new - terrified- could really use reassurance

After quite an emergency scare, our furry one has been diagnosed with pancreatitis, uti, and diabetes and just came home after 3 days in the vet hospital. They started her on Glargon (sp?? the one that starts with "glar") in the hospital and her blood sugars went from 20s down to regular numbers (I think they said 9?). Then as they waited to give her next dose, her blood sugars were dropping a bit on their own and she hasn't had insulin since jul 3. When we brought her home yesterday, her level was in the low-mid teens and they didn't want to make her go hypo. They actually said there's a possibility it might not be primary diabetes and related to her pancreatitis being inflamed, but that we'll have to wait and see what happens to her levels. So we got sent home without insulin but we're rechecking her at her regular vet who I trust and is great (saved our other furry one from hemolytic anemia when others weren't even sure how to treat it) on Friday.

I'm very scared right now because it's her first night home with all of this and she's obviously still feeling like ****. I've already phoned the vet hospital twice tonight (it's now 4am) because she's eating her diabetic canned (purina DM) quite well and I added some water to it, but I'm worried because she's not interested in the water bowl and hasn't been to the litter box since she got home. She's able to sit up and stretch and groom herself, and the vet hospital said last time I called I can wait until the morning and if she's still not doing much we can take her to our regular vet. I'm just terrified that I don't know how to tell if she's getting some much needed rest or if her levels are going haywire. I have a very strong fear that I'm watching her die because of the traumatic loss of other fur babies and I'm a real mess. I have a severe anxiety disorder and any reassurance right now that we can get through tonight (and all the days after!) would really, really help.

-Mel

 

The pancratitis, uti, and stress of being at the vet have a very significant effect on the blood glucose numbers. As the pain of the pancratitis and infection of the uti clear the numbers will come down and you will see a clearer picture of what's going on with the diabetes. Right now the diabetes is not the primary concern. We want to see the other things resolved.


If you early want to see what the blood glucose levels are doing then you could pop over to Walmart and buy a bg meter. We can help you learn to test at home if that's something you'd like to do. It's really pretty easy and may take some of the anxiety of not knowing away.

I'm glad she's eating. Most cats with pancreatitis that's the main issue. They usually have to have an anti nausea medication like cerenia. When my cat had pancratitis he was on cerenia, bupe for pain, and we did extra sub q fluids at home. Is he dehydrated? Feel of the gums feel wet or if they are sticky/dry. If you pull the scruff does it go back quickly or does it take more than 2-3 seconds?

 

Hi again Mel!
I have some questions first
So she was started on Lantus (generic name Glargine) but only on it for a few days? Do you know the dose she was on? Can you give us the dates and BG (blood glucose) readings from the hospital stay and any extras they took?

Might still be some stress from being at the Vet hospital. My boy usually defecates at the Vet and then nothing for next 24 hours until his stress settles. Just keep an eye on her, which I'm sure you are

That's a good sign , I think we have 5P's to check off for how well a kitty is feeling: Preening, purring, peeing, pooping, and playing

You could grab a glucometer from a pharmacy to test her BG at home. Many of us here do the same, partially for the reason that we're not stuck being our kitty's shadow . There are lots of tips and videos that can help you learn. Ask any questions about home testing here too .

Trust me, we ALL know that feeling of fear when our fur babies aren't doing well. I've been worried about my boy for a few days now because of something we're dealing with. The members here become close friends and little insulin families, we're here to support your kitty and YOU

 

Janet, I think she might be outside U.S. since she mentioned BG numbers in mmol/L .

Mel, could you confirm your general location for us?

 

Ah yes. Well it doesn't have to be Walmart obviously.... Anywhere that sells meters.

 

Thanks for the replies!

I'm happy to report that a little bit ago she came off the bed and went to use the litter box and I will add extra water to her purina dm in about 20 mins when she's due for her antibiotic. I'm still very nervous because of how off she is from feeling so crappy and I'm happy she actually came up onto the couch to snooze beside me but it's hard not to constantly want to wake her up to check. Once we see how well she has some soup-y wet food, I'll keep my fingers crossed she will have some water. Her skin does take about 3 seconds to return to flat from tenting it so I'll be phoning the vet first thing if she's still not interested in her water bowl.

I am in Canada, so that must be why the numbers they gave me were so much different than what I read from others. Unfortunately I'm not sure what her dose or exact levels were from the vet hospital but I do remember they said something about it being 23 and then insulin helped her get down to 9, and that she's still high by being around 14 or 16 but they said they would expect her to be back up around 20s without insulin if she has diabetes, so it might be secondary to the pancreatitis - but they also said it might be that glargon isn't the right insulin for her?

