New Member Izzy

Wow..well I never thought I'd be here! I have been following DCIN for a few years now and donate when I can...now here I am being a member of the Diabetic Cat Club.

Izzy is a 17 year old Maine Coone. She was diagnosed with CKD about 3 years ago and we have been going along with that feeding high protein, los phosphorus foods as she is allergic to corn, wheat and soy and all the prescription foods made her itch. So we have been going along...most with Fancy Feast Classics and Sheba Pate and occassional Friskies pate....much to my dismay as I would prefer her eating better foods. She has other ideas and we just work with it. She spent 15 days at the vet hospital back then and bounced back well until last week.

Last week she was was Really wobbly and I originally attibuted it to arthritis...until she peed on my bed. I knew somethign was up. I took her in they gave her some fluids and drew blood. The next day they cam back and said...she is diabetic...her blood suger was 819! No ketones in the urine though....how far did I want to take this....

I said...hook her up. Lets see if we can get those numbers to drop and give her a few days. 7 days later she is now home and on Lantus 2x per day...and OMG I should have read the letter from the Sugar Cat first...I totoally tortured her the first night...testing her and bothering her when all she wanted to do was SLEEP! well neither of us slept!

She seems to tire out so fast. She has trouble walking. I am looking into where to find Methylcabalomine....or something like that They said I could try. She has trouble getting into the litter box and she is eatint a little bit...not as much as I would like to see. And she is now on 100ml of Sub Qs every other day.

Sometimes I wonder if I am doing the right thing...if I am just trying because I can't let go. Others time I see a glimmer of the cat who likes to play.

Just taking it day by day and looking to cost savings where I can.

Thanks for listening! Janet & Izzy.

 

Hello and welcome to the FDMB. The best place you never expected to be. If you've been a supporter of DCIN, you probably know some of the basics.

So you are already home testing, have Izzy on a low carb diet, giving her very good insulin with the Lantus. All sounds good so far. What meter are you using?

What are some of the numbers you are getting now?

The methylcobalamin is available on line as Zobaline. Non-sweetener version for cats. Here is one link http://www.ilifelink.com/zobaline-for_diabetic_cats-3_mg_x_60_tablets.html

Or you can have it compounded at a pharmacy. I give it as a liquid via injection once a week.

Now, my best advice to you is to learn deep breathing techniques. It will help relieve the stress with this new journey in this sugardance you have started with your dear Izzy.

Breathe in, hold, release, breathe in, hold, release, breathe in, hold, release.

Ask any questions you want and we will try to help you as much as we can. We have a lot of experience in the day to day management of feline diabetes. Some one said "We like and breathe diabetes 24/7" It's true.

It will be ok. We have all been where you are now. We will help get you through this.

 

Diabetes is a chronic disease which may be managed at home quite successfully.

You can do it!

And many of the cats here will actually come to be tested, because we give them low carb treats for putting up with the minor annoyances of ear pricks and subcutaneous insulin injections

 

Thanks everyone. She is really easy to test and sub Qs are easy as long as I use the Terumo 21s and warm the bag to 100 degrees.

She has been really good at letting psycho mom test her lol

She has only be home since 7/1 and I drove myself crazy yeterday lol

Her numbers yesterday (we got home about 6pm) were 92 @8:30m pm, 76 @11:31 pm, 76 @ 5:30 am and 176 at 12:10 pm. The Vet said...calm down and stop poking her hahahahaha

I didn't give her the Lantus that evening because she didn't eat. I thought I had to wait until she ate?

Of course I was sure she was going to go into coma and I had no Karo syrup so yup....ran to the store for syrup. Then my friend said, tube icing so I got that too.

Total freak show! Love this cat to death and I know I'm on borrowed time and have been since her dx of CKD.

Was not excited to see the !74 bottle of Lantus says to disguard it after 28 day!! But my friend who is diabetic and uses Lantus said...she doesn't toss hers that early...just keep it refidgerated. So that made my day lol

 

I forgot to add I am using the Relion micro glucometer.

 

Hello and Welcome

I'm fairly new here myself, Poe is on Lantus too using a ReliOn Confirm, lots of the members here use the ReliOn meters, lancets, and syringes. It's quite a value, especially for the strips.

