Newly diagnosed -first curve-dosing help needed-AlphaTrak 93

Hello,
My cat Josie was diagnosed with diabetes last month and is on 4 units of lantus every 12 hours.
Today I am doing an at home curve test using an alpha trak.
My vet likes to keep me dependent on them for information. I have to go and bring the results in, and they charge me to analyze them and make any changes to her dose. I have no idea what the numbers mean.
Today, her first reading, before the shot, was 350. The second reading, 4 hours after the shot, was 153. That seems like such a huge drop. Is that normal?
I dont want to waste money I dont have bringing these results in if I am doing something wrong or it is a fluke. I will finish this curve today and then do another one in a few days and then wait and bring the results of both in together for the vet to look at.

 

Re: Newly diagnosed -first curve at home- help!

It is confusing at first to have the numbers without knowing what they mean. What you are looking for are patterns over time - what is the drop around the +6 point? How long is the insulin lasting? So one curve will give you info but not the whole picture. Getting pre shot numbers and nadir (lowest point in the cycle) will help you figure out what is happening over a week or so. Can you get a meter and start accumulating data at home?

Have you seen the Lantus forum? They have some stickies at the top of the page which really help explain how Lantus works in cats.viewforum.php?f=9

The good news is that your vet has you doing the curve at home so you get accurate numbers. Your dose is fairly high for a new diabetic. We usually recommend starting at one unit twice daily, then increasing based on the bg levels. Your drop is pretty dramatic. Be sure to get more numbers, particularly around that 6 hour mark.

 

Re: Newly diagnosed -first curve at home- help!

ok, something is wrong, it now says 93, at the 6 hours since injection site.
i did a test this morning with the calibrating soloution and it was normal.
What is going on!?

 

Re: Newly diagnosed -first curve at home- help!

The insulin is working, so this is good. Six hours is often the time when it's at it's strongest, it takes a few hours to get into his system.

But, please check him in one half hour and again one hour from now and make sure he's not still going down, Lantus is a long lasting insulin so let's be sure he's staying in good numbers.

Was 4 units your starting dose or did the vet raise it over time?

 

Re: Newly diagnosed -first curve at home- help!

Nothing is wrong. The insulin has really brought his numbers down. You want this this happen but you will want to watch for the next few hours to make sure he doesn't go too low. 90s are okay- under 50 is too low. If he goes that low, you might need to raise his numbers with some honey or higher carb food.


No need to panic. Just a heads up to be watchful to make sure his numbers start up, not go a whole lot further down.

 

Re: Newly diagnosed -first curve at home- help!

The vet started her at 3 units twice a day, and then after the in office curve, they switched her up to 4 units twice a day.

 

Re: Newly diagnosed -first curve at home- help!

The most likely reason the vet would have raised is because the numbers were probably higher during the in house visit. That's the primary benefit of testing at home - no vet stress. This is a terrific drop. Like others have said, just keep testing and posting your results.
When Jpsie was originally diagnosed, were there other complications besides "just" diabetes? Your starting dose does sound higher than normal, but is some cases there are circumstances that would lead to a dose bigger than 1unit, for instance. We are so used to "1u, BID" but not all kitties are able to start that low.

Welcome to the board!
Carl

 

Re: Newly diagnosed -first curve at home- help!

Her next reading will be in 20 minutes and I will post results then.

I took her to the vet after noticing that she suddenly was walking really weirdly, but couldnt see any injury to her back legs. They did bloodwork and urine tests and said she was diabetic, and the reason she walks like that now is neuropathy. i dont know how/why it came on so suddenly.

 

Re: Newly diagnosed -first curve at home- help!

oh, and she also had a UTI when they tested her urine, but they put her on pills and when retested later it was gone.
She is in normal health otherwise I think, she has FORLS occasionally and has had a few teeth removed, and she gets kitty acne sometimes on her chin. She was overweight, but has lost some, and the vet said it could be muscel wasting. But she was acting normal right up until her legs suddenly went.

 

Re: Newly diagnosed -first curve at home- help!

just stopping by to say Welcome!

you have found a great place for guidance...

and we LOVE your user name...

celi & binks

 

Re: Newly diagnosed -first curve at home- help!

Ok, now at 8 hours since injection, the reading is 113.

 

Re: Newly diagnosed -first curve at home- help!

That is a little increase but not much. Sometimes with Lantus, they "surf" for a few hours in the same number range. If I were you, I would post here and on the Lantus forum I gave you for advice on your evening dose.

The usual advice for new diabetics is not to shoot insulin if the cat is 200 or under, but to wait 20 minutes (without feeding) and retest to see that they are over 200 and rising in numbers. You got a nice drop but I am not sure how much insulin you should consider this evening. (I don't use your insulin).

 

Re: Newly diagnosed -first curve at home- help!

it says the insulin forums isnt for new users?

for the last reading in the currve, 12 hours after, do you do it before or after the second shot, and before or after feeding?

 

Re: Newly diagnosed -first curve at home- help!

my vet didnt even teach me when not to shoot. they just said to always give the 4, twice a day.

 

Re: Newly diagnosed -first curve at home- help!

No worries on the "new user" status...

I think that's kind of just a guideline so you can get good exposure,
and get familiar with how the board works.
The Lantus Forum tends to have a lot of traffic...so lots of folk get eyes on your post...
and lots of experience to help you out who are familiar with the insulin you are using.

celi

 

Re: Newly diagnosed -first curve at home- help!

The last reading in a curve is before feeding and before the evening shot....4units is a lot of insulin especially at those low numbers, what kind of diet is Josie on at the moment? There are some cats that do require that much but normally they have underlying health issues. Also the Alpha Trak tends to read higher than the human meters most of us use.

Mel, Maxwell, Musette & The Fur Gang

 

Re: Newly diagnosed -first curve at home- help!

You want to test at the 12 hour mark, before feeding. (food can artificially raise the bg levels so you want to get a true reading, without food.)

I asked someone from the forum to check in on you - I posted for you with a link to this post. It is true that we don't suggest you post there first, but when you need dose advice, you need to get it from the people who use your insulin, so it would be okay.

