? New Member - A little lost

Hi everyone. Please forgive this wall of text, but I'm trying to get my bearings. I'm highlighting my questions in pink.

Earlier this year we took Cairo to the vet after discovering a lump. She was diagnosed with a mammary tumor but also with diabetes which they said needs to be under control before we can remove the tumor. We learned how to administer the tiny dose, 1 unit (I'm guessing) twice a day. I asked about home testing, and the vet said they don't recommend it until they have done several curves (not sure why). Well, COVID-19 happened quickly thereafter, and we have not been to the vet with her.

After reading a lot on this site and the FB group, I realized I should probably be testing her. I asked the vet and they said not to, just bring her in for the curves. She gets extremely stressed at the vet, and I wonder if her levels are inaccurate when they test her because of it?

So, I ordered a Relion Premier, some lancets, and some test strips thinking that's all I needed. When it all arrived today, I tried it out on myself first, just to figure out how it works. I got a reading of 215, looked it up and freaked out! Then I read a little more and realized testing right after eating a bowl full of sweet delicious grapes is going to yield a higher than normal result. So I abstained from any further consumption and tested myself 2 hours later and got a result of 98. Seems legit. Then I found the booklet that must have fallen out of box when I was opening it. It had been chewed on a little by my puppy, but was readable. I learned that I need to calibrate it with some solution that was not included. I'm really confused on this point. Is calibrating necessary to yield reliable results? Should I venture out into this plague-filled world to acquire this magical solution before I start testing in earnest?

So I jumped back into this forum and started reading more about what I need to be doing to test properly. There is so much helpful information, but I am a little lost on a few things - some pretty basic things.
1) I created a spreadsheet according the instructions. What is TR under dosing method? I read the info on SLGS, and that seems like something I want to do, but I'm not what my current dosing method is.
2) I created my signature (hope it's right!)
3) After watching a range of YouTube videos, and reading instructions on testing kitties, I decided to give it a test run today - fearing the worst. As it turns out, Cairo is quite tolerant of the process. In fact, she liked the attention quite a bit. I successfully pulled off a test and got a reading of 168. I just realized I don't know what all those ranges mean for cats. Is it the same as humans, or is there a chart I can use to understand this?
4) Now, as it happens, today my alarm clock (the aforementioned puppy) rewarded/failed us with a delightful sleep-in which resulted in us missing Cairo's morning dose. As instructed, we skipped the dose, and will resume this evening. This is of course not a normal occurrence in our house. Should I wait until tomorrow to start a curve?
5) Now the real place I'm getting lost is really about testing. Is there a good place that describes creating a curve? I apologize if I've missed. I've been diving into link after link on the sticky threads and haven't found it. What I'm looking for is along the lines of: When do I start? Do I need to take a test every hour for 24 hours? How does it work with her eating throughout the day?

Other less immediate questions I have are about some of the side effects of Diabetes. About 3 years ago, Cairo started gaining weight and she lost the ability to hold her tail up. I took her into the vet several times between then and her ultimate diagnosis and each time she tested high in her blood-work but the vets (there were a few) always dismissed it as being stress from the visit. They attributed the neuropathy to arthritis that came up in an X-Ray, and the weight gain to her sedentary lifestyle. I'm now starting to wonder if she's been diabetic for much longer. When I learned about all the symptoms, it really describes what started happening. So questions are:
Is the neuropathy reversible once she gets diabetes under control?
Should I see a marked improvement in her activity when her diabetes is under control?
I've been told that her weight will go down when her diabetes is under control, so it makes me wonder if she's still not on the right dose. Does that sound like it could be true?
Is there anyone in the San Diego area that can recommend a good veterinarian for the treatment of diabetes? Our vet comes highly recommended, but I'm concerned at their aversion to having us home test, when it seems of utmost importance.

Sorry for the long post. Thanks for all the information so far!

 

Hello and welcome!

A lot of questions, I'll try to tackle as many as I can, but I'm going to put the most important info up front: that 168 you got indicates that Cairo is doing well, but it's really good that you are testing, as it's close enough to the normal range in cats (50-120) that testing is really needed to keep her safe (above 50).