More experienced people will chim in as the day progresses and given its a holiday, it might be slower than usual. Lots of very good reading though in the stickys for this board and the Lantus board.

 

Hi and welcome to FDMB.

So far you are doing everything right: Low carb diet, good insulin and hometesting. I have been using Relion meters for years, for 3 diabetic cats, and have been very please with them.

For your insulin, you will be able to use the Lantus long after the 28 days. Many people can use a vial up to 3-4 months before it starts becoming ineffective. You will know when it is not working as well by a steady increase in the BG readings. However, I would recommend that when you do need to buy a new vial, ask your vet for a prescription for the pens instead. The initial cost is about twice of that of a vial, however you get 5 pens. Because a vial will stop working long before you use it all, you end up throwing away a lot of it. With the pens, because they are smaller containers, you should be able to use almost every drop. One box of 5 pens will be enough insulin to last almost a year. You will draw the insulin from a pen the same way as a vial. It is just a smaller version of it.

Just remember to test before every shot. The order is to test, feed then shoot. You want to wait until your cat has eaten before giving insulin.

You are doing a great job. We know this is all new and a little overwhelming. You will soon develop a routine that works best for you. And we are here to help you along.

 

We keep the Lantus for 4 to 6 months with proper handling and storage. Here is a post on that. http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=151

Be sure to give the insulin shots and sub-q fluids in widely separated areas of the body. That is because the fluids can affect the rate of absorption of the insulin.

Janet and Izzy (17, female) Maine Coon
Relion Micro w/ Lantus
CKD on sub-q fluids

Would you be willing to cut and paste that info about your cat into your signature?

 

Hang a sec - can you tell me when these numbers were in relation to her shot time? Reason i ask is these are good numbers and i want to be sure there isnt the possibility she is dropping too low.... Especially as 2 IU is a high starting dose for any cat. What does she weigh? (Fyi normal cat is 40-130)

Lastly FYI we dont advise newbies shoot under 200, esp if the cat isnt eating. We need more data first, can you set up a spreadsheet? http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

 

They told me I didn't need to test her So I did't test her this morning before feeding her. I was going to do her glucose curve test tomorrow.

They said nubmers between 70-200 were normal....and to coninue with the lantus, so that what I have been doing. She has only been on insulin I think since last Saturday.

Should I test her before giving a shot? Should I not give a shot if her numbers are normal? I don't know what caused her to spike to 819?

it's all so confusing.

 

Definitely test before giving a shot, so you know it's safe to give the shot. If she was already low and you gave a shot, it could be dangerous.

As to the numbers at which you don't give a shot, it varies with your experience and your cat's reaction to insulin. As Wendy mentioned, new users are told not to shoot if BG is below 200, but as you get more data on your cat you will likely be comfortable (and safe) to shoot at lower numbers. If you are following Lantus Tight Regulation Protocol, there is information hereabout Shooting and Handling Low Numbers. The most important thing is "being data ready" - the more you test, you will know how quickly the insulin kicks in and how much it brings down her numbers. This doesn't mean doing a whole curve every day, but getting spot checks at different times on different days to help fill in the whole picture. Then you will be able to see a pattern and decide what you should do if you see lower numbers at preshot. You'll find setting up the spreadsheet Wendy mentioned to be really helpful so you can collect and make sense of all the numbers. Plus then others can help you by looking at the numbers in one easy-to-understand format.

My cat is quite weak in the legs too, but I've been giving her the methyl-B12 and I am starting to see some improvement. At one point she was almost falling on her face when she stepped out of the litter, but now she's walking around on her own more confidently although still awkwardly. It does take time but don't despair!

 

You really need to test before every single shot to keep her safe. If she is below 200 dont shoot, dont feed and come here and ask for advice.

Dont feed two hours before the shot so we know the preshot number isnt influenced by food.

How long has it been since her shot? Can we get a test now?

 

I ordered the b12 last night from the link this board gave me.

She is eating now...she didn't eat the first night. But she is back to eating. She is a snacker so I keep wet food out for her 24/7. I need to find a dry food she can eat...not because she eats it, but because my other cat is a "kibble crack head". So I keep kibble out for him but he is going to have to eat whatever is safe for her..

