My little joy Cupcake needs help

Dear all,

First of all I want to inform that I am not an english speaker, but I'll do my best to make myself understood.
I live in Europe, Lithuania. I have 1,9 years old British shorthair - Cupcake (male). He was treated with prednisolone in July-August (asthma). After two weaks of giving him prednisolone I noticed excessive drinking and urination. We went to a vet (it was the middle of August) and the blood test showed 18 mmol / L (BG) (320-330 in US units). Then I started to read everything I can find about this illness and decided to try to change his diet firstly. No more dry food, only low carb wet food and raw meat. Sadly, his BG level did not went to normal. After a month of the diet his BG was around 13 (235). So, I have started Lantus injections using Lantus Solostar pen. And no reaction ;( No reaction at all! Please, look at the numbers below:

< have created SS and linked in my signature >

I will write today's data soon. Please, help me and my fluffy ;( I am loosing hope.

 

And here are today's results:

< have created SS and linked in my signsture >

I am panicing. Sometimes crying. I have a fobia for needles and blood. It's very hard for me to make BG test, to inject the insulin. My hands are always shaking. I even started to drink valerian.
Cupcake is my dearest friend and I don't know what to do... ;(
I am an absolute newbie here, in this wonderful forum. I am sorry if I've posted my post in a wrong theme.
Shall I keep 3? Or start 4 units? Maybe the issue is samogyi effect? Or insulin resistance? We do not have vets here who specialises in feline diabetes.

 

Are you testing his sugar before or after feeding? Also the terms "doses" I am guessing you mean "Units" which is what the dose of insulin is called? Besides his sugar not changing much with tests does he have any other symptoms currently, such as excessive Peeing, eating like hes starved, or excessive drinking? I would book an appt with your vet As Soon As Possible and take your numbers any symptoms he may be continuing to have as well as a urine sample so they can check for ketones. It could be the Lantus isnt working as well as it could be and an insulin switch may be needed or he may be trying to go into Ketoacidosis which is a medical emergency requiring immediate vet treatment.

 

Dear Sandy96,

Thank You for Your reply.
Cupcake always has his bowl full with wet food. However after insulin injections I always give him raw meat. He do has a healthy appetite, especially when it comes to raw. But he is loosing weight.
Yes, I am sorry, I meant units of insulin and yes, sadly, he is peeing excessively, I guess. Cupcake does not drink a lot from the moment I started giving him wet food only.
The most important part of the situation is very sad but true: we do not have such qualified vets here and they are unaware of the illness.

 

Can you get ahold of Ketodiastix ? Walmart (or any store like that with a pharmacy) or a regular Pharmacy will have them to check for ketones and glucose spilling in his urine. If you cant find the combo sticks (ketodiastix) then just a ketostick which will give you the level of ketones in his urine.

 

Hello.
Are you testing Cupcake with a glucometer or Is the vet doing the testing?

Do not lose hope .... His numbers aren't in the awful range. He just needs time and to find the right dose and we can help you help him.
We have a protocol for increasing doses that has helped many kitties get regulated and sometimes even in remission.
Increases in dose are most often in 1/4 or 1/2 units, not whole units.

Have you seen this information?

New to Lantus
Shooting and Handling Low Numbers
and
Protcol for tight regulation

You don't have to do the Tight regulation... There is also a Go Slow approach if you aren't able to monitor .

 

Ok - you are here now and we can help you with testing and giving insulin. One thing to remember is that these needles are very small. I don't like to watch the needle going in my arm to withdraw blood but I don't seem to have that problem with the small needles we use here. We can help you overcome your fears and get you on a good safe program that will help you and your precious cupcake. We can hand-hold, advise, inform... whatever you need. Feline Diabetes can be managed at home with low carb canned food diet, testing and good insulin. I know that it is scary now but stick with us and we will try to make you comfortable. It is good that you are already testing and giving insulin.

Sandy is right, you can start with finding ketosticks to get some bg numbers from her urine. We have information for your vet if they are interested in learning. There is a Letter to your Vet somewhere here. I will have to look for it.

Ok so with lantus you have to wait for the depot to build up which takes about 6 cycles or three days. You should stay on one dosage for at least that long before looking at a change. You are changing the dose too soon. Some of us wait a week for the new dose to take. So start with 1unit twice a day, every twelve hours and hold that for several days. If there is no change then we move up to 1.25u twice a day and see if that works and then we consider 1.50units. If your kitty's bg starts going too low we back the dose down by .25. Lantus works best this way.

