Newly diagnosed

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Zoey831, Jul 25, 2013.

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  1. Zoey831

    Zoey831 Member

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    Jul 25, 2013
    Hi my cat who will be 11 soon has now been diagnosed with diabetes. The vet said to give her two cc twice a day of insulin. And to come back in 10 days for a blood curve test day. The vet did kot recommend to buy a blood tester for home , they said just to watch that she doesnt get drink or unbalanced. If she does to give her sugar and call them right away Does this sound normal ? Thank you in advance for your help
     
  2. Amy & Papaya (GA)

    Amy & Papaya (GA) Well-Known Member

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    Oct 20, 2012
    Welcome! It's great you found this board! Your cat is about the same age as my Papaya.

    Most vets don't suggest home testing right off the bat, either because they don't realize how important it is or because they think it will scare the pet owner away from treating diabetes. It's a lot cheaper and more informative to do testing at home than a curve at the vet's office, and as you can see from all the people on here who test at home, it's very do-able!

    We strongly recommend home testing because it keeps your cat safe and gives you the information you need to make important dosing decisions. There's lots of help with learning to test available here, too, so don't be afraid to ask anything you need to know.

    Can you let us know more details? What insulin did your vet prescribe? The favorite around here is Lantus. What is your cat eating? Oh, and what's your name (not sure if Zoey is you or your kitty!) And where do you live - there might be members right in your area who can help if you need some hands-on teaching.
     
  3. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    I hope you meant 2 units, not cc (cubic centimeters). Insulin is measured in units per milliliter (units per cc).
    A U-100 insulin has 100 units in 1 cc.
    A U-40 insulin has 40 units in 1 cc.

    Home testing will keep your cat safe - both too much and too little glucose can hurt your cat.
    If you test, you will know when it is safe to give insulin and when it is not. You also will be able to see how well the insulin is working.

    A human glucometer is fine. Many folks here use a WalMart ReliOn Confirm or ReliOn Prime, as both the meters and the strips are inexpensive.
     
  4. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Hello and welcome to the board.

    Yes what your vet is suggesting is pretty much normal from what many vets advise.. but is it ideal for you and your cat? Probably not.

    We recommend three things

    1. Home testing - with a human meter like the Walmart Relion. Vet curves are expensive and inaccurate due to the cat being stressed! Home testing gives you better data and keeps the cat safe from possible hypos. Waiting till she doesnt drink or gets unbalanced may be too late - and what if she does it at night when you are sleeping? I would buy a kit right now and start testing. We can advise. Then you wont need to go back for the curve!

    2. A low carb canned food diet - after you start home testing we advise changing to a low carb canned like Fancy feast classic pates or Friskies pates. What are you feeding now?

    3. A good insulin like Lantus, Levemir or prozinc. What insulin did your vet give you?

    Wendy
     
  5. Zoey831

    Zoey831 Member

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    Jul 25, 2013
    Wow I can't thank you all enough for getting back to me so quickly
    Yes zoey is my cats name :) they put her on Lantus , 2 units two times a day. She weights 8.5lbs.
    I currently have her on fancy feat wet and dry food but they just have me w/d science diet dry
    And said to keep her on the wet. I think I'm going to take the advice and go out and get the Walmart tester and strips
    Her level at the vet today was 537 , i got the insulin at Walmart pharmacy today and it costed me 160.00 plus 20.00 for the needles
    I am in bethlehem pa and my name is jackie any more info would be greatly appreciated. I love my cat and only want her to be comfortable and live a Long life.
     
  6. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    We generally suggest you ditch the dry. Read Cat Info for more information on feline nutrition, written by veterinarian Dr Lisa Pierson. There's a terrific food chart there that you can print out which has the percent of calories from carbohydrates for the listed foods. You want the percent calories from carbohydrates to be < 10%. The W/D is too high in carbs.

    If you decide you want to ditch the dry, drop the insulin dose down to 0.75 to 1.0 units, as that is an estimated dose for her weight.
     
  7. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
    Sounds like a good plan. Heres a shopping list!

