My Jake

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Jakesmama, Jun 6, 2014.

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  1. Jakesmama

    Jakesmama Member

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    Hi
    I'm new to the board and have questions.
    My fur baby Jake was diagnosed Oct 2012 and put on Lantus, 2 units twice a day. He is a big boy at 18 lbs. over time, his insulin was increased to 4.5 units 2x a day. In April he had 12 of his teeth removed due to decay. The doc and I were hoping his diabetes would revert, but instead it got worse and now he's up to 6 units 2x day.
    I feed him Royal Canin wet diabetic 1/2 can 2x daily and he munches on Royal Canin diabetic dry during the day.

    My question for now is,

    I've seen the cat food list on this message board, mentions specific varieties of Fancy Feast and Pro Plan. My prescrip food has corn gluten meal, wheat Gluten, soy protein isolate. Are the commercial brands better?
     
  2. Dusty Bones

    Dusty Bones Member

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    Oct 20, 2013
    Yes, brands like Fancy Feast, Friskies and others in pate style are lower in carbs than prescription or other vet foods. If you swap to a new food make sure you're home testing because his insulin needs will drop dramatically. Of course everyone here will tell you any dry food is bad, they're all high in carbs except for few high dollar ones. Dry food can also cause urinary issues.
     
  3. Jakesmama

    Jakesmama Member

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    Jun 5, 2014
    Thanks! Maybe I'll try feeding him 2 cans of the recommended food a day and wean him off the dry.
     
  4. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Please be home testing before you make the food switch. A change from a high carb food to a low carb food can dramatically reduce the need for insulin. 6 units is kind of a high dose, and we don't want to see Jake have a hypoglycemic episode.

    One question for you. Have the dose changes been based on the nadir (lowest point) in the 12 hour cycle? Or is your vet adjusting the dose based on other factors. Sometimes too much insulin looks a lot like too little.

    You may find this article by vet Dr. Lisa Pierson on Feline Diabetes informative. She talks about the appropriate diet for a diabetic cat and the need to adjust the insulin dose downward immediately to compensate for the reduction in carb intake.
     
  5. Jakesmama

    Jakesmama Member

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    I test Jake just before he eats his evening meal. Whatever the reading is indicates his dosage. Since after surgery he was on the high 300's the diabetic specialist recommended going from 4.5 to 6 units. He's still in the mid to low 300's 6 weeks after surgery.
     
  6. Jakesmama

    Jakesmama Member

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    I read the recommended article. Very informative! Thank you! I think Jake may be a bit overweight, so, like me, low carb will help him drop a couple pounds. I'll let everyone know how he does.
     
  7. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Lantus doses should be adjusted by the nadir, the lowest glucose level between shots.

    The only adjustments we make on pre-shot tests are:

    1) if the pre-shot test is below 200 mg/dL for new folk(150 mg/dL for experienced folk with test data) to stall - wait 30 minutes without feeding to see if the glucose is rising or not and optionally give a reduced dose or skip

    2) skip a shot - most common with new folk who don't have much glucose test data on how the cat responds to spcific doses.
     
  8. Jakesmama

    Jakesmama Member

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    So do I have to do a curve? His test is usually 8-10 hrs into his 12 hr cycle. Test first, then dinner.
     
  9. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Getting some more test data to find out when Jake reaches his lowest BG reading (nadir) would be helpful. You can do that partially with a curve, but if you can test around that +5 to +7 hour time frame, that is when most cats have their low on Lantus.

    By jumping from 4.5U to 6U, you may have bypassed the appropriate dose for Jake. It's very hard to tell the difference between too much insulin and too little insulin from only a few test numbers.

    We follow a modified version of the only published research study on Lantus dosing and adjustments, Tight Regulation. Dose adjustments are done in 0.25U increments, and sometimes in 0.5U increments, based on those nadirs. You might like to read the Stickies over in the Lantus Tight Regulation forum here to learn about this method of regulating your cat. Many cats even achieve remission, aka diet controlled status, using this method. It is an aggressive method of dosing so the amount of testing is important.

    There is also the Start Low, Go Slow approach which makes changes slower.

    If you would be willing to setup our standard format, color coded spreadsheet and enter some test data, that would be really helpful to us. Directions are here.

