Newly diagnosed 15 year old

Nataschia turned 15 in March, she has NEVER been sick and is tiny. She was diagnosed with diabetes exactly a week ago. Nataschia's average weight was always just around 6 pounds, she is down to 5. We started her on the Lantus insulin last Thursday - I believe at that time her levels were 388 (?) We were to give her just the smallest dose ONCE a day and had a follow up visit on Saturday. Saturday her blood was tested and she was still high (415) so we were instructed to give her the same small dose but TWICE a day. Took her to be checked again on Monday and her levels were 288. I was happy as the vet told me we were shooting for the high 100's and it had started to drop. We were to continue with the 2 shots a day. Just got back from having her tested and she was at 468! Now we are told to give her thhe normal "1" does tonight and then go up to "2" in the mornings - we will take her back on Saturday for another test.
I am beside myself that she dropped and now is high. I'm not dealing with this very well and my husband is the one administering the injections. I need help! Is he maybe giving "fur shots" is he shooting right through the skin? Is this "normal" in the beginning? PLEASE - ANY advise will be greatly appreciated!

 

Welcome Boris and Nataschia!

I think the vet raising it to 2u is much too high an increase. We prefer to do dose increases based on .25u at a time and holding that for a few days to see how they do before increasing again, if necessary. Another thing is that Lantus is a depot-style insulin and because of this cumulative effect, it is meant to be given consistently twice a day, the exact same dose. It sounds like your vet is trying to use Lantus like PZI or other types of insulin and this will not work.

For giving shots, how are you giving the shot and where? What size needle are you using: "long" (12.5mm) or "short" (8mm)? I don't really think you're having a problem with shots as much as that I think the dose might be too high for such a tiny girl like Nataschia and she might be bouncing to those high numbers you're seeing. I would like to recommend you start home-testing to see how Nataschia is reacting to the insulin. Here are some testing tips to help give you an idea of what testing entails.

 

Thanks for a response! First, for clarity, I am using the LANTUS Solo Star pen. The needles are BD Ultra Fine "mini" 5mmx31g.

The vet was VERY clear that she didn't want me "listening" to another vet's advice as she felt the slow way was the way to go and she hoped I'd listen to her. The pen can only dial up in increments of "1"

Starting last Thursday:

Glucose at 325 - started that day with ONE dose only - at the "1" mark

Friday - I dose - at the "1" mark

Saturday - Glucose at 416 - instructed to give TWO injections a day at the "1" mark

Sunday - 2 injections (12 hours apart) at the "1" mark

Monday - Glucose at 288 - 2 injections at the "1" mark

Tuesday & Wednesday - 2 injections a day, each at the "1" mark

TODAY - 1 injection this morning (7:30 AM) Glucose test at 11:15 AM - Glucose up to 468

NEW INSTRUCTIONS : Tonight an injection at "1" - in the morning(s) she will get an injection on the "2" setting

The vet said that the Lantus insulin is supposed to be SLOW acting so she is less likely to "spike" - today she also mentioned that we MAY have to change the insulin to find the right one for Nataschia. SHE didn't seem worried - I am a wreck! Nataschia is eating well - have her on a LOW CARB diet - she ate mostly dry food before but is wolfing down the wet. She weighed 5# a week ago and is still at that 5# mark - she hasn't gained OR lost. Her urine output seems to have reduced. She looks better but her back legs are still a bit wobbly - which was the reason I took her to the vet last week.

PLEASE HELP ME UNDERSTAND what I'm doing, how Nataschia "should" be responding and how long can it take to get them regulated?

 

The "slow" way is the way to go but your vet is currently not going very slowly by increasing in whole units. I think part of your problem might be that you're using the tips with the pens. Get rid of those since, as you've already learned, they're only useful for whole units. Get a prescription (if you need one) for 3/10cc, 100u syringes with half-unit markings. Walmart sells these (even though a lot of the time they tell you they don't; they just don't realize it) and use the syringes on the pen instead of the tips. This will give you much more control and allow for finer dosing instead of jumping whole units, which might bypass a good dose.

Since you just started giving injections, it can take about a week before the depot finishes filling up and you don't want to raise the dose too soon. I would hold off on the dose increase, especially since you don't know how low she might be going yet and the higher numbers you're seeing are most likely because the 1u might be too high already. The way Lantus works is that you base dose increases/decreases not off the pre-shot numbers, but off the lowest numbers in the cycle. For Lantus, this occurs around 6 hours after a shot.

Here is an example of a typical Lantus cycle:

How long ago did you get rid of the dry food? It can take up to two weeks (sometimes more) before seeing the impact of food on the BG (Blood Glucose) levels. I would also be hesitant in increasing the dose when getting rid of dry food alone can drop a cat's numbers 100 to 200 points or more. This is another reason why you might want to learn how to home-test.

For the wobbly back legs, it's called neuropathy and methyl-b12 (zobaline is the cat version) has been known to work miracles. It's completely safe to give and the cat pees out any excess so you don't have to worry about an overdose of b12.

For further reading that sums up much of what I've said, check out the "Tight Regulation Protocol" Sticky in our Lantus forum. You do not have to follow TR, but the information it contains is still the same.

I'm sure you'll have plenty more questions, so feel free to ask away! The only bad question is the one that goes unasked.

 

Like Kpassa said, with the Lantus Solostar pen, you want to be using regular insulin syringes to draw the insulin out of the pen. Do not use the pen needles that come with the Solostar pen because they are not able to consistently deliver such small doses.

Another reason, is that as you said, the pen can not deliver in less than 1 unit increments. With insulin syringes with half unit markings on the syringe barrel, you will be able to make dose changes in 0.25U increments.

You have a tiny kitty there. The protocol we use for a starting dose takes the cats weight in kilos * 0.25 units, rounded down to the next closest unit.

