Ovie is just starting Insulin

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KATIE&ovie

KATIE&ovie

Member Since 2017
I am very new to this. My kitty started Lantus insulin last night at 8 pm. The vet recommended 1 U 30 minutes after his meal in the morning and at night. His pre shot test was 372 (last night). I tested him again 2 hours later at 10pm and his BG went down to 272. I fed him at 7:30am this morning and tested him at 8am and his pre shot test was 69. Does the mean that the dose the vet recommended was too high for him? i left wet food out for him last night but he didnt eat it. Help!
 
Welcome, Katie!

It's awesome that you are testing at home. Have you looked in to setting up a spreadsheet? I know it seems complicated and daunting, but once you get it up, it's smooth sailing and people can help if you can't figure it out.

Which monitor are you using? Put that in your signature if you can, the more info you provide, the better people can help you. I don't have much to offer in interpreting if the dose it too high (I'm fairly new here myself). But, the 1 unit seems to be a pretty standard starting dose and of course, it can be too much (or too little) insulin for you cat. Testing and recording the data is the only way to know that and then you can make decisions about increases and decreases from there.

Read over the stickies at the top of this forum, it won't all sink in, but the more you review them, the better off you'll be navigating this crazy sugar rollercoaster. :cat:
 
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Hi Katie! Here's some basic info on finding a good dose:
Test every day AM and PM (no food at least 2 hrs before those tests) before feeding and injecting (12 hrs apart) to see if the BG is high enough to shoot the planned dose
Test at least once near mid cycle and before bedtime every day to map BG under the influence of insulin
Do extra tests on your days off to fill in BGs at other hours
If indicated by consistently high numbers on your SS, increase the dose by no more than 0.25 u at a time so you don't accidentally go past a good dose
Post here for advice whenever you're confused or unsure of what to do

Like Stacy said, read and reread those stickies!
 
Thank you guys. I will really study those stickies. This feels like such a daunting, scary task. I have the Prodigy meter for him. I will look into doing the spreadsheet. I downloaded a pet diabetes tracker to my phone but I don't think it's super detailed.

So, his pre shot test should be before eating food? I'm going to go back and do some more reading. I'm confused. ☹️
 
Hi Katie and welcome to you and Ovie,
Generally we Test, Feed, and Shoot more or less simultaneously (in that order). There is no need to wait 30 minutes after testing to shoot. The 69 you got this morning probably indicates that Ovie's dose is too high. We have two protocols in the Lantus/Levemir Forum and you at some point will have to make a decision as to which one you want to follow: TR (Tight Regulation) and SLGS (Start Low Go Slow). Both are described in the "Stickies" (informational posts at the top of the page). Whichever one you decide on, a Spreadsheet will help others to help you. There are instructions for setting up a Google Spreadsheet in the Tech Forum: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/ Ask if you need help setting one up. You will need a Google account to begin.
There are "cut-off" numbers for each of the protocols (i.e., numbers that are too low to shoot). I don't remember them offhand, but please read the Stickies.

I'm not familiar with the Prodigy meter. Many people here have found the Walmart Relion meters (either the Confirm or the Micro) to be a good choice. The strips are not expensive and the blood sample is very small--an important consideration.

Feline Diabetes is an adventure. The people here will help you get on the right path! Welcome!
 
Welcome to the forum.

When I started my second FD kitty on insulin...Levemir...similar to Lantus in that it is a gentle long acting insulin...I started her with 1 unit. She dropped like a rock with the first shot....400 at preshot to 45 at +7. I was not prepared for that since my first FD kitty showed very little movement in the beginning. I ended up using 0.25 units as a starting dose and then kept increasing from there. She did end up back at 1 unit after a couple of weeks, but at least there were no huge drops. ECID...every cat is different.

The more tests you can get in the clearer the picture will become as to how the dose and insulin are working for Ovie. Good luck :bighug:
 
Ella & Rusty & Stu(GA) said:
Hi Katie and welcome to you and Ovie,
Generally we Test, Feed, and Shoot more or less simultaneously (in that order). There is no need to wait 30 minutes after testing to shoot. The 69 you got this morning probably indicates that Ovie's dose is too high. We have two protocols in the Lantus/Levemir Forum and you at some point will have to make a decision as to which one you want to follow: TR (Tight Regulation) and SLGS (Start Low Go Slow). Both are described in the "Stickies" (informational posts at the top of the page). Whichever one you decide on, a Spreadsheet will help others to help you. There are instructions for setting up a Google Spreadsheet in the Tech Forum: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/ Ask if you need help setting one up. You will need a Google account to begin.
There are "cut-off" numbers for each of the protocols (i.e., numbers that are too low to shoot). I don't remember them offhand, but please read the Stickies.