    Are you only testing twice a day now? Before Jake eats and then gets his shot?
     
  10. Jakesmama

    Jakesmama Member

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    I test once, per specialist instructions. Before his evening meal. Then I feed him, wait a few minutes, give him his dose. I've wondered if I should test in the morning too.
     
  11. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Yes, testing before every insulin shot is a good idea. That way, you know how low or high the BG number is and if you should shoot or stall and not feed and retest to see if the BG number is going up or down. It's a great way to help keep your kitty safe and avoid hypoglycemia.

    Lantus dosing is based on the lowest point in the 12 hour insulin cycle. That is usually around +5 to +7 hours after the shot, but ECID (every cat is different) and some cats nadir earlier and some nadir later.

    For example, my Wink nadired around +3 to +4. That was because the duration of the Lantus was more than 12 hours for him so the previous shot and the current shot were overlapping and bringing that BG number down early in the cycle.

    You need to test in the middle of the cycle to find out when your Jake gets his low. That low is what the protocol uses to adjust the insulin dose for Lantus.
     
  12. Jakesmama

    Jakesmama Member

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    Thank you, I will test him around 3pm and see what he reads. I will also test tomorrow am pre-shot. Good thing he's a tolerant cat! dancing_cat
     
  13. Jakesmama

    Jakesmama Member

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    Jun 5, 2014
    3:30 I tested Jake and he was at 298. He usually tests at 325 around 6pm. I'm giving him his first low carb dinner around then, so I'll feed him, wait until his night shot and test again.
     
  14. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    It is less likely to provoke a GI upset if you switch food gradually - about 20-25% different food per dayn Some cats get nauseated, vomit, have diarrhea, of become inappetant with fast food changes.

    Plus, this will shift the glucose a bit slower so you have enough time to adjust the insulin, and less risk of going hypo.
     
  15. Jakesmama

    Jakesmama Member

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    Jun 5, 2014
    Ok I'll blend some of the new food with his usual stuff.
     
  16. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    We have a nifty spreadsheet grid to store your test numbers in a shareable Google Drive file
    Instructions are here.

    Once you get your spreadsheet set up or when you look at someone else's signature link, this'll make more sense!

    Understanding the spreadsheet/grid:

    The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

    Each day is 1 row. Each column stores different data for the day.

    From left to right, you enter
    the Date in the first column
    the AMPS (morning pre-shot test) in the 2nd column
    the Units given (turquoise column)

    Then, there are 11 columns labeled +1 through +11
    If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
    If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
    and so on.

    Halfway across the page is the column for PMPS (evening pre-shot)
    To the right is another turquoise column for Units given at the evening shot.

    There is second set of columns labeled +1 through +11
    If you snag a before bed test at +3, you enter the test number in the +3 column.

    We separate day and night numbers like that because many cats go lower at night.

    It is merely a grid for storing the info; no math required.
     
  17. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    All meters sold in the US must read within + or - 20% of what a lab would get.

    And, all human meters read approximately 30-40% lower than pet-specific meters. We do not adjust the readings from human meters; we ask you to note in you signature what meter you are using.

    We have reference values for human meters, so that is not an issue in most cases. Many of us in the US like the WalMart ReliOn Confirm, Confirm Micro, or Prime meters. If you're not a fan of WalMart, you can to our shopping partner Americal Diabetes Wholesale and purchase the Arkray Glucocard 01 or 01 Mini which are the unbranded version of the Confirm models made by Arkray USA.

    Comparing a human glucometer to a pet-specific glucometer is like reading temperature in Celsius vs Fahrenheit. Both are correct. You just need to know the reference ranges to interpret what the numbers mean.

    [Glucose reference ranges are unsubstantiated and have been removed by Moderator]


    * * * * * * * * * * * * * * *​
    Examples of using the chart:

    Ex. You are a new insulin user and you test your cat before giving insulin. The test is 300. It probably is safe to give insulin.

    Ex. You are an established user of Lantus, following the Tight Regulation protocol. You've tested around +5 to +7 to spot the nadir. It is 200 mg/dL. You probably need to increase the dose, following the instructions for the protocol.