5 pounds /2.2(kilos in a pound) = 2.27 kilos
2.27 kilos * 0.25U = 0.5675 units
rounded down to the closest unit = 0.5U starting dose.

If you were to give that 2U that your vet is recommending, you will likely send your cat into a hypoglycemic state. You can support a hypo at home of you have the proper supplies on hand.

ETA: We probably see 5-10 new diabetic cats on this board a week. Your vet probably does not see that many diabetic cats in a year. I know you don't have any experience with us 'strangers' on the internet, but we have a lot of experienced people here.

 

Okay, so we went out and bought syringes - watched Youtube video - did it BUT I noticed AIR BUBBLES in the PEN! What now! On the video she says that the insulin is no good if it has air bubbles! Just gave her the shot with "1" ......we drew "2" and expressed (?) to 1.

NEED MORE HELP ! cat(2)_steam

 

I know people are really particular about proper usage of the insulin and not shooting air bubbles back in and things like that, but it's going to happen. Don't worry; the Lantus is not that sensitive that those little air bubbles will cause it to lose potency. I'm down to the last few drops in my current pen and there is a big ol' honking bubble that has accumulated over the last couple of months. I could probably pull it out with a syringe, but I've been lazy and haven't bothered. :lol: Instead I just rotate the syringe around the air bubble so I don't pull any air in with the insulin.

You also don't have to overdraw and "express" (I like that word for it ). What's more important is that you don't have air bubbles in the syringe because that actually counts as a dose decrease. A tiny bubble the size of a pinhead is about .05u of insulin that is not in the syringe for the dose. If you have a lot of these air bubbles, then that can have significant impact on BGs. But, if you can draw the insulin to the 1u (or a little past if needed) with minimal to no bubbles, you should be fine without having to draw it all the way to 2u.

 

Some hints for drawing.

1.Do not inject air into the pen like you would with an insulin vial.
2. Do not shake or roll the Lantus.
3. Draw nice and slowly to minimize air bubbles.
4. Overdraw slightly.
5. Remove the syringe from the pen.
6. Hold syringe with the needle pointing up and give the barrel a couple of sharp flicks with a couple of your fingers to get the air bubbles to the top of the syringe.
7. Express the air bubbles and any excess insulin into the sink or a paper towel.

 

Hello there

I agree with what's being said. 2 units is too much for such a small kitty. I also think her blood sugar issues could be vet stress.. Many kitties get stressed at the vets and all these repeat visits could be making her more stressed. Also she could be bouncing.. Going too low from too much insulin and then shooting back up again.

So to get a better idea of what's going on, and to keep her safe I would strongly recommend you home test. It's more reliable since she won't have vet stress spiking her blood sugar, and it will save you money and give you a much better picture if what's gojng on.. What country are you in? We can recommend a meter and help you learn how to home test.

Another tip for withdrawin insulin.. Before inserting the syringe into the pen, empty any air out of it first. Keep your finger on the plunger firmly to ensure no air sneaks back into it, and insert into the pen and withdraw the insulin.

Wendy

 

Thank you for all the suggestions so far! I REALLY appreciate your help. We decided to go with your suggestions as I just had a bad feeling about giving her 2 units. We see the vet tomorrow so it's not like I have to sweat this out for days. We are keeping it just to the 1 until twice a day, 12 hours apart. We are using the syringe to draw from the pen and REALLY paying attention to giving the injection.

Here is another issue I need to resolve .... Tasha is a VERY shy cat, we have to "capture" her for the injections and she hates being caught. You all are suggesting that we test at home - how many times a day do you do this? I hate to add more "captures" to her little life right now. She is spending a lot of time under a bed - this is not highly unusual but she is hiding from us. She is very interested in food and comes out to eat and she's roaming at night. I feed them (she has a brother) upstairs and this morning she came downstairs and into the kitchen which she NEVER does - she is ravenous! I think this also could be that she has always had DRY food to nibble on and now it's gone. I am feeding extra - and they each have their own feeding bowls (which is new) and they are getting 1/2 can each of Fancy Feast (the recommended Classic's that are low carb) both in the morning and the evening, I have also been living no MSG turkey mid afternoon and also a little before bed. I am trying to get her to gain an ounce (while Boris will probably gain a pound!)
Is Tashie so hungry because of the diabetes? Or, is it due to the removal of the dry food? She has never been this interested in food! Should she be eating before of after the injection, or doesn't it matter?

Going with my gut instinct, I feel she is far better than she was last week. She looks better and brighter and I do feel we have a better handle on giving the shots. Need to understand more of this home testing though - if anyone would be willing to help walk me through this? Normally I have it together but this has just knocked me over the head! I feel like I need a few of her shots! oy!

 

Can you shoot her when she is busy eating? That keeps her distracted. Maybe ask the vet to shave a few spots so you can see what you are doing easier until you get the hang of it

We test before every shot. Then I usually recommend another midday if possible to see how low they are going (the low point is what you base dose changes on). And a test before bed to see what their overnight blood glucose plans are...

In terms of food, we have a calculation for how much they need but while her blood glucose is unregulated she is starving and may need more to maintain her weight. Anyway you can start with the below calculation and weigh her every week and adjust if need be.

Required calories per day = [13.6 X ideal weight in lbs] + 70 = 152 calories for a 6lb cat. Thats about 2 cans of fancy feast a day (they are about 80 calories each) so you need to feed her twice as much as she is currently getting.

How much does Boris weigh? Based on the above formula he may need more.

Our normal process is test, then feed/shoot. No food for 2 hours before the shot. As a newbie, if she is under 200 you don't shoot and dont feed. You wait 30 minutes re-test to see what her blood is doing before deciding to shoot or not and post here for help.

Wendy

 

My Chester learned the phrase "Test and Treat!" very quickly. All BG tests are followed by a treat - usually freeze-dried chicken or shrimp. That made a positive mental association, and now he knows when it's about time and he comes trotting over when I call him. We test, treat, shot and feed - in that order. I'll admit, he is a very mellow dude and a professional pet, but I seriously believe that low-carb treats or extra loving can really help test and shot time to go better.