BTW, what food are you feeding? We suggest wet lo carb. See this vet site for more info: www.catinfo.org. BUT if you are currently feeding high carb dry, we wouldn't want you to suddenly change without being ready to test often and be ready to reduce the dose. (when we changed from dry to wet, Oliver went down 100 points overnight)

You are doing great. Often vets don't give as much info as we provide. Sometimes they seem worried about making their customers nervous (we are big on knowledge is power) and often, they are not very up on feline diabetes. They have to treat many species and many diseases and can't be experts on everything.

 

Re: Newly diagnosed -first curve at home- help!

Sue & oliver put a note up in the Lantus forum asking for folks to come and help out...
I'm a regular, but mainly just here for support
and not advice. you'll get some very experienced eyes here that can give you guidance.

Thank you, Sue...nice looking out, as always!

celi & binks

 

Re: Newly diagnosed -first curve at home- help!

sorry...just saw you're on alpha track meter

 

Re: Newly diagnosed -first curve at home- help!

She is on medi-cal diabetic prescription dry food that the vet put her on.

Money is a major issue for me as I am on disability, and I have gone into debt just to pay for her syringes and insulin and the seemingly constant vet bills. So finding a food that is affordable while still helping her is the goal. The vet didnt give me a choice. It also has to be safe for the other 2 cats in the home as I cant handle having them all on different foods.
I know everyone on here says wet food is the only way to go, but could only consider that as a very last resort. I live in a shared home, and while I can tolerate the disgusting smell of wet food, the roomers complain, and i have found that having wet food out attracks bugs more than dry food, which can be an issue in an older building like mine. And having three cats on it, that would be 6 little cans a day, that is not something i want to consider unless i have to.

She has one more reading due today, in 2 hours. I will post when i know.
I dont feel comfortable adjusting her dose, the vet didnt talk to me at all about that, but anytime I go to them they charge me, even to read the curve chart.

I read that people test their cats before giving the shot (and the food i assume) and if it is too low they dont give it. what if it is too high? josies number was so high this morning, and then dropped so drastically.

I dont know how I am supposed to do this regularily. I already had to turn my life upside down to accomodate her schedual. Picking times I could be home 12 hours apart was hard. It had to be late enough that I can get home after my evening committments, so it is 11 am and 11 pm. which means no morning plans, no morning work, no nothing. i had to cancel a trip, i havent been able to go to my aunts cottage at all this summer. i feel like i am giving up everything, going into debt, for nothing. she isnt even getting better, and the vet is a leech. I am trying so hard not to resent her.
Everyone told me to just put her down or give her up, but she is 11, and diabetic, so i am sure the shelter would just kill her, and i cant kill an innocent animal i love with a treatable disease even if it is making my life so miserable i cry most days and want to scream with stress and anger.

 

Re: Newly diagnosed -first curve at home- help!

Hang in there!
We know your cat's name...what can we call you?

Honestly...others will be here to advise you better...
but I'm thinking they may suggest you skip the next shot.

Believe me- many of us have been in the same place you are...and we can give you some links where
you may be able to get financial help...
and suggestions on where to buy your supplies at much better prices.
and you've found the spot for great experience and knowledge...and endless emotional support!

We understand...it is a scary learning curve at first, and can seem overwhelming... but is truly a very manageable disease.



celi

 

Re: Newly diagnosed -first curve at home- help!

is it possible to get another test on Josie now?

the more numbers you have, the better info for the advisors...

regarding the "what is too high" question...
does your cat have a history of ketones?

If not...while we don't like the high numbers, they are actually safer than the really low numbers...
a cat can go into a hypo if too low...and that can be extremely dangerous.

 

Re: Newly diagnosed -first curve at home- help!

We have all felt just the way you are feeling. Overwhelmed by their needs and the finances, and just overwhelmed by the disease. What really helped me was to learn about diabetes. The more information I got, the more in control I felt.

We have a very successful protocol with wet lo carb food, a good insulin (which you have) and testing at home. If you absolutely can't do the low carb wet, there is a low carb dry (Evo) which is better than the prescription foods - money and ingredient wise.

We have free newbie kits with meter and strips. All you pay for is postage. See this thread: viewtopic.php?f=28&t=19541

If it would help to meet with someone who has a diabetic cat, post your city and state. Maybe we have someone who lives near you who could help.

Someone very wise told me early on in my journey to breathe. It will get easier. And you can have a support group of on line friends who understand what you are going through.

 

Re: Newly diagnosed -first curve at home- help!

one more question from me...
(you'll get lots and we don't want to overwhelm you)

what time zone are you in?

 

Re: Newly diagnosed -first curve at home- help!

I have never heard of EVO- is that available at normal stores, or online only?

I live in Ottawa Canada- I think that is eastern time?


I was lucky enough to get a meter sent to me by the people at "diabetic cats in need" from facebook. It was so wonderful and generous of them. I just paid shipping and they sent the meter and it came with some strips and lancets. Best part is it is the same kind as my vet uses, so once I run out of strips I cna buy them there. ( I dont have credit cards, so i hate shopping online)

I buy the syringes at walmart, where they are 4$ or so for 10. You can buy a 100 pack for a bit cheaper per needle, but you need to have more money upfront, and i dont.

Same with the insulin. I borrowed money in order to be able to buy the 5 pack of pen cartridges instead of the bigger vial. It was more expenive upfront (120$ or so) but will last longer. Even with these samll things and my cat on a high dose, if i followed the instructions on the package and threw it out 28 days after opening it, i wouldnt even be half way through it!

I will go test her again now.

 

Re: Newly diagnosed -first curve at home- help!

excellent!

DCIN helped us as well...and combined with the wonderful guidance we got here...my cat who was horribly ill is now in really good health!

and we saved a lot of money getting there.

i can see that more experienced folks are looking in, so I'll stay with you, but i'll probably hold off on posting so i don't get in the way.

celi

 

Re: Newly diagnosed -first curve at home- help!

She is now at 150. it has been 10 hours since her injection.

 

Re: Newly diagnosed -first curve at home- help!

Oh, and i have no idea about the ketone thing. the vet never mentioned it and i dont know how to test for it.

And my name is Angela. lol.