    Ex. Your cat is acting funny. The eyes are a bit dilated. You are concerned and test the glucose. The number is 35 mg/dL. ACK! The cat may be in a hypoglycemic state. You quickly follow the HYPO protocol linked in the glucose reference values chart. (which we really, really, suggest you print out and post on your refrigerator.)
     
  18. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    How is Jake doing today?

    How is the gradual food changeover going?
     
  19. Jakesmama

    Jakesmama Member

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    Jun 5, 2014
    Jake tested this morning at 346 after coaxing him from under the bed. He isn't feeling well and hasn't eaten his breakfast. Just sleeping. Haven't given him his shot yet.
     
  20. Jakesmama

    Jakesmama Member

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    Jun 5, 2014
    Yay! Jake finally ate! Gonna wait a few mins then give his insulin.
     
  21. Jakesmama

    Jakesmama Member

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    Jun 5, 2014
    Retested Jake before giving shot. He was at 349. Didn't eat all of his breakfast, seems to be running a fever. His ears are very warm. Gave him his usual 6 units.
    Right now he's eating a little more. Hasn't thrown up or anything.
     
  22. Jakesmama

    Jakesmama Member

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    Jun 5, 2014
    Tested at 4:30, read 211. Has eaten no dry food for at least 20 hrs. Will test again before bedtime insulin shot.
     
  23. Jakesmama

    Jakesmama Member

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    As far as the spreadsheet goes, I have a Mac, and can't download excel spreadsheets. Does anyone have a Mac compatible version?
     
  24. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    We don't download the spreadsheet. The spreadsheet is stored out on Google, so you need a google account setup. Once you have that done, just follow the instructions in the SS setup and link to your signature. You do all the updating directly from your google drive.
     
  25. Jakesmama

    Jakesmama Member

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    Jun 5, 2014
    Jake has been on Fancy Feast/Friskies pâté meals for three days. His sugars are not going down. Still on 6 units 2x a day. He's been diabetic for a little over 2.5 yrs, and on prescription food for that long. Not giving him dry food. Is it going to take a bit longer before I see a reduction in his sugars?
     
  26. KPassa

    KPassa Well-Known Member

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    Oct 23, 2012
    It can take a week or two before diet change is fully reflected in the numbers.
     
  27. Jakesmama

    Jakesmama Member

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    Jun 5, 2014
    Thanks! :smile:
     
  28. Jakesmama

    Jakesmama Member

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    Jun 5, 2014
    Well I don't know what's going on. Jakes sugars have gone from mid to high 300's to low to mid 400's!! Been feeding him Friskies pâté and fancy Feast pate. I think my cat is backwards!! He's on 6 units of Lantus twice a day. Sugars not going down!
     
  29. Larry and Kitties

    Larry and Kitties Well-Known Member

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    Dec 28, 2009
    Can yo post the BG values and times with relation to the shot?
     
  30. Larry and Kitties

    Larry and Kitties Well-Known Member

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    Dec 28, 2009
    Can you post the BG values and times with relation to the shot?
     
  31. Jakesmama

    Jakesmama Member

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    Jun 5, 2014
    I test Jake right before I feed him, and he gets his shot 12 hrs apart. If I feed him at 8am, he's tested just before. Then I test again around 5pm, then feed him. He does get a small meal between tests. His last shot will be around 7-8pm.
     
  32. Jakesmama

    Jakesmama Member

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    Jun 5, 2014
    I've been giving Jake 3 small cans of Fancy Feast a day, testing before I feed him in the morning and once at 6 hrs after morning shot. His evening shot is 12 hrs after morning shot. It's been a couple weeks since I started, but a few days without dry food. He's been diabetic since Oct 2012. I tested him this morning and his BG was 415!! Second time this week he's been that high. He's on 6 units 2x day of Lantus. He is always hungry. Not sure why his sugars are stil high. He usually tests in the 300's which still isn't good. What am I doing wrong?
     
  33. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Maybe you're doing everything right and something else is happening. It would really, really help if you used Google Drive so you could store his test numbers on our grid system (a spreadsheet, but no math).

    If you started at too high of a dose, that may trigger compensatory hormones to release stored glycogen which converts to glucose.
    If there is any infection, that can keep glucose levels elevated.
    There are some medical conditions which make a cat need much higher than usual doses - steroids for IBD, for example.