Don't lose hope. You found the best place for you and cupcake to hang out.

 

Okay- I can see from the chart that you started at 1 unit on the first two days but then you bumped Cupcake up each day. You can't do that with Lantus. The shed has to fill first. You need to wait AT LEAST 3 to 5 days before you increase his dosage to get the Lantus some time to work.

As he hasn't had insulin for that long I would take him back down to 1u twice a day (BID) for 5 days. His numbers are not that bad- he isn't in the 20's- so keep it at 1u as you need to first drain the shed back down to 1u. See what Cupcakes numbers are then after you have the baseline.

THEN increase by .5u at a time only. If you increase by full units you are increasing by too much at a time. Unfortunately too much insulin also looks like too little insulin.

Yes, this will take time but it is safer for Cupcake and you won't miss a the perfect dose for him by skipping over it too fast.

 

Sandy96,
I can buy Ketostix in the nearest pharmacy. I will not have my car till Saturday. That's why I have no possibility to go and search for Ketodiastix. On the 26th of September Cupcake was neutered and a vet took his urine test at that time (I told her about my fluffy's BG). She said that there is glucose in his urine (I did not asked for any numbers, levels of glucose in urine).
I am using bentonite clumping litter, how can I take his urine sample (it sounds very complicated)? And what to do then? How can I treat ketoacidosis? Can I delay my visist to a vet till Saturday?

Rhiannon and Shadow,
Hello and thank You for helping too!!!
Yes, I test BG at home, I use Accu-Check Active glucometer.
Thank You for Your support, for me, these numbers are very disheartening. Do You think that the issue might be just a time? Shall I increase his dose by 4?
Yes, I have seen the protocol. The bad thing is that I am using Solostar Pen and can adjust doses only by 1 unit. I know, I know... I must by syringes... This is just my fobia for them. I feel much more comfortable with this pen (needles are not so big!!! ). On the other hand, he does not react neither to 1 unit, nor to 3... So, maybe the adjustment of the dose is not the issue at the moment?
I am thinking about increasing his dose by 4. Maybe tomorrow? Can I wait till Saturday? Me and my husband have only one car and he is away till that time.
So now I only have a glucometer, insulin pen and can buy those test strips for ketones.
Cupcake sleeps all the time except the time when he eats.

Thank You, both of You! I appreciate Your help so very much!

 

Please don't increase the dose. You are increasing too quickly.

I would suggest going back to 1 unit and keeping at that dose for at least 5 days. Giving 1 unit of insulin every 12 hours.

Continue the BG testing. Accucheck meter is fine to use. And let's see how this works.

You need to give the insulin time to work, by increasing the dose every day you are not letting Lantus work properly and it is no wonder you are getting frustrated.

Also as soon as you can, please purchase U100 insulin syringes with 1/2 unit markings - This would be listed as 0.3cc (30 units or less) and I would suggest getting the short needles (which are 5/16 inches). This will help with your needle phobia as the actual needle tip is very tiny and short in length.

Your English is just fine and we all understand you perfectly.

 

You are all amazing! I don't know how to thank You all, thanks a million!!!
RobinCot,
I melt into tears while reading Your post and smiled too Cupcake is on a low carb diet for more than two months already. And yes, I do need the information for my vet.

Hmjohnston,
I understand the principles of "start low and go slow", but as I've mentioned in my previous post I have no possibility to adjust a dose by 0,25 or 0,5 with my pen. Anyway, don't You think these numbers are strange? 1 unit for two days, then 2 units for two days and now 3 units for 4 days already. And no reaction ;( The best day was the 6th of October so far. I am going to inject his pm dose after an hour. So what should I do now? Decrease till 1 unit again? I feel it won't work ;( Can I stay with 3 now?
Two cats of my friend went into remission this way: starting with 1, after a few days - 2, then 3 and 4 units. It took only about a month or even less and these too cats are ok without insulin at the moment. However, these cats demonstrated a great reaction to glragine (lantus). I guess my case is different.

