? OMG..Switched from NPH to Lantus Today. What to do/expect?

Discussion in 'Feline Health - (Welcome & Main Forum)' started by ELLIOTT & Fran Munschauer, Jan 21, 2016.

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  1. ELLIOTT & Fran Munschauer

    ELLIOTT & Fran Munschauer Member

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    Jan 1, 2016
    I have spent a great deal of time on the introduction page going crazy, worrying about Elliott but thanks to all of your great cat people, I was beginning to feel a tiny bit of peace, I think. NOW, It is starting all over because Elliott's BG are awful and so, I consulted our DVM switching to Lantus that started at 6 AM today. I believe that his weight of 14.8 ( 20 lbs prior to diagnosis) called for 1.78 u Lantus but was instructed to give 2 u BID with only a 6 hour peak check? I replied wondering why the nadir would be the same, since I performed the 6 hr NPH peak at 6 hours. Also, as a HCP with humans, I expressed that I was not comfortable NOT performing a BG prior to the am and pm meal and insulin injections. In the ER, I have never used Lantus, only Regular Insulin, so, called my daughter. She claims "It does not matter what the BG is prior to administering it, since Lantus does not kick in for many hours." Is she correct..I do not read this anywhere.??? Also, the DVM said that Elliott's BG would probably be high for first 3+ days. There was no mention of changing dosage and I should call him in 7 days..He sent off a Fructosamine level. Any advice on anything would be greatly appreciated. Also, I read that well regulated cats should maintain 60-150 BG levels at some point. I thought 60 was considered too low esp. since we're using home meters (AlphaTrak).Thanks for reading!!!!

    POOR ELLIOTT'S DIABETES SPREADSHEET:
    https://docs.google.com/spreadsheet...2rAeC4FxEqoeAUlnBPqganucis/edit#gid=361360320
     
  2. Larry and Kitties

    Larry and Kitties Well-Known Member

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    Dec 28, 2009
    N/NPH typically has maximum effectiveness in cats at 4-5 hours and you usually get relatively fast drop.
    The depot insulin like Lantus and Levemir build up over days to reach maximum effectiveness. For most cats they is not that much of form before shot to max effectiveness which can be 5-7 hours.
    Usually the starting does of insulin 1 unit twice daily but with data for other insulins it can be higher (or lower). Based on your N/NPH data 2 units of Lantus might be right. However, I would have started with 1 units to be on the safe side.
    Most of use here test before each shot and then periodically between shots.
     
  3. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Most important thing will be patience! As Larry notes, it can take 5-7 days on the first dose level and 3-5 days after that, to fully see how successful a given dose may be.
    You'll want to read over the sticky posts at the top of the Lantus forum to optimize your use of it.
     
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  4. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Hi Fran,

    According to Tight Regulation Protocol starting dose of Lantus is worked out at 0.25 IU per kg (2.2lb) of cat's current weight (if underweight) or 0.25 per kg of ideal weight for newly diagnosed cats who have not received any other insulin. If, as is the case with Elliot, there has been prior insulin treatment then the response to the previous insulin may be taken into consideration. Elliot's dose at 14.8lb/6.73kg would work out at 1.68IU Lantus. Maybe the vet has factored in the data you've already gathered for Elliot when setting the starting dose.

    As BJ has already suggested, if you read through all the stickies at the top of the L&L support group board they will give you a great introduction to Elliot's new insulin. In particular, I recommend you read about the insulin depot to get a feel for how differently Lantus works compared to NPH.

    Word of caution:
    The blood glucose reference ranges and thresholds in the Lantus board stickies are written for human meter users. The only Alphatrak guidance for which FDMB has a reputable reference source is the low number hypo boundary of 68mg/dL/3.8mmol/L. You need to consult your vet about the correct blood glucose reference range to use with your Alphatrak meter. There is some guidance on pet meter numbers and dose adjustments in the published Roomp-Rand Tight Regulation Protocol guidelines.