Anyway, on to the other questions!

Definitely! Vet stress can raise BG by 100pts or more! Home is much better for getting accurate readings.

Not usually, not unless you are getting strange readings from the meter and you want to check if it's working right. I don't even know if they can be usefully calibrated by a user, I don't think mine can (I don't use the Relion, though).

From the Lantus, Basaglar & Levemir forum: Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)

Typical curves are every two hours for twelve hours (one test to the next test), but people sometimes vary that depending on convenience, testing more or longer.

Yes, almost always neuropathy gets better once the diabetes is under control, but it can be a slow process. A lot of people here supplement with B12 (Zobaline is a common brand) to help.

Hard to say where Cairo is with respect to regulation, but once you get some more testing data, we can start to assess how she's doing and whether she needs a dose adjustment.

You guys are doing great so far with all this stuff! And it is so helpful to have a cat who takes to the testing right away!

 

Hello Sam, and extra-sweet Cairo

I'm a chronic lurker, but a few things have me worried. Could you confirm that you skipped Cairo's dose this morning, and you got your first reading some time today at 168? Also, your spreadsheet shows a PMPS of 123, and you then gave Cairo her usual dose of 1u? This worries me because 123 is a low number for someone new to testing to shoot; I'm going to try tagging a few more knowledgeable people to make sure everything is okay Many Lantus users are able to shoot that low, but they have a vast amount of testing to know how low the dose takes their cat

@Nan & Amber (GA)
@Deb & Wink
@Wendy&Neko

Will you be able to test Cairo in a few hours to see if her blood sugar is going up, or down?

 

Oh good catch! I was concentrating on the pink questions, and missed that the 168 came after a skip .

Yes, 123 is low for a newbie to shoot on Lantus. Definitely get at least one more test to see where she's going from here tonight!

 

Welcome to you and Cairo!

just wanted to say that Minnie had severe neuropathy to the point she could only take a few steps at a time, had to pee laying down and couldn’t jump on anything or even scratch her ear with her back paws. Once her diabetes was regulated, she improved fast and was about 80-90% better within 3 months even though one vet told me she’d likely never recover and another told me maybe 30% at the most. Then she continued to improve only at a slower rate and now she goes up and down the stairs, runs, she can climb on all the spots she used to and just a few weeks ago she started to finally be able to use her feet and pee and poop the correct way without having to put her entire back legs down. She’s on B12 daily as Nan said, we use the vitacost brand that comes in capsules and I mix it with her food, she was also on an antioxidant the first 3 months to help fight the oxidation around the nerves and gabapentin. I’m sharing this to give you hope!!

also, I just wanted to add about feeding the testing or doing the curve. It doesn’t matter. The only time you should not feed 2 hours prior is before the pre shot tests in the am and pm. So if you give her insulin at 7am, no food after 5am then you test a little before 7, feed and shoot. Same in the evening. That’s because those numbers are important so you know that dose is okay to give and you don’t want the food to give you an inaccurate higher number. If you’re doing a curve, you’d then test every 2 hours after the first 7am test for a 12 hour period.

keep the questions coming and we’ll do our best to answer them. It takes a village truly

 

Thank you all for such quick replies! Yes, I can confirm that we skipped her dose this morning, then I took a reading of 168 a few hours ago. I honestly don't know what good and bad ranges are. I also don't really know if I'm giving 1 unit. Are the blue numbers ideal? And the needle I'm using to administer is U100 31G, and I give up to the first tick, so I'm assuming that's 1 unit? I'll test again in an hour and over the next few hours.

Something I should add about her feeding. Both her and her sister eat very little in one sitting (~1 tbsp), but they munch throughout the day. If they don't eat regularly they vomit bile, and if they eat too much, they vomit food. Little Goldilocks, the pair of them! Cairo who is 15 lbs eats much less than Paris who is 7 lbs. So her weight doesn't make any sense.

Thanks for the tip on the B12! If I'm lucky it'll be delivered in a week.