 

Unfortunately, Tash is very skiddish, always has been. It has to be on her terms, she decides. She has NEVER taken a treat from me - she believes food is only eaten out of a bowl and, until now, purely ate to sustain. She is not the type of kitty that jumps on your knee. She ignored me for 10 years until I was able to be home more and then, very slowly, she started to jump on the bed with me at night & in the mornings and lay on my legs. She then would leave when the ShihTzu came to bed. Right now she is not even doing this - I think her legs are too weak to make the jump. I made sort of a cushy step ladder for her but she's not ready and when I lifted her on the other night she wanted off. This is all so new for her and my babies are quite routine, this is not normal and she's skeptical - I don't blame her! I am trying to have everything else as "normal" as possible but I am sure she is picking up on my stress so I am TRYING not to check on her as much - even went out twice this week (whoo hoo) and I think that helped.

Appreciate the advice on upping her food! Gees, what an education I'm getting! WHY doesn't the flippin' vet tell you half of this stuff! My husband is feeling better with the syringe over the needle for the pen so we accomplished that since yesterday. I still have to wonder if she was even getting some of the shots, especially in the beginning!

 

Okay so I want to scream from the roof tops! Taha is resting on her window hammock - her favorite place that she hasn't visited in over a week since this all happened! I can SEE her without crawling on the floor and spying under the bed! Could this be due to switching from the needle to the syringe? Could she actually getting the correct 1U dose now? We just switched last night so she has received only 2 jabs so far with the syringe but she seems much more like herself - or, could it be that now she's had insulin for a week and it's starting to regulate? SO HAPPY! Love my little tint Himmy girl with the big blue eyes!

 

I'm glad she's feeling better!
The ability to consistently dose insulin can make a big difference.
Love for your happy girl!

 

THANK YOU! I'll take any scrap going right now!

 

So. Just got home from having Tashie tested - she was at 78! She was 468 just 48 hours ago! She was also 4.15oz on Thursday - now at exactly 5#. She has been eating a lot and MUCH more like herself and even climbed on the bead with me last night, for the first time in 2 weeks (over the moon) ........ we have now been instructed to drop her to 1U ONCE a day. We have also gone to the low carb diet, no exceptions. Do you think this is down to her getting a REGULATED dose of insulin? I am so confused! I have just fed her again because I want to make sure she doesn't go too low - she had 1U at 7:30 AM, ate some and now is eating more. She was hanging out on her window hammock and seemed fine. What is the "normal" glucose level supposed to be? Vet admitted to me that Tash is the ONLY diabetic she is treating right now - didn't know about the needles with Lantus vs. the syringe but was open to listen to what we did. Any words of wisdom? AND AGAIN, THANK YOU ALL SO MUCH!
Bernadette

 

I dont know this insulin but this will bump up your thread. 79 is a beautiful normal number.
jeanne

 

Normal BG numbers for a non-diabetic cat are 40-130.

Please,do not give any insulin if the BG is below 200. Hold the food,hold the insulin and post here for advice. If you do not get a response, the safest thing to do is to skip the shot, do not give any insulin. OK?

Are you home testing?

 

So we should NOT give her insulin in the morning? What do you mean "hold the food" ...... the vet told me to make sure she ate when we got home? I am SO confused. Her numbers at 12:30 were 79, do not have testing kit here - vet told me to go to 1U just in the morning and do a re-check on Tuesday? I asked about testing her last week - she said no, she would do it.

 

What I meant by holding the food, was only if you were home testing and had not given an insulin shot yet. We want the BG to be above 200 before you give an insulin shot.

We are strong advocates of learning to home test your cats' BG yourself. Many vets do not recommend this for various reasons.

With that BG of 79, if that had been a pre-shot number,like tomorrow morning, you would not want to give any insulin. Not unless you were really experienced at managing a hypo and had lots of test data to know what your cat would do.

We home test to make sure the BG is high enough before every shot of insulin. We test to find how long the insulin is lasting (duration) and the nadir (lowest point) and the onset (when the insulin starts to work).

Would you be interested in learning to home test?

 

Think we HAVE to home test - if we give her insulin tomorrow and she is below 200, couldn't that really HURT her? She is tiny and 15 years old so there is no room for error here. Just called Wallmart and they have the Relion meters, they have PRIME, CONFIRM & ULTRA. Which should I get & I know we will need strips - anything else? Woah! What a lot to learn! What the heck should I do? Husband is losing patience with me - thought we were doing great & now this! Please go slow with me and if you could explain what I'm up against and so I can explain to him - he's losing it (with me, not Tash)

 

Don't worry; you guys are doing fine for just starting out. It's a really steep learning curve at first and we're here to help you through this process, going as fast or as slow as you need. We have a saying around here that it's "more of a marathon than a sprint." And yes, things get easier, especially if your cat ends up being one of the numerous cats that are "broken" diabetics, :lol: meaning they are diet-controlled and don't require insulin. Even if she doesn't, I compare managing Mikey's diabetes these last 8 months as easier than feeding them. :smile:

Since cats have a faster metabolism than humans, they need insulin twice as often. With Lantus, it does no work with once daily dosing. If you give 1u in the morning, Nataschia will end up with too much insulin for the first 12 hours and without insulin for the other half the day. At the very least, you'd want to give .5u twice a day instead.

I'm on my iPhone right now so I don't have quick access to a good shopping list for you and I apologize. But, if you check the "Three steps to managing diabetes" link in my signature, there's a shopping list in there for everything you'll need. If someone else doesn't come along with better links for you, then I'll try to get to a computer soon to provide this information more properly. ;-)

 

Yep; the sooner you can start testing, the better. It allows us to see how our kitties are reacting to the insulin and if they're going too low or not low enough. In that same link I provided you for the shopping list, there is a section on testing with some great links on getting started. I recommend you give some of those links a read-through, especially the Ear-testing Tips page, so you're familiar with all that testing entails. Some cats adapt very well to ear testing and you might have it down within a day. Other cats might take longer (it took me about 2 weeks with Michelangelo before we started getting our routine down).