I'll definitely go pick up a blood glucose meter soon, and I guess right now it's a waiting game as she recovers from all of this and just trying not to make it worse by stressing her out with extra vet hospital visits because I'm terrified! I'm hoping she can keep making small steps getting better and that we can make it to her regular vet on Friday without any more emergencies

 

Basically if you multiply by 18 you will have the numbers we are talking about. So 23 would be about 414 us numbers. A 9 is about 162 us numbers.

 

Glad to hear she's a little more herself today.

I have a video in my signature showing how I test my cat CC if uou just want to see how it's done at home.

 

It might not be so strange that a cat will eat wet food but not drink water. We have a civvie (what we call a non-diabetic cat) and in the years we've had him I have NEVER seem him at the water bowl. There's already a lot of water in canned food and you added more. I'm not saying that's something not to worry about but it is something to think about.
Now the big one and I hope no one thinks I'm being heartless. Cats and dogs have a very different set of emotions regarding loss. In the last 3+ years we have lost eight cats and they all went in pairs, always within a month of each other. Five of these cats were litter mates. As much as I wish they wouldn't they all seemed totally indifferent to one less cat in the house. The best example was Andrew and his Moma Zoe. Andrew would still try to breast feed at two years of age so there was some kind of bond there I can't explain. Zoe passed very suddenly, it was cardiomyopathy so basically she went from wheezing to death in 3 hours. Andrew never spent a minute looking for her or staring out the window. I've heard this from vets as well; you're crying for a week and the cat just thinks "More food for me". That's probably the most heartless thing I've ever written here. I have PTSD, not too bad and I have some anxiety disorder, mostly a feeling of impending doom so it's way too easy to transfer your emotions to your cat, something I've been doing for 35+ years. Is your cat now alone? That would be a reason for both of you to feel this way.
I'll give you some reassurance straight from the heart. It's awful losing so many animals in such a short time. Six of them died in a one year period along with my Mom. If you're cat is eating and grooming then there's still hope you will get through tonight and many more. I don't want to put the fear of God in you but neither am I giving you false hope. I agree you should buy a glucometer because then you'll know for sure and we can help you. I hope the best for you.

 

Hello from Ontario.

Strips in Canada are expensive. A number of people use the FreeStyle Lite, which uses a smaller drop of blood ($90/100 strips - or if you know someone who is a senior, they can get them cheaper on seniors' day at Shoppers Drug Mart.

There is also the Bravo meter. It takes a bigger drop of blood. https://www.diabetesexpress.ca/free...r-with-purchase-bravo-test-strips-p-2456.html (disadvantage is that you have to order the strips online - they cannot be bought in stores). If this is the one you choose, order at least 2 bottles of strips. One bottle for the testing kit, one bottle for the hypo kit.
http://www.felinediabetes.com/FDMB/threads/jojo-and-bunnys-hypo-tool-box.2354/ http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

You can start off by reading about Lantus here: http://www.felinediabetes.com/FDMB/...the-basics-new-to-the-group-start-here.18139/
(It is usually cheaper to buy from a pharmacy like Costco than from the vet. No prescription required in Canada. Just tell them that you have a diabetic cat.)

 

Hi,

You have received some advice and some straight talk. I am just here to say BREATHE!

You need to take care of you so you can take care of your kitty.

And yes, I know, this is hard but you need to breathe. It was one exercise I do all the time when I first feel my heart starting to race, when my mind will not stop - I take 2 minutes and breathe deep. In and out. 2 minutes.

I will tell you, this is very doable-diabetes is not a death sentence.

And welcome and here is a few of these

 

Hi there, me again. What Tracey just said about taking a deep breath is perfect advice. Cats and dogs will sense when you're agitated and nervous and in return you'll be making her nervous. Sometimes a cat is just sleeping.
I told you a pretty long and personal story before. It's a sad story and I'm sure a few members here may be tired of hearing it but the point was my wife and I made it through all the sad parts and usually ended up with a happy ending, and of course more cats. It's a big help to have someone there to help you, even if it's just for a good cry. Andrew, Noah's brother once swallowed an unused staple but he just pooped it out without any damage. Nigel was another of Noah's brothers and our first diabetic. He also had his moments but always pulled through. We've only had two diabetic cats, there's a member here who once had five at one time!
Today is only your first day so we all want you to stay calm. There are over 15,000 members here, some for much longer than 5 years so we've seen pretty much everything there is to see. If you stay really-super-calm you might end up with a 23 year old cat like I did. Quoting Tracey again, "diabetes is not a death sentence". Aside from any other problems having a meter at home will help you so much. Remember that we all started somewhere and all of us were freaked out in that first week or month too. You're not alone and no question is too stupid to ask. Keep us updated, even with what you might thing is the silly stuff. Update your profile so we can see what meds you're using and any other problems you've had. It all matters and we all really do care. Tracey is Canadian and so am I. We have members all over the world in lots of time zones so you'll never feel alone.
PS Your hospital should have a record of all the readings and amount of meds given. It's your right to ask for this info, don't take no for an answer.