I have been feeding him Now Grain Free which is high protein, lower phosphorus....though it appears perhaps high in carbs due to potoates? At any rate...a dry food search is on my to do list.

When do I use the pee sticks to test for ketones. Is this something I should do routinely or just occassionally? I will make it through all the topics...I promise

 

There are a few low carb dry foods you can feed but it would be best for both their healths if they only get wet. ie Innova Evo Cat & Kitten 8% (Currently on a recall), Wellness Core Grain-Free Original Formula (tan gold bag)11%, Nature's Variety Raw Instinct chicken 7%, and Young Again zero Carb 0%.

Can you get a blood test now please? I am a little concerned. Also you test for ketones twice a week, or when the blood sugar is over 360.

Wendy

 

She is at 110.

 

ok cool. So how long has it been since her shot?

 

Her shot was at 6:15 am

 

As far as CRF goes - have you been to Tanya's Feline CRF site? Lots of excellent information on managing a CRF cat. In addition to low carb foods for the diabetes, you want to keep the phosphorus low too. Cat Info has a PDF nutrition chart with many common US foods and their nutritional breakdown, including the phosphorus levels.


When you have a chance, you might want to edit your signature link for the spreadsheet. It looks a bit funky ;-)
The link should be
[color=#BF0000][b]link[/b][/color]
or
[url=link]text to display[/url]

 

ok so the 110 was 6? 7? hours after the shot.?

Reason i ask is that we need to know how low she goes - if she goes too low (under 50) then the dose is too much and she could drop dangerously low. The way lantus works is it acts as a curve - it reaches maximum action 5-7 hours after the shot...sometimes later.

 

she was at 6:15 am and 3 hours and 43 minutes later she was at 110.

 

ok so can you get a test at 5-7 hours after the shot? That 110 is pretty low and she could have dropped further after that..

Thats why we need a preshot test - if he preshot test was 120 then we know her curve is pretty flat and no need to worry to much but if her preshot was 300 and she dropped 200 points in 3 hours then we worry because she still has 3 hours to go before the insulin hits its peak - and how much more will she drop? below 50 and she could have a hypo.. make sense?

 

how about just shy of 9 hours later she is at 135.

 

135 is a good number. Not too low, rising a bit from nadir. Nice pancreas healing number.

 

ok so we can assume she dropped lower than 110 since the way lantus works. see below example of a curve. Would have been good to know how low she went as I am still concerned she might be getting too high a dose. We base dose changes on her lowest point of the day - we dont want to go under 50 remember..

Example of a typical Lantus curve:
+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.

A few things.. tonite if she is under 200 I wouldnt shoot. You dont have the data to know if you can keep her safe if you shoot and she is under 200.

Tomorrow or even tonite (if you shoot) can we get a test 5-7 hours after her shot?

Wendy

 

if I don't shoot her tonight and I do her curve tomorrow....will that be an issue?

Should I feed her, wait 30 minutes....test and then decided whether to shoot or hold off until the morning?

Does neuopathy cause them pain? She seems a little growly when I try and comb her by the base of her tail. She has always had some issue there...would start licking the air when you scritch her...but now she seems like it might be tad painful too.

 

Lantus works best on consistency, it takes a few days to build up in their systems. So if you skip tonite then your results for a curve tomorrow will not be quite representation of how that dose Is working.

Let's see how the test is at preshot time and we can go from there...

Neuropathy can feel like pins and needles but its more in their legs, not so much base of the tail..

 

So I take it...I need to test her again? I just fed her it's 5:43 and she did eat. She isn't a big eater but she did pretty well.

do I test her right after she eats? before she eats.

I normally try and give her a shot around 6:15 ish. I try to feed her around 5:30-5:45 and give it 30 minutes.

 

Really we want you to test before she eats. No food for two hours before the shot. Because that way when you do the test, the number isn't inflated by food. Anyway you know for tomorrow. Test, then feed/shoot.

Anyway get a test before you shoot and let us know what it is. Don't shoot if under 200.

Also what weight is she? I still think two units is too much to start.