 

BorisV: I don't really have any advice for you, because I am new at this too. However, you are not alone at feeling overwhelmed. I've only recently learned how to test and I still am only doing it once per day. I give my kitty two shots per day, but he is on Prozinc. He takes 2 units in the morning and 1 unit at night. His numbers are mostly in the 200's. He is much larger than your kitty. All of this isn't easy and it is hard to feel normal. Hopefully things will calm down for both of us soon or miracle...our kitties will go into remission! Hang in there...you are not alone.

 

Pteacher: Thank you for your words, I think we've found a fabulous place in this forum - I found completely out of desperation and, although it's all VERY overwhelming I am so glad I listened to the advice given so far. It's a hard decision to go "against" your vet's advice but I also have to pay attention to my gut and my kittie, something just didn't feel right. She perked up immediately and was at 468 just on Thursday. Of course, all I knew is that wasn't good and she dropped last Monday to 288 and then Thursday at 468! I have to wonder about a lot of things but she is SO teeny tiny and 15 years old and I am SO not ready for her to leave - not without a FIGHT! She has NEVER been sick a day in her life and until about a year ago, hadn't been to the vet in 13 1/2 years! Didn't need to - she's an indoor baby.
Hang in there and do something for YOURSELF - you'll be better for it - now, if only *I* could do that! I had the shakes so bad the other day I was contemplating her insulin - wondered if I was having "sympathy pains" most likely it's because I've had a hard time eating - stress does that to me. Kisses to your baby and if you need to scream & vent - I'm here!
thank you!
Bernadette & Nataschia

 

Weirdest bit of advice either of you might ever hear is this: let it overwhelm you for a moment. Scream and cry in frustration and anger, if you need to. Let it out! Then, pick one thing out of the vastness of overwhelming information and focus only on that for a bit till you get it down. (Home testing is usually the best item to start with because it leads to success in everything else.)

Instead of stressing out and trying to do everything perfectly at once, just relax and practice at doing one thing well for a bit till you have it perfected. As I mentioned above, there's a lot of information for managing this disease that even most vets can hardly be expected to learn it all. We don't expect you to learn it in a day, either! Take the anxiety and stress out of the picture and you'll eventually learn everything you need to know.

"We are what we repeatedly do. Excellence, therefore, is not an act but a habit." - Aristotle. (aka "Practice makes perfect!")

 

Hi there

I agree with what kpassa said, once a day is not a good way to dose Lantus since it runs out in 12 hours in a cat. So we need to find a dose you can give twice a day. Best way to do that is to start testing. meanwhile to be safe I would drop her to 0.5IU since 79 is low on just one unit and she sounds pretty small. But we really need that meter because it will be the best way to see what her dose should be, and save you $ at the vets all the time. When do you think you can get it?

How to test tips: https://docs.google.com/document/d/13c_CPZVKz27fD_6aVbsguadJKvjSrSAkD7flgPPhEag/pub

Shopping list below.


1. Meter ie Walmart Relion Confirm or Micro. The prime is good too but it needs more blood so not ideal for newbies.
2. Matching strips
3. Lancets - little sticks to poke the ear to get blood . new members usually start with a larger gauge lancet such as 28g or 29g until the ear learns to bleed. Optional - lancing tool.
4. Cotton balls to stem the blood
5. Neosporin or Polysporin ointment to heal the wound
6. Mini flashlight (optional) - useful to help see the ear veins in dark cats, and to press against
7. Ketone urine test strips ie Ketostix or ketodiastix - Important to check ketones when blood is high
8. Sharps container - to dispose of waste syringes and lancets.
9. Treats for the cat - like freeze dried chicken
10. Karo syrup/corn syrup or honey if you dont have it at home - for hypo emergencies to bring blood sugar up fast
11. A couple of cans of fancy feast gravy lovers or other high carb gravy food- for hypo emergencies to bring blood sugar up fast


Wendy

 

To get an avatar photo small enough to put in your user control panel,

go to shrinkpictures.com.
click make avatar
then in this exact order 1 2 3
1 click choose picture- brings up your photos and find one you like - click it
2 type" 90" in where it asks for size
3 click resize and wait

then choose the 1 of 3 you like best
click download below that one
save it to your desktop

open user control panel in the FDMB
select profile tab
select edit avatar
shrink the open window enough to expose the avatar on your desktop
drag it onto the box that says upload from your machine, wait till you see a plus sign appear(+), and drop that baby
click submit and hold your breath

We love to see pictures of other peoples kitties. ;-)

 

Promise you'll see Tashie as soon as mummy deals with the glucose testing! Right now don't have my head screwed on to do an avatar - as soon as I do, you will KNOW she is OKAY coz I will be wanting to show her all over the place!

 

Agreed, testing is your priority now to concentrate and learn how to do this home testing.

How can we help you with this? Did you see the testing tips document?

We'll wait patiently for pictures some other time.

 

We have the kit - need to be clear:

She had 1U this morning at 7:30
We should TRY to test now - BEFORE she eats? IF she tests UNDER 200 - NO INSULIN?
IF she tests higher - 1/2 U insulin?
WHAT IF WE CAN'T TEST - Like screw it up - what to do for insulin then? 1/2 U or none and try again in the morning?
We do have Karo and small syringes but rather not go that route. Have read how to test, think we are okay but need to know what to do about insulin & doses!

 

Ok the logic is

First - Test

If she is over 200, feed/shoot the 0.5IU.
If she is under 200, don't shot and dont feed. Wait 30 minutes to see what she is doing (going up or down) and post here while you wait. Based on what she is doing then we revealuate to see whether to shoot or not.