 

Labas, Mano tevai atvyko is Lietuvos po Karo. As gyveniu Kanadoj. Musu katenas, Tomas, buvo diabetics vos 12 metu. Jis numire preisia meta.
To all of our members, I have welcomed this member. My parents fled Lithuania after the 2d world war,when the Russians invaded. They only regained their freedom in the 1992. They have since joined the EU. The Lithuania my parents left was agrarian,but I do not know what it is like now. They are more European than English so there are no walgreens or walmarts there. As well using particularly specific nomenclature probably will not work. Since Thomas died I have rarely visited this side of the board, but for some reason today I did. I have not given medical help in eons, since we were very old school, but I will try to
explain things to her,sort of a translator.

 

If you want to keep to the 3 units, then keep to this and do test him. I'm just saying that changing the dose every day or every time you give insulin is not the correct way to use Lantus insulin. This may be ok for other insulins, but it's not good when using Lantus.

It will also make it harder to regulate Cupcake and get his numbers to be more consistent.

 

Oh, God, the world is so small! )) Greetings from Lithuania, Dear Dana & Thomas!
Hillary & Maui, thanks for your valuable pieces of advice! I've just called my vet, he recommends to stay at 3 units now... I need to test Cupcake's BG and make an injection. Hands are shaking... Going to take some more valerian.

 

You do realize that this fear is all in your mind. Cupcake is perfectly fine and probably doesn't really notice the injections and if you give him treats or brushes or pets after he will come looking for you when it's time to test and give injections....

 

Hi Cupcake and Mama! You've got lots of good advice above. I understand being scared of the needle - when KT was diagnosed, I almost fainted just seeing a needle. After a week, that scared feeling was gone. I now have 2 diabetics which I can give shots to without even a shake or upset stomach.

You do need to think about using the syringes instead. That pen needle doesn't always give you the same measurement for 1 unit. That's OK for humans that take lots of insulin but for kitties, a part of a unit is possibly a dose. The syringes will help you control that.

BIG HUGS! WELCOME AGAIN!

 

Hello,

So cupcake was on prednisone for 2 weeks for asthma before the excessive drinking and peeing? This happened to my cat (he was given an injection of depo Medrol) and the diabetes was steroid induced and after some time on wet food only, he went into remission. This may, repeat may, be what happened to Cupcake and if so, the chances of remission are very good indeed.

 

Could you buy U-100 syringes with half unit marks?
These can be used to get the insulin out of the pen.
And they help measure small doses.

Google translate version, English to Lithuanian:
Ar perkate U-100 švirkštų su puse vieneto ženklus?
Jie gali būti naudojami gauti insulino iš švirkštimo priemonės.
Ir jie padeda įvertinti mažų dozių.

 

Here are some glucose reference ranges used for decision making using glucometers. Human glucometer numbers are given first. Numbers in parentheses are for non-US meters. Numbers in curly braces are estimates for an AlphaTrak.

< 40 mg/dL (2.2 mmol/L) {< 70 mg/dL for an AlphaTrak}
- Treat as if HYPO if on insulin
- At nadir (lowest point between shots) in a long term diabetic (more than a year), may earn a reduction.

< 50 mg/dL (2.8 mmol/L) {< 80 mg/dL for an AlphaTrak}
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50 (2.8).
- At nadir, often indicates dose reduction is earned.

50 - 130 mg/dL (2.8 - 7.2 mmol/L) {80 - 160 mg/dL for an AlphaTrak}
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. (May even go as low as the upper 30s (1.7 mmol/L){60s for an AlphaTrak}; if not on insulin, this can be safe.

= 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- the lowest level pre-shot for ProZinc, PZI, or other non-depot insulins.

> 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

200 mg/dL (11.1 mmol/L) {230 mg/dL for an AlphaTrak}
- no shot level for beginners; may slowly reduce to 150 mg/dL (8.3 mmol/L) {180 mg/dL} for long-acting insulins (Lantus, Levemir, and ProZinc) as mid-cycle data collection shows it is safe

180 - 280 mg/dL (10 - 15.6 mmol/L) {may be 210 - 310 mg/dL for an AlphaTrak}
- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.

>= 280 mg/dL (15.6 mmol/L) {may be >=310 mf/dL for an AlphaTrak}, if for most of the cycle between shots
- Uncontrolled diabetes and thus at risk for diabetic ketoacidosis and hepatic lipidosis
- Follow your insulin protocol for dose adjustments
- Test for ketones; if more than a trace level of ketones, go to vet ASAP.