    On testing, as you have already remarked the start-over with Lantus makes everything 'new' again - especially because of its different mode of action. With Saoirse I always get preshot tests and mid-cycle tests, even while a dose is settling. It gives me a little more peace of mind and also helps with making dosing decisions. I'd suggest getting AMPS, AM+4, AM+7, PMPS and a 'before bed' test each day for the first while. Once you get a feel for Elliot's response to his Lantus, the two preshots plus a AM mid-cycle spot check and a 'before bed' test should give you a good idea of Elliot's response. (Note: if you vary the times of day for the mid-cycle checks it can help you build up a bigger picture without the need to test excessively each day.)

    Fingers and paws crossed that Lantus will work really well for little Elliot. :)



    Mogs
    .
     
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  5. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
    Good luck with the Lantus. Remember he might be high for a few days til the depot fills. So don't panic. Keep strong.
     
  6. ELLIOTT & Fran Munschauer

    ELLIOTT & Fran Munschauer Member

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    Jan 1, 2016
    OHHH...So much to respond to...I thought the "sticky" said that this area should be the second (or first) area to discuss my Cat's Health issue.

    The DVM told me to give 2 u Lantus but if I was not comfortable with 2u, I could give 1.5u, since 1.7 or(1.68) would not be easy to measure. He speculated that Elliott will probably end up on 2.5 u Lantus?I told him of this forum and members' understanding, experience, and patience for others just beginning to deal with DM..adding that "They told me everything that you just planned. These people are really vested in Cat health..". I told him about the cat people who (apparently) were caring and watching my thread closely. "She (Mr Worfman's Mom) posted a message to another member, that she needed to go to the store asking another member to keep an eye on Elliott' low BG" REALLY??? I did not expect such "caring" from anyone.

    I have used 3 meters but am charting the Alphatrak . I ran out of strips so used Relion and Bayer and used them before the AlphaTrak monitor arrived after diagnosis. I continued to test the blood gtt. with all 3 meters tracking differences in case AphaTrak broke or I ran out of strips. I am going to read the Lantus support group and about depot insulin right now ..after I go chase Elliott to perform another BG. Thank You!!! ONE MORE THING: After dx, I think we were starving Elliott because the cans of FF Classic are 3 oz, giving him 2/day=160-180 cal. Now, we give him 1.5 cans FF in AM and 1.5 cans in PM= 240-270 cal. When his BG has been low at NPH peak, I have given him .5-1 can FF (with faster acting substances close by if needed) Also, we boiled chicken breasts, cut in small pieces, and freeze most of it.. to give Elliott and brother treats, esp around BG test time. Elliott seems hungry all of the time..Elliott has gained no wgt since 12/31/2015. I have read that some cat people still free feed and others feed strictly...I am utilizing the strict feeding unless BG is low.. Thanks for all of your suggestions and experiences.
     
  7. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Noticed this hadn't been answered....and you're totally correct!! Using the AT meter, 68 is the lowest we want them going. If he drops below 68, you'd want to intervene and feed a little high carb "gravy-type" food to get him back above there

    If you do 1000 searches for "normal cat blood glucose" you'll get about 1000 different answers, but here we say on a human meter, 50-120 is what we're shooting for....On the AlphaTrak, there is no official "upper register" number, but generally, you're trying for 68-about 150
     
  8. ELLIOTT & Fran Munschauer

    ELLIOTT & Fran Munschauer Member

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    Jan 1, 2016
    I DON'T KNOW WHAT TO DO or what to expect next....When starting Lantus today, I did not expect the following
    BG- 6am-406 Lantus 2u +meal
    12n-283
    6pm-113 Lantus 1.5u+ meal
    7pm- 74 when starting on Lantus this AM..Is this normal? I am allowing him to eat right now.
     
  9. Nancy and Scotty

    Nancy and Scotty Member

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    Jul 13, 2014
    Scotty was on 13 units of ProZinc twice a day and his blood sugar would not come below 350, the first day the vet started him on Levemir at his office he started him on 4 units and by +6 he was at 60, it scared me and the vet. Because he will not eat at the vets he had me bring him home and give him some high cal food and he came up fast but just wanted to warn you that even though sometimes it takes a few days you might see an immediate response. That 74 you saw at 7PM is pretty much the way Scotty responds to Levemir, he does not seem to wait on the insulin building up in his body.
     