Dont screw it up But if you do, you could try again in 30 minutes but dont feed or shoot.

Wendy

 

Yes, try to test now before she eats. Post here, successful, or not on the BG.

Remind me again what the weight is on Tashie?

Remember to warm the ear first to get the blood flowing before you try an ear prick.

 

Tash is 5 pounds exactly. She is hungry - wants to eat - we are going to TRY to test in a few minutes - if she is UNDER 200 - I'm going to feed her okay?

 

If she is under 200 please dont feed or shoot, wait 30 minutes and retest ..

 

If she's low, why can't she eat? If she is under 200, isn't that okay to go until tomorrow?

 

Because if she is low we want to see what way her blood glucose is going without the impact of a food spike. Food hides what really is going on and we need to know that if you are shooting low.

 

But for now lets just see where she is.

 

We didn't draw enough blood - total morons here. Didn't want to get her all worked up. Gave up. Feeding her now. Guess we will try again in the morning? Again, if she is OVER 200 (before food) give her 1/2U (?) The vet said 1 a day but your thinking 1/2 x2? Sorry guys, I so appreciate your help - husband is ready to blow a cork! He's getting mad at ME because things are not going smoothly .......... you know - an interruption to his life! Gurrr!
I am going to watch her carefully though as she got NO insulin. Any words of wisdom here?

 

ok no worries - give her a treat for being so good! I would try and test her again in a few hours - again give a treat if unsuccessful. Give your husband and yourself a treat too Testing issues are very common at first but the ears do learn to bleed.. and you did great getting any at all!!

FYI You can hold the ear under the prick (the veins flow from the ear tip down) and it helps to "dam" the blood. Or make two small pricks in the same area. Make sure the ear is nice and warm first though and wait a few seconds for the blood to well up. You can even collect the blood on your nail and test that.

Its ok to skip tonite given she got 1 unit this morning but tomorrow I would start at 0.5IU - twice a day... assuming she is over 200.

Are you testing for ketones?

Wendy

 

Wendy, have no idea what Keytones are - yikes! Maybe we should "save" that for another day? So.......I had this bright idea - we BOTH just tested ourselves to get a better feel ( duh, should maybe have done this first but was sort of racing with the clock as she was hungry and it was the darned 12 hour mark) FYI - I was 107, husband was 110 - guess we are okay - phew - not room for anymore diabetics in the house right now!
We have made a plan to watch her carefully and re-test in the morning - BEFORE feeding. If she is LOW (under 200) we do nothing (right?) and if she is OVER 200, we do .05U - correct? Sorry - it needs to be drilled into my head - usually quite intelligent, not so much right now!
Again, I TRULY, from the bottom of my heart, appreciate all your time, patience & information. I am ASHAMED to say that my Dad had diabetes and I never REALLY knew what is was ....... he lived in the UK so I didn't see day to day and I'd just take him a load of calcium chews when I visited as he couldn't get them there. He died from it. Guess it's a good thing that I just tested myself, huh?!
I seem to have a bad habit of blocking out when it comes to my fur babies - I have not had human children so they ARE my world. I am trying to digest that diabetes is NOT a death sentence and remember that I was SO relieved to her it was diabetes and NOT renal failure, which I lost a Persian to - which is why Boris & Nataschia came to live with me in my overwhelming grief of losing Abbey 15 years ago. Just so you can understand me a tad better - Boris, her "brother" but not really, had a huge issue with cystitis, basically built a wing on the vets office but due to a major surgery and prednisone 3x week, he has been (fingers crossed) great for 5+ years. If I lost Tash, I don't know what he'd do as he takes such good care of her - washes her face and grooms her and makes her pretty.
I'll get it together - with YOUR help! Merci!

 

Hi there

It's a lot to take in at first, a steep learning curve. But you will get it.

So tomorrow morning, you are totally correct. If she is over 200 you feed and shoot the 0.5iu, that's half a unit, it's a very small amount... You have syringes with half unit markings right? And test again in a few hours.

If she is under 200 you hold off on shooting and feeding and come on here and post, then test again in half an hour.

We can discuss ketones tomorrow... Go relax... Maybe try a test again In a few hours..

Wendy

 

YIKES! Managed to do test @ 7:30 - it was 556! Yes, 556! We gave 1U insulin and she is eating. Hells Bells - what is going on?

 

Hi,
First of all, love your kitty's name. We also had a Boris and Natasha (different spelling) many years ago in the 1970's! Second of all, don't panic. Your kitty probably had what is known as a bounce because of the lower readings earlier. It takes a while for your cat's body to get used to insulin and regulate. It is trial and error in the beginning for sure.

Congrats on getting the blood test done! :RAHCAT That is a big big step cause now you will be able to know what is happening to her. Someone with more experience than me will be along soon to let you know what to do next, but wanted to let you know that you did fine. One unit should be ok. Just make sure to get another test at least at the mid cycle (+6 hours) or if you can, do one even earlier to make sure it was not too much insulin. If she is eating, that is a good sign too cause when they get insulin, they need food. Hang in there!

 

Thanks for the reply - I'm sitting here manically staring at the screen! Oh, the ups & downs! You guys are GREAT! Just having you here makes a HUGE difference - once I get this handled, I hope I will be able to do the same, it's SO important to be "supported"

PS. If you THINK you love their names, these are their full names - Boris Valentino and Nataschia Isabella. The names are really fitting for them as she is a teeny tiny Himmy with big blue eyes and she's a little "impish" and then Boris is a blue Exotic with a Yoda/Teddy bear face and is kind of "thuggy" ....... got them together and felt they needed matching names!