 

She is around 11 lbs. I'm going to test her in the next few minutes. If she is under 200....don't shoot her? hold off until the morning?

Then retest her at 4:30 am if I plan on feeding her at 5:30 and giving a shot by 6:15?

Then monitor her every hour for 12 hours?

Is that a good plan staring now for tomorrow?

 

Yes, if under 200 don't shoot. If over 200 I would only give 1 unit.

Tomorrow test, then shoot/feed.i shoot mine while they are eating. You want to test just before you shoot ie within 15minutes or so.. So that the number really is a preshot test.

Wendy

 

Also you want to test before every shot, mid cycle (5-7hours after the morning shot if your schedule permits) and a before bed test (2-3hours after PM shot) to ensure she isn't doing anything weird overnight.

You don't need to test every hour.

 

its 6:22 and she tested at 140.

I just re-listed to my Vet's message. They want to see her next week and they want the glucose curve test do be done..test before shot, feed her, shoot her and then test her every hours until 6pm (since I start at 6am).

So at 140, I should forgot her evening shot and do the curve test in the morning?

in looking at my excel sheet..which only has 4 days of various information, this is what it looks like so far:
7/1/2013 8:30 PM 92
7/1/2013 11:31 PM 76
7/2/2013 5:30 AM 76
7/2/2013 12:10 PM 176
7/2/2013 5:00 PM 1unit
7/2/2013 5:50 PM 61
I quit testing because the vet said it wasn't necessary and numbers between 70-200 were normal.
7/3/2013 6:15 AM 1unit
7/3/2013 6:30 PM 1 unit
7/3/2013 6:30 PM 100ml Sub Q
7/4/2013 6:15 AM 1 unit
7/4/2013 10:50 AM 110
7/4/2013 3:25 PM 135
7/4/2013 6:23 PM 140

updated to delete the duplicate 7/2 pm shoot.

 

Sounds fine to me, just trying to save your cats ears.

Ok so as a newbie I would advise you not to shoot with these numbers being so low, or shoot a reduced dose like 0.5.. This means tomorrow she will be high likely, and you should let the vet know that you did this the night before your curve.

Let me know

Wendy

Ps if you do shoot (because u dont know me from adam) you should be ready with syrup in case of a hypo and you will need to test at least at +2, and then through the night especially if she is dropping.

 

ugh. So stressful!! What to do! I don't want her to have high numbers on her curve test that give them a false reading, but I dont' want to give her insulin if she doesn't need it! ACK!

 

Well, you could call the vet and tell them Izzy dropped to 61 today on the 1U of Lantus that you gave. Because of that, you don't feel comfortable giving her that much insulin again.

Most vets freak out when they hear of numbers under 100. We know that cats can go down to 50's and still be safe. Down to 40's and be safe with food support. We worry when the numbers go under 40. That get's our adrenaline pumping.

You could tell them you don't think the curve would get any good numbers. You have these tests from the last few days. You could send them a link to your SS (spreadsheet). Especially since you can't even keep Izzy on the dose they prescribed for you, you think you need to make some changes.

 

They were not concerned at all with the 76s. They assured me those numbers were fine. I don't know if they would be concerned with the 61.

Does anyone use Lantus 1x a day or is it strictly a 2x a day insulin. I sure hate sticking her so much

 

It only lasts twelve hours so its best twice a day. They don't even feel the shot , especially if they are eating when you do it. The needle is so short and fine its painless.

Try not to stress.. Everything you are doing will give her the best chance for remission.

Did you shoot tonite or no?

 

I have not shot her tonight. I am afraid to now lol without testing her again. I don't want to sleep through an hypo incident.

 

7/5 6 am: pre food and no insulin shot the night before 246
fed at 6:40 am
next test 7:40

 

A token dose on insulin would be reasonable - 0.25 to 0.5 units. - if you can monitor. No disposable syringes have quarter unit markings, so you have to eyeball it. Some folks find calipers help standardize when giving low doses.

Not a bad number to start the day, though :smile:

 

finally go around to google Docs for SS:

https://docs.google.com/spreadsheet/ccc ... sp=sharing

 

We use a different standardized spreadsheet for keeping track.

