New here, please help

Discussion in 'Feline Health - (The Main Forum)' started by rowley978, May 19, 2013.

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  1. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    There are a few low carb dry foods you could give her although obviously it would be better if you give her wet, Innova Evo Cat & Kitten 8%, Wellness Core Grain-Free Original Formula (tan gold bag)11%, Nature's Variety Raw Instinct chicken 7%, and Young Again zero Carb 0%.
     
  2. rowley978

    rowley978 Member

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    May 19, 2013
    Update on Maggy for Saturday morning

    BG before test was 229

    Litter box isn't FULL of Maggy pee anymore. There was significantly less pee in the box.

    I have two water cups (one at kitchen sink, one in upstairs bathroom sink) and they normally have needed to be filled at least once a day if not more. Now they go down slowly (like they used to). I dont see Maggy drinking alllllll the time.

    Maggy does seem hungrier than before though, is this because he's eating protein instead of carbs and fat?

    How much canned food (5.5oz) should one 10 - 13 lb cat eat in a day? 1 full can? 2 full cans?

    Thanks for all of your help so far. Couldn't have done this without you all (especially the couple of mental breakdowns I've had while trying to do BG tests!
     

    Attached Files:

  3. terriy

    terriy Member

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    Maggy is soooo pretty!
     
  4. TheBowHuntress

    TheBowHuntress Well-Known Member

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    Nov 22, 2012
    Per Cat Info, daily calories should be about 13.6 x optimal lean weight in pounds + 70. For a diabetic cat and because diabetes doesn't let the cat use all the calories it consumes, increasing that by 50% is OK until regulated. According to Dr. Lisa's list, Friskies Ocean Whitefish & Tuna Dinner 5.5 ounce can (which is one of the primary food I feed to my cats) is 49% protein, 43% fat and 9% carbs--and the caloric value of a 5.5 ounce can is 171 calories. So there are approximately 31 calories per ounce. A regulated cat that weighs 13 pounds should then consume (13.6 x 13 = 176 +70) 246 calories. Therefore, for a regulated cat whose optimal weight is 13 pounds--he/she should eat about 8 ounces per day; roughly 1 and 1/2 cans of wet food, if you feed the variety mentioned above.
     
  5. Deb & Wink

    Deb & Wink Well-Known Member

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    Most people keep a notebook where they write down the test times, the insulin doses, how the cat is feeling.

    We have a standardized color coded spreadsheet we use for keeping track of the BG numbers, the units of insulin given, any additional remarks like how much food is being eaten, any test results. The instructions are here : http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207 It's a google template that you copy so you'll need a google account. Then , when you link it into your signature, we can see what is going on and advise you on maybe getting a test at a different time to see how Maggy is reacting to his insulin.

    You can even share the spreadsheet with your vet.
     
  6. Simon'sMommy

    Simon'sMommy Well-Known Member

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    May 10, 2013
    Maggy is a beautiful cat and you are doing great! I know how hard this is at first. You do get used to it and so does the kitty. Great job. You are on your way. This community is a life (and cat life) saver for sure!
     
  7. rowley978

    rowley978 Member

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    May 19, 2013
    We are through our 2nd full day of 1/2 unit shots. Maggy was 232 at his PM preshot test. I'm definitely in a routine now. Just need to get my cat that won't eat wet food, to eat something! I feel bad for her. She has always been a cat that only ate like 10 pellets of food at each sitting.. but did that about 20 times a day. She's so skittish, so its hard to get her to eat. I have been able to put her in a bathroom by herself, but she still only eats 10 pieces, and she waits at the door for me. She turns her nose up at all the different pates I've opened for Maggy and Sam. I'm going to get some of the dry food thats alright for diabetics (though I'm going to still do wet food of course), and maybe if I leave it out, she'll eat more? Or, do you think she'll eventually get hungry enough, and eat the wet food?
     
  8. Deb & Wink

    Deb & Wink Well-Known Member

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    Here is a wonderful article by vet Dr. Lisa Pierson on transitioning tips. http://www.catinfo.org/docs/TipsForTransitioning1-14-11.pdfMaybe one or several of these idea will work for your cat. They did for mine.

    One of the tips, is to use the cat's natural hunger drive to get them to eat. You want to do this safely and it can take time. A cat not eating anything for a day or two can lead to hepatic lipidosis, life threatening and harmful to the liver.
     
  9. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Do you think you can get the spreadsheet set up? it would really help to see how she is doing and if/when a dose change is needed..
     
  10. rowley978

    rowley978 Member

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    May 19, 2013
    I don't have time to do the spreadsheet, but here are my stats just copied from my own spreadsheet.