 

Google Translate English to Lithuanian (may cause laughter!)

Štai keletas gliukozės pagalbos diapazonai naudojami sprendimų priėmimo procese naudojant Glukometry . Žmogaus Glukometr skaičiai nurodyti pirmas. Skaičiai skliausteliuose yra ne JAV metrų. Numeriai garbanotas petnešos yra Preliminari sąmata AlphaTrak .

<40 mg/dL (2,2 mmol/l ) {<70 mg/dL už AlphaTrak}
- Elgtis taip , jei Hypo jei ant insulino
- Tuo žemiausias (žemiausias taškas tarp kadrų ) per ilgą laiką cukriniu diabetu (daugiau neimetus), gali gauti nuolaidą .

<50 mg/dL (2,8 mmol/l) {<80 mg/dL už AlphaTrak}
- Jei iki mažiausio , valdyti su maistu , ty suteikti padauginti vidutinio angliavandenių maisto ir neleisti vyksta žemesnėje nei 50 (2.8).
- Tuo žemiausias , dažnai rodo, dozės mažinti uždirbamos.

50-130 mg/dL (2,8-7,2 mmol/l) {80-160 mg/dL už AlphaTrak}
- Dėl insulino - puikus valdymas , kai po griežtą reguliavimo protokolą.
- Išjungtas insulino - normalus numeriai (gali net eiti ne mažiau kaip viršutinių 30s (1,7 mmol/l) {60s už AlphaTrak} , jei ne dėl insulino , tai gali būti saugus . .

= 150 mg/dl (8,3 mmol/l) {>180 mg/dL už AlphaTrak}
-Žemiausią lygį iš anksto nušautas už ProZinc, PZI ar kitų ne depo insulinų.

> 150 mg dl (8,3 mmol/l) {>180 mg/dL už AlphaTrak }
- Tuo žemiausias rodo,dozę didinti gali prireikti , kai po griežtą reguliavimo protokolą.

200 mg/dL (11,1 mmol/l) {230 mg/dL už AlphaTrak}
- Ne kulka lygis pradedantiesiems ; gali lėtai sumažinti iki 150 mg/dL (8,3 mmol/l) {180 mg/dL} ilgai veikiančių insulinų (Lantus, Levemir ir ProZinc ) kaip ciklo viduryje duomenų rinkimas rodo, kad jis yra saugus

180-280 mg/L (10-15,6 mmol/l) {gali būti 210-310 mg/dl už AlphaTrak }
- Kiekvieną kartą, -inkstų slenkstis (priklausomai nuo duomenų šaltinio ir katės inkstų funkciją) , kur gliukozės išsiliejimo į šlapimą .
- Bandymas ketonų , gliukozės yra per didelis.

>= 280 mg/dL (15,6 mmol/l) {gali būti >= 310 mg/dl už AlphaTrak} jei didžiąją tarp kadrų ciklo [/u
- Nekontroliuojamas diabetas ir taip gresia diabetinės ketoacidozė ir kepenų lipidosis
- Sekite savo insulino protokolą dozės
- Bandymas ketonų ; Jei daugiau neipėdsakų lygio ketonų , eikite į veterinarą asap.

 

Well I found the AAHA Guidelines that you could give to your vet on treating diabetes in cats and dogs but I can't remember how to post it as a link. Bear with me until I can figure it out or if somebody else can provide it that would be great.

 

Dear all,

You are so helpful, thankee! As regards my English, it's ok, I do understand every word you say ;-) Just informed You that the English language is not my mother tongue.
Ok, I do understand the importance of changing the doses by 0,25-0,5 not by 1. Are the needles intended for syringes as short as those I use with my pen? 5 mm, 6 mm, 8 mm? Oh, I see Hillary & Maui has answered, ok, I'll try to check what's the situation about thsese syringes and needles in my country. With pen everything is more simple, I hate those needles. Ok, I will try to change my pen into the syringes next week. Can I stick to 3 units with my pen till that time? Hillary & Maui, I'll keep 3 units till weekend then. Sure, I'll keep checking BG despite the fact I hate doing it
I still can't understand why there is no reaction? Ok, the doses where changed too quickly, but anyway: 2 days with 1U (to avoid any misunderstandings, this is 4 injections, AM and PM, so 4 injections of 1U all in all), the same with 2U: 2 days with 2U and then, from the 5th of October till now - 3 units.
Tonight's results: 18.40 19,3 (340-350) injected 3U. I give him 2 injections twice a day: at 7.00AM and 7PM. AMPS was 15,7 (280-285) and at 13.20 - 19,5 (350-360), nothing changed at PMPS too: 19,3 (340-350)...