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  10. ELLIOTT & Fran Munschauer

    ELLIOTT & Fran Munschauer Member

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    Jan 1, 2016
    Thank You..I guess I should just carryon as ordered???
     
  11. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    Looks like you may just need to reduce his dose....74 isn't too low (yet), but it's unusual for them to have such an immediate response

    Let's see how this cycle goes a little longer
     
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  12. ELLIOTT & Fran Munschauer

    ELLIOTT & Fran Munschauer Member

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    At 8:05pm after eating a little more BG=69..Behavior-chasing red lazer-not lethargic
     
    Last edited: Jan 21, 2016
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  13. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Have you got some Fancy Feast Gravy Lovers in the house? He's still safe, but he's getting close

    If he's a good eater and you're sure you can get him to continue to eat, I'd give him another teaspoon of his regular food and recheck in 30 minutes (we don't want to fill him up now in case we need him to eat later)
     
  14. ELLIOTT & Fran Munschauer

    ELLIOTT & Fran Munschauer Member

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    Jan 1, 2016
    Yes..I will feed him some now. Thanks and re-check BG.
     
  15. Nancy and Scotty

    Nancy and Scotty Member

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    I just realized you are using an alpha trak, you are going to have to test all night and may even want to give him Karo Syrup through the night, do you have any high cal gravy food, if so you need to feed him that, as much of the gravy as possible, I will be up all night and will check in hourly, you also need to decrease on your next dose.
     
  16. Nancy and Scotty

    Nancy and Scotty Member

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    I am so glad you jumped in on this too, I did not realize at first she was using an alpha trak.
     
  17. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Wow! That's quite the response (good) Elliott's having to the Lantus. Looks like the Lantus will be a much better "fit" for him.

    You're in good hands and as you can see, you don't have to deal with this all on your own. I'll check in too to for awhile to see how things are going.
     
  18. ELLIOTT & Fran Munschauer

    ELLIOTT & Fran Munschauer Member

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    WELL.Elliott had perfect blood values except for the BG=DM..and so...if something happens to him because I don't know what I am going to do!!!! My DVM told me that his BG would be high for next few days. I should have done that go slow method? He told me to start at 2U. First, I read the Lantus/levemir "depot" article that said "DON'T FEED" after a low BG right away because then, I won't know what is really going on= I won't know the process of how the Lantus is working..but I did feed him twice after both low BG's. And so, if his BG is increased, what does that really tell me? Apparently those depots hold little pouches of Insulin and release them whenever. And so, I should perform hourly BG for the next 12 hours? I wish I had a BG curve to see how Lantus works when switching insulins..but can't find one. If this is normal, I am sorry for bothering all of you!!! I am sorry but did not know where else to turn. My DVM was not worried.
     
  19. ELLIOTT & Fran Munschauer

    ELLIOTT & Fran Munschauer Member

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    Relion read 54..I always check with 2-3 meters. I was trying to stop doing that. Relion, Bayer and Alphatrak. However, Alphatrak is what is recorded (note inserted may read Relion)
     
    Last edited: Jan 21, 2016
  20. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    First....breathe.....as long as you're home testing, you're pretty much in control of his blood glucose

    As long as he's above 68 on the AT (don't try switching back and forth with meters....it'll only confuse you right now) he's perfectly safe
     
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  21. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    You don't need to test every hour usually..EXCEPT right now, with him running so close to 68, we want you to keep a close eye on him so keep testing every 30 minutes until he's coming up at least a little

    Since we don't have any data on him with Lantus, right now the important thing is keeping him safe
     
  22. Nancy and Scotty

    Nancy and Scotty Member

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    Re: Relion 54, need to keep feeding him gravy cat food and testing every 30 minutes to hour, he can keep going lower all night. Is he a good eater?
     
  23. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    As far as the 54 on the Relion....that's still a safe number too...we don't feed high carb until they drop below 50 on a human meter, 68 on the AT
     
  24. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Fran, deep breathes! As Chris says, please stick to one meter. Not only will you get confused but those trying to help you will get confused too!
     