    Removing dry food usually drops the glucose, sometimes as much as 100 mg/dL. When I changed my GA Spitzer to low carb canned, his dose of 3 units dropped to 1 unit.
     
  34. Jakesmama

    Jakesmama Member

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    Jun 5, 2014
    He started out on 2u 2x a day. Over the past 18 mo his dose increased. Then I discovered he needed 12 teeth removed, and after the surgery this April, his bg's have gone up instead of down. He isn't on any other meds, has no other health issues. Should I try giving him less insulin? I'm afraid to, I don't want his BG to get any higher!

    I've tried to get the spreadsheet, but I'm having trouble finding it. I downloaded Google Drive.
     
  35. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    When too much insulin is given, compensatory hormones release glycogen for conversion into glucose. This raises the levels. When/if you exhaust those reseves, you may see a sudden drop or even a hypoglycemic event, which is why it is so important to test around the expected nadir or +5 to +7 hours post-shot.

    For the Google Drive - work with it on the web, not with the downloaded app. Got to the web page, make sure you are logged in, then follow the instructions in the previous link on creating a spreadsheet (download the template to your PC, do not do anything except immediately upload it into Google Drive. Print the additional instructions out, if needed.
     
  36. Jakesmama

    Jakesmama Member

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    ok i tried to do the chart, lets see if it works
     
  37. Jakesmama

    Jakesmama Member

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    ok heres the chart, how do i fill it out?
     
  38. Jakesmama

    Jakesmama Member

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    OMG!! I just tested Jake at his 6 hr mark, and he tested at 53!!!!!
    He went from 415 to 53 in one day!! Gave him a tiny bit of dry to bring his sugars back up a little.
     
  39. KPassa

    KPassa Well-Known Member

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    Oct 23, 2012
    How is he doing now?
     
  40. Jakesmama

    Jakesmama Member

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    He's under the bed. Gotta wait till he comes out to retest him.
     
  41. SweetAngel

    SweetAngel Member

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    May 30, 2014
    hope he's ok.

    With the spreadsheet, you just click on the cells and type in whatever. If you like, have a look at mine as an example. I only started using it less than a week ago, so maybe look at some others too.

    x
     
  42. Jakesmama

    Jakesmama Member

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    He's ok. I just tested, he's up to 165. It's 5:15pm. Two hrs till shot time.
    I need to know what the cells mean, except the date one of course. What info goes where?
     
  43. Jakesmama

    Jakesmama Member

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    Jun 5, 2014
    Ok I figured it out.
     
  44. SweetAngel

    SweetAngel Member

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    well done on the spreadsheet, if I can do it anyone can!!

    He's getting pretty low numbers, if you shoot below 200 I'd test him at least every couple of hours. I don't want you to go through what I went through last night when Angel had a hypo (luckily a mild one, but still so worrying).

    hugs x
     
  45. Jakesmama

    Jakesmama Member

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    Jun 5, 2014
    I gave him 3u last nite, he tested this morning at 219. Fed him and then gave 3u 20 min later. Will test around 1pm. 3u is half what he was taking. :D
    By the way, these are U. S. numbers. I noticed you're in the U. K.
     
  46. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Because we are in many different time zones and because interpretation and taking action depend on when a test is with respect to the shot, it really helps if you report them in terms of
    AMPS - morning (AM) pre-shot
    PMPS - evening (PM) pre-shot
    +# - any test # hours after shot
    Ex
    +3 - a test 3 hours after the shot
    +7 - a test 7 hours after the shot.

    A note: the nadir, or lowest glucose level between shots, moves around. It can be helpful to test different days at slightly different times to help clarify your cat's specific tendancies.
    Ex
    +6 Monday
    +7 Tuesday
    +5.5 Wednesday
    And so on.
     