    5-Jun 7:05pm 381 1 unit
    5-Jun 10:30pm 118
    5-Jun 10:50pm 95
    5-Jun 11:30pm 95
    6-Jun 12:30am 110
    6-Jun 2:30am 312

    6-Jun 7:00am 315 1 unit
    6-Jun 6:30pm 169
    6-Jun 7:10pm 156
    6-Jun 8:05pm 200 no shot

    7-Jun 7:20am 243 1/2 unit
    7-Jun 7:10pm 270 1/2 unit

    8-Jun 7:10am 229 1/2 unit
    8-Jun 7:00pm 232 1/2 unit

    9-Jun 7:45am 205 1/2 unit
    9-Jun 7:20pm 142 no shot


    I gave a half unit this morning, but I think it was a tiny bit under that ( haven't picked up new syringes yet that have 1/2 unit marks). Tonight, given that he was that far below 200, I opted for no shot. In your opinion(s), will I get a higher reading tomorrow that my last 2 or 3 days of pre shot tests?

    I'll try and get that spreadsheet done, just so busy. I also have to find dry food that is ok for Maggy to munch on here and there, because I read all of those ways to get a cat to go over to wet food, but they don't really talk about if you have multiple cats..... .thats whats making my conversion very tough right now.
     
  11. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Some low carb dry foods.

    From Wendy & Tiggys list:
    Yes, since you skipped the shot tonight, you can expect a bounce tomorrow AM. I don't think you have enough data yet on how your cat reacts to insulin to give the full dose tonight.

    Have you fed? If not, test again in 30 minutes from last test. You may be able to give a reduced dose, 0.25U safely.
     
  12. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    If we do the sheet for you, will you be able to keep it updated?
     
  13. TheBowHuntress

    TheBowHuntress Well-Known Member

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    Wow! Beautiful job of keeping track of all those tests (and all the testing you do). You really are doing great! I'm really proud of you. Keep up the good work! party_cat
     
  14. rowley978

    rowley978 Member

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    May 19, 2013
    Sure I could keep up with the chart.

    Maggy was at 293 this morning pre shot. He had eaten about 2 hours previous to that test (I couldnt hold him off any longer, I wasnt able to sleep!)


    So, I'm going to get one of those dry foods so my middle cat doesnt starve!... I feel so bad for her. I guess I never noticed her eating habits (how she only eats like 15 pieces of kibble each time). Ive been keeping a closed container of their old food around the house with me, so when I find her alone, I open it up and let her munch for a bit. Shes just been skittish forever.

    I'm not sure how this is going to work in the long run. She just won't even sniff the wet food I'm giving Maggy. Sam has no problem being on the exact same schedule as Maggy. Poor Bones just doesnt feel that way.
     
  15. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Ok cool, do you want to PM me your SS and I will transfer it across to our format?
     
  16. rowley978

    rowley978 Member

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    May 19, 2013
    Is there a "general rule" on the following scenario...:

    Maggy normally gets his shot around 7:30 am and pm. Tomorrow evening I will not be home to do this. I may not make it home until 10ish. Should I give him the shot then, or skip it for the evening, and test/shoot in the AM the following day as normal.
     
  17. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    The general rule in that scenario, giving a late shot, is that now becomes your new shot time. Next shot should be given in 12 hours. With Lantus insulin, shot times can be moved 30 minutes once a day or in 15 minute increments twice a day.

    You can also skip the shot entirely. Pick back up in the morning, knowing the number is going to be higher.

    With experience and enough test data, when you know better how your cat would react to the insulin, when the onset is, when the nadir is, how long the duration is. In that case, you could do a reduced shot, like half. Not recommended for someone in your situation, without much test data.

    late shot acts like a dose reduction
    early shot acts like a dose increase

    One skipped shot is only a tiny setback. "Better too high for a day, than too low for a moment. "

    This is also when you want to teach another person in the family to test and shoot.
     
  18. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    You can slowly shift no more than 30 minutes per day, either in 1 chunk or 2 15 minute chunks.

    Can you shoot 30 minutes later tonight and tomorrow morning? Then it won't be quite so far from morning to evening shots.

    Then, shift back slowly - 30 minutes the next 2 mornings to get back on track.
     
  19. rowley978

    rowley978 Member

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    May 19, 2013
    ok, well, even if I do a half hour tonight (gave him shot at 8:00 instead of 7:30), and a half hour tomorrow morning 8:30 instead of 8... then I'm still going to be way off tomorrow night... by like 2 hours. Seems I should just skip it?

    In another question... is there a time where I should switch back to 1 unit from 1/2 unit? Maggy has had between 205 and 232 for the past 4 days while doing the 1/2 unit. Today he's been 240 and 268 in the Am and Pm preshot tests. If it keeps creeping up, does that raise a flag for a change?
     
  20. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    No.