 

Once you start home testing you can use the Spreadsheet template most of us use here to track and share BG numbers: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

And if you have a moment, setting up your Signature with some information will be helpful as you continue to post: http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/

How many days has she been on insulin and how many units? Lantus is a depot insulin and can take a little bit to see the depot in action. I'm currently in this stage with my boy. It's also possible as pancreatitis and UTI clear up her BG will be lower. Infections can cause higher BG's. Don't worry about Canada numbers, majority of the active members know how to convert .

Feel free to keep asking questions

 

Take a deep breath We've all felt this way at one time or another. I thought a FD dx was a death sentence. And then there was pancreatitis. And then the stomach ulcer. And then IDB. It can all be easily managed. Especially with the help of all the wonderful people around here.

When my sugar kitty is in normal ranges he never drinks water. I add water to his already wet food as well. Vet said it was totally fine.
From my little personal experience, pancreatitis can elevate your kitty's bg lvls as well as them being at the vets office.

And WHAT?! There's a pancreatic cat that eats?! You really are fortunate on this one.
If she's eating, grooming, resting comfortably, I'd say you're pretty well off..

And some cats grieve and some don't. We had one of our civvies go missing about a year ago. One of the 3 we have still looks through the house for him, the other 2 couldn't care less.
If you think that she's upset, try talking to her. Who knows it might make you both feel better

Bottom line - this is an amazing community of people who've seen it all. There's most always someone around to give some advice or just reassurance. But you CAN do this Now go have a glass of wine. The cat is important, but you are too.

 

Thank you everyone for all of the support - I will make a longer post with replies to everyone after I rest a bit. It makes such a difference to hear from others who also care so much about their furry ones and understand the struggle.

A quickie update: I'm finally able to stop having to go check on her every half hour and she's been up onto the window sill and the couch today too instead of just that one spot on the bed. She's also been very good about eating her slushy wet food (after adding water) so I'm beginning to calm down and feel like we'll make it okay until we see her regular vet on Friday who I know will give me all the info about everything that's going on and then I can have all the info I need to get help on here too

 

I'm so sorry to hear about so many losses in such a short period of time. I definitely noticed a difference in monkey (the one who is currently sick) and our other cat when their brother died very suddenly. It's partly why I wasn't sure she was sick until just recently because she's been a bit different since losing him a couple years ago.

Tomorrow is our appointment at the regular vet and I'll be relieved once we have more info.. it's been a very long few nights and days waiting and watching!

 

I hope this is the right place to post with more questions . . .

Yesterday (July 10) Monkey was kept at her regular vet during the day to get her started on 1 unit of Lantus daily, and this morning was my first time giving the insulin myself. She's on once daily dosing because it seems to last longer in her and July 10th with administration at the vet she went from 22.6 at 9am to 3.8 at 9pm.

This morning she was 22.0, so I gave 1 unit. This evening at the same time she was 3.8 yesterday (9pm) she's now at 17.0 again! I left the Lantus out of the fridge when we got home from the vet yesterday for approx. 4 hours and I'm not sure if I ruined it. I called a pharmacy just now and they said they're not sure about cats but in humans it could be left room temp for 28 days which doesn't seem right.

I'm not sure about giving her another 1 unit right now if she's reading at 17 because I don't want to mess up her timing or curve (I'm so new to this, I'm probably not making sense) and the vet thought it would just be once a day. There was also a small bubble in the syringe this morning that I couldn't tap out no matter how much I tried and maybe she didn't get enough because the amount of insulin is already so small?

She's still eating her wet food every time I put it down (every few hours or if she comes over and asks for food) and the emergency vet said as long as she was eating I should hold off and wait until the morning and I can ask our regular vet.

What should I do??

 

Hi Mel,
The Lantus should be OK if you left it out for a few hours, refrigerating extends the life better. Just keep an eye if you see any white floaties develop. Have you been able to look at the SS link I posted above? What kind of meter are you using?
Let me know if this is correct for now:
10 July
09:00 - 22.6, gave 1.0U Lantus
21:00 - 3.8, skipped?

11 July
09:00 - 22.0, gave 1.0U Lantus
21:00 - 3.8, skipped again?
Current time - 17.0

What time zone / country are you?