Hello Squeaky and KT!!! Thank You for Your comforting support

Dear Dsmithkma, yes, exactly! I think Cupcake's diabetes is steroid induced. As I've mentioned before, he is on wet food only for two months already. His BG, as You can see from my first post, was 13,8 (254-250) before starting insulin injections. Today I have 350-360

Dear BJM, Yes, I'll try to figure the issue of syringes out. Thanks!!! Thank You for the information provided. The translation to Lithuanian is verryyyyyy funnyyyyyy :mrgreen:

 

AAHA Diabetes Guidelines

 

RobinCot, thank You

I've talked to my vet. I am worried about this horrible ketoacidosis ;( I even have no idea how to test ketones, I mean, how to take a sample of urine? I'm using a clumping litter, Cupcake will not go to an empty toilet :shock:
And what then? What shall I do with these ketone related numbers? My vet says I just need to give him some still mineral water, ensure he is drinking enough.
What to do? How to treat? Can I do something at home to reduce ketones? Jeeesus, and how to test it? ;(
Made 3U injection tonight, going to try to sleep...
I don't know how to thank You all

 

Couldnt fall asleep. Have checked BG: it's 20,3 (360-370) after 3 hours of injection, while the PMPS was 19,3 (340-350).
I have never seen such the big numbers before His BG is rising from yesterday, You may notice it from my first post where I've listed all the numbers in detail. It seems like insulin is making damage not healing ;(
Before the start of insulin injections his BG was 13,8 (245-250) only. Is this a rebound? Should I keep 3U? Tomorrow will be the 4th day with 3U.

 

My signature has a link to Secondary Monitoring Tools. Click on that and read the tips on urine ketone testing.

There are some meters which can test the blood for ketones; you'll have to see if there are any where you are. A pharmacist/chemist may know.

Also, smell his breath. If it smells like nail polish remover or fruity, it can be a sign of diabetic ketoacidosis.
The smell does not always happen, but if it does, go to the vet immediately.


Lantus Starting dose = lean weight in kg * 0.25
How much does Cupcake weigh?
How much should he weigh?
Take the lower weight, in kg, and multiply by 0.25; that is the dose where he should have started.

 

I don't have much to add except to suggest using a ladle to catch Cupcakes's urine to test for ketones.
I use one for Katie, just stick it under her while she is urinating in the box and get a little to test (you don't need much).

Also wanted to tell you I love your photo of Cupcake! What an adorable kitty he is!!

 

You really need to read the links that were provided regarding how to use Lantus.

viewtopic.php?f=9&t=1581


and

viewtopic.php?f=9&t=150

Please don't be so quick to change dose. This is a process, and it takes time, think of it like a marathon not a sprint. right now, you are gathering information by getting the bg tests, so we can start to see trends.

If you need something to do, you could work on building your google spreadsheet and attaching it to your signature. this will be most helpful for everyone and an easy way for you to keep track of the bg's and start to see the trends.

here is a link to help you -- viewtopic.php?f=6&t=50130

viewtopic.php?f=6&t=104021

 

Labas,
As matau kad jus gerai kalbat angliskai, tai as rasysiu angliskai kad visit suprastu.
I still have cousins who live in Lithuania; they cannot speak English although I know their children can.
The syringes that most people are talking about are B&D ultrafine II. The product code is 328440. I checked their company website, and they do not have offices in Lithuania. They say to contact their Swedish office for help. If anyone knows whether I can ship to the EU, I still have some left from when Thomas died. I am pretty sure they x ray overseas packages.
I used to take Thomas' pee samples by watching him go to the litter box and catching it in a small,flat
container.
Dana

 

Please be careful with the dosing. Have you read about the Somogyi effect yet? If you bypass the required dose and your cupcake is getting too much insulin, her liver will try to rescue her too low blood sugar by releasing whatever it's got in store to raise her blood sugar higher....this can protect her for a while, but after a few
cycles of this, there's nothing left in the liver for the rescue and hypoglycemia (which is much more immediately dangerous than high blood sugar) can occur.