I tried to post a photo of my furbabies as my icon but it was too big.

 

Re: Newly diagnosed -first curve at home- help!

Oh, I found a store in Ottawa that carries that EVO stuff. Is thier dry cat food better than the medical diabetic stuff? They have a fish kind and a turkey kind, any ideas which would be better? how woukd i switch? just slowly mix the two together?
There are no prices on the website but i am going to call tomorrow and see if it is reasonable.

 

Re: Newly diagnosed -first curve at home- help!

I can definitely understand your stress! You can definitely make this more manageable, both financially and emotionally.

First, while dry food is doable, it will make regulation and remission more difficult. If at all you can do wet food, it truly will make a huge difference. It doesn't have to be expensive food... I know many people here use the large cans of special kitty from Walmart (or similar generic from target or the grocery store). Those large cans are 14 oz and are $0.50 to $0.75 each. I know it isn't as cheap as dry food, but if you can do it, it is a worthwhile investment in terms of the effects the change will have on the health of all your cats. You'll find that most folks here feed only in the first 1/2 of the cycle as allowing food after the cat has hit the low point in the cycle will allow numbers to rise without having the full action of insulin to counterbalance it. I have to be out the door by +2.5 (2 1/2 hours after shot time) every day, so Willie gets food at pre-shot, +1 and +2, then I leave him a cube of frozen food that will melt that he generally eats by +6. Freezing the food (ice cube trays work great) would help cut down on the bug issues (if not the smell). I won't say that it isn't more inconvenient than dry food, but the truth is, it allows you to be much, much more successful in getting your cat regulated or even off the insulin (or OTJ, "off the juice" as we call it). You will need higher doses of insulin and you'll require more close management on dry food. If you make the decision to switch to wet food, you will want to reduce your lantus dose... the food alone can result in a triple digit swing downward in numbers.

Second, I'd strongly urge you to ditch the Alphatrak and go with a human meter. I let the vet convince me to buy one of those meters and the costs were simply too much. The cheapest I was ever able to get strips was $0.81/strip, which insane! There were days when Wilie needed close monitoring that I'd spend $10/day. I just couldn't do it. You'll find that only a handful of folks here use the alphatrak... most use a human meter. The Relion Confirm from Walmart is a great meter... the meter itself is $9 and the strips in-store are $0.40/strip, and you can get a generic version even cheaper online through American Diabetes Wholesale.

If you haven't done so already, I strongly encourage you to head over to our lantus forum and print out the stickies at the top of the page. They contain valuable information that will allow you to become the manager of your cat's diabetes. You'll find that very few of us here rely upon our vets for dosage decisions. We follow the dosing protocol outlined on the lantus page and tweak the dose based on the criteria listed there. Our vets aren't always the most supportive, but ultimately, it is our pets and our decisions, not theirs. Taking control of your cat's diabetes means no more costly trips to the vet for "analysis."

Once you're able to achieve a level of regulation, you'll find that the stress level reduces dramatically. It took awhile and it wasn't easy, but Willie, while still on insulin 9 months after diagnosis, is healthy, happy and generally well regulated on a very low dose of insulin that allows me a great deal more freedom.

Please continue to ask questions as you have them!

 

Re: Newly diagnosed -first curve at home- help!

Well, HELLO, Angela!

I saw some folks checking out your condo...and they may come in with more questions,
but i do know that they will ask you to test at her +12 (which is shot time...)
and then post the number before you shoot...
the main concern is that you don't shoot too low of a number and put Josie in danger.

It's a lot to take in, girl!
but you've already overcome one of the biggest hurdles...
hometesting your cat!

nice job...

celi

 

Re: Newly diagnosed -first curve at home- help!

The vet says they wont work with human meters that they are too unreliable, and that i had to either buy a pet one or rent one from them.

 

Re: Newly diagnosed -first curve at home- help!

Welcome, Angela!

First, Lantus, if kept refrigerated after you open it, will not go bad in 28 days. Many people on the Lantus forum use their pens for considerably longer. There is information on this in the sticky note on the Lantus board on caring for you insulin.

Canned food is far better for any cat's health -- not just a diabetic cat. If you purchase the 15oz cans, you will be spending a lot less than if you buy the 3 oz cans of food. Please see this website on feline nutrition if you have any questions about the issue of canned vs. dry food. Lisa Pierson, DVM will make you a believer! There are a number of commercial cat foods that are low in carbs and will cost far less than prescription foods from your vet. Janet & Binky's list is a resource and contains info on what's available in Canada.

You do not need your vet's permission to change your cat's insulin dose. Given your PM shot time, it is very unlikely that you will be able to contact your vet if you have a question about what to do with a dose if your cat has a number that's too low to shoot. That said, we do use a specific dosing protocol on the Lantus board. It is based on research published in a leading feline veterinary journal. (Also, note that in the dosing protocol, the numbers that are typically referred to are based on a human glucometer. When using an AlphaTrack, a dose reduction is earned when numbers drop below 80.)

You may want to consider getting a different meter. The strips for the AlphaTrack are prohibitively expensive and if you are running low, the only place to get them is at a vet's office or on-line. The majority of us use a human glucometer. The Relion meter and strips (at Walmart) are among the least expensive you can get and are widely available. Since cost is an issue, this may be something to consider.

As far as a human meter being unreliable, your vet is full of it! The published study I referred to has a table for human meters and one for an AlphaTrack and/or serum chemistry analyzer. As you pointed out, your vet wants to make $$$. If human meters are so unreliable, there would be a lot of humans who are being over or under dosed on their insulin. There's no logic to what your vet is saying. The tables that I'm referring to are linked in the Tight Regulation sticky or I'm happy to send you the journal article.

3.0u of insulin is a large starting dose. In addition, we typically change doses in increments of 0.25u, not in 1.0u amounts. (FYI - 4.0u is not a large dose of insulin compared to some cats. It just seems like it was a high dose to start with and was not raised in a systematic way.)

As for your cat's neuropathy, a form of B-vitamin, methyl B-12, is very effective in treating diabetic neuropathy in cats. Zobaline is a type of methyl B-12 that has been formulated for cats and is safe for a diabetic cat. I believe it's available via Amazon.

