Still learning-When should I test on lantus?

I am still new, never posted on this forum. I am in the process of putting all my data in my spreadsheet I just downloaded last night. I have only tested right before I give kitty shot. What other times should I try testing my kitty on lantus and why? I appreciate any input. I apologize for not posting numbers yet.

 

Here's the most basic testing routine we recommend:

1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
3. do extra tests on days off to fill in the response picture
4. if indicated by consistently high numbers on your spreadsheet, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
5. post here for advice whenever you're confused or unsure of what to do.

 

Thank you! I didnt take food up this morning or last night. Maybe the food jumped his reading a little higher to 419. Even though he's still high. I go back to vet Tuesday to see how he is doing. Once I get all my data in spreadsheet maybe I should print to show the vet? I am constantly worrying about overdosing and getting him to gain weight. Im afraid she will up the dose and then I would really be worried. Been looking at other peoples sheets to see when they test, I am still too new and nervous yet to try to adjust the dose myself. But I could probably do testing throughout the day to see what his numbers are

 

There's no one "right" way to test. The minimum is a pre-shot test (to make sure it's safe to give insulin) and at least one test per cycle. It's helpful to try to time the additional test to somewhere around nadir (the lowest point in the cycle) which with Lantus is somewhere in the range of 6 hrs after a shot (+6). However, nadirs differ for many cats and nadirs can and do change.

If you look at people's spreadsheets, you'll get a sense of how frequently people test. I was a "testaholic" as are many others. I like data. Gabby was also a kitty who had an early nadir (around 3 hrs after her shot, except when it wasn't) and could dive into low numbers. I would test a lot early in the cycle to make sure she was in safe numbers.

Looking at Nermal's SS (spreadsheet), you do want to get some spot checks. Lantus dosing is based on the nadir and not on the pre-shot numbers. That's why we push for you to get some tests during each cycle. We generally encourage you to always get a "before bed" test so you can go to sleep with a pretty good idea that your kitty is in safe numbers.

While you may not be comfortable with dosing, many of us have been here for years and have gotten good at guiding new members. You'll also want to take a look at the information on the two dosing strategies we use: the Tight Regulation Protocol (TR) and the Start Low Go Slow (SLGS) method.

Also, please don't hesitate to ask questions. There's an overwhelming amount of information in the sticky notes and all of the associated links. It really does become easier and you have an entire community of people here who are very generous with their time and knowledge and willingness to help you.

 

I appreciate all of the advise. I will try to test him tonight before going to bed. Guess I should stay up late for it
I give shots 630 am and pm due to my own schedule. I am still working on inputting my spreadsheet-trying to do it over the phone. I keep an old fashioned system-pen and paper.

 

Welcome. I used the email my ss to my vet every few weeks. He showed it to all his vet students when they spent a week at his practice. I’d definitely bring a copy to your appointment and see what type of response you get. I wasn’t going to test at all at first but soon became a testaholic, lol. Max liked to drop at night.

 

Thank you

 

If you look at garfie ss you can tell I also was a testaholic! I will admit it I had a problem, I was always worried even paranoid. I would input on his ss but I also use the pen and paper and colored markers to color in each poke I did. You never know when computer would crash then what all data gone. Me I had to learn how to use a computer and learn about what to do to help my boy. Ask questions even if you think they may be wierd you have family here just ask for help.

 

Hi, where are you? You haven't posted since Saturday? I hope everything is OK?

If you need advice people will want to check Nermals' SS. The more data (testing) you provide the easier it will be to help you help Nermal.
There's a ton of info here to read. The more you know about the insulin & how it works the easier it will be for you to understand about his dose & how much to increase or decrease.
I'm happy to hear your vet is interested in the SS My vet told me in the beginning it was Cruel to poke his ears so many times. After I started keeping a spread sheet & showed it to him he was amazed!
I told him Ravan comes to me to be tested now. He knows I love him & he trusts me to help him.