    Lantus dosing changes are based on mid-cycle tests. The lowest point or nadir is used for deciding if the dose needs to be increased or decreased. Most cats nadir is somewhere between +5 and +7 hours after shot. Some are early at +3.5 to +4. Some are late at +8 to +9.5

    That is why, getting some other tests in during the cycle is so important. Every Cat is Different(ECID) and you need to test to find when Maggy's nadir is. To complicate things, the nadir time can change a bit.

    The pre-shot tests are done to insure the BG's are high enough to give the insulin. You would not want to give insulin if the BG was too low, say 100 for now. Maggy could easily go below 40, which means supporting with food, testing and possibly an emergency visit to the vet to bring those numbers up and prevent seizures and convulsions.
     
  21. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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  22. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    I agree with Deb - Lantus works in a curve so the preshot levels are usually the highest of the day and Maggy will drop lower during the day.. how low? We dont know and it could be too low so we dont want to increase the dose until we know. So do you think you can get a mid cycle test and/or a before bed test for a few days?
     
  23. rowley978

    rowley978 Member

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    May 19, 2013
    I know nobody should be saying they're "too busy" to get these blood tests during the day in, but i really am too busy. I'm just not home for it!

    Anyways, I feel comfortable with what I'm doing for my cats life.

    My question is, this morning, Maggy's pre shot test was 195. He got .5 insulin. This evening I fed him at 5:00. I took a blood test at 7:15 and it was 369. I decided to test one more time before eating or shot. I tested a half hour later, at 7:45, and he was 407. I fed him, and gave him .5.

    Thoughts on this scenario? One of my conclusions I've come up with is that I didn't do a good job on his shot this morning. I had this weird feeling that I may not have pushed the needle in far enough... I felt around, but felt nothing wet. With such a small amt. of liquid in the shot, even if I had missed, maybe I wouldnt even know it? .


    Thanks!
     
  24. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    I suspect the morning shot was fine, this looks to me like a bounce. You shot under 200 and he dropped low and then his body overreacted and caused his blood glucose to shoot up.. He may have dropped quite low.. Or just lower than his body is currently used to..

    I understand not being home but we need to know how low he is going.. If he is dropping too low he could need a dose decrease, he may even be going into remission. But you are at work all day so here's a suggestion..

    1. Set up a spreadsheet so we can take a good look for trends and see what we can work out
    2. Next time you see a number under 200, on a weekend day or at night preshot, get a test a few hours later and let's see how low he is going

    Deal? We can help with the sheet too if you need help

    Wendy
     
  25. rowley978

    rowley978 Member

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    May 19, 2013
    ok, so given what happened yesterday morning... should I not shoot at 191 this morning? Or do even less than a half shot? I am going to do a curve this weekend for sure.
     
  26. rowley978

    rowley978 Member

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    May 19, 2013
    After 191 pre shot this morning.. and not giving him his shot this morning because of that.. I tested him tonight before his scheduled shot, and he was 558, the highest he's ever been! Thoughts on what this means? :?
     
  27. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    My guess is that he may be going low for him, or dropped quickly enough to trigger some compensatory hormones.

    You need to check around +5 to +7 hours after the shot to see how low he is going. You want him above 50 mg/dL. Lower than that risks a hypoglycemic event.

    Also, you want to test, feed, and shoot all within 10-15 minutes.
    Pick up food about +10 hours after the shot so that when you do the pre-shot test, it is not a food influenced value.
     
  28. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Very interesting.. Without a test a few hours later I can't say for sure what was going on.. The lantus could be lasting a little longer in Maggys system and he could have continued to drop even without the shot today.. And then bounce. Or he could have just bounced off the blue.

    I hope he does this at least once when you are home to test so we can find out what's going on for sure!!
     
  29. rowley978

    rowley978 Member

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    May 19, 2013
    Ok thank you. I'm going to stay up tonight to get him at +6, around 1:30am
     
  30. BJM

    BJM Well-Known Member

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    An infobit about sleep. Most humans have a sleep cycle of 45 minutes. Waking during the middle of a sleep cycle is oftern quite difficult, whereas waking at the end of a cycle is easier. Thus, if you need to catch a nap, do so for a multiple of 45 minutes (3/4 hour, 1 1/2 hours, 2 1/4 hours, 3 hours, etc).

    Just in case it might be helpful. :smile:
     
  31. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    We haven't seen a black before so he might not come down as much as in the past. If he does, you might also want a +10 to see if he hits a low before AMPS and what the trend is..
     
  32. rowley978

    rowley978 Member

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    ok,.... but why so low in the morning the past two mornings, but high in the evening..?
     
  33. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    It's called bouncing.. Does this help?...