 

Did the Google Spreadsheet - filled it out starting from the beginning. It's called Tasha's Glucose. I chose "publish to the web" - does that mean you can view it? Need to make sure I am doing it right. :roll:

 

Well you skipped last night which didnt help but that was the safe thing to do - and also for all we know he could have dropped too low yesterday on the 1unit and then his body overreacted and bounced afterward.. So we need to find out why he had that high and the testing will show us.

Great job on the testing!!! Now we did think 1unit might be a little much but since you are now testing we can find out for sure. You always need to get preshot tests but also for the next few days try and get a midcycle test around 5-7hours after the shot, and a before bed test. That way over the next few days we can see how the 1 unit is working and adjust accordingly.

I can access your spreadsheet - can you make sure you "share" it? or "publish to the web"?

Wendy

 

Can not access your spreadsheet, yet. Please check the share options you used. Up under file, share. and then I forget what to set them to. Haven't done it recently.

 

Just hit "republish now" let me know -

Tash isn't eating much? Normal? She's visible and chillin' on her hammock.

 

Still can't access.

Was the link you copied to your signature in the user control panel the one from the " Publish to the WEB" pop up window, down towards the bottom?

 

Husband is gone - can't test alone. When he returns in a couple of hours (?) we will re test - TWO QUESTIONS:

1) what to do if he tests high inbetween the insulin? - Just chart it?
2) If she tests high at the 12 hour mark - dose her with 1.00U ? Or, should I drop it to 0.50? Or, do we go with the 1.00U until she "levels" a bit ?

THANKS!

PS. Have you been able to see my SS? Did I do it right?

 

Just re did the signature and hopefully you can pull up SS - funny, it's showing on MY posting? - Meaning, I can see it and click on it (under my post)

 

Yes, I can see the SS just fine now.

Anything you put in your signature will show up at the end of every post you do. That is why we ask people to put things like your name, your cats name age and sex, the insulin you are using, the meter you use for testing, food fed. Think of it as a quick snapshot of your cat to help us help you better.

Yes, just chart it on the SS. High or low. Nice to post also so we know there is a change to look at.

Don't know yet. She needs to be over 200 tonight at PMPS for you to shoot the 1U like you did this morning. I would like to see a few tests today to see what she does, especially around your +6 time.

You could try for a BG on your own. :mrgreen: You may not be ready for that yet, but lots of us test alone. I have to because there is no one else around to help.

 

Will test as soon as he gets home - just not ready to make a mess of things and freak her out - right now she is staying "visible" and that is easier for me to watch her. I will post update as soon as she is tested. I'll try to get more info in the signature line ASAP. THANK YOU!

 

Thank you for the more signature info. That always helps.

She certainly showed you this morning with that high 500 number that you definitely need to be giving her some insulin. Now we will have to get a few tests and see how she is trending to see about the right dose. It might take a bit to find a dose you can give twice a day, 12 hours apart and keep the BG's out of hypo territory. (Above 50).

It's always better to start low, like at 0.25U, and work your way up the dosing scale. Especially since Tashie is such a tiny kitty.

Has she gained any more weight? Is her appetite good? All 5 P's present today? (peeing, pooping, preening, playing, purring). Remember, your cat is more than just a set of numbers. The 5 P's plus appetite tell us how she is doing. We call it the WCR or Whole Cat Report.

ETA: And we have a picture now! She looks so big in her picture. Hard to realize she is a tiny 5 pounder. How long is her fur?

 

Just poached her some chicken - should I hold off from feeding until tested? Will post numbers ASAP after.

Tashie was the BEST on Friday - this is when we were far more confident that she was receiving the insulin - when we switched to the syringe. She got 1.00U morning & evening. She ate like a little pig that day and had gained an ounce when weighed yesterday - she was 4.15 Thursday and 5.0 yesterday.

She is peeing & pooing. Neither cats are big purrers. She's on her hammock sunning herself, a favorite thing to do & it makes her visible unlike last week under the darn bed.

When she is in full coat, she looks huge! Right now it's her summer coat, much less ;-)

 

The only time we ask you to withhold food is 2 hours before the pre-shot tests. Those are the ones we do not want to be food influenced if at all possible. It they are, just note it on the SS and in a post. Life happens.

We might also ask you to withhold food if the pre-shot is under the shoot/don't shoot threshold. but only to get another test or two and see if the BG is rising enough to give insulin.

Tiny Kitties with big fluffy coats! So cute. I bet her coat makes her look like a ten pound heavyweight.

 

Did test at 2:55 she tested 176. Received 1.00 U this morning at 7:30 when she tested high. She isn't eating much. Now, when we test again right around 7:30 - is she is ABOVE 200 - give 1.00U? If she is low, hold off and re test? What about feeding, hold off?

 

If she is above 200 at PMPS, it should be ok to give insulin. I would like to be more conservative, and only have you give her a 0.5U dose tonight.

Here is why:
You skipped the shot last night because she dropped too low on the one unit from yesterday morning. She is really high this morning because of that skipped dose, bouncing we call it. Once you put the insulin into Tashie, there is no way to get it out. She is such a tiny kitty, I think a 0.5U dose is more appropriate.

We can increase the dose after a minimum of 6 cycles or 3 days if the 0.5U of lantus is not working. We will need some test data to determine if that would be a good idea. Would you be able to try for a test tonight just before you head to bed?

We also want to hold the dose to give the insulin depot time to rebuild, refill.

We are trying to find a dose that is low enough that you can give it consistently every 12 hours, no skipped shots.

p.s. I think your SS got messed up a bit. Would you take a look and make and corrections you need to do? Also, for that shot last night that you skipped, please put a zero in the dose column. That way, we know you did not simply forget to update the SS, but did a skip.

 

Sorry about the SS - Just completely did a new one - not as focused as I usually am! Think I caught all the mistakes and actually looked up the testing times and put them in appropriate boxes. What do you mean when you say "hold the dose"? Are you suggesting BOTH morning & evening dropping her to 0.5U or do 1.00 in morning and 0.5 in evening? Thanks!!
Bernadette

 

When we say 'hold the dose', we mean to keep giving the same dose of insulin. Do not increase the amount. Do not decrease the amount.