 

Thanks for the response I was just setting up the spreadsheet last night but I haven't set it up yet. I'm using an accu-chek aviva connect and I'm in Canada in the Pacific time zone (UTC -08:00).

The info would be:

July 10:
09:00 - 22.6 gave 1.oU Lantus
21:00 - 3.8 (skipped and gave food)
22:00 - 3.9 (gave food again)
23:00 - 4.8
01:00 (July 11) - 7.1

July 11:
09:00 - 22.0, gave 1.0U Lantus
16:00 - 9.6
21:00 - 17.0 (skipped because vet didn't say about giving in eve, this was just about an hour ago)

The vet said it looked like it might last 24 hours for Monkey so she didn't give instructions about giving more assuming it wouldn't be going up again in the eve. She seems pretty hungry this eve so I'm putting her food down pretty often. Is it okay to wait until the morning to do a shot so that I can see what her regular vet says?

 

Insulin usually doesn't last 24 hours in a cat so the dose may be too high. Do your syringes have half unit markings? I'd go ahead and stay skipped for tonight since it's past the hour of usual shot time. Just don't feed her 2 hours prior to pre-shot time.

 

Should I keep checking her BG tonight? Or is it okay to wait until morning? I don't want her little ears to take any more abuse and to be honest I'm not sure what I would do differently if it were higher other than continue watching for any signs that she's not well.

The vet did say that it doesn't usually last that long but there was maybe 5% of cats (or 1%?) that it might last 24 hours, and if that didn't continue to last that long she might need to be switched to another insulin because it being 18 hours or something apart would be hard to do. They said it's also possible she'd need it twice a day, but we'd have to wait and see what it does. It just surprises me that one day she was 3.8 at 21:00 and the next day with the same dose she's at 17.0. I know it can take a while to get regulated and I might have given too little this am (syringes have full and half marks, we got the 3/10 U-100 ones), I just wasn't prepared to be so damn confused right away. I'm trying (and failing) not to panic right now :/

edit: was able to set up the spreadsheet just now and added to my signature

 

My baby is on a different type of insulin

Are you testing her BG 2 hours after she eats?

 

If you skipped the shot tonight, there's no real need to test...but if you do, it's all great data to have to see what happens when you don't!

No insulin=No hypo

Since she dropped so low yesterday, she's "bouncing" today....bounces can take up to 3 days to clear.

Bounces happen when they 1. drop too low, 2. drop too quickly, 3. drop into numbers their body isn't used to anymore (or any mix of all 3)...the liver releases stored sugars and hormones to bring them back up fast. Those hormones and sugars will take time to clear the body

I really think you should try to reduce to .75 or .5 so you'll be able to get twice a day dosing in without having her drop too low to shoot

 

So other than the AMPS and PMPS, all other readings should only be done if it's been 2 hrs since she's eaten?

 

Thank you for explaining that - at least it makes sense even if it's not ideal. I'll call the vet first thing to ask about reducing the dose and the timing of the shots given her numbers today and yesterday.

Thank you everyone for your support, it helps a lot!

 

No you don't have to wait two hours after eating to test mid cycle. It's important to wait 2 hours for preshot testing so you know the true number is high enough to require insulin.

 

I usually have an easy time taking in lots of info and not missing anything but everyday learning about managing FD is like a smack in the face in terms of everything I feel like I don't know. Now I'll be sure to not give any food 2 hours before preshot tests. I also didn't find the Lantus info thread until last night so I didn't realize you weren't supposed to inject the air into it first, like most video demos I watched said to do. And of course, I still freak out several times a day checking on her to see if she's really just sleeping and reminding myself that there's no need for pricking her little ears 100 times a day for bg levels. Vet this am said to go ahead with 1.0U Lantus as usual but still do not give any this eve and they said to call as often as I need with my numbers to double check. I thought today I'd test at +6 as well as +12 and I guess I'll see if her rebound is still going on from the first day (July 10) going down to 3.8.

If there's anything else I could be doing please let me know! Thanks to everyone for the advice and support

 

I'm with Chris and China, for the idea to try a reduced dose of like 0.5u twice a day. 1.0U is seeming like too much right now. Too high of a dose can make it look like insulin lasts longer than 12 hours.

 

I like the idea of .5u twice a day vs. the 1.0 once a day. Lantus is better when given every 12 hours. That said. I have noticed with Jones that it can last longer than 12 hours some days. Again, testing and updating your spreadsheet will help define Monkey's patterns for you.

You got this!