I'm not familiar with the Prodigy meter. Many people here have found the Walmart Relion meters (either the Confirm or the Micro) to be a good choice. The strips are not expensive and the blood sample is very small--an important consideration.

Feline Diabetes is an adventure. The people here will help you get on the right path! Welcome!
Click to expand...

Thank you for info. :-) I will look into it. The low and slow seems like a good option for us. I do have a google account so I will probably start a spreadsheet some time today.
 
Tuxedo Mom said:
Welcome to the forum.

When I started my second FD kitty on insulin...Levemir...similar to Lantus in that it is a gentle long acting insulin...I started her with 1 unit. She dropped like a rock with the first shot....400 at preshot to 45 at +7. I was not prepared for that since my first FD kitty showed very little movement in the beginning. I ended up using 0.25 units as a starting dose and then kept increasing from there. She did end up back at 1 unit after a couple of weeks, but at least there were no huge drops. ECID...every cat is different.

The more tests you can get in the clearer the picture will become as to how the dose and insulin are working for Ovie. Good luck :bighug:
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Do you think I should do a curve starting out? He's super chill and will let me do it. Our vet didn't do a fructosamine test on him bc he had pancreatitis and we are pretty strapped financially. I know the fructosamine would give a bigger picture on his condition.

I'm thinking we will do the go low and slow method.
 
Welcome to you. Sorry you have to be here but hopefully it won’t be for long. I’m glad that you found us right away because based upon your vet’s instructions to waitto shoot a half hour after feeding he might not be as knowledgeable about lantus as we are here. There’s a lot of info here so take it in as you can and post with questions as often as you need.

I definitely think the starting dose is too high. Most new to insulin won’t shoot under 150. If you choose SLGS your shoot number will be higher. I’d get a +2 test.
 
KATIE&ovie said:
Thank you guys. I will really study those stickies. This feels like such a daunting, scary task. I have the Prodigy meter for him. I will look into doing the spreadsheet. I downloaded a pet diabetes tracker to my phone but I don't think it's super detailed.

So, his pre shot test should be before eating food? I'm going to go back and do some more reading. I'm confused. ☹️
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You would do a preshot test anyway, with or without food, but it's better to have no food 2 hours prior to shots so you can see the number without food influence. It is overwhelming at first, but it gets easier. The spreadsheet is a way to get help on this forum, it's in a format that everyone can use no matter what country or timezone they are in. It's also a great visual with the colors to see how your cat is trending. It's fine to keep a separate log at home for just you, but try to keep your spreadsheet up to date so that people can help you here (especially if you're in a crisis, that's not the time you'll want to try to update and fill in the blanks). I keep a handwritten log with all my diabetes stuff that I put info down in immediately with exact times when I test and shoot and notes on weight and food, but I try to put that in my online SS as soon as possible. Once you make it a habit, it's no big deal.
 
KATIE&ovie said:
Do you think I should do a curve starting out? He's super chill and will let me do it. Our vet didn't do a fructosamine test on him bc he had pancreatitis and we are pretty strapped financially. I know the fructosamine would give a bigger picture on his condition.

I'm thinking we will do the go low and slow method.
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The best thing to start would be some spot checks. Always a preshot test, with no food for at least 2 hours before the test, to make sure the number is not food influenced. Lantus "usually" will have an onset ( start of action) at +2 -+3 hours after the shot, so getting a test in that time frame would be useful. The peak action is "usually" around +5-+7 hours so another test in that time frame to see when the nadir (lowest reading) occurs would be useful. It takes a number of days for the depot to build up with either Lantus or Levemir, so it is hard to judge after only a day or so. My feeling is that doing some spot tests at this point will ensure that the dose is not to high and your kitty doesn't drop too low. Starting with 1 unit is quite normal, but since ECID it is good to get those tests in between shots to see how Ovie is responding.

You have started off in great fashion with already home testing. That is so very important to keep your kitty safe. Setting up a spreadsheet to record your tests gives a great visual aid and is most useful when other members need to weigh in.

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
 
Thank you for your response

I just checked him again. He ate at 7:30 am... I checked him at 10:40 am and he was at 62. I fed him again bc that is pretty low without insulin isn't it? He's been like 15 hrs without an injection.
 