  47. SweetAngel

    SweetAngel Member

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    May 30, 2014
    hi Cory,

    How's Jake doing today? I gave you US numbers coz I didn't want to confuse you, what's going on is enough to take in without being given numbers that don't make any sense.
    Well, just going to call the vet and see how my boy is doing

    x
     
  48. jane and stewey

    jane and stewey Member

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    May 12, 2014
    Although I am new to this diabetic cat care, I am a retired nurse and was involved in diabetic teaching at one point in my career. With my cat Stewey, I found that despite whatever type of food I was administering...I required significant regimentation. Aloughing her to graze (even on dibectic dry) kept her blood sugars in flux. Her numbers were all over the place. By keeping her on scheduled feeding times, giving the same portion of food each feeding...brought her blood sugar numbers into a consistent range. This regimentation saw her coat become healthier, her energy levels rise and her personality come back to normal. Perhaps, once a week, I may see an elevated sugar. Before regimenting her feeding times and amounts, her sugars were steadily rising and her insulin was up to 4 units twice daily. She now receives 1 unit twice daily and is doing well. She does not have any other health issuse at present which does enfluance her response. I also only feed her wet food. The dry food is just that...dry. And the carbohydrate level of the diabetic dry is still too high. Most of the dry contains very little animal base protien as well. Give it some thought. A new regime may help Jake in the long run. Good luck, Jane and stewey
     
  49. Jakesmama

    Jakesmama Member

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    Jun 5, 2014
    Jake is doing well on wet food only. He tested a little high this morning, but I'm wondering if the Friskies food had anything to do with it. He's been eating Fancy Feast. I didn't get to test his nadir today because he's sleeping under the bed. He was full of vinegar this morning, trying to climb up onto my dresser. If he comes out soon, I'll test him, otherwise i'll wait for his pm test.
     
  50. Jakesmama

    Jakesmama Member

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    220 @ 3:30
     
  51. BJM

    BJM Well-Known Member

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    It would really, really , really ....
    Be helpful if you posted your numbers as described previously.
    Is 3:30 +5? +6? +7? Or something else?
     
  52. Jakesmama

    Jakesmama Member

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    Jun 5, 2014
    It was at +9 because he was sleeping under the bed at +6
     
  53. BJM

    BJM Well-Known Member

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    A 220 at +9 is nice. Right around the renal threshold, the point at which glucose is excreted via the urine. Ideally, you want as much time as possible below that as long as it is a safe number. The specific level varies with the cat and renal function.
     
  54. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Would you be willing to add a bit more information to your signature? Like the insulin you are using and the meter you use for testing, any complicating medical conditions Jake has, food being fed. These little tidbits are nice to see at a glance in you signature, and help us to help you better.

    Thanks for considering doing this.
     
  55. Jakesmama

    Jakesmama Member

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    Jun 5, 2014
    Morning pre shot Tested at 387 at 6:30 am. I gave him 3 units at 9:pm last night, his shot was 2 hrs late.
    I gave him 3 units after his amps and breakfast at 7:00am. I'll test again at 12pm for his nadir.
     
  56. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Ok, you're narrowing in on that nadir for Jake. Looks to me like Jake could still be bouncing a bit from that low of 53 a couple of days ago. Let's see how he continues to do and maybe think about increasing the dose in a couple more cycles. Hold steady for now, and let's see what the evening tests show.

    Are you able to get any tests at night, beyond the evening pre-shot test (PMPS)? It sure is nice to see that 'one last test before you go to bed test' in the evenings. Many cats go lower at night. If you don't test much in the evenings, you are 'missing half your data' as Sienne and Gabby would put it.

    You might want to think about going over to either the Lantus Tight Regulation forum or the Relaxed Lantus forum for insulin specific recommendations. I think it's time you graduated to the next step on the message board. TR is much more active and has many more experienced people to help you out. Relaxed is more laid back and not as active. You can follow either the TR or Relaxed protocol on either forum.
     
  57. Jakesmama

    Jakesmama Member

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    Jun 5, 2014
    Right now I only test 3 times, because I'm tight on budget and his strips are expensive. He tested at 210 at +5 today. When I start my new part time job I will get a different meter with less expensive test strips.

    I'll take a peek at the recommended message boards.

    Thanks!
     
  58. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Yeah, that's why many of us use human glucometers with pet specific reference numbers.
    The 2 used a lot here are the WalMart ReliOn Confirm/Confirm Micro or the Prime. If you abhor WalMart, pop online to American Diabetes Wholesale via our shopping link above and look up the Arkray Glucocard 01 and 01 Mini which are the unbranded Confirms (also made by Arkray).
     