    Bounces - what are they and is my cat doing them?
    When a cat is first diagnosed, the blood glucose has probably been high for a while. As the insulin starts to take effect and numbers start to come down, the liver has to learn to adjust to the lower numbers. We call this "liver training school". But before it relearns that low numbers are ok, when the BG drops to a number lower than the liver is accustomed, or if BGs drop low, or if the BG drops suddenly, the liver”panics” and reacts by releasing counterregulatory hormones and glucagon. This drives the BG back up. This is what we call a "bounce". Bounces can take up to 72 hours to clear so we are generally careful about increasing doses during the bounce. Once the bounce clears, then you can see the "real" numbers and determine if the dose needs to go up or down.
     
  34. rowley978

    rowley978 Member

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    Interesting. Yes , thank you for sharing.
     
  35. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    He could be dropping low at night and bouncing from it during the day. Many cats do go lower at night, a few night tests for the next few days may tell us a lot.

    Tonite maybe we will only see a big bounce but if we can do these tests the next few nights..
     
  36. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Setting the alarm to wake you for the +6 may help you get some sleep tonight. Another option for you instead of trying to stay up until 1:30.
     
  37. rowley978

    rowley978 Member

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    May 19, 2013
    ok so preshot 558
    +1 525
    +4 324
    +6 334


    Ill do a full curve this weekend during the day after morning shot.
     
  38. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Isnt that interesting.. you can clearly see him clearing the bounce... and he is still dropping. Looking forward to that weekend curve. By tonite he will probably have gone back up.. he is determined to not let you see how low he goes ;)
     
  39. rowley978

    rowley978 Member

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    May 19, 2013
    Not sure if you looked at my ss but he was 278 preshot this morning.

    I think that I may have been giving too much insulin..? Im doing .5 units, but I hadn't been using the syringes that are marked in half increments. I finally got some of them a few days ago and looked at one, and noticed that i wasn't lining it up quite right. Could this be a contributor?
     
  40. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    I did see that which was why i was thinking the bounce is clearing.
    Can you get syringes with 1/2unit increments? you are going to need them I think ie For U-100 syringes (Lantus, Levemir), get 3/10 cc, half-unit marked, short needle, 30-31 gauge ie Relion 3/10cc 30 & 31 gauge short, BD Ultra fine 3/10cc short, Terumo Thinpro Insulin Syringe 31G 3/10cc.

    Wendy
     
  41. rowley978

    rowley978 Member

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    May 19, 2013
    I am using the .5 unit syringes now. Should I have the plunger right ON the line, or right BEFORE it. I've been doing it right on the line because I think thats correct.

    So I did my curve today (click my link in my signature if you'd like to see). I was off by an hour in the morning because I was thinking I was doing it every 3 hours, but I wanted to do every 2 hours, so thats why the hours seem a bit off.

    Thoughts?

    Thank you
     
  42. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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  43. rowley978

    rowley978 Member

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    Of course I was asleep at his +3 last night.

    This mornings preshot he was 190. Shoot or leave alone.?
     
  44. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    I am kinda torn. You dont have a lot of data to know how he will behave but this is so close to 200 and last time you skipped he went so high after. Are you able to stay home and test today a bit? And do you have strips and syrup?

    Over time, if you had more data then I would say shoot as per this:http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=147

    Wendy
     
  45. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    I posted on Lantus to get some more thoughts. I do know you are an hour over preshot time now so maybe get another test in to see what he is doing? That will help the decision... I assume you fed at shot time too?

    BTw - great to see a blue!
     
  46. rowley978

    rowley978 Member

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    May 19, 2013
    Just took a shot at +2 after eating, and no shot given since he was 190.. and now he is 210. What a strange animal I have!
     
  47. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    He is surfing on the Lantus that is still in his system. He will probably shoot up soon.. if you can adjust to this new time (your next shot would have to be 11.5-12 hours from this shot time) you could shoot now and move back by 30mins a day.

    Wendy
     
  48. rowley978

    rowley978 Member

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    At +8 Maggy was 435. I didn't shoot this morning.
     
  49. Deb & Wink

    Deb & Wink Well-Known Member

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    With a skipped shot this morning, that 435 at +8 is not unexpected. There has been no insulin to keep his numbers down.

    Maggy needs some insulin tonight for sure. Let me go look at the ss. Be right back.

    ETA: No updates on the SS for today so not sure what to advise. Would you please update the SS?
     
  50. rowley978

    rowley978 Member

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    Sorry about that! All updated!
     
  51. Deb & Wink

    Deb & Wink Well-Known Member

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    Thanks for the SS update.

    With that high number, if the PMPS is high also, you would be safe to give the 0.5U that you have been giving.

    With that low 190 from this morning, it's likely that Maggy has been going lower overnight. Would you be able to get what we call a 'before bed test'? A BG test before you go to bed for the night. It will give us more data to work with.