Tuxedo Mom said:
The best thing to start would be some spot checks. Always a preshot test, with no food for at least 2 hours before the test, to make sure the number is not food influenced. Lantus "usually" will have an onset ( start of action) at +2 -+3 hours after the shot, so getting a test in that time frame would be useful. The peak action is "usually" around +5-+7 hours so another test in that time frame to see when the nadir (lowest reading) occurs would be useful. It takes a number of days for the depot to build up with either Lantus or Levemir, so it is hard to judge after only a day or so. My feeling is that doing some spot tests at this point will ensure that the dose is not to high and your kitty doesn't drop too low. Starting with 1 unit is quite normal, but since ECID it is good to get those tests in between shots to see how Ovie is responding.

You have started off in great fashion with already home testing. That is so very important to keep your kitty safe. Setting up a spreadsheet to record your tests gives a great visual aid and is most useful when other members need to weigh in.

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
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I definitely tested him wrong yesterday. I fed him and then tested. So his reading was 372 after a meal.
 
I think you are off to a great start and have a good plan. Just wanted to comment on the fructosamine test. If you are home testing, I don't see any value in this test. It is basically a long term average. Once you have your spreadsheet with pre-shot, mid cycle and a few other spot checks you will have much better data that is far more valuable than a simple average. Please don't feel bad you haven't done this test - in my opinion it would have been a waste. Your time, effort, and money is better spent with a good home testing routine.
 
KATIE&ovie said:
I definitely tested him wrong yesterday. I fed him and then tested. So his reading was 372 after a meal.
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For the preshot test you always allow at least 2 hours with no food. That way you know that the reading is not food influenced and that it is a safe number to shoot. After the shot is done I personally feed about 4 times in between shots...a couple of regular feedings and a couple of snack feedings.
 
Carol in Chicago said:
I think you are off to a great start and have a good plan. Just wanted to comment on the fructosamine test. If you are home testing, I don't see any value in this test. It is basically a long term average. Once you have your spreadsheet with pre-shot, mid cycle and a few other spot checks you will have much better data that is far more valuable than a simple average. Please don't feel bad you haven't done this test - in my opinion it would have been a waste. Your time, effort, and money is better spent with a good home testing routine.
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Thank you Carol. I'm trying to manage his diabetes in the most affordable way I can. I told the vet I could do curves anything really to save money.

I downloaded the google sheets app so I will start on the spread sheet. But I'd imagine I have to start it when he has had insulin right?
 
Yes - use the spreadsheet to track his response to insulin. If I understand you correctly, you have given 1 shot, but skipped the 2nd because of a low number. What I would suggest is you start with your first pre-shot number. Include any additional tests taken at the +2, +6 etc. For the skipped shot, record NS and keep the same schedule - for the example here where you mention it is +15 since his last shot, I understand that to be 3 hours past the time of no shot (so it becomes your next +3).

I hope this make sense - please ask more questions if it doesn't. Meanwhile, good call on skipping the shot and I want to make sure you have good guidance on a lower dose?
 
KATIE&ovie said:
Thank you for your response

I just checked him again. He ate at 7:30 am... I checked him at 10:40 am and he was at 62. I fed him again bc that is pretty low without insulin isn't it? He's been like 15 hrs without an injection.
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That’s great without insulin. Was he started on insulin after just one test? I definitely think his starting dose is too high. It will be interesting to see what his pops number is.

Max only had one curve at my vet’s office and that was after his first shot. Testing at home is more accurate. No vet stress. I tested enough, actually a lot, so never did a real curve. As for a fructosamine, maybe we did it once other than when I felt he might be in remission and I didn’t. He wasn’t.
 
He was diagnosed in March but we had just moved and couldn't afford to start treatment. They were telling us intial costs would be upward of $800 to 1k and told me to euthanize him if we couldn't afford it. Since then we started wet food but he had been to the vet a few times in between and his reading were in the 370s to 400.

The vet we took him to for the pancreatitis was very understand of our financial situation (my husband lost his job) so he was like let's try 1U. I told the vet I'd do whatever I could to reduce costs.

YOu are right.. 1 U is probably to high to start. I started the spread sheet too. I'll add it to my signature.
 
Carol in Chicago said:
Yes - use the spreadsheet to track his response to insulin. If I understand you correctly, you have given 1 shot, but skipped the 2nd because of a low number. What I would suggest is you start with your first pre-shot number. Include any additional tests taken at the +2, +6 etc. For the skipped shot, record NS and keep the same schedule - for the example here where you mention it is +15 since his last shot, I understand that to be 3 hours past the time of no shot (so it becomes your next +3).