This is why everyone's trying to get you to start fresh and go slowly...just to avoid this possibility. Wikipedia has a description of somogyi rebound if you haven't read of it in this forum yet.

Hang in there! Definitely it is a stressful time when we're first learning to treat. It does get easier! The two things to really watch for are the ketones in urine and the possibility of giving too much insulin.

Best wishes to you and good thoughts for a healthy Cupcake soon! :smile:

 

It seems my earlier post disappeared. I see a few others have answered your question about how to test his urine for Ketones so i wont confuse the issue by answering again. I hope everything is looking better now sugar wise and am hoping when you get the Ketosticks that it comes up negative and that Cupcakes problem is the lack of an insulin depot.

 

Just saying welcome. You already received a lot of good advice. Bothe my grandparents came from Lithuania

 

just wanted to add that you can try covering your litter box with a plastic bag.....
If Cupcake will use it, you can get a sample that way. Some cats will, some cats won't.

 

Good morning to all my supportive team!
Well, I have a lot of information to study. One thing I've done this morning - created my fluffy's SS and I guess it works! Is it ok? Do you see everything now? I've converted BG units to US (mg/dl) for Your convenience.
I will read everything, but cannot do it so quickly. So the question is what to do now? Keep 3?

Thank You once more for Your help! It is such a good feeling that me and my Cupcake are not alone
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Cupcake is beautiful. I bet you have lots of good pictures of him

Your spreadsheet looks great. Thank you for getting that set up. It will help us to help you.
I would stick with the 3 units for now, and try to get some more mid-cycle tests in at night time. Cats often go lower at night time, and it's the nadirs (the lowest numbers) that we need to see to determine dosing. Can you set an alarm?

 

Dear Dyana,

Oh yes, photography is one of my hobbies
Thanks for the reply, ok, I will stick to 3 now and will set an alarm, will try to wake up at night. Will do everything I can. If I managed to make BG tests and injections I can cope with getting up at night What time should I check after PMPS checking? My PMPS is at 07.00 PM, so I can check let's say at 11.00 PM or even 12.00 PM without getting up at night. What do You think?

We've managed to reach our first blue number! I am smiling, but on the other hand - worried about not going too low. I have a possibility to change the dose only by 1 unit so far. Have looked to the assortment of pharmacies in my country - found 13 mm and larger needles, omg :shock: Anyway, have no car till Saturday.

 

Hello again!

What do You think about today's results? I am a little bit nervous, we have our PSPM after two hours... Shall I stick to 3 despite the blues? :shock:
I am not psychologically prepared for shooting low.
I have read the sticky: "STICKY: LANTUS & LEVEMIR - SHOOTING & HANDLING LOW NUMBERS". As far as I understand, I need to check every 30 minutes if my PMPS is low and catch the moment of BG rising, am I right? And then shot? Despite the time? Even after, let's say, two-three hours from PMPS? And keep 3U? Am I thinking right?
Oh dear... I was worried about no reaction firstly and now I am facing this sugardance ;(

 

Re: My little joy Cupcake needs help - going to have low PMP

Morning ( here)

Good to see Cupcake in the blues....
I know it makes you nervous at first....

You have the sticky....
Do you have a gravy food or honey/syrup on hand just in case....? Extra strips?
You might be facing whether to shoot a blue or not.
It's good to have someone helping when it's your first time.

I won't be here in an hour..... but I will send a pm to someone to keep a watch for you when you get your pm bg number.


You might want to remove the 911 icon ( go to your first post and click on none) so that it will be off for now..... You might want attention later.

 

Re: My little joy Cupcake needs help - going to have low PMP

Oh, Rhiannon and Shadow, thank You for beeing here! Good morning!
Evening here
Yes, I have the sticky. I have a bottle of maple syrup. I have some Royal Canin (just in case). What do You mean by extra strips? Strips for glucometer? Oh yes, I always have some extra strips.
Shall I decrease the dose and shoot a blue? Or shall I wait and check? And then shoot 3?