The more information you read the better. Can I ask when did you stop feeding Dry food? Some kitties have gone into remission when dry food was eliminated. It usually lowers the bg right away.
I still keep a written note book with Ravan's bg readings.A year ago my computer crashed & I lost a bunch of Photos of my grandkids,so now I need to make sure i have the important stuff saved i.e.Ravan's SS

Nermal has such beautiful Blue Eyes! And I love unusual names, Nermal?

Trust the "Old Timers" here that are gracious enough to stay around to help us. They have a lot more experience with diabetic cats. MORE than nearly ALL vets do.

Ask questions, test more. We've all been New like you.

It will be OK. It gets easier the more you know. I promise. (Not easy! Just easier )
One more thing. I know most people give the shot in the scruff of the neck. The first time I tried that I did a fur shot! Now I give Ravan his insulin in his side about in the middle. He has black fur so I make sure I see skin & aim the needle at an angle not straight in. Never did a fur shot again !

Hope to "see" you again!

 

Yeah his fur shot was an accident really he went for the cap of the needle right when I was about to do it and it even pricked my finger, not making that mistake again. I give it on the sides, they are shaved from the vet. Going to vet tomorrow actually to ser his progress. I live in Norman, Oklahoma.

 

So vet wants to to start tonight giving 2 units of lantus, however she did say I could call her personal number if there are any problems.

 

Laura, you may want to wait on giving Nermal an increase of a whole unit tonight. Let some of the experienced Lantus users take a look and weigh in. That's a big amount for a cat and by increasing by that much, you might miss the right dose, pr lower his BG too suddenly and scare his liver into releasing sugar because he is used to the high numbers. That starts a bounce and that is not fun.
Most increases are advised to be 0.25 to 0.5 U at a time. Do you have syringes with half unit markings?
You know that the members here have been taking care of sugar cats for a long time, and have dealt with all these issues before.
Listen carefully to the advice, we all want the best for Nermal.

 

She said his numbers are still very high and she was definate on the amount. I asked sbout smaller units and she says he should be fine on 2 units. The vet is only 2 miles away. She said I could call her cell if I had any issues. She said don't give any if he falls below 200

 

I think you should increase only to 1.25u. I'm sorry, but we have seen many, many more diabetic cats than your vet ever will. Please start to get more mid-cycle tests if you increase.

 

This is so crazy frustrating. I am torn on what to do. She says she has hundreds of diabetic cat patients.

 

Laura, what is it going to hurt to increase gradually? I just would hate to get up tomorrow morning and see that you and Nermal had to go through a hypo in the night. That is hard on the cat and the bean. I am not saying don't trust the vet, just be careful of Nermal. He is precious and I know you want to do the best for him. Do you have your hypo instructions printed out, do you have your hypo toolbox ready? And lots of strips for testing? I see that he is still high, and that worries you. I understand, but also not shooting if under 200 also disrupts the insulin depot. You don't wanting him bouncing up and down.
Take it nice and easy, accelerate gradually, don't peel out.

 

I am thinking i will do the normal dose tonight, since I have a horrible migrain. Run tests throughout the night.

 

I do have Karo available. She said I should do the 2 units when I am able to watch him. So I was thinking in the morning shot I should do what she suggests. She says she always has her phone on her, and can have her staff see me after hours if necessary. I asked her about just one and a half unit. She does not think it is enough, she said she wants his pancreas to start healing. It is kind of hard to think straight today I apologize I suffer from horrible migrains.

 

I'm sorry you are not feeling well Laura, please take care of yourself. You are going to decide what to do, I just tend to try to err on the side of caution. 1.25 or even 1.5 U might avoid a hypo is all, and you will be able to determine if it's not enough if you hold through the recommended number of cycles.
A hypo is seriously unpleasant and can be very dangerous for a cat. Yes, you can call the vet if a hypo is happening, but you still have to handle that event, and you can go to the vet after hours, but it's going to cost you if you do that, and be very unpleasant for Nermal. It's hard on our cats just to go to the vet, that in itself raises stress levels. We also want his pancreas to heal, that's the ultimate goal.