I am suggesting you give 0.5U in the morning and the same 0.5U in the evening.

With Lantus, a consistent dose for at least 3 days will let the insulin depot refill. Then we can see the effects of this dose change. We may need to stay at this dose longer than the 3 days. We may need to decrease the dose before the 3 days is up but ONLY if Tashie drops below 50.

We are trying to find a dose low enough so you can give it every 12 hours without a BG drop below 50, and without having to skip a shot.

 

GOT IT!!! Thanks! Will do - and I just caught her eating! Think it took most of the day fro her to "recover" from the high. Now to take it S L O W and monitor her - is it better to test at the SAME time every day or change it up? I don't want to prod her more than 3X a day or I'll never see her!

 

Always get the pre-shot tests. Always. Please. We have seen too many kitties here go hypo and don't want to see that with Tash.

Then a good one to get is a test before you turn in for the night, what we call a "before bed test".

Early on in this journey, you may need to get a few more tests than the 3 you want to do. A +5-7 is good on your day off, to check for that nadir time. Dose changes with Lantus are based on those nadirs, not the pre-shots, so we will need to see a few of those tests.

If she is acting funny and you think something is off, do another test. Look over the list of hypo symptoms and check for those first. The only hypo symptom Wink ever showed, was gigantic, dilated pupils in his eyes. Even with bright light.

A random test at different times during the day helps to fill in the SS and gives us more clues.

 

Hello guys - great job on the SS

This mornings 556 could also have been a result of a "bounce" from yesterdays low green - maybe more likely even than the skipped shot.

Ok we need to discuss ketones.. In your shopping list was a pack of ketone urine test strips - did you get any? If not, you should as soon as possible. Ketones are a sign of diabetic ketoacidosis (DKA) which is very serious and very expensive to treat. They tend to happen at high blood sugar with not enough insulin.

You should be testing the urine a few times a week, and whenever Boris is over 350. If you ever read more than trace and/or if you smell nail polish remover from his breath then an immediate call to the vet is in order!

Maybe pick some up tomorrow? They are pretty cheap. we have tips on how to get urine sample too.

Wendy

 

Just took reading and updated Tashie's SS. She was 109 - we gave .05 U - as you said unless she was BELOW 50, go ahead with the new lower dose. I just put food down, will check on her soon. Will try to re test in a few hours. Please confirm we are on the right track! Thanks!

 

Yikes - Deb said to only shoot if she is over 200! The 50 number was the indicator of a dose change only - yes I know its confusing but right now we have to deal with the fact you shot at a low number! SYou definately you want to get a +2. She may drop low tonite so you are going to have to get more tests in and be ready for a possible low..

Do you have spare strips? Syrup or honey? High carb food? Coffee (for you)

Wndy

 

Crap! PLEASE TELL ME WHAT TO DO - should I give her Karo now? OMG! FREAKING OUT! WHAT TO DO - I'M A WRECK - husband is ready to kill me!

 

With Lantus, a consistent dose for at least 3 days will let the insulin depot refill. Then we can see the effects of this dose change. We may need to stay at this dose longer than the 3 days. We may need to decrease the dose before the 3 days is up but ONLY if Tashie drops below 50.


WHAT DID I READ WRONG?

 

No need to freak out.. this is perfectly controllable and easy to manage but you will need to do a bit more testing.

Do you have enough strips (at least 10)?
Syrup or honey?
any high carb canned food with gravy?

Lets get a test in two hours to see what she is doing. I also posted a 911 on the "expert" board to have a member come over. they will sit with you ALL NIGHT if they need to.

the good thing is you caught it. Many owners will never test a day in their lives and shoot low and go to bed and the cat has a hypo. You know you shot low, lets handle it. The under 200 rule is for newbies only. I shoot regularly around 60 and no worries. The only danger here is that you dont know how Boris will behave so we have to be careful this first few times.
Wendy

 

Do you mean you gave .50 dose (1/2 unit)? As Wendy said, please get a +2 test and post the results as soon as you get it, okay dear? Someone here will stay with you. It will be okay. Accidents happen; it is not your fault.

 

You read nothing wrong. What I think was missed is that newbies are advised to not shoot under 200 until they have enough data to know what the cat does. It could be fine and Boris could go up over the next few hours, or stay flat, or go up and suddenly dive into low numbers. Without the data we dont know. So we play it safe and advise newbies to come here if the preshot numbers are low for the first few times.

 

Also, with regard to hypo symptoms: Gobbles only showed a symptom one time (and there were many times he was very low). Other than the one time he showed a symptom (slightly shivering), I would have never known he was low if I hadn't tested him.

 

hello, I am the husband involved with Tasha. I have not seen all the posts concerning the "when to dose, when not to dose" subject. I would just like to know what is the number on the glucose meter when we should give her a shot and when not to. As of now the indicators I have is that above 200 is not good (insulin shot), below 200 is good (no insulin shot). Am I correct ? We had a reading of 106 and thought the magic number to not dose at was 50 and gave her a .50 injection.
PS we just gave her some food mixed with a little Karo and she ate some of it.

 

hello there

Ok here is the logic.... we advise new members not to shoot under 200 because they dont have enough data to show how the cat is going to behave .I routinely shoot as low as 50 because I know how my cat will behave and how to handle low numbers. Look at my sheets for reference if you like.

If the cat follows a typical lantus curve it will drop down and come back up. Given you shot at 109, how low will the cat drop.?. you dont know.. and If he goes under 50 this is a hypo. However there are many factors at play and the cat could instead stay flat or go up. Over time we get enough data to know what the cat is doing. So the first few times a newbie shoots at a lower number than typical we coach them through it. and over time the newbie gets used to shooting at lower and lower numbers as the cat approaches regulation or remission.