    Many cats drop lower overnight. Maggy may be doing that.

    Since you skipped the shot this morning, the numbers will be higher for a bit. The insulin depot needs to build back up.

    I'd like to see at least 3 days on a dose without any skipping if possible. You do need to gather some more test data, especially for those mid-cycle numbers. We really only have yesterdays 6/22 tests to show us some idea of when Maggy's nadir is. Looks like it's somewhere after +3 and before +6.

    Looking at the SS, based on the curve yesterday AM cycle, it looks like a dose increase may be due or some more bouncing going on. Hard to tell which. That 190 this morning leads me to believe that Maggy dropped much lower overnight. That tells me the dose may be ok or too much. Hard to tell.

    For now, I'd like to see the dose stay the same and get a few more test numbers.
     
  52. rowley978

    rowley978 Member

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    May 19, 2013
    Ok, my pmps was 367. This cat is crazy. Why did it go down?

    Anywho, I will do a before bed test tonight.. and then I'll try and get some random ones. Its just hard since I leave for work at around 8:30 and come home around 4:30 or 5 every day (besides weekends).
     
  53. Deb & Wink

    Deb & Wink Well-Known Member

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    If you get home from work a few hours before you take the PMPS test, that is an opportunity to get a test then. Only after you have said hello to the family of course.

    Why did the number go down? No way to tell for sure.
     
  54. rowley978

    rowley978 Member

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    May 19, 2013
    Before bed test at +3 was 243.

    I'll do morning tomorrow, and then when I get home from work as well. Any thoughts on threshold for shot/no shot for tomorrow morning.. still 200 ?
     
  55. Deb & Wink

    Deb & Wink Well-Known Member

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    Yes, I still think 200 for shoot/no shoot threshold. Over on the Insulin Support Group Lantus TR forum, the shoot/no shoot threshold is 150. I think you need to gather a bit more data before you are ready for that.

    Have you read this topic on shooting low numbers? http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=147 It talks about gathering data to prepare yourself for shooting those low numbers.

    We have 2 forums geared specifically for Lantus users. Insulin Support Groups (ISG) for Lantus TR and Relaxed Lantus. You always have the option to post over there for advice on the insulin you are using. Before you make your decision, I suggest going over to one of these forums and seeing how things are done. Read a few posts, read the Sticky topics at the beginning of the posts. Get a feel for if you think you would be comfortable in an ISG. It's up to you weather you want to post here in Health or over in one of the ISG's.
     
  56. rowley978

    rowley978 Member

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    That is a tremendous amt. of information. ... I feel like I need to go back to college for some of that stuff.

    Anyways, I did a "when I get home" test, and what not. .. I'm updating my ss. I'll get a before bed one again tonight, and some more tomorrow... trying to add to my collection of data.

    Thanks
     
  57. BJM

    BJM Well-Known Member

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    Check my signature link for Learning Tips.
     
  58. Deb & Wink

    Deb & Wink Well-Known Member

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    Yes, I've compared this to a crash course, college master's degree level in managing feline diabetes. It's a lot to learn but we can help you with a lot of it. Take it slow and easy. It's a pass/fail degree and when you have learned one lesson, you move on to the next.

    Thanks for those few extra tests. Keep getting more data when you can and adding it to the spreadsheet. It all helps, especially at the beginning when we are trying to find the nadir.
     
  59. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Look on the bright side, you will be able to educate your vet, and its good to challenge your brain in new directions...

    Lots of yellow today.. Come on maggy I want some blue!!
     
  60. rowley978

    rowley978 Member

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    May 19, 2013
    Hey all

    So I did a test when I arrived home from work today and Maggy was 150. I just did his PMPS and he's 115 now. Should I feed, or hold him off for an hour and retest?



    EDIT : Also, could my cats lack of appetite (all 3 of them) because of the high heat and humidity have something to do with it? And/or could they be getting sick of the pate? Nobody finished the can I put out this morning at 8am. I threw away probably half of it. Its very hot and humid here this week.
     
  61. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Dont feed. hold off 30 minutes and retest and let us know.
     
  62. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    How is your supply of strips? Do you have high carb wet in the house? syrup? Can you stay up tonite if need be?
     
  63. rowley978

    rowley978 Member

    Joined:
    May 19, 2013
    I'm ok with strips, but I don't have high carb wet food, or high carb any food. I have honey and I have ice cream? Does that count ? He loves ice cream... or, used to love it when I was able to let him have a few licks.

    Staying up, not really an option tonight. I'm running on fumes as it is this week... but I'll do it if I have to .
     
  64. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    ok then - if he doesnt go up to over 150 I would skip.. or maybe give 1/4 unit. I hate to see him losing momentum but we do what we can.. it will happen again.