Someone is taking his / her morning coffee at the moment and someone is looking for his / her evening valerian

 

Re: My little joy Cupcake needs help - going to have low PMP

So we are having 160 PMPS... What shall I do now? Still stick to 3? Wait? No? Yes? Jesus... :shock: :?:

 

Re: My little joy Cupcake needs help - going to have low PMP

You have several options:

1) you can wait 30 minutes and test again to see if you get a rising BG number above 200 and then give insulin

2) you can give a reduced amount of insulin - such as 1/2 of what you would normally give - 1.5 unit instead of 3 units (we call this the BCS - big chicken **** dose ;-) )

3) you can skip the shot altogether and wait until the next shot time to test and give insulin

It is really up to you and your schedule.

 

Re: My little joy Cupcake needs help - going to have low PMP

Hillary & Maui, You are my angel at the moment! Thanks a million!

I have no pissibility to reduce by 1,5 I can inject 2U instead of 3U. Anyway, ok, I will wait 30 minutes and... I will shoot 2 tonight. Will check after it.
Is it a good idea?

 

Re: My little joy Cupcake needs help - going to have low PMP

Labas,
If you skip a shot because you are uncomfortable with shooting at a low number, nothing bad will happen. We say, better too high, than too low for even a minute. I have never used lantus, only levemir so I do not have any experience with it. But if you could go to the post office, and find out if I can send you my left over syringes I will do that. It seems that I can ship them out of Canada, but Lithuania does not except Drug paraphernalia, and I do not know if insulin needles are considered that. I was telling my husband about you last night, and he was wondering if Cupcake has a Lithuanian name, and most of us on the board refer to ourselves by our names, so what is yours if I may ask
Danute

 

Re: My little joy Cupcake needs help - going to have low PMP

Labas! << Means Hello in Lithuanian
Dana & Thomas, You are amazing, thanks for Your goodwill! I'll try to find syringes here in Lithuania, do not want to burden You.
I delayed the evening shot for an hour and decreased the dose from 3U to 2U, as You all can see from SS. I hope it was a good decision. Shall I keep checking during all the cycle now? Or can I calmly sleep tonight?
My dearest Cupcake's name is Cupcake but we call him Kupkis at home Dear Danute, my name is Ruta or Ruth in English It's very nice to meet You. I live in the capital of Lithuania - Vilnius. Work as a lawyer and translator Have two cats at home, both British shorthair males. The second kitty is a newcommer, we brought him home a week ago

 

Re: My little joy Cupcake needs help - going to have low PMP

Some things to keep in mind now that you did give insulin and gave it late.

How late did you give it? Meaning, how long after his normal shot time did you give the insulin - ie. 30 minutes, one hour, etc.?

Hi Ruta,

If it was longer than 30 minutes from his normal shot time, you will need to continue that same time tomorrow and slowly work back to your normal shot time.

Yes, it is a little tricky with Lantus that it likes to keep to the 12 hour time schedule.

So, let us know and we can then help you figure out how to get back to your regular time. It shouldn't be that difficult since it probably was within the one hour window.

If I'm looking at this correctly, it's 8:16 pm your time (I'm in NY and it's 1:16 pm here) so I think you are 7 hours ahead of me.

I would suggest getting one test in 2 hours and then one more before you go to sleep. Depending on these numbers, it will help you decide if you need to stay awake or not.

Sorry, this isn't an exact science and flexibility is key.

 

Re: My little joy Cupcake needs help - going to have low PMP

Dear Hillary & Maui,
I gave him insulin 50 minutes later than usually. I always shoot at 7.00 AM and 7.00 PM, so tonight I dit it at 7.50 PM. Should I give him insulin at about 7.20 AM tomorrow morning? And how about PM shot? And what about the dose? 2U or 3U? Maybe I shall stick to 2U from now on? :shock:
Thank You, Your posts helped me much!!!
You are absolutely right - it's 8.34 pm here

 

Re: My little joy Cupcake needs help - going to have low PMP

We like to change times either 15 minutes per dose, or 30 minutes per day.

The 1st option works best for cats that are very sensitive to the insulin.

 

Re: My little joy Cupcake needs help - going to have low PMP

Let's see what the tests you take tonight and tomorrow look like. But I'd say at this point, stick with 2 units. I know more fluctuating of the dose, but maybe we can keep him at 2 units for the next 5 days.