We do have some members who are in your area. You might want to ask if they like their vet and if so, who they use given the kind of approach to charging that your vet uses.

 

Re: Newly diagnosed -first curve at home- help!

Hi Fuzzy and Josie and welcome to Lantus Land,
Your situation sounds challenging, but I'm sure that you will be able to come to grips with it as soon as you know better what you are doing. Begin by doing some basic reading in the "Stickies" (informational posts) at the top of the Lantus Forum. Start with "New to the Group".
It does sound as if Josie was started on too high a dose. Most kitties starting Lantus begin with a dose of 1 unit every 12 hours and we adjust the dose gradually, according to the protocol in use here (described in the "Stickies"). Your vet does not sound very helpful and it sounds as if he/she is deliberately keeping you dependent on vet visits (charging for simply reading the curve; prescribing "special"--i.e., expensive--food; making you buy the Alpha Trak meter and strips, which are the most expensive on the market, etc.) Is it possible for you to switch to a different vet? Many people on this board visit their vets for other health issues while dealing with feline diabetes on their own--with the help of many experienced people on this board.

The dry food you are currently feeding might be a problem, since low-carbohydrate canned food is very important for a feline diabetic. Many people find that an automatic feeder can help solve the feeding problem in a multiple-cat household. Canned cat food doesn't all smell bad! There are many good choices of commercial canned food low in carbs listed in "Janet and Binky's List" (see the "New to the Group" Sticky). Many people here feed the "Classic" pate line of Fancy Feast. There are also many good "premium" foods on the market that are much lower in cost than vet prescription foods (Wellness; EVO; Merricks) and have much better ingredients.

The ReliOn glucose meter (sold at Walmart) is inexpensive ($9.00) and its strips are the most inexpensive on the market. Many, many people here use the ReliOn Micro or the ReliOn Confirm (both use the same strips). If you are on a budget, this is the meter to get.

I am not knowledgeable enough about dosing to be able to advise you, but I believe that someone who is will be along soon. In the meantime, it would be very helpful if you would set up a Google spreadsheet for Josie. There are instructions for doing this in the Tech Forum. Anyone helping you with dosing will be able to see Josie's patterns much better on a spreadsheet (every cat in the Lantus Forum has a spreadsheet).

Dealing with Feline Diabetes can be overwhelming at first. We have all been in your shoes. But you will find that it gets much easier. We are all here to help. Do join the Lantus Forum and post every day (we call our daily threads "condos"; see the Lantus Forum for samples of our subject lines).

Good luck, and welcome,

Ella & Rusty

p.s. I see that while I was writing this many others have already given you lots of excellent advice. I'll post this anyway! By the way, your vet is wrong about the Alpha Trak being the only meter that is accurate. Most meters are accurate enough for our purposes. In general, the Alpha Trak reads about 30 points higher than "human" meters. Most people here use human meters because they are much less expensive. All results are relative.

 

Re: Newly diagnosed -first curve at home- help!

I'm in Ottawa. Sending you a PM.

 

Re: Newly diagnosed -first curve at home- help!

Hey there- I just wanted to stop by and say that you're doing GREAT! Remember to breathe....

My cat Smokey was diagnosed only a month and a half ago and I went through the same thing you did. I cried pretty much all day for 3 days. I thought about putting him down (he's an ornery, three legged, 12yr old). Worried about the money, went to a vet who basically told me I was an animal killer for thinking about putting him down. I'm single and I work during the day- I can't be home to test all of the time... and I don't have someone to watch him while I'm out of town...

I will say that time has helped a great deal. I've worked out my schedule so that I can give the shots- though it is inconvenient at times. I (and I think many others) give the shots early in the morning (like 5-6am) then go back to sleep... that way I can test just before leaving for work to get an idea if this is going to be a "normal" cycle and feel comfortable being gone all day. Plus, then I can still do evening activities- I come home from work to test and give the shot and feed then go back out. It has been a scheduling adjustment for sure but Smokey is doing so much better so it is worth it for me.

It's great that you have a meter and are testing- you're already ahead of the curve!!! I (and many of us) us the ReliOn meters (either Confirm or Micro models). You can get them at Walmart for $7. The great thing about them is that the strips are MUCH cheaper than anything else I've found. You can get the strips in packs of 20 if money is tight (I think they are $8 for 20) at Walmart- it sounds like you go there anyway. You can also get the strips in packs of 50 but they are no cheaper per strip so the only benefit is not having to go to Walmart as often. I know you've already got an ATrak meter but you might want to really look at what the strips will cost when you have to buy them- it may end up being cheaper in the long run to get a new meter that has cheaper strips. Walmart also has cheap lancets (I think it's like $4 for 100 lancets- I use 26-28 gauge- not the 31 gauge).

As for food, if you have to feed dry, Evo is the way to go. You can't get it at Walmart or the big box pet store but I just looked it up and there are several places in Ottawa you can get it. Here is a link to locations that sell it in your area: http://wtb.evopet.com/?new=true Just type in Ottawa and there are about 6-8 places in the area. Evo is usually sold in more "boutique" pet stores- but it WILL be cheaper than the vet stuff. Be sure to call before you go though! It will be cheaper than the stuff you're getting from the vet and better quality, lower carb food. Also, if you do use Evo- you will feed a smaller volume- Evo is a very high calorie food so don't just feed the same amount as you are with the DM food- there is a chart on the bag to follow (by kitty weight).

As for using the insulin past 28 days, I think that the vast majority of people do use it past 28 days without a problem at all. They say to keep the cartridges at room temp once you open them but that is because the injection mechanism needs to be at room temp to be accurate (you aren't using that part- you are pulling with syringes). If you keep the Lantus in the fridge, and don't inject anything into it that would contaminate it and don't shake it, it should be good for a lot longer. Plus, you are testing the blood sugar levels at home, so you'll know when it stops working.

I will leave dosing advice to more experienced eyes. There are several of them and they are GREAT. They have really helped me get Smokey regulated. I have followed their advice and skipped my horrible vet. He didn't know the latest info on Feline Diabetes and was not interested in learning. I'm in the process of finding a new vet but I can't afford another $200 vet visit to someone new when I know what is going on. I use the advice I get here and how I see Smokey is doing- No curves at the vet, no paying them for advice... That is horrible that they are charging you for looking at some numbers and recommending a dose. It sounds like they are in it for the money- not the kitties.