    1. Meter ie Walmart Relion Confirm or Micro.
    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 with pain relief 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 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

    And once you start testing you would be best to stop the dry and make sure the fancy feast is the classic pates only ( or other low carb flavours) . that will help bring her blood glucose down and help her towards regulation or remission.

    Lantus is a great insulin for cats - plus it lasts up to six months if you keep it in the fridge ( not the door - and dont shake or roll it either), so it will last you quite a while!

    Let me know when you get the meter and we can give tips on how to test.

    Wendy
     
  8. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Hi Jackie and Zoey from Bethlehem PA and welcome to the FDMB. You've already received some great advice from folks here.

    That starting dose of Lantus is pretty high. Most cats don't need a higher dose to start than 1 unit unless there are extenuating circumstances such as ketones or DKA (diabetic ketoacidosis).

    For an 8.5 lb/ 2.2 kilos per pound = 3.86 kilos. (These calculations are based on the lower of ideal weight or current weight if underweight).
    0.25U per kilo = 0.965U of Lantus insulin, rounded down to the nearest quarter unit for safety. That gives us a maximum of 0.75U to start.

    So your vet started your cat on more than twice as much insulin as the protocol we use. We like to start low, and go slow, gradually increasing the dose in 0.25U increments. It's safer for your cat and avoids bypassing the appropriate dose for you cat, Zoey.

    Lantus is cumulative. It has a depot so the shot you gave today, only part of it went to work and the rest into storage in the body for slow, gradual release over time. If this were my cat, I would drop the dose to 0.75U and let the depot fill up over the next 5-7 days and reevaluate.

    I would highly recommend getting that meter and the other items from Wendy's shopping list quickly and learn to home test now. We don't want to see your cat hypo on such a high starting dose.

    I would not use the Hill's W/d dry or wet. It's what kept Wink in high numbers for months and once I stopped using it, he went into remission. He eats Fancy Feast classic pates and Friskies pate style canned food only and does not get his frequent UTI's anymore either. He has been in OTJ (off-the-juice, insulin being the juice) for four months now and no more UTI's.
     
  9. Zoey831

    Zoey831 Member

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    Jul 25, 2013
    Ok I ordered the alpha trak2 should have it tomorrow and I only gave her 1 unit this morning after she ate. I'm afraid she willgontoo low and I will not know bc I don't have the tester. I originally thought two units was too high for her also but I did as te vet told me to. Thanks again for all the help. Turns out that we do feed her the fancy feast classics only and they look like patte but don't say it. Chopped grill feast classic, and tender beef feast classic. Are these good for her ?
     
  10. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
    Sounds like a good plan but the AT meter strips are expensive and not much more accurate than human meters I mentioned above.. but if you can afford it then go for it! Otherwise I would pick up the Walmart brands

    All Fancy feast classic pates are great - you want any low carb canned under 10% calories from carbs - see column C in here: http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf

    Did you stop feeding the dry?

    Wendy
     
  11. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    The Fancy Feast classics are the pates we mentioned. Just wanted to clarify that.

    Wink loves those! His absolute favorite flavor was the Fancy Feast Turkey & Giblet classic. It's the flavor I used to get him off the dry food. He'll also eat the Chicken Feast, LIver & Chicken and the Chopped Grill. He hates fishy flavors, which is fine since you don't want to feed those too many times in a week because of the mercury and other contamination.
     
  12. Zoey831

    Zoey831 Member

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    Jul 25, 2013
    yes i took her off of all dry food. The vet called and all her labs came back good. Im happy there was no damage from the diabetes. Still waiting for the tester.
     
  13. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Most of us are on a budget and find the cost of the AlphaTrak test strips prohibitive. The Arkray Glucocard 01 (from ADW) which is the unbranded version of the WalMart ReliOn Confirm has worked well for a lot of us and the test strips are relatively inexpensive.

    When in doubt, conservative choices are safer.

    The word Classic should be along the lower edge of the label.
     