 

I also agree on 0.5 twice a day

 

I'm very hesitant to change it without talking to the vet but it does seem like this dose is giving her numbers that aren't good. I just tested at +5 and it was still 20.5! (It was 23.5 at 09:00). I got paranoid about having left my Lantus out of the fridge for 4 hrs on a hot day by accident so I just spent $120 on 5 more cartridges and probably spent too much but at least I'll know that's not the problem. She had such a good response to the Lantus the first few times, I really hope it's normal for the response to vary in the first few days/week.

 

I also agree on the 0.50 unit twice a day. Lantus is intended to be dosed twice a day with kitties because of their faster metabolism, whereas people and dogs usually only have 1 shot per day. However even some people need to use it twice a day. If you look at the drop on June 10 from 20.6 at preshot to 3.8 at the next preshot that shows that 1 unit is too high. Lantus should have a much more gentle curve. When the numbers drop that much it causes "bouncing" where the body releases stored glucose to bring the numbers back up, since the body "thinks" this is an emergency situation. This can cause high numbers for several days. What you want is 24 hour coverage with a controlled drop rather than a huge drop. Dosing twice a day will give you 24 hour coverage and not cause such big drops. As you see how this works then you can adjust the dosing as needed.

 

You hold the syringe - Lantus lasts about twelve hours - so really you are just splitting the 1U recommended dose into two .5u doses. Insulin is not a drug, it is a hormone - so the reactions is not quite the same in the body.

I think you will her numbers will go down more slowly and she may not bounce as much.

 

Happy to report that I just talked to the vet who said the same thing about her higher numbers today and yesterday being from the upswing of it dropping too low (it's 25.5 right now and I've never seen it that high) and like you guys said it's probably too high a dose, so for the next 2 days I'm to give 0.5U Lantus in the am (still none at night) and just keep a close eye on the numbers and phone them into the vet as often as possible. I really trust this vet but I was starting to wonder if so many people with this experience disagreed with her course of treatment so it's relieving that she came to the same conclusion

 

Glad your vet was able to recognize that the dose was too high. However I respectfully disagree with only dosing one time each 24 hours. The AAVM (American Association of Veterinary Medicine) states that kitties should receive glargine...generic name for Lantus...every 12 hours.


"

• Initiate insulin therapy with PZI or insulin glargine at a starting dose of 1 U per cat q 12 hours." Glargine is the generic name of Lantus.

https://www.aaha.org/professional/resources/diabetes_management.aspx

Many vets are used to dealing with diabetic dogs and do not realize that kitties are not dosed the way dogs are. A dog would usually only receive one shot per day. Because of the faster metabolism with kitties insulin normally will not last more than 12 hours, which means that the kitty only has insulin in their system for 12 hours out of a 24 hour period.

 

Again with just one a day? That makes no sense. Why leave him with no insulin support for half the day?

 

From my understanding, the vet explained that while Lantus is meant as a 24 hr insulin in humans, it obviously doesn't last that long in *most* cats, but that she's seen some that it lasts longer and they just need one injection a day. She mentioned this was a very small percentage of cats that may respond this way to Lantus. She's also more concerned of Monkey going hypo while we figure out how she responds so I'm doing the 0.5 unit starting this morning and calling in her numbers to them to confirm/deny that her high numbers the last couple days were from an upswing after going too low and go from there. It's only her 4th day on insulin and vet said it can take a while to see what will work best and doesn't want to risk her going hypo. It already seems like her upswing is starting to come back down as her AMPS was 20.5 this morning (it had been up to 25.5 last night and came down to that on it's own). I'm trying my best to understand everything that's going on and do the best thing for Monkey but this is getting so overwhelming, I don't want to do the wrong thing.

 

Take it slow, breathe, think about what you need to do next. One thing you can do quietly at your own speed and in small chunks is to read the yellow info stickies on the Lantus forum. Then come back here with any/ all questions you have. Right now you're confused and overwhelmed and getting a barrage of well-intentioned comments. It can feel like just too much.

 

Thank you I'll definitely check out the posts in the Lantus forums

I found this article that describes what my vet told me so much better than I ever could, if anyone has time and can make more sense of the signs/numbers could they take a peek at monkey's SS and tell me if that explanation for her BG numbers the last few days (day she went low was July 10).

http://www.vetsulin.com/vet/Cats_Monitoring_Somogyi.aspx

 

The existence of true "somogyi effect" has pretty much been dismissed....the original study done was only with a handful of people (not cats) and has not been able to be proven since.

What's going on with Monkey is called "bouncing" ( I explained in this post) as well as not getting enough insulin.....Lantus needs to be given every 12 hours. In humans, it's generally given once a day, but a cat has a much faster metabolism than a human and it just doesn't last that long.