 

Do you want help putting it into our format? Our format will really help us keep track of what's going on in relation to time and trends. It's colour coded so anyone here can come in quickly and advise.

 

Both Wendy and I have done this SS setup for people. Just ask and we'd be glad to help.

 

Wow...now that's a detailed ss!

Yes that would be awesome....what do the color coding within the sheet mean? and what are AMPS?
I do give Izzy Miralax too usually in food in the am..which sometimes she eats and sometimes not. I usually use FF appetizers for her miralax.

 

AMPS = am pre-shot test
PMPS = pm pre-shot test
U = Units of insulin given
+1, +2, +3 are the hours since you give the shot.

Remarks column for notes like when you gave the sub-q fluids, foods fed when, etc.

Color coding is for the different BG ranges. There is a key, colored coded at the top of the SS.

I'll send you a PM, Upper left hand corner of your screen. I need some information to set this up for you.

 

Janet asked me this in a PM.

You decide by looking at the patterns and trends over time. I would not base any dose adjustments on that curve you did today, for the simple reason that you needed to skip a shot last night. The numbers this morning were undoubtably higher than they would have been. A bit of a 'bounce'.

After that glucose curve you did today, I would stay at 1U for now and monitor closely. You will probably need to learn to shoot low numbers sooner than later. I would suggest that you print out this article. shooting and handling low numbers

You want to be able to hold a dose for a minimum of 3-5 days or 6-10 consecutive cycles to see what effects the Lantus is having. The Lantus builds up slowly in the body before it starts to have it's full effect. If your cat drops below 50, then it is an immediate reduction, down 0.25U.

Because of that skipped shot on 7/4 PM, the counting of the cycles starts over.

We can guide you in shooting low numbers, but you need to have plenty of test strips on hand, some high carb (HC) food, karo syrup or honey or another simple sugar and the ability to stay around to monitor for several hours.

If you need to skip another shot because Izzy is low again, we would probably suggest that you lower the dose to 0.5U. We want to find a dose that you can give Izzy 2 x a day, without dropping her too low, or having her be too high.

Right now, you are in the data gathering phase of this sugardance. It took time for Izzy to become diabetic, it will take time to regulate her.

If you can, we strongly suggest getting a final test before you go to bed. Many cats drop lower at night so it is a good habit to get this before bed test in nightly.

 

This morning she is at 98 AMPS, fed her, and then I decided to shorten her dose to .5. I can be here all day to watch her and yet I am struggling with the glucose curve since the one I did yesterday apparantly isnt truly indicative of her numbers since I did not give her the PM shot the evening before.

I didn't want to totally skip this morning too! But I was afraid of giving her a full unit.

All so confusing on what is the right thing to do....and scary!

 

Nice numbers and good idea to reduce the dose. Can you get a +2? That should tell you roughly what the curve will be like today ie

If the +2 is higher you probably will be fine and the cycle will be inactive
If the +2 is the same or lower you will be doing more testing as its an active cycle

I am thinking the 1 unit is too much. You might want to stick with the 0.5 for a while to see how that does. Any activity today is a result of the "depot" from the 1 unit so we wont know how the 0.5 unit does for a few days.

Wendy

 

yes I will be able to test her at 2+, an hour after that I will be leaving for work (9:30am) and won't be home until 7:30 pm, so her PM dose will be outside of 12 hours. It's my weekend job which pays for her extroidinary vet bills....but I may have to cut my shift to 1 4 hours shift if this long day is going to interfere with her insulin. Monday through Friday I work 7-3:30...which is why I have her on a 6-6:30 am shoot.

 

+2 is 131

 

Looks like she might be bouncing off the greens, can you get a before bed test tonite? It's always a good idea so you know how the cycle will be.. If the +2 is higher generally means an inactive cycle, but if its lower or the Same the cycle is more likely to be more active.

Great numbers though!

 

yes I will do a bedtime test. Poor thing has had such a snotty nose and runny eyes. I have been running the vaporizer for 24/7. She is up now.....alert and ate a little bit more. I am concerned that I haven't see any stool from her..though maybe she hasn't eaten that much? I'm in the process of moving so I went an dug out my food scale so I can start weighing at least her breakfast and dinner. In between it's hard to say if Salem helped any.