  14. Zoey831

    Zoey831 Member

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    Jul 25, 2013
    Ok this might sound like a silly question but since i took her off of the dry food, which is use to have access to all day long, should i feed her 3 cans a day? I use to give her one can a day, but since the dx i started giving her two times, one each right before her shots, I feel like she needs more so yesterday I gave her and extra can right before bed. Will this be bad for her diabetes? Also what treats are safe for her? I havent given her the pounce treats since her dx also thanks in advance
     
  15. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    What sized cans?
    If the 3 oz size cans, yes, I'd probably feed 3 per day for an average sized cat.

    How much does she weigh?
    Is she underweight or overweight? (Ie need to gain or lose)

    I free feed the 14 civvies and put the food twice a day. They nibble all day and everyone is fine.
     
  16. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
    We have a formula to tell you how much to feed but it depends on how well her diabetes is regulated so I would recommned using this as a guideline and weigh her every couple of weeks and adjust food accordingly:

    Required calories per day = [13.6 X ideal weight in lbs] + 70

    FF pates are about 85 calories a can: http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf

    Also many of us here feed freeze dried chicken or liver as treats as they are low carb and our cats love them but here is a list of ideas: http://www.felinediabetes.com/FDMB/viewtopic.php?f=14&t=9172

    Wendy
     
  17. Zoey831

    Zoey831 Member

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    Jul 25, 2013
    she lost weight and is down to 8.5lbs, and yes its the 3oz cans. the thing is she is always hungry and would prob eat 5 cans if i gave them to her, so thats why i ask.
    again i cant thank you guys enough so glad I found this site and didnt hesitate to register. thanks for the chart too.
     
  18. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    At her current weight, it looks like at least 2.5 cans could be fed. If she needs to gain, rounding p to 3 cans makes sense.

    Also, until regulated, she'll be hungry because she can't use everything she eats.
     
  19. Zoey831

    Zoey831 Member

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    Jul 25, 2013
    I fed her at 10am and gave her 1 unit of insulin after. Then fed her at 4pm an just got the tester so I tested her and she came back at 178. Much lower than 537 ( at vet) but still high. I will retest her again before she eats tonight and gets her second dose. My question is should I bump her up to the two units twice a days as the vet recommended ? Or keep her at the 1 unit twice a day , I lowered it bc I was afraid to give her too much considering I took her off oh her dry food. Thanks !
     
  20. KPassa

    KPassa Well-Known Member

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    Oct 23, 2012
    178 at +6 hours after a shot is a bit high, but it's a nice number to have when first starting out. Usually doses are initially held for about a week when starting insulin. How long have you been doing 1u? Since Thursday? I would probably hold this dose a little longer till the depot finishes building and we have some more data. Food changes can also impact BGs up to two weeks (or more) for some kitties, so she might still have farther to come down now the dry is gone.

    In the meantime, we have this handy spreadsheet we use for tracking numbers and patterns for our kitties if you'd like to set one up. It gives us a better view of how Zoey's numbers are flowing. And please let us know if you need any help setting it up, as well. :D
     
  21. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
    I would hold the dose for now until you get more tests in - just to see where Zoey is. Unless Zoey drops below 50 in which case you will reduce immediately by 0.25units!

    Definately set up the spreadsheet as Kay suggested ( we can help if you have issues).

    Then you will want to ideally get 4 tests a day:

    - before every shot (preshot)- this is mandatory as you dont want to shoot when too low. As a newbie this number is 200. If you see a number under 200 at preshot please dont shoot or feed and come here and ask for advice - and test again in 30 minutes to see how the number is and whether it has gone up. This is why we suggest you dont feed for 2 hours prior to shot time, so the number isnt influenced by food

    - mid cycle, 5-7 hours after morning (or evening) shot if your schedule allows. Lantus dosing is based on the "nadir" or low point which occurs in many cats around this time. If the nadir is too low over 3-5 days, you reduce dose. If nadir is too high for 3-5 days, you increase.

    - before bed , 2-3 hours after evening shot. This gives you an idea of what Zoeys nighttime plans are. If its lower than your evening pre shot , it can mean an active cycle so you might want to set the alarm for another test around 5 hours!