    Next time you go shopping, pick up a few cans of a gravy cat food for these situations. Syrup will work in a pinch but gravy food is better.

    Wendy
     
  65. rowley978

    rowley978 Member

    Joined:
    May 19, 2013
    He's at exactly 100 now 1/2 hour after the PMPS. Try for 1/4 shot, or skip?
     
  66. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    How much longer can you wait before being too badly off schedule?
     
  67. rowley978

    rowley978 Member

    Joined:
    May 19, 2013
    another half hour I guess
     
  68. rowley978

    rowley978 Member

    Joined:
    May 19, 2013
    still dont feed, right?
     
  69. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Yep.. Don't feed. Let's see where he goes although its likely you will need to skip again..
     
  70. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Yes, the heat may reduce appetite - less active = less calorie use.

    With the heat, you may want to use a thick ceramic plate and chill it in the fridge or freezer to help keep the food cool while its down. Some folks will freeze part of the meal so that it may be nibbled as it thaws. Or place some freezer packs under a plate.
     
  71. rowley978

    rowley978 Member

    Joined:
    May 19, 2013
    still 100 exactly. I fed him and I am giving no shot tonight.
     
  72. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Yep sounds good. Get a test in 2-3 hours if you can though,, let's see when he starts to shoot up.. He will probably be high again tomorrow am.
     
  73. rowley978

    rowley978 Member

    Joined:
    May 19, 2013
    So maggy was 391 on yesterday morning when I hadn't given him the shot the previous night. Last night he was 279, so I gave a shot. This AMPS he is 174. I'm waiting a half hour and retesting to see what direction he's going. I am not going to be home today.. Still half shot, or 1/4 shot? Thoughts (if anyone is around ). Thank you.

    ** He went up to 180 at 1/2 hour after the AMPS.

    I gave him 1/2 shot
     
  74. TheBowHuntress

    TheBowHuntress Well-Known Member

    Joined:
    Nov 22, 2012
    Hi,
    I see you're looking for dosing advice. I don't give advice, but if you add this: "? dosing advice" to your subject line (go all the way to your first post to change it) then click the "?" icon, I am sure someone will help you :D
     
  75. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    When you say you gave 1/2 shot - is that 1/2 unit or 1/4 unit?

    174 is within meter error of 180 so he was kinda flat. However he did this same thing on the 26th and then started to increase a few hours later so probably will do the same. Are you around to test today to see?

    Wendy
     
  76. rowley978

    rowley978 Member

    Joined:
    May 19, 2013
    Maggy's Updates - Rowley978

    I gave his normal 1/2 unit shot this morning.
     
  77. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Great to see some mid cycle tests...

    Any chance of a before bed or mid cycle night test? am wondering if you need to sneak the dose up a little ie to 0.75 ... but am very wary about that in case he is dropping low at night..

    Wendy
     
  78. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    How's maggy doing???
     
  79. rowley978

    rowley978 Member

    Joined:
    May 19, 2013
    Maggy is doing well. I went away for a week earlier this month and had someone come give his shots to him. He was alright when I got back, so thats good. His tests are still all in the high 100s, 200s, and up to the mid 300s, so, I guess thats where I'm at! I'm still having a hard time getting mid cycle shots. Just too busy.
     
  80. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Ok good cos I was a little worried. Maybe you want to do a curve once a week ( every 3 hours or so through the day) just to make sure he isnt dropping too low or staying too high.

    I still think he is dropping low some nights - you gotta wonder when you see a blue preshot, how low he went the cycle before.

    Wendy
     
  81. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Well, it's undoubtedly time for a dose change, but without some mid-cycle tests, it's impossible to gauge how much.

    I'm not comfortable suggesting a dose change amount without some of those mid-cycle tests. Catch-22 situation here.

    You've been giving this same dose for more than a month. Even the SLGS (start low, go slow) protocol does not usually hold doses for more than a week at a time.

    We need at least a consistent 'last test before you go to bed at night' test. And a couple of weekend mid-cycle tests.

    I remember you said you have a full time job, long commute, 2 young children and probably a lot of other life complicating responsibilities. But Maggy needs your care too. How can we help you to help Maggy better?
     
  82. Hi Steve,
    First time posting to you, so a belated "welcome to the board" to you and Maggy. I happened to notice that Kat "dropped my name" a few weeks back...

    And you've progressed way past "newbie basket case" for sure. Yes, Kat wins the award hands-down! Dude, she was having issues with one of her cats having "runny poos", and she set up a "Deer Cam" hidden camera in the basement in order to find the offender! (relax, Kat, you're still my favorite "basket case" :lol: ).

    And now Gobbles is off the juice!