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  25. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    As far as this goes, both using TR and SLGS, you have to start "somewhere" on the dose....the numbers will tell us if the dose is too high or not. The main difference between the two protocols is how often you adjust the dose and at what point you reduce. TR is a more "aggressive" protocol, but it also has better results
     
  26. jayla-n-Drevon

    jayla-n-Drevon Well-Known Member

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    Your in great hands--
     
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  27. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Example of an ACTIVE, but NOT necessarily typical Lantus cycle:
    NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.

    +0 - PreShot number.
    +1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
    +2 - Often similar to the PreShot number. You'll probably see an active cycle if the +2 is the same/similar or lower than the preshot number.Continue testing!
    +3 - Lower than the PreShot number, onset has started.
    +4 - Lower.
    +5 - Lower.
    +6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
    +7 - Surf (hang around the nadir number).
    +8 - Slight rise.
    +9 - Slight rise.
    +10 - Rising.
    +11 - Rising (one of the quirks of Lantus/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
    +12 - PreShot number.
     
  28. ELLIOTT & Fran Munschauer

    ELLIOTT & Fran Munschauer Member

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    Jan 1, 2016
    9:03pm AlphaTrak- 68 repeated=62. Relion=51.
     
  29. Nancy and Scotty

    Nancy and Scotty Member

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    If it were me knowing how Scotty reacts to Levemir I would keep feeding a little high cal food and testing every hour at least until I saw his numbers climbing a little. Scotty's nadir on Levemir is usually about +8 and he always lets me know by wanting to be fed then but I have had him drop really low (like 30 on Relion) at +4.
     
  30. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    How's his appetite? Is he still willing to eat?

    If you can give him another teaspoon of his regular food, I'd do that....he's surfing now and we just don't want him dropping any more
     
  31. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Also, when he's this close to the "line", it's important to test every 30 minutes....we just want to keep him safe
     
  32. ELLIOTT & Fran Munschauer

    ELLIOTT & Fran Munschauer Member

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    Elliott acts like I have starved him-eats- just finished another 1/2 can off F flaked+sauce. He is running from me when I try to get him..like he used to before diag with DM. Also, I am using the laser pointer and he is chasing it...will keep checking him a, behavior and BG..and then decide what to do in AM...I guess. will check BG at 9 pm. I do not expect all of you to stay awake. If Elliott gets worse, I guess I will get that Karo and start rubbing it in his mouth on the way to the DVM..I appreciate each and every one of you.I hope that I can help you all someday... I will keep posting...but You all need to sleep to care for your own cats tomorrow!!!!
     
  33. ELLIOTT & Fran Munschauer

    ELLIOTT & Fran Munschauer Member

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    Jan 1, 2016
    OKAY..I can do that now q 30 minutes!!!
    9:50 pm-AlphaTrak=79
    Relion= 61
     
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  34. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    That's better!!

    If he's still climbing at the next test, you can wait and re-test in an hour

    He's really doing GREAT!!
     
  35. ELLIOTT & Fran Munschauer

    ELLIOTT & Fran Munschauer Member

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    will do and THANK YOU ALL!!!!!!
     
  36. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    And you're not keeping anybody up...it's only a little after 10pm here and one of the great things about the message board is that there's almost always somebody online from somewhere in the world!
     
  37. Nancy and Scotty

    Nancy and Scotty Member

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    I am so glad Elliott has come up a little, I work from home and will be on duty until 0500 CST so I am up all night anyway. I always know when Scotty is going low because he gets very rowdy and aggressive and he is always starving when he is low. Normally he is just a big lazy blob that wants to pile up in my lap. If he beats up one of the civies I am running for the testing kit.
     