    Wendy
     
  22. Zoey831

    Zoey831 Member

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    Jul 25, 2013
    I just took it again it it is 339. She is due for both food and insulin. Should I give her just the one unit ?
     
  23. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
    Yes, hold the dose for a day or two and keep testing as I said above. This could be a bounce.
     
  24. Zoey831

    Zoey831 Member

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    Jul 25, 2013
    Ok thanks :)
     
  25. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    So for today FYI..

    AMPS + 6 178
    PMPS 339

    Before bed test?

    Wendy
     
  26. Zoey831

    Zoey831 Member

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    Jul 25, 2013
    Ok I will try to take it in two hours again
     
  27. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
    Cool. It will be a good indicator of tonites cycle as I mentioned above..
     
  28. Zoey831

    Zoey831 Member

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    Jul 25, 2013
    Hi. I have another question, I did a curve test today , I have been testing her every 2 hours , the next time to test will be 930pm and that's also when I feed her and she is due for insulin. Do I test her right before I feed her then give her the insulin then retest in two hours ?
    Thanks
     
  29. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
    That works - we always recommend a test 2-3 hours after the evening shot anyway.

    However the issues with curves is that they only tell you one day ... and so the cat is high you wont know if its because she isnt getting enough insulin, or she is getting too much and is bouncing. Thats why we recommend daily tests to get better idea of trends and bounces - and keeping track in a spreadsheet. Best to allow the bounce to clear first so you get a good picture of whats going on before making any changes.

    http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207



    Wendy
     
  30. Zoey831

    Zoey831 Member

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    Jul 25, 2013
    Ok so I have been testing everyday but not around the clock usually before each shot.
    On 8/6 she was
    9:51am 172 fed n shot given( last feed night before at 950pm and shot given)
    8:50pm 162 fed n shot given
    8/7 today
    9:44 am 170 fed n give shot
    11:41am 254
    1:41 pm 163
    3:41 pm 136
    5:31pm 139
    7:34 pm 126
    9:43pm 334 gave shot n fed her
    Will test in two hours again
    What everyone's opinion
     
  31. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Great numbers! She is coming down into nice numbers during the day. I would be very interested to see how low she drops at night, its likely lower again.
     
  32. Zoey831

    Zoey831 Member

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    Jul 25, 2013
    So these numbers are what the vet is lookin for ? These numbers are good for zoey? I'm not sure what I am suppost to be looking for , of you know what I mean
     
  33. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
    These aren't bad. A normal cat is around 40-130 but many vets like 100-300 since its safer and away from possible hypos.

    However if your goal is remission (which is possible for sure and likely in many cats) you want to keep him in a normal range as much as possible.

    What's your goal?

    Wendy
     
  34. Zoey831

    Zoey831 Member

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    Jul 25, 2013
    My goal is def remission.
     
  35. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
    Great! We can totally help with that. A spreadsheet would help immensely.. We can track what he is doing and keep on top of dosing when needed.. Use the link I provided above to set one up.

    Let us know if you need help with it.
     
  36. Zoey831

    Zoey831 Member

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    Jul 25, 2013
    Ok I will try that tomorrow
     
  37. Zoey831

    Zoey831 Member

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    Jul 25, 2013
    ok ladies, I started my template but i dont know what any of the abrv mean
    AMPS?
    pmps?

    thanks in advance :smile:
     
  38. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    AMPS = morning pre-shot
    PMPS = evening pre-shot

    +1 = 1 hour after insulin shot
    +2 = 2 hours after insulin shot
    etc
     
  39. Zoey831

    Zoey831 Member

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    Jul 25, 2013
    great thanks!
     
  40. Zoey831

    Zoey831 Member

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    Jul 25, 2013
  41. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
    the link isnt working but i think You need to "share" the sheet so we can access it, and also you didnt copy the entire link and some is missing?

    EDITED TO Add - thats it! it works!