  59. Jakesmama

    Jakesmama Member

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    Jun 5, 2014
    Jake tested at 120 at +10.5 (5:30p) then I fed him. His shot is due at 7pm. Should I retest? Or just give him 2u? Been giving him 3u.
     
  60. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    The pre-shot clues you in if it could be safe to shoot, plus the info from nadir tests.

    I'm going to take a stab at it here - you may need to reduce another 1 to 1.5 units.

    It takes roughly 5-7 days on the first dose to stabilize and since you started logging at 6 units, then dropped to 3, and are now seeing pre-shots of 102, it makes sense that sticking with 3 units may be too high.

    Skipping a dose will allow the buildup to drain out a bit (we call it the depot - crystals of Lantus under the skin which slowly dissolve to take effect). Jake may be higher in the morning, but I think I'd only do 2 units tomorrow morning. If you won't be able to check around the nadir tomorrow, you might even make it 1.5 units.
     
  61. Jakesmama

    Jakesmama Member

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    Jun 5, 2014
    Thank you. I gave jake 2.5u before I got your message. I was contemplating 2u, but was not sure if that would've been too much of a drop. Let's see what happens tomorrow morning......
     
  62. Jakesmama

    Jakesmama Member

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    Jun 5, 2014
    324 at 6:30am AMPS. Hmmm. Gave 3u at 7am.
     
  63. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    BJM suggested dropping the dose back to 2U and maybe even down to 1.5U if you were not around at nadir to test. I agree with that suggestion.

    Lantus is not an insulin where you want to keep changing the dose for every shot. You have that depot or storage area under the skin to think about. Reacting to a higher number at pre-shot and increasing the insulin based on that higher pre-shot is only going to lead to erratic BG readings. You want some consistency in the dosing with Lantus, and you want to base any dose changes on the nadir or lowest point in the 12 hour cycle, not the pre-shot readings.

    You need to give the dose changes time to take effect and that can be anywhere from 6 to 10 cycles (3-5 days). This is where you need to borrow a pair of patience pants from my vast lending closet and put them on.

    You might want to go over to the Lantus Tight Regulation forum here and read through those stickies at the top of the forum. There is lots of great information there. Not sure if you want to use TR (Tight Regulation) or not, but the folks there can guide you even if you decide you want to go the more Relaxed approach. You may be ready to start posting in one of those insulin specific forum, for more guidance on the dosing for your Jake.
     
  64. Jakesmama

    Jakesmama Member

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    Jun 5, 2014
    So if I drop jake to 2 units twice a day, and his number is high, then I should wait a few days to see if he stabilizes? I gave him 3 units this morning, and at +5 he is at 200.
     
  65. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Looks good after skipping. Maybe hold it to see how it shakes out for him, just watch and catch a test between +5 - +7 when he is likely to hit his nadir.

    If he goes below 50 mg/dL on a human glucometer, it is an automatic dose reduction of 0.25 units if he is a new diabetic.
     
  66. Jakesmama

    Jakesmama Member

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    Jun 5, 2014
    He isn't a new diabetic. He was diagnosed Oct 2012. Of course I don't know what the criteria is to determine new from long-term.

    I've been struggling to get him either stabilized or otj.
     
  67. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    New diabetic kitty is diagnosis less than 1 year. Long term diabetic is considered to be any kitty that has been diagnosed with diabetes more than 1 year.
     
  68. Jakesmama

    Jakesmama Member

    Joined:
    Jun 5, 2014
    Jake's amps today were 463. I'm concerned about his high morning numbers. I test him at 6:30am just before breakfast. Then I give him his am shot at 7am. Usually his nadir numbers are good, and his evening numbers are good. Then the next morning his numbers shoot up. I feed him 4x a day. 6:30, 10:30, 2:30 & 6:30. I try to get his nadir around +5 - +6.

    Should I spread out his meals a little farther apart?
     
  69. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    With Lantus, test, feed, & shoot all within 15 minutes, barring a tendancy to hurl breakfast.

    With a tendancy to hurl breakfast, feed a teaspoon or two, wait 15 min to make sure it stays down, shoot, feed remainder of food in 1 or more mini meals.
     