 

148 at 10:30pm. 2.5 hours after her insulin.

 

How often does she normally poop?

Looks like she is coming down, you might want to get a +5 if you can to make sure she doesn't drop too low..

Wendy

 

amps at 6am 87. her last shot was only 10 hours ago because of my work schedule. I need to get her back on to a 6 am scheduled M-F, so her Sunday shot I wil move up 45 minutes.

 

With Lantus, we change times no more than 15 minutes per shot or 30 minutes 1 time per day. This is because of the depot/carry over effects. Otherwise, when shifting earlier, you may get unexpected lows that require monitoring and frequent feedings of high carb foods to prevent hypoglycemia.

 

You can skip since she is low and put her back on schedule tonite.

 

D your syringes gave half unit markings? This dose might be too high and you might want to try 0.5 instead.

 

BJM here is my problem. I work 2 jobs one job M-F leave home at 6:30 am and get home at 4m, 2nd job Saturdays I leave at 9:30 am and get home at 7:30 pm. So 15 minute increments to get her back on her Monday scheduled is not going to work for us. So what do you suggest? I always skip her Saturday PM shot? and start her back on at 6:30 am Sunday? I am 40 minutes from work so I can't drive back and forth every day to change her schedule in 15-30 increments.

I checked her BG at 6am she was at 87. She had some kibble and I held off her shot because i know it's too soon.

Wendy: at 7:30 she was at 131 and I gave her .5 based on how yesterdays numbers went (she was at 98 amps and 131 2 hours later). I am off today, Sunday (my only day off to keep up with constant vet bills) and I will monitor her. No my syringes don't have 1/2 marks so I simply eyeball it squeezing out one droplet at a time.

I just don't know what to do to keep her dosed correctly when I have 2 conflicting schedules

 

Remember Lantus is a depot insulin which means it builds up in the cats system over time, so although you shot 0.5 yesterday, you wont instantly see the effect of that reduced dose. It can take a day or two to see the effect of a dose change. And of course you gave 1 unit last night so we wont know now. I suggest you try the 0.5 for a few days to really give the depot a chance to catch up.

Saying that you look like you will need better syringes as eyeballing can be a little inaccurate ie Relion 3/10cc 30 & 31 gauge short, BD Ultra fine 3/10cc short, Terumo Thinpro Insulin Syringe 31G 3/10cc.. or buy calipers.

Hows this for a dosing plan? Lantus allows 30 mins flexiblity to move each day and so this works?
Monday - Thursday 6.15am & 6.15pm
Friday 6.15am & 6.45pm
Saturday 7.00am & 7.30pm
Sunday 7.30am & 7.00pm

Wendy

 

Given that shooting early acts like a dose increase and shooting later acts like a dose decrease, what you may want to do is a slight reduction in dose when you need to shoot earlier and just tolerate the slight increase in glucose when you need to shoot later. As you collect data, you may be able to develop a standard amount that you'll reduce when shooting earlier.

You may be able to tweak the carb level of the foods to help with the time shifts, too. A smidge higher carb when shooting less than 12 hours; a smidge lower carb when shooting longer than 12 hours, with an intermediate level for the standard 12 hour shot cycles.

Maybe note the schedule issue in your signature block?

 

Monday - Thursday 6.15am & 6.15pm
Friday 6.15am & 6.45pm
Saturday 7.00am & 7.30pm
Sunday 7.30am & 7.00pm

Saturday reality is I won't get home until 7:30. If I test her, get her food ready and give her time to eat, then the shoot is more like 8pm-8:15pm.

I will look for those syringes. Costco only had one kind so that's what I originally purchased.

 

ok hows this?

Monday - Thursday 6.15am & 6.15pm
Friday 6.15am & 7.00pm
Saturday 7.15am & ~ 7.45pm (shoot her while she is eating)
Sunday 7.30am & 7.00pm

 

Monday - Thursday 6.15am & 6.15pm
Friday 6.15am & 6.45pm
Saturday 7.00am & 7.30pm
Sunday 7.30am & 7.00pm

Then Monday again at 6:15? that 45 minute diference is ok?

 

Better than no shot!