    Wendy
     
  42. Zoey831

    Zoey831 Member

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    Jul 25, 2013
    i tried changing it to zoeys spread sheet but couldnt figure that out, just glad i got it up there lol and i think i put it in my signature too

    ok so how often should i be testing her daily, i know someone said 4 times but what are the important times. i need to get on a schedule
     
  43. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
    Why is there a blank line between aug 6 and aug 7?

    Numbers do look good - few thoughts, first the red last night was probably a bounce. he is likely coming down from that now. He may have gone low on the 6th so mid cycle checks would be good when you get a blue or low yellow preshot number. Remember if you ever see a number under 50 you will want to reduce by 0.25units.

    Also When you see a low yellow or blue preshot number at night I would aim for another test in 2-3hours to see how low he plans to go. If this is lower than preshot you might want to set the alarm for another test around +6 as it implies an active cycle.

    Wendy
     
  44. Zoey831

    Zoey831 Member

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    Jul 25, 2013
    wow so much to learn, thank you for helping

    the blank is bc i set it up wrong. just put in the wrong column
     
  45. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
    Not to worry, we can help!

    But in a nutshell we want to know how low he is dropping because its that low number (called a "nadir") you base dose changes on. If the nadir is too high, we raise the dose. If the nadir is below 50, we reduce the dose.

    For many cats the nadir is 5-7 hours after the shot. But it varies.

    For now keep going the way you are but if you see a low preshot number ( low yellow or blue) then get a test 2-3 hours later to see what his plans are. And then more frequent tests after that if he is dropping. Especially at night as many cats dont eat as much then and so drop lower.

    His numbers so far are looking great though! Can you add a row at the top to show when you started giving insulin and how much? Even though you dont have data for testing?

    thanks!

    Wendy
     
  46. Zoey831

    Zoey831 Member

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    Jul 25, 2013
    ok I did thank you
     
  47. Zoey831

    Zoey831 Member

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    Jul 25, 2013
    another question, can i send that spreadsheet to the vet? will they be able to open it? Or is it only people with a google account?
     
  48. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    I believe you do not need a Google Account.

    From the File Menu, select Share. Adjust your settings so that anyone with the link may see it. Copy and save the link from the dialog box. Click Done.

    E-mail that link to the vet with a copy and paste manuever, it'll be easier than trying to type it in by hand.
     
  49. Zoey831

    Zoey831 Member

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    Jul 25, 2013
    thank you for the help, :smile:
     
  50. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
    Ok cool but maybe update the sheet to show when you went from 2 units to 1unit? The whole history is useful.. sorry.
     
  51. Zoey831

    Zoey831 Member

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    Jul 25, 2013
    ok, i will add that in the notes thanks..I notice now with this spreadsheet that 2 was too much for her but 1 is too little for her. do they have needles that would show 1.5 doses?
     
  52. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Yes, there are various insulin syringes available with half unit markings. Those are the smallest made. You want to look for 3/10 cc, 5/16" or 1/2" needle length, 29-31 gauge, with 1/2 unit markings on the barrel. I know the Wal-Mart Relion brand has the 1/2 unit markings. So do Terumos and some BD's I think.

    Our shopping partner, ADW, in the link at the top of the screen has a couple different insulin syringes to choose from.

    Would you be willing to update your user control panel and add your location of Bethelem PA to the profile? User control panel, profile tab, edit profile, location field, fill it in and submit to save. Optional but it helps us. I had to go searching through your posts to find out if you lived in the US or not, before I gave my syringe information.
     
  53. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
    Cool. Did you shoot last night? I don't see any tests or dose?
     
  54. Zoey831

    Zoey831 Member

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    Jul 25, 2013
    ok thanks for the info, and i added my location

    i forgot to update last nights dose and bg reading. i did not test after that as i couldnt stay awake.
    i am going to try to test today at 3pm, before her shot at 10pm and two hours after that.
     
  55. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Sounds like a good testing plan.

    Thanks for adding your location to your profile.
     
  56. Zoey831

    Zoey831 Member

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    Jul 25, 2013
    Morning. This morning she is at 153 amps. The vet sad anything over 150 and I can give her the 1 unit. Do you agree ?
     