I'd really try to give Monkey the .5 both in the AM and PM and let's see how he does over the next couple of days.

Hang in there!! This diagnosis is tough and so is learning (and understanding) how to treat it, but we'll be with you every step of the way!

 

Oops, sorry you had to explain that twice - I'm so panicked about monitoring her that I miss most of what I hear and read which is making VERY hard to figure out what I'm doing. I'm very very nervous about doing twice a day shots without the vet's ok because I know our vet is very up to date on her info (though she called a rebound an upswing, but I assume it's the same thing) and she saved my civvie cat from a very rare and awful reaction to tapazole that attacked her bone marrow when no other vet was able to figure it out.

I don't think what people are saying here is wrong about 2 shots a day, I'm just afraid that the vet has an understanding I don't about the dose and how it might affect everything else that's going on with monkey. I know she has pancreatitis, some nodes on her spleen, and had some numbers elevated in her bloodwork for her liver - she also just finished antibiotics and had a fever for 2 days while in hospital. I'll have a decision to make when I do her AMPS tomorrow about whether to dose twice - hope folks here can help me figure out what to do once I have AMPS info?

Thank you everyone for the constant encouragement and answering my questions multiple times because I'm having information overload and panicking.

 

No worries!! There's a massive amount to try to learn, much less remember, especially at first.......each time you'll remember little bits and pieces and soon it'll start making sense to you too!

You might want to send your vet some of the latest research on treatment of diabetic cats.

On page 218 of the AAHA Guidelines for treatment of diabetic cats, under "Outline of Initial Approach" it says "Initiate insulin therapy with PZI or insulin glargine at a starting dose of 1 U per cat q 12 hours" (Insulin Glargine is Lantus)

Another good study to read is Management of Diabetic Cats

 

2 shots a day is the norm.

 

Going to start 0.25U twice a day this morning (vet keeps telling me to keep it once a day but I trust the research that's been linked here and everyone's personal experience) - is this a good place to post any questions/concerns during the day about her bg? Or do I make a post in the lantus support group?

JanetNJ - I was having trouble doing the bg testing and I watched your video and it helped SO much to know that I can use the back of her ear, we have no problems now so thank you for sharing that

 

I was thinking of you. How is Monkey feeling? Is the uti clearing? Is he back to his old Monkey self?
I'm glad you found the video helpful and you were able to test!!!!
Let us know if you need anything else.

 

Wanted to add I'm really glad you be dosing twice a day now. If your question is specifically about the dosing lantus, moving the question to the lantus boards may get more eyes on it.

 

I think she's still feeling pretty crappy. She's very good about eating every time I put her food down because she's so hungry but she still mostly just goes back and forth from the bed to the window sill and sleeps a lot. I was so happy that twice in the last few days she actually wanted to play (even if kind of "lazily" because she isn't feeling great). I hope to see her more herself soon.

Turns out they just gave her antiobiotics in case she had a UTI at the vet hospital but a few days later they phoned with the results that she didn't have one, so that's good! I got Cerenia from the vet but they just gave me one box and it ran out yesterday - is it something that should be given continuously?

 

cerenia is usually given as needed (1/4 of a 16 mg tablet is the most common dose) So you said she's hungry? Is she actually eating the food?
What did they give her for pain?

When my cat had pancratitis he got cerenia, bupe for pain, and we did 100 ml of daily sub q's for about a week. He was back to himself after about 5-6 days.

 

I'm glad you're going to try this today. Post your BG results as you get them. We'll be curious to see how she does.

 

As convinced as I was yesterday this was the right thing to do, my anxiety is making it very hard to cope with "going rogue" from the vet's opinion. Intellectually though, I definitely see the benefit of twice a day so here are her #s so far:

AMPS -22.5 - 0.25U Lantus (did my best to measure correctly)
+2 - 23.0 (I've never measured at +2 so I hope it's higher bc the insulin has not kicked in and she had breakfast?)

 

Only a little tiny bit higher at +2 and yes food may still be present

 

She does eat a lot, especially compared to how picky she usually is with her food. She's underweight right now so I am giving her as much low carb wet as she wants - usually about 2-3 tbsp every couple of hours. I am unable to work myself right now because of my own illness so at least I am able to be here and check her and feed her all day if needed.

Monks got pain meds for the 3 days she was in the vet hospital but we were just sent home with antibiotics. Regular vet (who I'm not happy with at the moment for recommending once daily dosing) said that cerenia, if used at double the dose for nausea is actually an anti-inflammatory and there's apparently 2 schools of thought about pancreatitis in cats - one being that it's idiopathic and the other that it's an immune system response and anti-inflammatory meds should help. Now I'm concerned if Monks is still looking like she feels pretty crappy, I'm just not sure if it's from high bg? Vet is not open Sundays but I'll be ready to leave a message with the receptionist that I am doing 0.25U BID and perhaps ask about pain meds?

