin and his diet all at once so we still don't know which made the most difference but he took a very fast ride down the dosing ladder. Personally, I suspect the food made the most difference for us because the insulin was still perfectly clear and had no floaties in it, but who knows really.

So unless someone with more experience than me tells you to pitch it and get new, I'd keep using it for a bit and watch LB's numbers as closely as you can. If you can start using the spreadsheet you will really get a good idea of how things are going. I love that thing, it's pretty awesome. I don't know who designed it but I'd love to give that person/s a hug. Once you get to using it you will see patterns that you'll miss by just keeping a log or diary of numbers. I was simply writing Tugger's numbers in a log for months, of course, I was doing a lot of things wrong in those days... but once I started using the spreadsheet I could really see what was going on with him. I really don't know much of anything about spreadsheets or the programs that run them so I was pretty happy to find this one that was pretty much just ready to start typing in =) Computers are confusing and frustrating at times, I know. Some days I hate the things, but then I think about how this computer gave me access to this forum and I look over at Tugger who is diet controlled thanks to the help of these folks... and I can't really hate it anymore

We're all here to help so if you get stuck with something just come holler Someone is almost always around and I have never ever seen someone who refused to try to help in whatever way possible when a member calls out for help, and if we don't know how to help we can always PM someone who can. So keep posting here, we'll keep helping you out =) We'll figure out this spreadsheet thing and help you get it started, no worries!

 

I hope someone will have some ideas for us. I thought I picked the right way to share it. Try this link and see if it works: https://spreadsheets.google.com/pub?key ... utput=html

The other problem we are having is that Marilyn and David can't access it, even using my goggle password and account. Anyone know how to fix it so they can? I will also head over to TECH.

 

That works I can see it now =)

Let me pull up Tugger's ss and see if I can figure out how to do that. I set one up for Missy and Foster Cat Kitty so I should be able to figure it out once I look... be right back...

 

OK, click on Share--> See who has access -->People with Access (tab) and from there you should see Marilyn's name with a drop down box where you can set permissions. Set it to Is Owner. That should do it. I think. If not, set it to Can Edit. One or the other should work....

 

Thank you! I will go try it.

David and Marilyn are in Australia so we only have this short window to correspond. Afraid they may already be asleep.....

 

Ahh yes, I well remember the difficulties communicating with friends down under in the days of IRC chat. Seemed like I had to stay up very late or be up very early to talk with them. She'll see it when she wakes up then =) I will be up pretty early in the morning so I will keep an eye out for her then, and I know we have some late night posters around so they can catch her if it's night time for us. I'll probably crash early tonight as I have to take care of three sets of dogs tonight, so three walks and three bedtime potty breaks will probably have me knocked out the instant I get home I-) but the kitties always wake me up for breffis as early as they can get away with lol. Plus tomorrow is Brady's arrival so I'll be up and excited about that

 

Thank you so much. They have been really working to get a spreadsheet together so they can post on Lantus and get dosage advice. Have a great day - sounds exciting!

 

You're very welcome =)

It will be a very exciting day/weekend here =) I'm so anxious for Brady to get here! I can't wait to meet him =)