  57. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    If you do shoot, you will want to check around +5 hours after the shot to see how low the glucose is getting. And you'll want to have high carb food and Karo syrup handy in case you need to bring the glucose up a bit.

    Here are instructions on How To Handle A Hypo, just in case you need to intervene.

    Also information on Handling Low Numbers
     
  58. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
    When you shoot that low it's always a good idea to get a test in a few hours. You don't want him dropping too low plus its useful data because over time and as his pancreas heals, you should start to see more and more lower numbers and will need the data to know if and when you can shoot.

    Wendy
     
  59. Zoey831

    Zoey831 Member

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    Jul 25, 2013
    Hi ladies. She is due now for insulin and bg is 135. Should I give her half of one or none ? She is eating right now so I know it will be rising
     
  60. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    How late can you stay up testing and feeding her if she were to go low?

    If the answer is not at all, then you might shave the dose 0.25 units (which you'd have to eyeball between 0.5 and 1.0).

    As you collect test data, you'll be able to shoot at lower numbers with more confidence it will be safe.
     
  61. Zoey831

    Zoey831 Member

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    Jul 25, 2013
    Ya that's what it is. I'm afraid she will go too low and I won't be able to stay up. Ugh I think it's best not to shoot and just test when I get up. I rather that then her go too low, right ? Especially since I won't be up to watch her

    Thanks again for all the help I feel like I keep coming on asking the same questions.
     
  62. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Please, keep asking all the questions you want and need to, as many times as you need to. It takes time to get a handle on all this information and start to feel comfortable.

    "Better too high for a day, than too low for a minute."
     
  63. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    That is a reasonable decision. I did almost an all nighter with Spitzer the first week and I have a sleep disorder. It was pretty grueling.

    Sometimes, getting the same question answered different, yet correct, ways may help your understanding of the information. And sometimes asking the same question slightly differently brings out additional details.
     
  64. Zoey831

    Zoey831 Member

    Joined:
    Jul 25, 2013
    Thanks again.
     
  65. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Lets hope future low preshots happen during the day! It would be a shame if we lose any momentum or possible remission due to having to skip repeated shots.

    Her numbers look so good I think her pancreas might be trying a bit. Remission isnt out of the question and I have hope for her - just need some more tests so we can tweak the dose if need be.

    Wendy
     
  66. Zoey831

    Zoey831 Member

    Joined:
    Jul 25, 2013
    The problem is we r going away for a few days and have my sister testing and giving the shots, makes me nervous. I didn't know if I should just stop all shots until I get back but now that you write her pancreas is trying maybe I should have her give zoey the shots. I am just nervous that she will go too low and I won't be here to watch her.
     
  67. KPassa

    KPassa Well-Known Member

    Joined:
    Oct 23, 2012
    When I have others watching Mikey for me when I'm gone, I usually have them give a slightly reduced dose. He might run a little higher while I'm gone, but at least I know he's getting insulin (for the most part). Make sure your sister tests before every shot. If they have to skip shots because Michelangelo doesn't feel like cooperating for his test, then I'd rather have a missed dose than them shooting him when he's low. He also has a tendency to drop lower when I'm gone (he doesn't eat as much), so usually it only takes us a day or two to get back in business once I'm home again. A slight setback, yes, but better than him going without insulin for days at a time or him having a hypo while I'm gone.
     
  68. Zoey831

    Zoey831 Member

    Joined:
    Jul 25, 2013
    Excellent thank you
     
  69. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    me too - i reduce the dose too so maybe lower it to 1/2 unit?

    Also

    - give her a reference syringe with food colouring in it so she can refer to it.
    - give her the vets emergency number/map
    - print this link out for her and stick to your fridge. Go through it with her + leave a copy beside a hypo kit http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=15887
    - give her this forum info for emergencies!