 

So far her AMPS was 22.4 and she had 2-3 tbsp of food, she was 23.0 at +2, had 2-3 tbsp of food at +3:30, tested 23.8 at +4, and she's having another 2-3 tbsp now (+5). Hoping that's normal for it still to not go down?

 

Most likely she's still bouncing today from the hypo yesterday. It can take 3-6 cycles for a bounce to clear. Just hang in there and as long as she's over 15 (usually I'd say 11.1 but raising it a little til we see how she adjusts to the twice daily dosing ), stick with the 0.25U twice a day.

 

All of yesterday (first day of 0.25 BID) she was quite high from the bounce, but since her AMPS today of 20.3, she was 16.8 at +2, 11.3 at +4:30, and 14.6 at +6:30. Should I continue with twice daily?

 

Yes.

 

Sounds like a plan to me . If I don't see any post updates, I'll track down her SS and peak in a couple days

 

I'm so glad you're doing this. She might bounce again but that's part of FD.

 

Thanks everyone

I left a message at the vet's office about changing the dose myself and I emailed them Monkey's spreadsheet - I'll still continue with twice daily dosing regardless of what they say though as long as it's best for my little one.

 

Yes! So happy to see that you giving monkey the insulin twice a day. I've been following along the whole time and was hoping you would do that.
Everyone is awesome here! Thanks to all the help I've gotten, I was able to get my 1st diabetic cat into remission and I also got skittles into remission for over a year until his tooth got infected. And I hope to get him back into remission once I can finally afford to get his dental work done .

 

I'm happy to report that when I stocked up on Cerenia at the vet today, one of the other vets (regular one wasn't there today) said the twice daily 0.25 is just fine I didn't realize I was supposed to keep giving Cerenia every other day because they just gave me one box at the time, so I hope Monkey will start feeling better with that on board.

I was wondering about doing the BG checks because for the last few days I did a ton of them because I was so panicked, but would it be safe to just do AMPS, +6, PMSP, +6 (so, every 6 hours)?

 

Go you! Well done for being really brave!

I did amps when I was working I came home at lunch and did the + 4 or 5 or 6 depending on when I could get home. Same in the evening for pmps etc. But my kitty was very reactive so I was most concerned around or coming up to nadir.

Many people do your schedule and then a curve once or twice a week. That works too.
I think really it's what you are happy with yourself and what makes you feel confident.

 

Definitely AMPS and PMPS, as for a +6 every day, if you are able try to switch them around to cover periods between +4 and +7. So one day get +4, next day a +5, and so forth. Helps in finding her nadir too

Glad you had some support from that Vet about two shots a day . We'll be here to support you both too

 

0.25 twice a day has been going okay (I think? hard for me to interpret her spreadsheet), but today at +7 she's at 22.7 and she was 17.2 at AMPS. Is that normal or could I have done a furshot?

 

I think she's bouncing from those recent blues. I think the twice a day dosing is the way to go. Keep this dose for another couple of cycles but I think it'll be time to try 0.5 u twice a day in the near future.

 

Hope you just got a little busy and nothing bad happened last night

 

I hope not Yong... hopefully we will hear something soon.

Edited: I just looked at Monkeys SS and the .25 is bringing him down nicely. I wonder what a fat .25 would do!

 

Everything's good, I just fell asleep before putting it on her spreadsheet last night

Her AMPS was 16.8 and I'm just waiting for her to finish her breakfast to do her shot

 

Tomorrow's day 7 of 0.25U twice a day - should I do a curve to see if her dose could be raised to 0.5U? Or wait a bit longer?

 

You really don't have to do a curve at all as long as you keep testing as often as you are.....as long as you can get at least 1 mid-cycle test on the AM cycle and a "before bed" test on the PM cycle, that's enough to tell us what we need to know.

I would like to see an occasional earlier test on the PM cycle...Like a +2 or +3

Look at your spreadsheet and find where big "holes" are that there aren't any test results and try to sprinkle tests in those places.

I think you're good to increase to .5 tomorrow

 

That's an impressive SS!
Way to go both of you! I can see the insulin his bringing him down.

If you are concerned about going straight to .50 you could give a fat .25 for a few cycles and see how Monkey does. A fat dose is simply where you draw a little more than .25 into the syringe.

 

Well we did 0.5U starting this morning, her AMPS was 24.4 which surprised me, so I hope everything's okay today

 

Could be a bounce from last night. Have you gottena ketone test recently?