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  38. Terri Lynn & Jake

    Terri Lynn & Jake Member

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    Mar 31, 2015
    You are doing great! The fact that Elliott is playing like you say, reminds me of my Jake when I switched him to Lantus. I was amazed at how well it was working. Jake was on 1.5 units of insulin in March of last year. I did just switch to Levemir a few weeks ago and he is now at 1 drop twice a day. Fingers crossed that this is just the beginning of beautiful, steady numbers for Elliott. :)
     
  39. ELLIOTT & Fran Munschauer

    ELLIOTT & Fran Munschauer Member

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    Jan 1, 2016
    10:50pm- AlphaTrak=66,
    Relion =41
     
    Last edited: Jan 21, 2016
  40. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    OK....time to break out a little high carb food....If you have some Fancy Feast Gravy Lovers, pop the top on one, put it back on and "squeeze" the gravy into another bowl and give him a couple teaspoons of the gravy

    If you don't, add a few drops of Karo, honey or syrup to a little of his regular food and give that to him

    Retest in 30
     
  41. ELLIOTT & Fran Munschauer

    ELLIOTT & Fran Munschauer Member

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    Jan 1, 2016
    Do cats like Karo? I just gave him the last gravy one..He is running from me now so will I shove Karo in his mouth? I will look to see if any gravy food can be found...I found one more and squeezed gravy into bowl and added 1 tsp Karo to side in case he won't eat the karo!!!
    He ate all + Karo+the food left in can by 11:15pm
     
    Last edited: Jan 21, 2016
    Reason for edit: more info
  42. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Hang in there! You're doing great!

    A few drops of Karo on a teaspoon of food may not be noticeable and he may just eat it.

    If you have any flour, you could make a quick roux and add some to the regular food. (A teaspoon of flour, a few drops of water or broth from the canned food stirred in, heated to help it mix into a gravy.)
     
    Last edited: Jan 21, 2016
  43. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    What were you feeding all this time? Brand and variety?

    Some cats will willingly lap up Karo/honey/maple syrup...others won't....if he won't and you don't have something with gravy, you can try a little yogurt or ice cream (if he's ok with dairy) or rub it directly on his gums
     
  44. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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  45. ELLIOTT & Fran Munschauer

    ELLIOTT & Fran Munschauer Member

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    He began eating only FF Classic (lowest carbs)since diagnosis..Prior he ate all the FF meals with gravy etc + dry Iams. I had a few cans of left hidden in cupboard. 1 is grilled tuna in gravy.
    11:25pm-1/3 left of can FF with Karo dripped over-ate all again.
    Elliott is not a happy boy...He is hiding when I approach because he knows what is going to happen. I will test his BG at 12 MN...This cat has been eating since 6pm!!!! Elliott and his brother will not eat anything but their cat food (and boiled chicken breast cut i to treats) BUT he must like the karo..since he licked it all up..If his BG doesn't increase at MN ???
     
    Last edited: Jan 21, 2016
  46. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Don't go overboard...we want him to be safe, but we don't want to send him to the moon

    A couple of teaspoons of just the gravy OR a few drops of Karo is enough...we just want to support him and get him up a little
     
  47. ELLIOTT & Fran Munschauer

    ELLIOTT & Fran Munschauer Member

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    That is what I was just worrying about, "I hope that I did not go overboard."
     
  48. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    It'll help me know better about what's been going on if you could tell me exactly what kind of food you were feeding earlier (from +1 to +4)

    If it was Fancy Feast, was it flaked tuna? Tuna Florentine? Tuna Tuscany?
     
  49. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Oh....and don't feel bad about "overdoing" it....the first time China went below 50 I knew to give her some syrup, but didn't know how much so I dumped about a cupful into a bowl and let her at it (was surprised that she liked it!!)

    Only later did I learn I was only supposed to give her a drop or two at a time....needless to say she went high!!

    We ALL do it the first time!!
     
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  50. ELLIOTT & Fran Munschauer

    ELLIOTT & Fran Munschauer Member

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    Jan 1, 2016
    12MN- Alphatrak= 112
    Relion=82..I hope this will last. he seems very tired this time-didn't fight me.???
     
  51. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    OK....that last meal really took him up

    You can wait an hour to test again....if he's still climbing at that point, I think you can relax

    I can't stay on much longer though...forgot I have to take my mom to physical therapy tomorrow morning

    IF he drops down below 68 again, just a couple teaspoons of the gravy and test again in 30 minutes....but I'm hoping he's getting past nadir and will settle down now

    Don't be surprised if he's high in the morning....He may "bounce" off the low numbers tonight

    If he's over 300 in the morning and you can test, you could try giving 1.25 and see how he does...if he's under that, I think I might try just going with 1U and let's work our way up if we need to

    Others may chime in with other opinions though. I'm not the only one here who can advise you and that's one of the best things about the message board...getting several opinions on the best course of action.