    Also give the vet a credit card number and let them know you will be away

    Wendy
     
  70. Zoey831

    Zoey831 Member

    Joined:
    Jul 25, 2013
    Thanks so much. Great advice
     
  71. Zoey831

    Zoey831 Member

    Joined:
    Jul 25, 2013
    The vet said to give her a insulin vacay for the day I am gone. But to have my sister check her, with her numbers dippin she said it might be risky and it's better to be high than too low. I will get in touch with you all when I get back, thanks
     
  72. Zoey831

    Zoey831 Member

    Joined:
    Jul 25, 2013
    Ok I am back and started giving her her 1 unit friday night. she did really good while we were gone. The vet said to do another curve in two weeks and to call if she dips before that.
     
  73. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Welcome back! Good to hear that Zoey did well while you were gone. Hope you had a nice vacation.
     
  74. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Welcome back!

    Can you get a before bed test ( or a test 2-3 hours after the shot) next time you see a blue pre shot? I worry and wonder how low she goes those times and that might tell the vet if you need a dose change.I also wonder about bouncing.

    Wendy
     
  75. Zoey831

    Zoey831 Member

    Joined:
    Jul 25, 2013
    Sure next time I will do that when I see a blue number oddly it was over 300 again tonight Pre shot. I'm thinking it might be the kinds of good. I notice she is lower on chopped grill feast ff classic I think I justify add what kind of food to my log. Thanks again
     
  76. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Might not be odd - could be a bounce. Need more mid cycle tests.. before bed tests..nag nag ;)

    Wendy
     
  77. Zoey831

    Zoey831 Member

    Joined:
    Jul 25, 2013
    The schedule I have her on right now is 10 and 10 so that's basically my before bed test lol. I might have to change her schedule to 8 and 8 but that's hard for me bc we usually are not home at those times. Running with the kids morning noon and night. And I have to stay on a every 12 hour schedule right ? On e school starts I might be able to get a better schedule
     
  78. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    How about 9 and 9? Or 9.30 and 9.30 and an occasional before bed test at 11.30?

    Wendy
     
  79. Zoey831

    Zoey831 Member

    Joined:
    Jul 25, 2013
    i could try that. maybe tonight i will give it to her earlier. will that mess things up? and then try to stay on that schedule.
     
  80. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Depends how high she is - if she is high pink you should be fine but i would be more inclined to move it by 30mins a day.
     
  81. Zoey831

    Zoey831 Member

    Joined:
    Jul 25, 2013
    ok thanks :)
     
  82. KPassa

    KPassa Well-Known Member

    Joined:
    Oct 23, 2012
    How are things going with you two?
     
  83. Zoey831

    Zoey831 Member

    Joined:
    Jul 25, 2013
    Good thank you, she was a little low this morning and last night but she seems good. Acting really well, eating and drinking normal. I still have yet to get her on a better schedule
     
  84. KPassa

    KPassa Well-Known Member

    Joined:
    Oct 23, 2012
    How is she doing? I saw you had to skip a shot last night because she was too low to shoot. If that starts happening more often, then it means it's time for a dose decrease! :thumbup
     
  85. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Please get some tests between shots, especially between 5-7 hours after the shot - even if it means setting an alarm at night. She may be going too low between shots, which means a dose decrease is warranted.

    If you cannot test between shots until the weekend, please reduce to 0.5 units; I am concerned she may be going low enough to hypo and if you aren't able to test, you could come home to a comatose cat or worse.
     
  86. Zoey831

    Zoey831 Member

    Joined:
    Jul 25, 2013
    Because she dipped? And I skipped ? Now she is high. I'm guessing bc I skipped ???? Now that I changed her to 7 and 7 I can start testing more.
     
  87. KPassa

    KPassa Well-Known Member

    Joined:
    Oct 23, 2012
    It could be because of the skipped shot but it looks more like a bounce to me. The problem is, we don't know how low she's dipping until you can get some more mid-cycle tests. The schedule change should help with that. ;-)

    Bounces
     
  88. Zoey831

    Zoey831 Member

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    Jul 25, 2013
    Ok thank you.
     