 

She's stubbornly stayed around 17 today which I wasn't expecting I've yet to do a ketone test, I have the ketostix and today I've put saran over the box and put our civvie cat in another room, but of course now Monkey doesn't seem the least bit concerned with the litter box. Was really hoping to get one today but there's only so long I can stand our civvie scratching at the door so I might have to try again tomorrow.

Is it okay to stay at 0.5U twice a day given her numbers today?

Edit: Success! Ketones are negative

 

Sometimes a bounce an show as flat cycle too. She should be OK to stick with 0.5U. 15 July may have just been a weird day.

 

I'm confused because tonight (at +2 and +4) after her PMPS, she's gone up instead of down. It's getting a bit harder to give the injections and I'm not sure if maybe I'm not getting it right or if this is just something that happens with BG levels. Another night of no sleep for me I guess because I can't stop panicking that something is wrong

 

It all looks ok to me, yes they are flat and high(ish) but give it a few cycles to settle down and see how it is from there. Nothing is wrong kitty's system is just adjusting to everything

 

Could just be a flat bounce from the yellow PMPS. As Tara said, her system is probably trying to adjust so things look a little backwards. She's just being a little Monkey . What is becoming more difficult with injections? Please make sure you get some rest and take care of you. We have to stay healthy since our kitties rely on us

 

Today her AMPS was 21 and I just gave her 0.5U but once again had trouble with the injection and I'm not sure how much went in. At first she clearly didn't notice the injections but now she is jumping away right after I poke her and just as I'm going for the plunger I'm kind of having to chase her to get it in. I'd go by the smell of the Lantus to see if it was a furshot but she always has the faint smell of it on her fur around her scruff now. This morning was the first time I'm more convinced I missed than I am that I got it. I can try putting my arm all the way around her chest and doing the side of her scruff for her evening shot?

 

I suffer from needle phobia (I'm not just afraid of them I can go into anaphylactic shock) so you can imagine this was difficult for me. My vet gave me a small vial of saline to practice with. So I got a small soft toy and practiced prob close to 100 times on it. When I'd run out of saline I used water.
I shot her between her shoulder blades not her scruff, I also held the syringe barrel between my hands to warm the insulin up to body temperature. It also helps to watch which side the bevel on the needle is too as that can help.

Maybe just practice your technique a bit? And always reward after.

 

Was hoping someone could take a peek at Monkey's spreadsheet just to let me know everything looks okay and that we're on the right track. Today was the first day I've seen so many yellow numbers and her PMPS was 14.1 (I'm working on the assumption that this is a good response?). I haven't been able to sleep for a few days now from worrying but tonight I'm really going to make the effort to resist staying awake to test her during the night.

Ty everyone for the hugs, advice, and support

 

That's looking promising! I think people might suggest you give a little more insulin, either a fat dose or go a wee bit higher to .75 but wait and see what they say. I'm really just here to give a bit of moral support and shake my Pom poms and cheer people along.
Definitely on the right track!

 

YOU are important too, so tonight just get a +2 or +3 (before bed test) and if it's her usual drop, go to bed . That was a lovely green last night. Personally, I would hold the 0.5U for another couple cycles (2 cycles per day) to see how she does during the day with it. Then maybe re-evaluate and fatten the 0.5U or move to 0.75U BUT I am still a newer Lantus member so you could always post over there to ask more experienced eyes to look

 

Lovely green last night. Yes, hold the 0.5 u dose for now. Please post on the Lantus forum and have a look at the TR and SLGS yellow info stickies there. There are guidelines in each that tell you when to hold a dose, lower it or raise it based on PS numbers. You'll find it very helpful.

 

Thought I would post this here as well as the Lantus group in case I got a quicker response, Monkey's AMPS just now was 10.1 - should I hold her shot today??

 

Not sure what's going on but today is the second day Monkey's AMPS has been blue (yesterday was 10.1 and today was 8.4). I skipped yesterday and she went up to 22.8 during the day. I know 8.4 is right on the line of being safe to shoot as per the Lantus ISG guidelines and when I rechecked in 15 mins she had actually gone down to 8.1 so I decided to skip today as well. Can someone please give me an idea of what's going on? I posted in ISG but nobody responded

 

It's kind of like a delayed bounce, so the depot is probably stabilizing. What I would do when you're going to be home with her is try the 0.5U dose if she gives you another PS of like 8. With Lantus they like to say "shoot low to stay low" but it is definitely nerve wracking the first time

 

Well my anxiety is intense but she was at 9.3 and I was still able to do her 0.5U shot - I just hope I can keep taking deep breaths until I know the danger of her going hypo is over