Now the issue with giving her karo is that it wears off fast and they can come down again, so you should get a test in an hour to see where she is then. Then you may need to keep testing at regular intervals (depending on what she is doing) to see how she behaves. Now this isnt a reason to worry - she may well not drop down - and if she does we are prepared. We are just playing it safe here.

how are you doing for strips? For now too, dont give any more syrup.. you want to see what she is naturally doing so we can decide if and when to give syrup and to keep her hungry enough to eat it if and when needed.

Wendy

 

I'm popping over from Lantus TR ISG at Wendy's request.

First....let's just breathe and be calm.

Bernadette and DH: while we like to have a little data before a new member shoots 109, it's ok. You can test, and if you don't have HC food/gravy, you have LC and karo. You've got alot going on and alot of stress so sometimes things happen but you did good by posting

Also, below 50 is not a hypo. It's considered a hypo when the cat has clinical symptoms. Clinical hypos on lantus are rare. But we are a very long way from there.

I need to look at her SS but just wanted to pop on quickly. Before I suggest which test you get next, I just need to peek at her SS. Be right back.

 

Please get a test at +1. Please do not wait until +2, ok?

Did you feed her? What did you feed please and did you feed at her shot time?

 

They just gave low carb and syrup..

 

There is a very helpful video on YouTube on how to test a diabetic cat. Unfortunately, I can't figure out how to even find the link to post here. :-x The name of the video is
How To Test Your Diabetic Cat's Blood Sugar At Home
By Mark Portier.
You're doing a great job with everything.
Liz

 

Here's Mark and Buddy's youtube video: [youtube]_zE12-4fVn8[/youtube]

 

Any update?

And I just want to be sure...you gave her 0.5u.....not .05u right?

 

Bernadette her - just re tested and updated SS - she is at 126. What now? I REALLY appreciate your help - it's a freaky situation and we are trying to hold it together! Please advise.

 

It's really ok. We deal with low numbers all the time. It's best to be cautious.

It would be helpful if you can let me know how/when you feed and the tests in terms of how many hours since you shot.

PMPS 109 fed LC and syrup? How much
+1 or +1.5: 126

Please correct any of that. The 126 is a spike from the food/syrup. I can let you know the next test time once you let me know when you fed last and what exactly. Sound good? I'll be here for your response.

 

Just so you know, there are a few people here watching as well as Marje but we will be letting her take the lead on this. You are in good hands with Marje.

Wendy

 

Lantus onset is approximately at +2...depending on the cat and the rate of absorption. I don't want to go past +2 for the next test. Could you please see my above post and let me know where you are in the cycle?

I know the SS shows 126 at +2 but new members often get confused where to put an in between test so I want to be sure, as soon as possible, where we are.

Thanks

 

Marje, I have NO idea what you mean when you say at +2???? What does that mean? We injected AND fed (low carb) at 7:30. Just retested at 9:00. There is not a place in the spread sheet for 1/2 hours. What now? Just did her 25 minutes ago

 

Ok....we are all in different time zones so when you say you Shot/fed at 7:30, that doesn't mean anything to me. So think of the injection as zero time. One hour after you shoot is +1, two hours is +2, etc.

So it sounds like the 126 was 1.5 hours after you shot, correct? And you did NOT feed any syrup/karo when you shot or since, correct?

You can put the 126 in the +1 box on the SS. Just put 126 @ 1.5.

Ok...please get a test at +2. ....which should be now.

 

Any update? Just checking...I need to test and shoot Gracie but I will still keep an eye out. Don't worry if it just takes me a second to respond, ok? I'll be right back.

 

Just popping in to see whats going on?

Tashie - Do you have an updated reading for us? We are waiting and watching to help keep your kitty safe and worry when we dont hear from you.

We dont want her to do anything unexpected so some more tests will keep her safe. Marje is very experienced and will be able to give good instructions to help.

 

Okay, so you had me wigged - just took another test - she is at 63. Tested at 10:30. Recap - tested at 7:30 107 - gave 1/2 unit of Lantis. Re tested at 9:00 and then now at 10:30. What now? I THINK she peed outside of the litter box - on that bathroom tile. No biggie, just noting. I have noticed this a few times in the last few weeks- BTW, have 2 cats - one with a history of cystitis so you don't think I'm crazy! So, now what? She is "quiet" and sick of being tested :?

 

Ok....this is not something that we normally do but I think we should in this instance. We are going to "abort the cycle" which means I want to get her up.

If you have HC gravy, please feed her two heaping tsp of the gravy. Normally I would ask that you test in 30 mins. That is the best thing to do but if you think she will not allow you to do that, please give her 3 tsp of the gravy and test in 45-60 mins.

If you don't have any HC gravy, please feed her two good tsp of LC food with a large drop of honey, syrup, karo...any of those will work...and test in 45-60 mins.

It's very important to do one of the above. Preference is test in 30 but do what you can. Please let me know if you have a question.

PMPS :107 LC
+1.5: 126
+3: 63

 

What is HC gravy? Have no clue what you are meaning! HELP US - freaking out AGAIN!

 

I'm sorry...I thought the Health folks went through some of this.

HC is high carb. Do you have any foods like Fancy Feast gravy lovers?

Right now, please feed the two tsp of low carb food with a good drop of honey, karo, syrup whichever you have.

 

I have some gray lovers - will TRY to get her to eat now - doing it - wish me luck!

 

Good job. Please give her three tsp if you can.

I'd really like a test 30 mins after she eats the gravy. We can slack off testing once we get her up.

 

TRYING.....

 

If she won't eat, please rub karo, honey, or syrup on her gums.

Breathe...she is safe right now, ok? Step at a time.

 

Will do - will you stay with me? scared!

 

I am not going to leave you. I will stay with you all night, ok.

 

You are fab! If I EVER sound ungrateful - I'm NOT! Just Soooo tired! And husband does not do stress well!