    I know there's been a lot of input about doses and numbers and tests at whatever times per day, etc. already. What I'd rather ask is "How is Maggy doing"? Forget the numbers and the meter. We like to see what we call the "Whole Cat Report" on occasion. There's a concept we call the "5 Ps" here. Purring, Preening, Pooping, Peeing and Playing would be the five of the P's.

    Usually, cats have issues with most of those things just before, or just after they are diagnosed as diabetic. What we hope to see over time, as they get more regulated and better numbers overall, is an improvement in the things that were "not good" before you started giving insulin.

    So how is Maggy doing? Were any of these things an obvious problem before, and have they improved since you began treating him?

    My cat, Bob, for instance, was peeing buckets. He quit grooming himself, and had dandruff. He rarely showed any energy and just laid around most of the time. He was pretty much a mess. It took several weeks, but the difference was amazing. The last real sign with him was "Playing", but that was mostly due to his Potassium levels being way under "normal" and once that was fixed, he could jump up on the bed once again. He's still pretty lazy, but that's just "Bob being Bob" rather than a sign of illness.

    Now about the dose and test stuff...

    To me, it looks like, on paper, Maggy might be able to use a slight increase in dose. But I'm not certain of that. I should also say that Bob wasn't on Lantus, he was on PZI, and it's a different type of insulin completely. But that's what my vet used, and that's what worked for Bob. So any "advice" from me on your insulin, Lantus, should be taken with that in mind.

    You don't have to test 10 times a day, or 5 times a day, every day, in order for this to "work". It's more a matter of "when" to make it logical based on the fact that you're using Lantus.

    Others have told you that the dose with Lantus is based mostly on the "nadir" reading. That doesn't mean you need a test at every nadir every day. But that's the number, when it comes time to question "does he need a different dose?", that the answer is going to depend upon.

    I know you have a life you have to schedule around. Looks like you're up early for work, work all day, and that makes mid-cycle tests during the week extremely difficult. And because you get up before the sun comes up, staying up all night really isn't an attractive option. So, we try to help you figure out what is possible, and we work with that.

    Bottom line - Feline Diabetes doesn't take over our lives. Each of us does what we can do. "Us", the people who try to help when people ask for help? Our "job" is to try to explain what we believe is the best way to treat diabetes, while we also need to treat every cat and every new member in a unique way that takes into account that every cat is different, and every caregiver is different. "We" have to try our hardest to work with what "you" can do.

    So, let me try by asking some questions:
    What days is it possible for you to get a "nadir" test, whether that's during the AM cycle or the PM cycle?
    Is there one day a week maybe that you would be able to get 3 or 4 tests in a 12 hour period?
    How soon after the AM shot do you leave for work?
    How soon after the PM shot would you go to bed (in a perfect world)?

    If you can tell us that, then we'd be better equipped to give you any advice related to adjusting his dose.

    Whatever you can do, we can work with.

    And let us know how those "Five P's" are doing?

    Carl

    P.S. I grew up in MA.... how 'bout them Sox? :D
     
  83. rowley978

    rowley978 Member

    Joined:
    May 19, 2013
    Thanks Carl, and everyone, for the latest posts.

    I'll answer Carls questions the best I can here.

    In terms of getting tests and when I leave for work/get home.

    I leave around 8:15 am.
    I do Maggy's test/shot between 7:30 and 8 so I can get my final things together to leave.

    I get home between 4:30 and 5:30 each weekday.

    I go to bed between 9:45 and 10:30 each day.

    The best chances I'd get to do more tests during a 12 hour period would be Saturday or Sunday, just not regularly. But maybe it could be EITHER saturday or sunday. I'm probably home for at least one of those days each weekend.

    In terms of the 5 p's..... Let me look back.
    Yeah, I'd say that before being diagnosed, Maggy pee'd A LOT. Otherwise, he was fine (besides weight loss and being REALLY HUNGRY). After diagnosis and staring on lantus, everything, besides his weight, which has stayed around 11 or 12 lbs from 15 or 16, has been totally fine. He started peeing a lot less, and wasnt as thirsty and hungry. He's always been playful when necessary (I have two other younger cats in the house). I hadn't seen anything really change. However, for the past month +, I'd say that the urination has crept back up again to being more, but nowhere near pre-diagnosis levels.

    Otherwise, its just a normal day here. The tests/shots are routine now, which I thought would have been impossible. But, thanks to everyone here, I've made it doing those.

    Hope that info helps, and I'd love to see Maggy's numbers get/stay lower. Some of my high numbers are, what I believe, due to Maggy getting some dry food (diabetic) in close to his test and subsequent shot. One of my 3 cats refuses wet food, so I got one of those uber-expensive dry foods ..... gold bag, raw something something chicken. I know that he likes to snack on it here and there, and I think thats where the high numbers come from. In the morning, when he's been sleeping on my face all night, he hasn't eaten in probably 5 hours... and sometimes his numbers are below 200.