I know this is a lot of information but you can refer back to it. These are just all things the helped me over the past month or so.
Hang in there- you're doing great and people are around to help with dosing.

Angela, welcome to the Lantus family!

 

Re: Newly diagnosed -first curve at home- help!

Trying to make a SS for on here- what do the amps and U colums mean?

 

Re: Newly diagnosed -first curve at home- help!

There you go, girl!
the wise ones have got your back...

how are you feeling?

stress can wear you out!

 

Re: Newly diagnosed -first curve at home- help!

Hi,

Welcome to FDMB. This site is absolutely amazing. I couldn't imagine dealing with Maverick's diabetes without them. They help thousands of cats a year and know so much more than any vet could - who sees a handful of diabetic cats a year. They are quite clueless.

Send me a PM with the name of the vet and office that you go to. I went through four vets trying to find an open minded vet. Vets in Ottawa are rip offs money wise and have huge ego's.

I did every single curve of Mavericks on my own and saved a fortune. But I wanted a vet I could be open and honest with about every aspect of his treatment. The vets I tried were "its my way or the highway" type vets and I felt I couldn't be open and honest with them. I had made up my mind that I was following the protocol on this forum and the advice given here. Maverick was down to a single drop of insulin 0.10 unit. I finally found an awesome vet and was excited about working with them on his other issues (arthritis, asthma), but I lost him suddenly shortly after finding her. Its a long story - but his breed is prone to heart disease and it was probably undiagnosed and he threw a clot. I'd be happy to share his vet's contact information with you. She is expensive but read up on the tight regulation protocol and agreed to let me continue to manage Maverick with this protocol. Because I saved so much money doing my own curves etc, I wouldn't need to see her to manage his diabetes and could afford having her treat him for everything.

Trust this site. I adopted a diabetic cat from an animal shelter after losing Maverick. I knew with their help I could manage the new cat's diabetes. If I only had my experience with the previous vets to draw on, I definitely wouldn't have been up to adopting a diabetic cat. Turns out because I knew to home test - he tested at 2.8. He hasn't had a drop of insulin since the day I brought him home. They were shooting him blind and he didn't need insulin.

If you have to chose who to listen to ... your vet or this site.... this site hands down.

I'm drained today - but I'm sending you a PM with my number.

Karrie

 

Re: Newly diagnosed -first curve at home- help!

AMPS stands for AM (as in morning) PreShot- this is the blood glucose number from the reading you take just before you give a shot (same for PM (evening) PS)

U stands for the units of Lantus that you inject at that time.

 

Re: Newly diagnosed -first curve at home- help!

AMPS = am pre-shot number
U = units given
PMPS = pm pre-shot number

Hello....and welcome!

 

Re: Newly diagnosed -first curve at home- help!

Where do you buy the methyl b12? do you only use the special cat kind? if so, do you have to get it online or from a vet? Amazon.ca doesnt carry it and .com wont ship it to me.

I will keep my eyes open for members in my area and ask what vet they use. There are dozens of vets in this city to choose from, but I need one nearby, as I dont drive and the cab to and from the vet with the kitty can be as much as the visit. We cant take pets on the bus.

I am definitly going to look into the EVO stuff and see about slowly swithcing over to it instead.

And I just wanted to thank everyone very much for thier help.
Only one more reading today, in an hour, and then I am supposed to feed her and give her another 4 units. I will post on here with the reading.

I am rather overwhelmed. I dont feel like I know enough to make these decisions of how much to give and when or not to give, and I am afraid I will do the wrong thing and hurt her or kill her or something.

 

Re: Newly diagnosed -first curve at home- help!

Maverick ate the special kitty walmart wet food. He loved Turkey and Giblets. But the chicken, the beef and some of the other flavours are low carb. They are only 50 cents a can. We had to convert him to wet food which was a long process for him.

You can buy evo from Global Ryan's. If you buy the small bag, and he won't eat it you can return it for a refund. They may have trial packages also.

 

Re: Newly diagnosed -first curve at home- help!

You've got your sheet up!!! That's great- small steps! I know you're tired and overwhelmed but you'll get there- Promise! I was afraid that everything I did was going to kill Smokey too- It didn't- and you won't either. It is worse for the blood glucose to go too low than to go high.

 

Re: Newly diagnosed -first curve at home- help!

we're blessed in the fact that our vet is very open-minded...
she often comes to FDMB as a learning exercise...
and we're truly grateful for that.

I'm like many others...i quickly figured out that the wise folks here who gave us guidance really knew what they were
talking about...and it has been wonderful for us.

we don't, however...want to put you in the terrible position of "who to choose...the vet or the forum"
but as others have said....some vets are better at this than others.

I can tell you this without hesitation though...
the MAIN CONCERN of folks here is the safety and health of your kitty

 

Re: Newly diagnosed -first curve at home- help!

For now...just remember that TOO MUCH insulin can be dangerous...NOT ENOUGH is generally not.

it'll get easier, Angela...I promise!

EDITED TO ADD: i went through some crazy numbers with binks, and there was NEVER a time when there wasn't someone here to help me through it.

celi

 

Re: Newly diagnosed -first curve at home- help!

Welcome Josie and Josie's human (a name would fit nice here ),

First off take a deep breathe, if you have already found DCIN and they are involved with you, and now you have found us, you and Josie have landed in the absoluted the best place in the world to get all the help you and Josie could possibly need.

I have two diabetic cats that I have adopted from this very board and DCIN as diabetics. I also have 11 non-diabetics, everyone here eats exactly what my two diabetics eat, Just plain old Friskies Pate Style canned food, Wal-mart has the big 13.5oz cans. But I also understand the problem though with roommate having a problem with the smell. But I do know with the change in diet alone to low carb/high protein wet food, and a short course of insulin my first diabetic Maxwell will celebrate his 1 year anniversary on this coming Nov. 1st. And he has been to the vet exactly once in that year, and even then he wasn't a patient he was helping me give them a demo on how I test him at home! And my newest diabetic Musette has yet to see my vet and while she is still a work in progress, I have been adjusting her dose of Lantus now sololy based on the numbers and the help and advice from the folks on this board.