  89. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    I agree. Please try and get some spot checks in this weekend as well as preshots. Lets see how low she is going. Esp. around 5-7 hours after the shot and before bed. It would be good to get spot checks for 2-3 days in case the bounce holds around that long.

    Any chance of a before bed test until then?

    Wendy
     
  90. Zoey831

    Zoey831 Member

    Joined:
    Jul 25, 2013
    Yes. I think I can get test in before bed now. I have her the shot at 7pm so I can test at 10pm tonight
     
  91. Zoey831

    Zoey831 Member

    Joined:
    Jul 25, 2013
    Gave her 1 unit at 7 pm and just retested now at 10:20pm she is down to 309
     
  92. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    She is coming down from a bounce, can you get a +6 or +7?

    Wendy
     
  93. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Now you are home testing, the following may be helpful:

    Here are some glucose reference ranges used for decision making using glucometers. Human glucometer numbers are given first (mg/dL). Numbers in parentheses are for non-US meters (mmol/L). Numbers in curly braces are estimates for an AlphaTrak.

    < 40 mg/dL (2.2 mmol/L) {< 70 mg/dL for an AlphaTrak}
    - Treat as if HYPO if on insulin
    - At nadir (lowest point between shots) in a long term diabetic (more than a year), may earn a reduction.

    < 50 mg/dL (2.8 mmol/L) {< 80 mg/dL for an AlphaTrak}
    - If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50 (2.8).
    - At nadir, often indicates dose reduction is earned.

    50 - 130 mg/dL (2.8 - 7.2 mmol/L) {80 - 160 mg/dL for an AlphaTrak}
    - On insulin - great control when following a tight regulation protocol.
    - Off insulin - normal numbers.
    (May even go as low as the upper 30s (1.7 mmol/L){60s for an AlphaTrak}; if not on insulin, this can be safe.

    > 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
    - At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

    200 mg/dL (11.1 mmol/L) {230 mg/dL for an AlphaTrak}
    - no shot level for beginners; may slowly reduce to 150 mg/dL (8.3 mmol/L) {180 mg/dL} for long-acting insulins (Lantus, Levemir, and ProZinc) as data collection shows it is safe

    180 - 280 mg/dL (10 - 15.6 mmol/L) {may be 210 - 310 mg/dL for an AlphaTrak}
    - Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
    - Test for ketones, glucose is too high.

    >= 280 mg/dL (15.6 mmol/L) {may be >=310 mf/dL for an AlphaTrak}, if for most of the cycle between shots
    - Uncontrolled diabetes and thus at risk for diabetic ketoacidosis and hepatic lipidosis
    - Follow your insulin protocol for dose adjustments
    - Test for ketones; if more than a trace level of ketones, go to vet ASAP.
     
  94. Zoey831

    Zoey831 Member

    Joined:
    Jul 25, 2013
    Ok so she was 124 + 6 hours after shot. So that is good
     
  95. KPassa

    KPassa Well-Known Member

    Joined:
    Oct 23, 2012
    That is very good. :D I hope she still has a bit further to come down into some green. if so, it will also keep her from climbing back up too high by pre-shot. She might be due for a decrease soon if you find yourself having to skip many more shots. :thumbup
     
  96. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Can you start testing hourly? Lets see if she comes down more. Not all cats drop to the low at exactly at +6/
     
  97. Zoey831

    Zoey831 Member

    Joined:
    Jul 25, 2013
    I can't test hourly as I am waiting for my new strips to arrive today or tomorrow. If I had more I would
     
  98. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Shame. Next time though you see a blue I would get a test in an hour - you want to keep testing till she goes back up so you can see how low she goes.
     
  99. Zoey831

    Zoey831 Member

    Joined:
    Jul 25, 2013
    so she is in blue again, 156, i will test again soon, just feed her but didnt give her the insulin.



    Update 1 hour later Nd after she ate she is now at 313
     
  100. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Ok cool! If you maybe stall only 30 minutes next time (dont shoot or feed) you might be able to catch the rise before it gets that high. The less she rises the better so that it keeps her lower.

    Wendy
     
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