What BJM said about the timing. Either do it in 15 minute increments for AM and PM shots until you are back to your normal time or just do 30 minutes once a day until back to normal time. Whichever is easier for you. And since you're only 1 hour late, within 2 days you will be back to normal time.

 

Re: My little joy Cupcake needs help - going to have low PMP

BJM, Hillary & Maui, thanks! I got it, I'll change a shot time in 15 minute increments.
As regards dosing, ok, I'll check the results and will decide then. Do not want BG to go high again. We're having pretty nice results with 3, maybe it is too early to reduce...
All of You are so great!

Well... 280 +3 after PMPS. I think I'll keep on 3...

 

Hello and welcome to the board!

You are doing great and dont worry - these numbers arent that bad at all! Nice to see some blues yesterday.

Question though - what food are you feeding (brand and type)?

Thanks
Wendy

PS you really want to get syringes, the pen tips are very inaccurate and can vary by as much as a unit each time

 

Me and Cupcake are saying good morning
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Oh, I don't know how to put a picture, not a link here. This photo was taken last Christmas. He was about 15,4 lbs (7 kg) then and now he is only 11 lbs (5 kg).
Katiesmom, hello and thank You for Your compliments to my muffin

Considering the numbers of today's AMPS I think that I shouldn't have decreased the dose by 2U last night. If such the situation will occur again I will try not get scared and keep 3U despite the blues. Am I thinking right? Well, I know that every case is different.

Hello Wendy&Tiggy! Greetings from the small and cosy country near the Baltic Sea for You too!
Thank You, my worries are fading away little by little.
Till the diagnose (You call it DX, yes? ) I used to feed him dry food (Acana, Orijen, Taste of the Wild) and wet food (mostly Almo Nature). After the diagnose I've read every word at CatInfo.org. I'm feeding wet food (Bozita, Catz Finefood, Carny) + raw now. It's really difficult to find low carb wet food here. My dearest husband went even to Poland to buy Catz Finefood! I usually give him raw (beef liver, poultry hearts, beef, chicken and turkey filet) every morning and he always has wet foot 24/7. Sometimes I pump a dose of salmon oil into his wet food, sometimes I give him a quail egg.

I'm going to take Cupcake to a vet this weekend. Will try to find out everything about syringes.
Hugs to all! Thank You You are here!

 

You don't necessarily change the dose just based on one test. Please stop second guessing and stick with one dose for the next 3-5 days. If you change the dose for each shot, you will have a much harder time getting Cupcake regulated and potentially into remission.

Yes, remission is possible. But you need to follow the protocol in order to get there. Now that you have a spreadsheet going, if you would like to, you are more than welcome to post daily on the Lantus forum. The people there will be able to help you with dosing, when to change, when to hold, etc and someone is always over there all the time.

Just something to consider. Of course, you may also continue to post here on health too.

 

Hillary & Maui, thanks for the reply. I've just wrote on the Lantus theme. Sorry, I'm just a noob here that's why I have so many doubts

 

No need to apologize, you need to learn to trust your judgment and please read the protocols about using Lantus, that will help you to feel more confident too.

 

Hillary & Maui,

I've even printed them and having in my hands now. However, I do not understant where is my nadir? Why I see those blues just before PMPS? Carryover, overlap... I've read the theoretical part but still do not know what to.

 

Cats may vary in when the nadir happens.

On the average, it is between 5-7 hours after the shot. Your cat seems to run later.

 

Thats good on the food!

The key to Lantus is consistency.

It is a depot insulin. That means it takes a few days to build up in the cats system. Or a few days to drain.
So you dont see the impact of a dose change for 2-3 days after you start the dose.

So its important to give the same dose ( as per protocols you see here) for at least 3 days consistently to see how that dose is working before you change it. Unless he drops under 50 in which case you would reduce immediately.

Wendy

 

Almost looks like Cupcake is bouncing like Dusty was. His numbers going from low to high overnight. If it continues do what I did and stop the insulin to let him stabilize. You're doing great!

 

This is not good advice, you don't want to stop giving insulin to let him stabilize. Not sure where you got this information from, but it's not a good idea and could be potentially dangerous advice.

 

That was from my personal experience with Dusty and great advise from Cupcake and others. I'm glad no one told me not to do what I did, Dusty's now 4 days from OTJ. Cupcake, by all means follow established protocols.