I hope this make sense - please ask more questions if it doesn't. Meanwhile, good call on skipping the shot and I want to make sure you have good guidance on a lower dose?
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I started the spread sheet. I think I did it correctly. I will add it to my signature. His PMPS and AMPS says that it was taken after his meal. Tonight I will make sure it is before his meal and no food for two hours before.
 
I think you have been doing things right since March. :cat:

Good call on the transition to wet food. I'm not sure if this is a low carb (LC) variety or a way to get away from dry. When you have a chance, check the food chart to determine carb %.
 
low 60s after NS?!:woot:
:D:D God bless you!
hopefully the wet LC food alone will be enough to control the BG level.

PS. Fire your "understanding" vet in the rudest fashion possible and get a moment to write a nasty Yelp feedback for him.
 
It's strange though. My mom is diabetic and I have been spot checking his BG before starting the Lantus when I was able to get her meter. His BG has always been in the mid to upper 300s when I've checked. That's why I'm confused his BG has been in the 60s all day.

I feed him the Friskies patte variety. The ones I feed say they are 4% and 5%. I've seen other sites that say they are 9%
 
Welcome. Lots of good people trying to help here.......
Please don't risk anything until kitty is regulated and you know how Ovie reacts to insulin. That will take some time, unfortunately (take a look at Toro's SS in August 2017, jumping like a monkey).
Please follow the SLGS or TR (whichever fits you better) from this forum and you'll be fine - they are both safe and proven.
Friskies are good, we use them too......little bit more carbs than Fancy Feast pate but will probably work. We use Friskies as "HC" when the BG is low because of their 5% carbs (FF are 0-3 % carbs) and because Toro loves Friskies and he'll devoure them anytime - and when he's in low BG numbers he MUST eat . :)
Good luck...and be patient. On the end the patience will pay off.
Cheers.
 
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Toro & Ovi said:
Welcome. Lots of good people trying to help here.......
Please don't risk anything until kitty is regulated and you know how Ovie reacts to insulin. That will take some time, unfortunately (take a look at Toro's SS in August 2017, jumping like a monkey).
Please follow the SLGS or TR (whichever fits you better) from this forum and you'll be fine - they are both safe and proven.
Friskies are good, we use them too......little bit more carbs than Fancy Feast pate but will probably work. We use Friskies as "HC" when the BG is low because of their 5% carbs (FF are 0-3 % carbs) and because Toro loves Friskies and he'll devoure them anytime - and when he's in low BG numbers he MUST eat . :)
Good luck...and be patient. On the end the patience will pay off.
Cheers.
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I will look up Toro's story. I'm looking to learn as much as I can.
 
At what BG number do you typically give the insulin? I will be doing his PMPS in an hr. I tested his BG 30minutes or so ago and he was 147.
 
KATIE&ovie said:
At what BG number do you typically give the insulin? I will be doing his PMPS in an hr. I tested his BG 30minutes or so ago and he was 147.
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The numbers you look for are shown on the forum’s SLGS and TR protocols.
We(wife and myself)usually shot full dose over 100 or reduced 0.25/0.5 U under 100(numbers for human meters). But that’s only us and only if we are home and able to monitor the kitty and check the BG @+4-+6 when Toro is having it’s Nadirs.
I believe these numbers are a little bit more aggresive than the ones from the forum’s protocols so I suggest you don’t follow them before you know how your kitty is reacting to very low BG numbers(which you’ll have sooner or later if you shot low).
Cheers.
 
Toro & Ovi said:
The numbers you look for are shown on the forum’s SLGS and TR protocols.
We(wife and myself)usually shot full dose over 100 or reduced 0.25/0.5 U under 100(numbers for human meters). But that’s only us and only if we are home and able to monitor the kitty and check the BG @+4-+6 when Toro is having it’s Nadirs.
I believe these numbers are a little bit more aggresive than the ones from the forum’s protocols so I suggest you don’t follow them before you know how your kitty is reacting to very low BG numbers(which you’ll have sooner or later if you shot low).
Cheers.
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Thank you. I'll look at the SLGS again. I knew I saw it somewhere. My brain is mush today.
 