 

Welcome Sam and Cairo ,the solution is only used like Nan said if you start getting strange readings, you don't have to calibrate anything
ReliOn™ Premier Control Solutions are for use with the ReliOn™ Premier family of blood glucose meters andReliOn™ Premier Test Strips to check that the meter and the test strips are working together properly and that the test is performing correctly.

 

Alot of members use this , I use it myself you can buy it on line from Vitacost
Vitacost Vitamin B-12 Methylcobalamin -- 5000 mcg - 100 Capsules
It's 17.99 just be sure this is the one you buy
The only difference is the Zobaline has 200 mcgs of folic acid
So I buy the folic acid at the supermarket and crush it up and add it to the B-12
If you can't find the 200 mcg get the 400 mcg and cut it in half
The Vitacost brand is a capsule so just open it and pour the powder on the wet food
Has no taste, no need to crush it up
The Zobaline is 33.99 for 60 pills, too expensive
I saw a big improvement I'd say 3 months, could be sooner

Vitacost Vitamin B-12 Methylcobalamin -- 5000 mcg - 100 Capsules

• SKU #: 835003001804
• Shipping Weight: 0.23 lb
• Servings: 100

 

Both numbers you got today are excellent numbers for someone new to testing. Especially with a skipped shot this morning. For a little perspective, new members are often told to skip the dose if the pre-shot is below 200, or if the member has made it to the Lantus board, I believe the no-shot number is lowered to 150. As you can see, Cairo was quite a bit below that number at tonight's pre-shot, so it's a very good idea to get some additional tests tonight.

For a bit of hopeful news, the fact that Cairo came down on her own from when you first tested her, to pre-shot, could mean that her pancreas is helping out a bit. That would be very good!

 

Okay, I just tested again (she protested this time), and it came in at 101 (1.5 hours after the shot).

 

did she eat after or right before the shot? That’s a low number for less than 2 hours after which means she’s likely going to continue to go down. Do you have carby food you can give her now? Like FF grilled or gravy? Please test her again at +4. Here are some guidelines from the Lantus forum for you with what to do and how to interpret the number ranges:
http://www.felinediabetes.com/FDMB/threads/the-basics-new-to-the-group-start-here.18139/

 

Can you take a photo of where on the syringe you draw up to please for us to see?

 

Bron, she’s at 101 @ +1.5. Did you catch that? I’m concerned she may drop too low in a few hours

 

She ate about a tablespoon of wet food before the shot. She comes back every hour to eat a little more throughout the night. By morning the food is gone and they are both hungry for their am meal.

 

The most carby thing I have (I think) is a churu so I gave her that and she scarfed it down.

What's weird is that we usually just shoot her up 2 times a day without testing until today. Does this mean we've been giving her too much this whole time?

 

Maybe not the whole time, but she sure is showing some signs today that her pancreas is active!

I'm not sure what you mean by a churu-- do you mean the yummy sugary fried pastry? If so, I imagine that will give her a boost, for sure!

The easiest 'cat carb' to have on hand is any 'gravy' variety cat food-- lots of carbs in the gravy, so often we just feed them a bit of that to bring them up. Another thing to have available is honey or karo syrup (or maple syrup, anything like that). That's for emergency lows-- it's a quick boost, so it's good for bumping them up, but it doesn't last long and too much can lead to an upset stomach and vomiting.

 

By the way, your pic looks good, that is definitely 1U.

I would try getting another test later tonight if you can. The carbs she just got will bump her up a bit in the short term, and hopefully keep her from going too low later on (if indeed 1U is too much for her).

Definition of "too low": below 50 (that means it's definitely time for some quick carbs)

If you can't stay up too late and are worried, another thing you can do is leave some extra food out for her (I'm sure she'll be a fan of that plan!). A lot of cats will instinctively seek out food when their BG goes low.

Love the avatar, she's adorable!!!

 

Also, I looked up "churu" and it seems to be a cat treat of some kind? I was thinking it might have been an alternate spelling of "churro", lol

 

ibana churu is a carby threat. I use it for Minnie too they love it it must have crack in it ha!
Your pet will love this Inaba Churu Grain-Free Chicken, Tuna, Scallop Puree Variety Pack Lickable Cat Treat, 0.5-oz tube, pack of 20:

 

Have you taken a BG test since the BG of 101?