 

When you have to make the 45 minute jump to an earlier time, you might 'skinny' the dose to avoid going unexpectedly low.

 

ok maybe this - revised Sunday

Monday - Thursday 6.15am & 6.15pm
Friday 6.15am & 7.00pm
Saturday 7.15am & ~ 7.45pm (shoot her while she is eating)
Sunday 7.15am & 6.45pm

 

he is dropping, can you get a +6 or +7?

 

sorry I have been moving and I missed the post for +6 or +7...I just did +8 and she is at 236

 

ok cool.. on her way back up..

 

should I stick with the .5 at 6:45pm then?

 

Yep, let's give it a few days to see how it does. It takes 3 days or so for the depot to build up and see the full impact of a new dose . Unless she drops under 50 in which case we would reduce again.

Also you might see a higher than normal preshot tonite. Don't panic. This is a bounce off her probably too low numbers last night as its likely she dropped lower than the 79. Just hold the course.

 

I won't panic since I forgot to get the preshot number <sigh>. I have her her SubQs and she ate and I forgot the test. Damn it.

I need to get into a routine. I hate poking her every hour or 2, her poor ears. I surprised she lets me near her! She is still so stuffed up I'm surprised she is eating anything, since I doubt she can smell

 

Do her now instead. It's very important to get preshot test, or within 15mins of food.

 

You don't need to test every 2 hours. Always get a preshot test. Then it's good to get a mid cycle (5-7hours after shot) and before bed. Any signs of a low and you check more often.

If before bed is same or lower than preshot then you might want more tests but if its higher then you can probably go to bed.

 

For congestion, a warm, wet washcloth may be used to wipe off any disharge from the eyes and nose.

A preservative-free moisturizing eye drop may help loosen the congestion from the top - their eyes drain into the sinuses.

 

so in the mornings...I just have to take it on faith that it's ok...since I will never be able to take a a mid day test

I have been wiping her eyes and nose with a warm cloth. I have had the vaporize running all the time.

she has her good moments and her not so good. She walked into my closet today...that is the furtherest she has gone so far. At least she can stand and walk

 

Well you can get mid day cycle tests on sundays and you might want to do a test around 11 or 12 at night to get the midcycle once or twice a week?

 

Dosing adjustments for Lantus insulin are made on the lowest point or nadir. That is usually in the middle of the cycle, +5 to +7.

I see you work 6 days a week. Ouch! ohmygod_smile

Wendy has already suggested the nadir tests on Sunday.

Some other ideas for you:
Take a test as soon as you walk in the door from work. M-F. does not need to be every day, but some days.
Saturday mornings, you can probably get a +2.
That 'last test just before you go to bed' is another possibility.
Then there is the dreaded 'set the alarm to wake up at night mid-cycle test'.

These don't have to be all the time. Just some options to think about for filling in those bare spots on the SS. These are some ideas to see what the BG numbers are doing at other times of the day.

Because of your work schedule, it sounds like you want the SLGS or Start Low, Go Slow protocol.

 

ok I need to create a schedule to make this into a habit.

are we talking a couple times per week?

If so I am thinking my new world looks like this:

Monday - Thursday 6:15 AM & 6:15 PM shots
Monday and Wednesday - BG tests as soon as I walk in the door (4Pm) + her pmps 5:45 so she can eat and be shot @6:26, and another BG as bedtime.
Tuesday and Thursday - set the alarm for midnight for a BG
Friday 6:15 AM and 7:00 PM
Saturday 7:15 AM & 7:45 PM (shoot while eating)
Sunday 7:15 AM & 6:45 PM and made sure to get a +2, +5 and +7

Back to Monday Schedule and start over?

 

Not sure what you mean "BG tests as soon as I walk in the door (4Pm) + her pmps 5:45 so she can eat and be shot @6:26"?

heres how I do it based on your timing
6pm test. Immediately after test give treat
6.05pm put food bowl down immediately after test. Ensure cat starts to eat.
6.10pm Shoot... cat may still be eating - means is distracted.

Wendy

 

it was suggested that "Take a test as soon as you walk in the door from work. M-F. does not need to be every day, but some days."