    Tomorrow, I'd suggest starting a new thread in the Lantus Forum...You'll get the most experienced eyes over there
     
  52. Nancy and Scotty

    Nancy and Scotty Member

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    Jul 13, 2014
    Whew finally !!! I will still be up the rest of the night and will check in about 45 minutes to see how he is doing. Thank goodness he is a good eater, it must be so hard for people who have cats who are picky eaters and have to deal with this.
     
  53. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    Glad to see you're going to be around a little longer @Nancy and Scotty

    I hate leaving someone, especially on their first PJ party!!!

    Don't forget Fran....a little chocolate for the bean should be part of every hypo kit!!
     
  54. ELLIOTT & Fran Munschauer

    ELLIOTT & Fran Munschauer Member

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    Jan 1, 2016
    6pm-1.5 can= FF Classic-Ocean Whitefish +Tuna feast (all 3 oz cans)
    +1- .5 can= FF Turkey Feast in Gravy (sliced)
    +2- .5 can= " " " "
    +3+4- 1 can=FF Fish +Shrimp Feast (flaked)
    +4-+5- 1 can =FF Ocean white Fish+ Tuna feast in Gravy (Grilled) + Karo on each half. The is the best i can remember. I htought there was a "sauce" one but not in garbage???
     
  55. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    OK...the FF Fish + Shrimp is low carb....that explains why he came back down

    The Turkey Feast in Gravy is high carb

    Make sure that you re-stock your supplies as soon as possible....The Fancy Feast "Gravy Lovers" are the best ones to have around when you need them
     
  56. ELLIOTT & Fran Munschauer

    ELLIOTT & Fran Munschauer Member

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    Jan 1, 2016
    "..A little chocolate for the bean.." I guess I'll have to look that one up tomorrow????

    And YES I WILL HAVE FRANK BUY MORE REGULAR FF WITH GRAVY..THANKS!!!!!
     
  57. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    LOL....we call each other "beans"....short for "human beings"

    On the FF 'with gravies"...they're lower carb than the Fancy Feast Gravy Lovers Line---these are the ones you want to have around for nights like this
     
  58. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Hi Fran and welcome. Chris asked me to pop in as she has a pillow beckoning her.
    I think Chris's plan will work. Two units was too much insulin to start. It's much easier to start on a lower dose and work your way up safely, than to be initiated into the low numbers dance as you've done tonight. Great job by the way! The Lantus depot is still building, and to see low numbers this early on means too high a dose. Actually, looking at your NPH numbers, says that 2 units was too high.

    If you are concerned in the morning, do your preshot test, do NOT feed, and post on the Lantus forum for guidance. On the Health forum here, we suggest that new users not give a shot if he is lower than 200 at preshot time. On the Lantus forum, experienced users will shoot lower with guidance from others.
     
  59. ELLIOTT & Fran Munschauer

    ELLIOTT & Fran Munschauer Member

    Joined:
    Jan 1, 2016
    Oh GEEZZZZZZ..Good..I guess..What next??? I am really a little tired but must carry on as poor Elliott hates me tonight!!!
    Alphatrak= 220
    Relion= 174
     
  60. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    How long since you last fed any food? High carb food can last in the system a couple of hours, after which the numbers can come down again.
     
  61. Nancy and Scotty

    Nancy and Scotty Member

    Joined:
    Jul 13, 2014
    220 quite a difference, if it were me to be on the safe side I would not give over one unit in the morning. You have been brave through this, I have never had Scotty stay low like that for so long, if I feed him a little gravy cat food he will usually bounce up about 30 points and stay there until next shot time.
     
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  62. Nancy and Scotty

    Nancy and Scotty Member

    Joined:
    Jul 13, 2014
    From the numbers we are seeing tonight I would say you will be able to get Elliott in remission on the Lantus soon and he can be a diet controlled happy cat again.
     