One of the other and perhaps the best things that I learned when I first got here, besides how to test and dose my cat correctly, was that the vet works for me. That this was my cat, and I was the one that knew her best, because I live with her day in and day out. The vet sees her for a few minutes to a couple hours every now and then. I got lucky, I have a great vet that was willing to work with me as a partner in my animals' health and well-being, but I had to shop around for one that would. And I was also lucky with this vet that he readily admits when he does know something and is willing to learn new things from me.

This is such a very managable disease, but it is best managed at home just like a human diabetic, and we are more than willing to hold your hand/paw through it all, and unlike your vet, we never close, we never go on vacation and we have no office hours, since we literally have members all over the world. Someone is always around to be an ear to listen, a shoulder to lean on and to offer advice. From your very first post you become family and we will worry about you and Josie like family.
I know it is hard to go against your vet, and take a bunch of advice from strangers on the web, but everyone of us that will post to you either have or have had a diabetic cat that not only are they treating successfully on a daily basis, those cats are their babies. And everyone of got here just like you feel today, stressed out, over-whelmed, and scared to death because our baby was sick.

Mel, Maxwell, Musette & The Fur Gang

 

Re: Newly diagnosed -first curve at home- help!

What is too low?
Today Josie went from 350 to 93 in 6 hours. That seems drastic to me, but I have no idea what is normal.

How often should I do curves? I cant be at home with her for 12 hours in a row all the time, but I want to get accurate information.

 

Re: Newly diagnosed -first curve at home- help!

I thought I posted this, but it dissapeared-

Do you test everyday before each injection/feeding?

 

Re: Newly diagnosed -first curve at home- help!

I believe that normal on an Alpha Trak is between 70 and 150 so 63 at +6 (6 hours after injection) is a nice safe number. Too low would be around 50 and still dropping.

With Lantus the lowest point when it is most effective is right around +6 to +7, she should start rising again after that. You're doing great!
Musette is on Lantus I test her before every shot to make sure she is high enough to safely give insulin too, and then get spot checks through out the day and a few every now and then in the evenings. I usually try for at least the preshot tests and because I am home all day at least her +3 which is about where her onset is, and then again at about her nadir (lowest point), but again its because I'm home with her.

Mel, Maxwell, Musette & The Fur Gang

 

Re: Newly diagnosed -first curve at home- help!

The occasional weekend day I can be home for hours at a time with her, but not ussually. This would certaintly be easier for families with multiple caregivers!

 

Re: Newly diagnosed -first curve at home- help!

Then just do it on the weekends. The really important ones are the ones right before the shots, and when you can get it the nadir. Then just catch the others when you can. Then every couple of weeks run a curve. I use to do like a +2 one day, maybe the next I would get a +9 then the following day grab a +5, so I have a rough idea of what she was doing at different times throughout the day.

Oh and the nadir does matter if it's between the day to evening shot, or the evening to morning shot, you could even set your alarm, get up test and go right back to bed, done that a couple of times myself.

Mel, Maxwell, Musette & The Fur Gang

 

Re: Newly diagnosed -first curve at home- help!

Her latest number is 162. I am supposed to feed her and give her another 4 units now.


Is the nadir a time or a number?

 

Re: Newly diagnosed -first curve at home- help!

Angela, I do test before every shot. That way I know that Smokey's sugar is high enough for me to give insulin. I also try to test before I leave for work (ends up being about +1.5) and that way I know that there isn't something weird going on (dropping too fast) while I'm at work. I try to test around +5 to +7 over the weekends, that way I'm getting a test closer to the Nadir fairly often. I also try to test before I go to bed at night (usually ends up being +3 to +5) and if I think that the number is too low I'll set an alarm to test at +6 to make sure he doesn't go too low. It's a lot but it has gotten easier and I've adjusted to it for sure. Plus, Smokey likes it- he gets a freeze dried shrimp treat (be sure that your treats aren't high carb- most are (like temptations, greenies...)- Purebites, sold at big box pet stores, are just freeze dried protein- no carb) so he loves it...

 

Re: Newly diagnosed -first curve at home- help!

Nadir is the time point when the insulin is "most active" and the blood glucose is lowest during a cycle. It varies for every cat and every type of insulin. For most cats on Lantus, nadir is around +6 hours. But every cat is different (ECID). As you start to test regularly, you'll figure out when Josie's nadir is.

 

Re: Newly diagnosed -first curve at home- help!

Hi again, Angela,
You don't have to do a bg test every hour. A mini curve is: AMPS, +3, +6, +9, PMPS (in other words, every three hours). A more extensive curve is every 2 hours: AMPS, +2, +4, +6, +8, +10, PMPS. Most people do a curve about once a week. But any readings you can get are helpful. It is most important to get AMPS, PMPS and something in mid-cycle (+5 or +6; the lowest bg number usually comes close to mid cycle--this is the nadir. Lantus dosing is based on the nadir, not on the pre-shot numbers; the reason we always get the pre-shot numbers is to determine if it is safe to give a shot). The other important test is a bedtime test, so that you can see where Josie might be heading in the evening cycle. Whenever you can do tests of other hours, put them into your spreadsheet. You don't have to get all of the numbers for every cycle. Fill them in when you can. Patterns will begin to emerge as you get more data.

Since the Alpha Trak generally reads 30 points higher than a human meter, 93 on the Alpha Trak would correspond to about 63 on a human meter. This nadir is considered safe, but it is a pretty low "safe" number, especially in a newly diagnosed cat experiencing large swings in blood glucose. I hope that one of our experienced dosing people will be along to help you decide what dose to give the next time you shoot. Please post this number (Alpha Trak 93) in your next subject heading (go back to your first post of today and edit the subject line there, so that people will see your question).

You are doing well and you are asking important questions.

Ella & Rusty

 

Re: Newly diagnosed -first curve at home- help!

BUMP (bumping your post up).