    Thanks again!

    Stephen
     
  84. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Ok then, with your life schedule, here are some possibilities for testing to give us some more data to work with.

    1. a before bed test. this may be a +2 or a +3. I would suggest this one every night.
    2. an in the door test. This may be a +9 or a +10
    3. one weekend day. Try to get a couple of tests in the +5 to +7 timeframe. Your choice for which weekend day, no need for you to do both days, unless you really want to. :mrgreen:

    There are other possibilities, but it would mean shifting your shot schedule earlier. I have no idea how feasible that might be for you.
     
  85. Libby and Lucy

    Libby and Lucy Senior Member Moderator

    Joined:
    Dec 28, 2009
    your schedule is somewhat similar to mine. I get home a little later, but also stay up later (night person).

    Here's what I do:

    6:30-7:00 - wake up, test/feed/shoot

    I leave at about 8:15, so I have time to do a +1 at 8:00 if he is low in the morning. I rarely need to but the time is built in just in case I need it.

    Get home at around 6, 6:30-7:00 - test/feed/shoot

    10:30 - +4 test.

    If +4 is lower than expected or dropping fast, I will stay up for +5. If not, I usually start moving toward the bed around 11:30.

    (my cat KK is on Levemir, and with Levemir +4 tends to be more useful than +3. With your cat on Lantus, +3 should be ok, then stay up til +4 if you are surprised by the +3 number).

    Weekends I get tests whenever I can, but try to get something resembling a curve on at least one day each weekend. That might mean +4, +6, and +8 or 9. If I'm home both days on a weekend, I'll try to get different tests on the other day. It's not a big formal thing to me and it's not necessarily all planned out (KK is my third diabetic cat, so it's just part of the routine). If I'm going out to the store I'll grab a test before I leave and another when I get home. If I take a nap I'll test when I wake up. If he starts pestering for food more than usual, I'll grab a test in case he is trying to tell me he is dropping. He gets treats when he is tested, so when I am home he tends to ask for tests. :smile: So if he asks for a test, often he'll get one.

    It takes a little while to put together data this way, but it's how it works for those of us who work outside the home. You'll figure out a plan you can stick with.

    Welcome to FDMB!
     
  86. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    :lol:

    oohhh that really made me belly laugh !!! I'm still giggling as I type this...lolololol
     
  87. rowley978

    rowley978 Member

    Joined:
    May 19, 2013
    Maggy status update.

    I've been doing more tests in the last two days. See my ss if you are able to check it out. I did a before bed last night, and then every 2 hours today (though I missed the +10).

    I'll do some random tests tomorrow.

    I'll also try and get the before bed one each night.
     
  88. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Thank you Stephen. This is really going to help us see if a dose change is needed.
     
  89. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    That's interesting, what i see is that maggy was dropping really nice last night. I wonder how low she went.. Maybe even into green. Then today she bounced off the low.

    I would hold the dose a day or two till you see blue again and then try and get more tests at a regular 1-2 hour interval till you see a yellow.(even at night sorry) Let's see if we can catch that low. If its under 50, we reduce dose.
     
  90. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    he is coming back down again. I cant believe we are constantly missing the low :(

    Anyway I am wondering about a slight fattening of the dose to say 0.75 ... if we cant catch that low soon .... but would like everyone else's thoughts. Its not the safest idea since we really arent getting enough tests in but we have rarely seen a green no matter what.
     
  91. rowley978

    rowley978 Member

    Joined:
    May 19, 2013
    Just did a +3 and he's at 138 (see ss).
     
  92. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Ok good - can you get a +5?

    Wendy
     
  93. rowley978

    rowley978 Member

    Joined:
    May 19, 2013
    +5 for Maggy today is 130
     
  94. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    I would say Maggy is due for an increase also. I'd up it to 0.75U.
     
  95. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    I'd get a +7 just to see if maggy keeps dropping..
     
  96. rowley978

    rowley978 Member

    Joined:
    May 19, 2013
    +7 is 123
     
  97. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    ooh still dropping. :)

    get a +8 (might be green) or +9. She is probably going to go up soon.
     
  98. rowley978

    rowley978 Member

    Joined:
    May 19, 2013
    179 at +9
     
  99. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    On the way back up, good to know though. Ok 0.75 next I think. What do you think?
     
  100. rowley978

    rowley978 Member

    Joined:
    May 19, 2013
    I feel that would be a good idea, but my only concern is that I'm starting it on a Monday (when I"ll be unable to do any spot tests and/or monitor his behavior. I'm feeling it would be better to do this on a Saturday morning (change in dosage) so I'm there for him? Or is .25 such a small amt. that it won't have that much bearing on it given his numbers and historical fluctuations?
     
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