KATIE&ovie said:
Thank you. I'll look at the SLGS again. I knew I saw it somewhere. My brain is mush today.
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But looking at Ovie’s numbers.... be very careful especially if you switched him from dry food to low carb wet food... that switch alone may have reduced drastically the BG numbers and may need just a small dose of insulin.... or none. Take his fasting BG for few days and go from there.
 
Toro & Ovi said:
But looking at Ovie’s numbers.... be very careful especially if you switched him from dry food to low carb wet food... that switch alone may have reduced drastically the BG numbers and may need just a small dose of insulin.... or none. Take his fasting BG for few days and go from there.
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He has been eating wet food since March. I didn't give him any insulin. Tonight. I will probably check him again soon. He ate a half can of food at 8pm.

Let's say I check him at 10 and his BG rose to like 250-300 would I give insulin? Or wait till what I planned would be his next "scheduled" shot.

Thank you for all of your advice.
 
At 250-300...for sure. But you have to try to be constant at shooting at 12 hours interval. If you can't do that better skip when you are out of schedule.
 
KATIE&ovie said:
Let's say I check him at 10 and his BG rose to like 250-300 would I give insulin? Or wait till what I planned would be his next "scheduled" shot.
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Shot times with Lantus are 12 hours apart, regardless of the numbers you see in between. You did no shot tonight, try and find a time both a.m. and p.m. that works for you and stick with it. Plus, your example would likely be food influenced. You need at least 2 hours before shot to make sure the number is not affected by recent carb intake.
 
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Thanks guys. I tested and his BG was 180 2 hours after his meal and no shot. I will see where he is at in the morning. I do want to stick with an 8am and 8pm schedule.

Thank you for all of your help.
 
KATIE&ovie said:
Thanks guys. I tested and his BG was 180 2 hours after his meal and no shot. I will see where he is at in the morning. I do want to stick with an 8am and 8pm schedule.

Thank you for all of your help.
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About the food...Lantus starts working aprox. 2 hours after shot....so you'll have to develop a feeding schedule for Ovie.
Us (and again, it's just us) we feed Toro 1/3 of food @ 1 hour after AMPS and 2/3 @ 2 hours after AMPS. He's usually out of food 4 hours before the next shot which works perfect to get an accurate PMPS BG reading. We try to duplicate the schedule during the night and get some BG tests then (especially that Toro has lower BG numbers during night).
So unless the AMPS or PMPS numbers are too low for shooting, we never feed him during or before the shot.
Other members can comment on this, I believe there are a lot of other feeding schedules used out there (some with automatic feeder involved, etc.). Different kitties, different schedules, different responses to treatment.....every cat is unique, that's the beauty (and the beast) of it. :)
Cheers.
 
I need to come up with a solid eating time schedule. I have started to give him a half can of friskies at 8am and one at 8pm with snacks in between. I'm not sure what to do about overnight though. I just took his AMPS and he was at 259. He is eating now. The SLGS method says to start at .5 u of insulin? The vet said 1u but it made him low for over 24 hra
 
You might want to start a new thread, with today's date, Ovie's AMPS and use the question mark in the thread, asking for dose advice. I'm still learning as I go, but my personal opinion, if it were my cat, I'd consider starting with 0.25u given that Ovie had a lot of lower numbers yesterday, with no shot. I'm more conservative, I'd rather keep my cat safe, you can always increase if the dose doesn't do enough. For me, it was important to get an understanding of patterns, and you only have one day of data behind you ;). Hope you get some advice from more experienced folks, but those are my thoughts.
 
KATIE&ovie said:
I need to come up with a solid eating time schedule. I have started to give him a half can of friskies at 8am and one at 8pm with snacks in between. I'm not sure what to do about overnight though. I just took his AMPS and he was at 259. He is eating now. The SLGS method says to start at .5 u of insulin? The vet said 1u but it made him low for over 24 hra
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Agree with Christie: if Ovie' were my cat, looking at his numbers (259 after 24 hours with no shot in between), I'd consider starting with 0.25u. In few weeks you'll be at 1u anyway if 0.25/05/075u are not enough..........not big deal.
But as Christie, I'm relatively a newbie here...maybe more experienced members will tell you different.
Cheers.
P.S. "Snacks"...I hope they are no dry food, there is no place for dry food for a diabetic cat. Unfortunately, as they all seem to love dry snacks. :)
 
No dry food here only wet food snacks.

So I updated in a new thread. The night before last when I thought I gave Ovie 1u it was actually 10 (agghhhh) I misread the syringe. I feel awful I put him through that. ☹️
 
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