You should edit your first post and change the subject - to newly diagnosed, dosing help needed. If you edit your first post it changes the subject line so people can see you need help.

 

Re: Newly diagnosed -first curve at home- help! AlphaTrak 93

Posted on the Lantus forum that you need dosing advice- eyes are coming...

 

Re: Newly diagnosed -first curve at home- help! AlphaTrak 93

Angela:

Just saw this and am jumping in. Is the 162 her PMPS (PM preshot)? If so, that is a 132 (approximately) on a human meter. Let me look at your SS and your day and I'll brb. It's ok to stall a few minutes on the shot. DO NOT FEED

 

Re: Newly diagnosed -first curve-dosing help needed-AlphaTra

yeah, the 162 is her pmps. it has been almost 12 hours since her morning shot, and she hasnt had her evening one yet.

 

Re: Newly diagnosed -first curve-dosing help needed-AlphaTra

Ok....you don't have the data to shoot this number. You have a few options:

1. Skip the shot.

2. Stall and test every 20 mins or so (do not feed) until you get a pretty good rise and then shoot. In order to do this, you'll have to be able to delay your shot tomorrow morning as you will shoot 12 hours from when you shoot tonight and then slowly work your way back to your regular time....which we can deal with in a bit. Stalling acts like a reduced dose.

3. Shoot a reduced dose on time.

Personally, for it being your first day, I'd probably go with door number 1 or door number 2.

If you stall and shoot after she comes up, you still need to be prepared by having HC food, karo, plenty of test strips, etc. Do you?

eta: I really am leaning towards door number 1. What do you think?

 

Re: Newly diagnosed -first curve-dosing help needed-AlphaTra

Here is the info on shooting low from our Stickys in the Lantus ISG:

 

Re: Newly diagnosed -first curve-dosing help needed-AlphaTra

I cant change her shooting schedual, I have already messed my schedual up to accomodate hers, and I cant just cancel my plans to stay home with her again tomorrow.


I dont know what Karo means.

 

Re: Newly diagnosed -first curve-dosing help needed-AlphaTra

Karo is light corn syrup. You can use any kind of syrup or honey to bring a cat up when their numbers are low. She is coming up from her 93 which is good.

You can't stall at all....if you can stall even 30 minutes, you could easily make it up tomorrow. If not, then I would consider just skipping and getting back on track at your normal time tomorrow.

You can also just shoot 1 or 2 units but you will need to monitor her very closely for the next several hours and make sure she continues to rise.

eta: my other concern with you shooting much of a dose is that if she does drop, all you have on hand is dry food...correct? Dry food takes a while to kick in and bring the numbers up and then it tends to linger. Karo or other honey or syrup will wear off quickly and the kitty's numbers could turn around and come back down.

There is a link to "Handling Low Preshots" in my signature block that gives additional info.

 

Re: Newly diagnosed -first curve-dosing help needed-AlphaTra

FWIW, I don't think you have the data to shoot this low of a number. I have no doubt that Josie's numbers will be high in the AM but in this situation, that's OK.

What this is telling us is that you may need to reduce Josie's dose. The goal is for you to be able to safely give 2 insulin shots every day. From what you've seen today with Josie's numbers, my guess is that she has been dropping into lower ranges and then bouncing back up. That's not abnormal but now that you're home testing you are able to see the pattern.

Also, the "normal" range on an AlphaTrack if 80 - 150. Below 80 earns a dose reduction (an 80 is equivalent to a 50 on a human glucometer).

 

Re: Newly diagnosed -first curve-dosing help needed-AlphaTra

Angela, Don't forget that your Alpha Trak reads about 30 points higher than a human meter. The guidelines Marjorie cited are based on the human meter. So your reading of Alpha Trak 162 corresponds to 132 on a human meter. She is correct that you don't have the data to shoot this low of a number (especially since you are giving a rather large dose).

Ella

p.s. I see that Sienne is here. Follow her advice. She is very knowledgeable.

 

Re: Newly diagnosed -first curve-dosing help needed-AlphaTra

So what do I do now? Feed her her dry food, or feed her corn syrup? It is 11:30 at night I cant stay up much later to test her, I am exchausted and have to get up in the morning.

 

Re: Newly diagnosed -first curve-dosing help needed-AlphaTra

I'm sorry I confused you. Feed her as you regularly would at this point. Since you aren't giving insulin tonight, just give her shot to her tomorrow morning at the regular time. Please read through Sienne's post regarding dose and what to shoot tomorrow morning after you test her.

The corn syrup is only if their numbers are really low (below 80 on your meter; below 50 on a human meter). We just like to know a caregiver is prepared if the kitty goes below those numbers.

eta: she may be high in the morning from skipping a shot but that's ok.

 

Re: Newly diagnosed -first curve-dosing help needed-AlphaTra

In all honesty, I think you should skip the shot. She's not sufficiently low that you need to intervene with corn syrup. You just feed Josie they way you usually do.

I would suggest lowering her dose in the morning. I do think 4.0u is too much insulin based on what you've seen today. Would you be comfortable with reducing the dose back to 3.0u?

 

Re: Newly diagnosed -first curve-dosing help needed-AlphaTra

ok, no dose at all tonight, then in 11 hours, test her again, and then depending on the number, shoot either 4 or 3?

 

Re: Newly diagnosed -first curve-dosing help needed-AlphaTra

Sienne is suggesting you might want to shoot 3 units at your regular time tomorrow. We don't raise the dose by 1u as your vet did (from 3 to 4). You can miss the correct dose that way and end up like you have today. It's possible she has already been in low numbers and the high numbers are from her bouncing up.

 

Re: Newly diagnosed -first curve-dosing help needed-AlphaTra

Hooray!! you'll be able to sleep tonight!

I'm another one who follows Sienne's advice like she were a messiah :lol:

(sorry, Sienne)

sounds to me like she feels 3u would be safer tomorrow...

rest well, angela...you deserve it!

and good job, girl!

celi

 

Re: Newly diagnosed -first curve-dosing help needed-AlphaTra

ok, i fed her 30 minutes ago, then did one last check just now and she is 198. Still too low to shoot?