When I walk in the door is around 4pm. That doesn't count as her pmps blood glucose test...correct? if not, then

I would be doing a blood glucose (BG) test at 4 and another one at before her insulin.

For some reason I thought I was suppose to wait 20-30 minutes after she ate to give her insulin. If that is not the case, then yes I could be doing it closer.

She isn't big on the treat thing. She does't care whether she has them or not and sometimes she doesn't want them at all....based on the SubQs she has been getting for a while. The insulin shot and even the ear poking is nothing compared to the SubQ fluids and how long they take. I choose to use a smaller needle rather than the harpoons the Vet gives me...so it takes a while.

If I do not put myself on a set schedule, my changes of missing testing is likely. I have much more to do than just her, although at the moment she is top priority. I still have 2 other cats, a dog and 2 horses...and it doesn't take much to get me side tracked in shoveling a stall or something to get myself off schedule with her.

 

Fluids tip: I saw a vet tech put the bag under her arm and press it like bagpipes to get the fluid in faster.

You may already be warming the fluids to body temp; that helps with comfort for a cat having trouble staying warm. Some folks sit the bag in a bowl of warm water to take the chill off.

 

Your tentative testing schedule looks good. Try it for a bit and see what adjustments you need to do. Lot's of other animal care responsibilities on your plate. Basically, do the best you can.

I think doing a testing schedule with your extremely busy life is a great idea. Wish I had thought of that with Wink. ohmygod_smile I just kind of did random tests when I thought of it. As well as a curve now and then.

The 'walk in the door' test does not count as the PMPS test. You want the PMPS test to be within 5-10 minutes of the insulin shot.

With Lantus, you can test, feed, shoot as quickly as you can get it done. No waiting required to shoot theLantus insulin after you have tested. Many people shoot while the cat is eating. Some insulins do require you to wait and make sure the cat has eaten enough, but not Lantus.

It will get easier with time. It will become a routine. Right now, you are still trying to get into the groove of testing and shots. It takes a few adjustments. Hang in there, we are here to support you and offer other suggestions if something is not working out.

 

Is there a way for me to follow this thread so I don't have to hunt for it every time I log in?

Izzy's amps was 271 this morning. .5 given so.

I do warm her fluids. I have an infrared thermometer and I try for 100 degrees or she gets cranky. I hang the bag high so I can make sure she doesn't get more than 100ml.

 

yes - at the very bottom of this page, in the pale blue bar to the left is a link that says "subscribe topic". Click on it and you will get an email with a link every time someone responds.

Wendy

 

224 at 4pm tonight. another 1/2 hour before her PMPS and shot. pmps 284

 

Ok cool. Let's see where she goes over the next day or two.

 

shouldn't she be under 200?

 

Ideally yes but at the same time you don't want her too low. We need to give the dose time to settle and tweak if need be..

 

The insulin vs glucose relationship often makes a smile shape. It may be fairly steep in some cats, flatter in others.

 

So hard to be patient

 

amps 7/9 is 359

 

Its ok - below is the logic around what we are doing here and when the dose will change. Remind me though what food she is getting? For some reason I thought it was just FF pates but I see on your SS she is now getting dry too? what kind is it?

 

She always has one or more of these available to her. Fancy feast pate, Sheba pate or Frisbees pate. I did pick up some merrick and BG Closeout which she doesn't seem to like

My other cat... The kibble crackhead has Now Grain Free (which previously was Ok for Izzy CRF) which is now mixed with Instinct which is not good for Crf but better for diabetes.

If she doesn't have access to food she throws up bile.

She doesn't eat dry often... But does occasionally.

 

329 @ +10, 305 pmps. Not eating much so I boiled her some chicken and broth tonight.

 

Ok are you testing at home for ketones? Please test ASAP.

I am going to get some dosing experinced people over here to advise tonites dose.

Wendy

 

You did shoot this morning didnt u? The column is blank for dose.

 

I only quickly scanned your condo.

From looking at your spreadsheet, I would think it's okay to give the 0.50 dose.
It looks to me like the green numbers you saw on the two AMPS tests on the 6th and 7th were partly due to the previous 1.00 doses. I would continue to get tests at every mid-cycle you can, like at nights, on workdays.