 

So my needle does not have in between. It is a U100. He has gained 6 ounces-but could gain a little more.

 

So, tomorrow, when you feel better, find some syringes with half unit markings. We found ours at Walmart, the ReliOn brand, (after getting a box of the wrong kind.) Take your empty box with you and compare the labeling, not the brand, so you get the right kind. You can always put the little bags of ten back in when you get home. And you will most likely use them later.
If in doubt, ask. Most of the staff aren't actually aware that the syringes have half unit markings, but they do. One step at a time, Laura. That's all anybody can do. Learning the sugar dance is a slow process that requires patience, so take it easy on yourself and stay the course. You will have the reward of Nermal getting better and better.
I know that someone posted a picture of the box of ReliOn syringes a while ago but I don't know where that is, hopefully someone does and can post it.

 

I have been buying needles from the vet-she told me I needed a script to get needles

 

I looked that up, I didn't realize that, pardon me. Here in WA there is no regulation preventing us from getting insulin syringes w/o a prescription.

 

Yea I think Oklahoma must have one. This is a wacky state.

 

As far as I know in most places they want people to have access to clean needles, even if they intend to use them for "bad" stuff, from a public health standpoint it's much better than having people using or sharing dirty needles, just like providing access to condoms, it prevents a lot of potential health risks to the general population. Nonetheless you should be able to get a script from your vet for 30 unit syringes with half unit markings. I buy mine on amazon and it's never been a problem.

 

IL does too.

 

So I barely slept last night, decided to give Nermal 1 unit this morning. I was debating and debating about the 2 units. I decided to go with the vet’s advise. I double checked with her on the dose, and interrogated her pretty much. She is worried about him getting ketoasidosis. I made the choice to give 2 units. I am going to stay up late with him, and test him. I have Karo syrup just in case. I also can call my vet’s cell phone(this is how she reassured me). Her or her staff would be right there for him if need be, and it’s less then 2 miles away. My vet has Taken an effort to build my trust. I do appreciate everyone’s advise. I would not have checked his numbers every 2 hours today if I had not come here. I just had to go with the vet’s advise.

 

Ultimately everyone is just sharing their own experience. You have to trust you gut, whether that means "know thy cat" or taking your vet's advice or going against it. You are a great cat mom!!

 

Good luck this evening!! Plenty of people keeping an eye on you, so make sure you keep us posted...

 

Thank you-I really did debate the advise I got here yesterday. I slept for only 4 hours. I am watching him like crazy, even through a 2 day headache. I’m afraid I have not let him sleep very well. Going to test again in 30. My vet did a lot of convincing to me, I told her I came online here, and kept asking her are you sure about 2 units- not 1.25 or 1.50? She says she has 100s of diabetic cats she sees, it is a cats only clinic.

 

You have to trust your gut. You’re going to do just fine tonight. And yes, sleep deprivation is part of it, especially at first. It’s great that you have a good relationship with your Vet. Like someone else said, we are all just sharing our experience and lending advice. Don’t feel bad about going with what you feel is right. Just make sure you test often and if you run into any troubles reach out and make sure you put a “911” in the header of your thread. There’s always people here to help. In the beginning, I had people stay up all night with me and Jade ( literally all night) it made such a differenc to know I wasn’t alone. These people saved her life.

 

I do appreciate everyone here, i have gotten great advice. I have gone through so much lately with him it is hard to take in so much information. I just took it again at 11:30 and it is still high. He does seem to have more energy, I see him stretching and grooming more then he was before I started him on insulin, and standing taller. I just don’t understand why his numbers are still so high. I wonder if he is reacting on my stress?

 

Could be... and aren’t you pretty new to this? It’s going to take time. And patience. Lots of both. So t forget to breathe. More energy is a good thing! You’re doing a great job. Don’t get frustrated... baby steps. I promise you that we have all been where you and feeling exactly the way you feel. It gets better.