  70. Jakesmama

    Jakesmama Member

    Joined:
    Jun 5, 2014
    Well he doesn't hurl, so I just have to shoot a little sooner after he eats. His nadir was 263 at +6 today.
     
  71. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    You might think about making changing that 2:30 pm feeding to a before bed feeding time instead. Since you shoot around 6:30 -7:30 am. by feeding at 2:30 that would be +8 to +9 hours after the shot. You usually want to avoid feeding after the nadir (+5 to +7), because there will not be enough insulin left in Jake's system to process the food.

    Do you think you could move the that one feeding to a just before bed feeding? More like 9:30 - 10:30 would put it at +3 to +4 after the PM shot and before the nadir. I'd try that and see how it works for Jake.
     
  72. Jakesmama

    Jakesmama Member

    Joined:
    Jun 5, 2014
    I'll try that.
     
  73. Jakesmama

    Jakesmama Member

    Joined:
    Jun 5, 2014
    I've changed his schedule to amps 6:30am, feeding ,Shot, small meal at 11am, then nadir test around +5, dinner around 6pm, PMPS at 6:30pm, shot, small meal around 9pm.

    His morning numbers are lower. Seems to be working.
     
  74. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Glad to hear that making that small change in Jake's feeding schedule seems to be helping to get lower numbers.
     
  75. Jakesmama

    Jakesmama Member

    Joined:
    Jun 5, 2014
    Ok, his numbers are up again; should I remain at 2 units or increase to 2.5?
     
  76. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    How many days has he been on this dose?

    Are you following the Tight Regulation protocol or the Start Low, Go Slow protocol? Both are linked in the Lantus Tight Regulation forum. Read these over carefully as they explain how to safely adjust the dose and when.
     
  77. Jakesmama

    Jakesmama Member

    Joined:
    Jun 5, 2014
    5 days. Doing a modified tight regulation protocol. 3 tests a day, 4 small meals a day.
     
  78. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Actually, I'm thinking a small reduction.
    Why? The pre-shot < 200 suggests he may need less and he's bouncing because he went low overnight.

    And it takes up to 3 full days for a bounce to settle, so you might just hold the dose another day.

    Any chance you can snag a before bed test, or even set the clock for around his nadir to see if he is going low?
     
  79. Jakesmama

    Jakesmama Member

    Joined:
    Jun 5, 2014
    Yeah, that's what was suggested on the tight reg board, the later test.
     
  80. Jakesmama

    Jakesmama Member

    Joined:
    Jun 5, 2014
    Ok, did the +2 test, he was just 2 points below his PMPS number. This AMPS, taken at 6:10 was 127. I'm holding off giving him his shot. Should I give him less?
     
  81. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    I see you got some advice on the TR forum. It'll be best to stick with posting there unless it is a medical emergency, such as hypoglycemia or high ketones (vet visit for those).
     
  82. Jakesmama

    Jakesmama Member

    Joined:
    Jun 5, 2014
    I got great advise there! Thanks to everyone here who helped me get Jake down from 6u 2x daily to 2u 2x a day! Hopefully I will be posting OTJ soon!
     
  83. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Way to go Jake! Down from 6U to 2U in less than a month! Excellent job there. Hope you can keep dropping that insulin dose down, slowly but gradually and do get to go OTJ, like Wink.

    :RAHCAT Go Jake, GO! :RAHCAT
     
  84. Jakesmama

    Jakesmama Member

    Joined:
    Jun 5, 2014
    Today his numbers were up because I had to give him a can of Hill's M/D today. But now he's back on his Fancy Feast, so I'll do a +2 and see what happens. Hopefully he'll be down tomorrow.
     
  85. MollynSkooter

    MollynSkooter Well-Known Member

    Joined:
    Jun 4, 2014

    Can I get a pair and a back up pair of those pants, please? lol
     
  86. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Don't know your favorite color, so here are a couple of choices for you.



    Or how about these, to go along with those "Stinky Pinky" BG numbers Jake was giving you all day yesterday?
     

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  87. Jakesmama

    Jakesmama Member

    Joined:
    Jun 5, 2014
    I'll take the stinky pinky pants....... :lol:
     
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