  63. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    A saying you'll hear a lot here is ECID or each cat is different. Cats really vary on how carb sensitive they are. I can get away with a 16% carbs high carb food, but some people need over 20% to get their cat to rise. The amount your cat just came up could also be as a result of the karo. Karo doesn't last as long in a kitty as high carb food.
     
  64. ELLIOTT & Fran Munschauer

    ELLIOTT & Fran Munschauer Member

    Joined:
    Jan 1, 2016
    I thought I was in the Lantus forum..maybe not..maybe haven't gotten there yet? I don't know. Sooo. Take BG at 6 am..do not feed and post and wait for guidance as what to do? What if no one is around to guide me? Your site suggests do not administer any Insulin if under 200? That sounds reasonable especially after this AM's BG=113...Then, I guess I need to transfer all of this info to the Lantus people? If the BG is >200, Shall I consider Lantus 1u?? I don't expect you to answer. This is a MESS..I guess that I will...I don't know what I will do. Start from scratch with Lantus Members. I have written and said so much, I don't know what more to say..but Thanks so much for caring about Elliott!!!
     
  65. ELLIOTT & Fran Munschauer

    ELLIOTT & Fran Munschauer Member

    Joined:
    Jan 1, 2016
    11:15pm, Elliott finished up the FF and 2 little servings of karo poured on each 1.2 can of food.
     
  66. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    6pm-1.5 can= FF Classic-Ocean Whitefish +Tuna feast (all 3 oz cans) ..THIS IS LOW CARB
    +1- .5 can= FF Turkey Feast in Gravy (sliced)...this is 17%
    +2- .5 can= " " " "
    +3+4- 1 can=FF Fish +Shrimp Feast (flaked) this is low carb at 0% carbs
    +4-+5- 1 can =FF Ocean white Fish+ Tuna feast in Gravy (Grilled) + Karo on each half.....this is 17% carbs PLUS the Karo
     
  67. ELLIOTT & Fran Munschauer

    ELLIOTT & Fran Munschauer Member

    Joined:
    Jan 1, 2016
    Nancy and Scotty..That would be sooo great !!!!!!! I don't expect a miracle--just some stable non life threatening BG's
     
  68. Nancy and Scotty

    Nancy and Scotty Member

    Joined:
    Jul 13, 2014
    Yeah Scotty's an IAA cat, I had him in remission from Feb to Nov but now he's back on 4.25 inits 2X a day. I think I would have a hard time with a regular non-complicated diabetic cat. I would probably test them 50 times a day.
     
  69. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    You don't need to start from scratch with the Lantus forum members. Just point them to your post here and they can read it. That along with the spreadsheet is the tool we use to communicate.

    We have people around the world on the forum - someone will be up and on in an earlier time zone who can help.
     
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  70. Jeanne & Dottie

    Jeanne & Dottie Member

    Joined:
    Jan 9, 2016
    Fancy Feast Gravy lovers...hokay, going out to buy some of that today.

    I'm going to reccommend a wonderful chocolaate for beans: Ghirardelli Intense Dark 86% cacao midnight reverie. It comes in a 3.17 oz. bar and supposedly compares to regular chocolate, as fine scotch compares to moonshine. Walmart carries it, and also some of the superdooper jumbo grocery stores.

    I started out eating it for my health. Supposedly the darker the chocolate, the better. "Only a tiny piece." I told myself. "Just a smidgen, a tenth of a bar." This after being addicted to Dove Chocolate for years. (mmmmm how CREAMY!)

    Ha! I have to put the darn stuff out of reach or I'll kill that bar in a day, and make myself really ill. If someone told me I'd develop a hankering for a bitter chocolate, I'd have laughed in their face.

    So it's probably not a chocolate to have for emergencies, when you want to eat a WHOLE LOT in A VERY SHORT TIME...because it's really dense in cacao. Dunno the caffiene levels in it...probably would rev you up that you can tap dance in your sleep... But for a special treat now and then? Wowzer!

    Hey, I just found out that cats don't have taste receptors on their tongues for sweet taste. So technically they shouldn't care about anyone adding syrup to their food. Unless what's left over in corn syrup besides the sweet taste is yukky,:eek: not sure.