 

Re: Newly diagnosed -first curve-dosing help needed-AlphaTra

Angela:

The issue is, once you feed her, then you would be shooting a food-induced number. That means the 198 might not be a "true" number but just a food spike. Shooting a food spike can be risky.

Having said that, it is not possible to know with the dry food if this is actually a food spike this soon or it's just her normally coming up. IMHO, I'd skip as has been suggested.

 

Re: Newly diagnosed -first curve-dosing help needed-AlphaTra

Ok, well I guess I am going to bed then.
Missing a dose worries me, dont know what it will do to her, but sounds like it is better to have too little than too much.

 

Re: Newly diagnosed -first curve-dosing help needed-AlphaTra

It's ok. It would be the same if you gave her a fur shot....which happens, too. Yes, she will probably be high in the morning. But everyone either has to skip a shot or accidentally gives a fur shot. The kitty always gets back on track.
It's better to spend a day at high numbers than an hour at really low ones.

It's most important now to find the correct dose for her. You are welcome and encouraged to join us in the Lantus ISG. There are alot of eyes on each kitty each day and we can help you with dosing, low numbers, low preshots, etc.

Hope you get some rest.

 

Re: Newly diagnosed -first curve at home- help!

I have seen EVO products at regular pet food stores in Canada. You can use the following link to locate stores carrying EVO products.
http://wtb.evopet.com/?new=true

 

Re: Newly diagnosed -first curve-dosing help needed-AlphaTra

Josies number this morning (2 hours before she would normally get her morning shot) was 414.
I started a thread on the lantus board as suggested. link below.


http://www.felinediabetes.com/FDMB/view ... =9&t=52461

 

Re: Newly diagnosed -first curve-dosing help needed-AlphaTra

Her reading this afternoon is much higher than yesterdays midday reading, but last night I didnt inject at all, and this morning gave only 3 units instead of 4 so I assume that is why.


Also, I went and bought some EVO food. It is only a little cheaper than the vet stuff (32 instead of 38 for a 3kg bag) but it has less carbs and more protein. I am going to start mixing the two together to switch them over. Will this effect her numbers or dosage?


(xposted to the other thread, hope thats okay, wanted to make sure the people who mentioned the EVO to me saw this)

 

Re: Newly diagnosed -first curve-dosing help needed-AlphaTra

Yes, you can expect the bg to be higher when you have skipped. Hopefully a consistent dose and your testing to see how it is working will help make this dance easier.

Unless you want to, you probably don't need to mix the two. Usually tummy upsets are only with the switch from dry to wet. I don't know if you will see a change in numbers. There is a definite correlation with most cats when they are switched to wet lo carb but you may not see a huge difference with the EVO. Every cat is different.....

 

Re: Newly diagnosed -first curve-dosing help needed-AlphaTra

Hello! Welcome!

I second the opinion to ditch the alphatrak and get a cheaper, human meter. You need something affordable that allows you to test multiple times a day. I don't know if you can get the Relion meter at Walmarts in canada, but if not the Aviva Accuchek is a very good meter, and while the strips are expensive in the store you can get them on ebay and amazon for about half the price.

I also adding my voice to switching to canned food. If your cats eat their meal all in one sitting like most cats do, then you won't have to worry about bugs. The smell doesn't bother me but it did my boyfriend at first, but he got used to it. It's only at meal times anyway. Also, because he complained about the smell for a while I refrigerated the food before I opened it--it doesn't smell at all when it's cold. You can get big cans (13oz) of inexpensive food like friskies or Special Kitty to feed all of your cats, and keep it in the fridge. It will still work out to be cheaper than the more expensive dry food.

You do need to do things at your own pace though, but this is just something to think about for the future! The EVO dry is way better than the prescription stuff so that's a good first step.

 

Re: Newly diagnosed -first curve-dosing help needed-AlphaTra

To those who mentioned the relion metre- are you all american? they didnt have them at any of the places i have checked here in ottawa canada.

 

Re: Newly diagnosed -first curve-dosing help needed-AlphaTra

Relion is sold exclusively at Walmart.

hope you're doing well...

celi & binks

 

Re: Newly diagnosed -first curve-dosing help needed-AlphaTra

in canada too?
i went to walmart today and there were none on the shelves, and so asked at the pharmacy if they have any others, and specifically mentioned relion and they didnt know what i was talking about. said any metres they had were on the shelves.
maybe it is just an american thing. or maybe my store just doesnt carry it.
they only had the big name ones.

 

Re: Newly diagnosed -first curve-dosing help needed-AlphaTra

Yes - you are correct. Walmart in Canada does not carry the Relion metre. I use the OneTouch Ultra and have found the least expensive strips at Costco $74 for 100. And you do not need to be a member to buy at the pharmacy. I also buy my insulin there - again least expensive. The other thing some members do is shop at Shoppers Drug Mart and collect points with the Optimum card (their loyalty card). Every few visits there are enough points to get strips or insulin free.

 

Re: Newly diagnosed -first curve-dosing help needed-AlphaTra

Just thought to add that the metre is free if you buy a box of strips - just don't say its for a cat. This is at any pharmacy and most if not all metres.

 

Re: Newly diagnosed -first curve-dosing help needed-AlphaTra

Have you looked into buying online? 74 cents a strips is still almost twice the price others have quoted finding online. But all I can find is american sources that charge too much to ship.

 

Re: Newly diagnosed -first curve-dosing help needed-AlphaTra

Can you use ebay? I had a brand name meter and always bought my strips on ebay for less than half the price of stores. Just be sure to check the seller's rep and the expiration dates. (The sellers seem to be retired people who are selling off their excess Medicare supplies....)

 

Re: Newly diagnosed -first curve-dosing help needed-AlphaTra

i have never used ebay before, as i dont have a credit card. can you use the prepaid ones on there? do you have to bid?
i will have to check to see if .com ships here and if so if it is expensive, because .ca never has as many things.

 

Re: Newly diagnosed -first curve-dosing help needed-AlphaTra

Yes you can use the prepaid ones. Payout for ebay is thru Paypal.com. Paypal will also allow you to set up an automatic payment from your checking account too. It takes 4 days for a check to 'clear'...most sellers ship as soon as the 'clear' notice is received.