 

My estimation of churu carbs was wrong. I thought the tapioca was more than it is. https://www.chewy.com/inaba-churu-grain-free-chicken-puree/dp/169571#Nutritional-Info

Just took another protested test and it was 76. I poured Karo syrup over a piece of salmon and she ate it all.

 

How long after the dose of insulin was that?
Please test again in 30 minutes to see if she's coming back up

 

Hey Bron I see she is 76 @+3 and in the remarks says gave some Karo and salmon
I see those treats are only 1.8 carbs, found it out on the Chewy's site
Dry matter says 5.56

 

Sam I see on your SS in the remarks column it says 6:45 pm
Where do you live, can you run out and maybe buy some cat food maybe Fancy Feast Gravy Lovers or Friskies

 

Hopefully the karo will bring her back up in the short term.
I can see it on the SS now thanks. When I checked it was not on

 

I wonder if he can run to a store and pick up any food with gravy, says he gave her the honey at 6:45 pm , some place must be open

 

Signature says San Diego. But is later there than 6.45 pm

 

You are good, I missed that , yep its 10:45 there right now, maybe there is a 7-11 store near him, it's a convenience store here in the US that's open 24/7 don't know now though with this virus

 

Sorry for the confusion. Yes, it's late here. I just whipped up some homemade gravy that I know from experience she likes. It's cooling in the freezer right now. She seems fine. Went back for food again after the salmon with Karo. I'll take another test in 15. Unfortunately I can't drive because I've taken Benadryl for allergies.

 

Sam she is adorable, she looks like a little kitten
We will check in in 15 minutes,
Sam I can't resist, you can't drive because you took Benadryl, you must be a light weight lol, I'm only kidding

 

Regardless of how the night goes, 1 unit going forward is likely too much insulin for Cairo, at least for someone so new to testing. Tomorrow you will need to shoot a smaller dose. Do your syringes have half unit marks on them?

 

The picture is from when she's a little kitten. She's an older more "robust" woman now (like me), but all my pictures of her turn out fuzzy.

If there's one thing I'm good at is making fatty carby things on the fly! My custard textured gravy (I made it extra thick) was received happily, but like I said, she eats tiny portions often. The test this time was easier and it was 105 (before gravy, after syrup).

LOL, I'm miraculously allergic to almost every antihistamine, and also most of mother nature. So the only thing I can take is Benadryl. It used to knock me out for 48 hours, but I've toughened up to the point where I get a night's sleep and enough allergy relief to survive.

 

No, I don't have half units on my syringes. Should I just eyeball half?

 

Hi Wendy, see #15 he posted a pic of the syringe , doesn't look like it

 

Actually, maybe I'll post the test result before her morning shot and wait for a response. Do I need to start a new thread, or can I just add to this one?

 

I think you should post over on the Lantus forum in the morning. There are more people there at that time to help you.
Have you retested after the 76?
ETA I see BG 105
I would retest in one hour to see she is not dropping back

 

The Lantus forum
http://www.felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/

 

I said she looked like a kitten, I'm sure she is still adorable
As for the syringes, you will have to eyeball it for now
But if I were you I would buy the ones with half unit markings, I posted a pic up top for you, we usually decrease or increase by 0.25 units or 0.5 units.
It makes it a lot easier

 

If the picture had been rotated I would have known for sure, plus Sam said not.

It would be ideal if you can get syringes with half unit markings. We actually change dose by 0.25 units at a time, so the half unit markings allow you to eyeball. For tomorrow you can eyeball taking some off. Maybe try filling an old used syringe with coloured liquid to someplace you think is around 0.75 units. Then you can use the sample as a guide.

 

@Bron and Sheba (GA) Bron I have to get some sleep, it's almost 2:30 am and I'm seeing double
Got up at 6 am and haven't slept yet. I hate to leave you alone, but can't keep my eyes open. I hope Cairo will be OK, talk to you tomorrow

 

Good night Wendy

 

My goodness, go to bed girl. You must be exhausted! Thank you.

 

@SamB have you retested the BG again yet?