    That's a shame kitties can't taste sweet. I feel sorry for them, because my life would be so much the poorer without sugar.o_O And imagine not EVER knowing Dove chocolate?
     
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  71. Nancy and Scotty

    Nancy and Scotty Member

    Joined:
    Jul 13, 2014
    I will still be up at 0600, I will watch for your post but there will be others up then too.
     
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  72. ELLIOTT & Fran Munschauer

    ELLIOTT & Fran Munschauer Member

    Joined:
    Jan 1, 2016
    EICD? You have no idea the jargon here that I could not figure out until a nice member listed all of the meanings..but not EICD... Shoot. AMPS,PMPS, etc,etc I still don't know what "bump" refers to when not in a sentence. And so, by 3 am Elliott's BG could plunge again....Who are the Lantus experts or do I just ask anyone for help like ASAP at 6 am or shall I follow Chris's plan? I will wait to see the next BG's..YOU ARE EXCEPTIONAL PEOPLE.. I HAVE NEVER KNOWN THAT PEOPLE LIKE YOU EXISTED!!!!! I HAVE TOLD EVERYONE ABOUT YOU. I think that no one can really appreciate all of you just by hearsay..First hand experience has taught (or reminded) me the greatest lesson of "CARING"..That of which I have been quite skeptical over years of seeing the way we treat animals!!! (Oh, and people too)
     
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  73. Nancy and Scotty

    Nancy and Scotty Member

    Joined:
    Jul 13, 2014
    ECID Every cat is different. I would be very cautious, maybe even not shoot more than .50 if his blood sugar is over 200, I mean from the time you shot the 2 units yesterday morning it was just one big drop and you don't really know what a good lantus number for him may be, I would rather see him high for a couple days and increase his insulin slowly to see where he really needs to be. Like I said I will be up at 0600 though and don't worry other people will see and jump in to help. By the way bump is just sort of internet high five.
     
  74. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    You can test again now, and if Elliots blood sugar is still as high as it was last test, you are probably OK to call it a night. If you are worried, leave some food out for him to graze on if he should go low. But it's unlikely he'll go into danger territory now.

    The Lantus forum, like the rest here are all open and peer reviewed. There are no "experts" but there are some people with more experience than others. Your job is to sift through what is posted and do what you are comfortable doing. We are not there with Elliot as you are.

    I'm off for the night. Good luck tomorrow.
     
  75. ELLIOTT & Fran Munschauer

    ELLIOTT & Fran Munschauer Member

    Joined:
    Jan 1, 2016
    Nancy and Scotty...I agree completely..I will do a 3 AM BG and try to stay alert for the 6 am start over again..Frank,( husband) has been relieving me at 6 am but today, I had better be ready for ????
     
  76. ELLIOTT & Fran Munschauer

    ELLIOTT & Fran Munschauer Member

    Joined:
    Jan 1, 2016
    Thanks and goodnight!!!!
     
  77. ELLIOTT & Fran Munschauer

    ELLIOTT & Fran Munschauer Member

    Joined:
    Jan 1, 2016
    AlphaTrak=323...Relion=297
     
  78. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

    Joined:
    Jul 18, 2011
    That's a bounce caused by the low numbers he hit. His body isn't used to being that low and releases hormones to bring him back up. Nothing to worry about. A bounce can last as long as 6 cycles, but since ECID, you don't know for sure how long it will last in your cat until you have a lot of data on him.

    You did just fine, Fran. We all panic the first time our kitties go low. You are right about the people here. They literally saved my Cinco's life, and my sanity. They have helped me with all of my kitties, and when I lost my beloved Civvie, Minka, a few days ago, the sympathy and compassion was overwhelming. People that join this forum are here because they love their kitties, and they identify with each other because of shared experiences. Once you've been helped, you want to pass it on.

    When you post in the morning, start a new thread in the Lantus & Levemir forum and do a subject line something like this: "1/22 Elliott AMPS 200. Dose?" There is also a ? icon you can add if you put your cursor over the first part of the subject line where it says "no prefix". We have plenty of East Coast people that log on early to see if anyone needs help, so you should get a response. BTW, where do you live? It helps to know what time zone you're dealing with.
     
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