Update on Felix

Felix went to the vet and his glucose was at 300. They said it was spilling into his urine but I caught it in time and no damage was done. Now we have a prescription of Lantus. The vet said to give him 2U each day but I prefer to test him and give him an accurate dose. I tested him about a half hour ago and he was at 74 do I need to give more insulin? That is a lot better than the 300 numbers he was at recently. He has not yet eaten yet and it looks like he is not interested in eating.

We are to do a curve and then drop it off at the vets. Can someone tell me how to do that?

Thanks so much!

Sandy

 

Hi, Sandy,

Welcome to FDMB! You will find extremely knowledgeable and supportive people here. It's wonderful that you have started testing.

I'm more in the supportive than the knowledgeable category. But I would say that you don't have enough data on Felix to shoot 2 units of insulin with a last test of 74 (which is a great number).

I'd like to let others explain the curve process to you, but to get started, tell us what Felix's diet is. Sometimes a diet change alone can reduce numbers significantly.

Again, glad you found this site. Felix will do well!

 

How much insulin did you give?
How many hours after the shot did you get the 74?
What are you feed the cate and when do you feed?

A curve is taking blood glucose reading ever two you after the shot, including one at shot time.

Are you giving insulin one or twice a day

 

Felix is fed Friskies Turkey & Giblets special diet. I'm thinking of feeding the raw prey diet.

Felix went into remission in 2009. We were very active in the forum back then and now we are back.

Friday 11:15 AM he received 3U of Lantus after testing at 224. Friday at 8:40 pm his BG was 146 (no insulin was given). Saturday at 6AM he received 3U of Lantus before feeding then was tested at 11:45 AM and he was at 74. Today, Sunday at 4AM he received 3U of Lantus. At 10:40 AM this morning, he tested at 57.

So that is what has happened so far.

Thanks!

 

IMHO 54 is too low. If he goes below 50 or 40 at all you need to test again and make sure he is going up, not further down or else he may go hypoglycemic. Hypoglycemia kills very quickly. also Lantus is typically give 2 times per day, so it would be 1unit in the morning and 1u in the evening exactly (or as close as you can get) to 12 hours apart. I would NOT give any insulin with a number like that no matter what. I would be convinced I was going to kill my kitty.

Go read the stickies on the Lantus board. Check out some other people's Lantus kitty spread sheets and see how they do it.

I hope you see this and don't give that much insulin again, and only 1 time per day. You'll do just great, but the dosing and schedule is taking this kitty too low right now in my opinion.

He may have gotten even lower than the 50 number or the 70 number at some point in his cycle, but you don't know unless you test more often. He may have been seriously close to hypoglycemia.

 

I have to post one more time because I am scared for Felix. Lantus has a shed, or build up period which you don't see much action from it (or shouldn't) I am scared that after Felix fills his shed he is going to be very very low. Lantus is a slow and long acting insulin and should not be used to pull the numbers down like a crisis insulin.

The Lantus protocol suggests to start all cats on a 1u am and 1u pm schedule and go from there. 3s is a high amount.
Sorry for posting so much, just scared about the hypo situation.

Wishing the very best for you and your Felix kitty.

 

Re: Update on Felix-147

I thought I would ask before I handled on my own. I just tested Felix and he is 147. Do I give more Lantus at this point? Normally, I would just wait until the morning between 4-6AM to give him insulin but based on the replies I got, I may have being doing it incorrectly.

Any advice given would be very much appreciated.

Thanks!

Sandy

 

One more question, Felix weighs 17 lbs. Do I need to take his weight into consideration when giving insulin??

Thanks,

Sandy

 

Hi,

I'm also a newer member but I was given to understand that when starting a kitty on lantus, we don't give them the shot if their numbers are below 200. Just to be safe that we don't send them into hypo.
Also like everyone else doing the 1 unit in the am and then another 1 unit 12 hours later is best for starting out.
I would probably skip his shot this am if he's still around 147.

 

Good morning!
I would not give that shot and just skip it. Test a little during the skipped shot time.
My kitty weighs 16 pounds and was started on 1u 2x per day. Take a look at his spread sheet. So the first 3-5 days on his are his shed filling, then you can start to see some good reactions, and the blues and greens came as soon as I switched his food. If I had been giving even the whole 1u 2x per day still he would be hypo. Not to mention 3u!!!

My opinion and my suggestion (and it is just a suggestion) would be to skip this dose and give 1u at the next 12 hour point in time. Then start on a 1u every 12 hours dosing. You may want to contact your vet first. There may be some other reason we are not aware of that he started that 3u dose. ? See what other people here say too. I am certainly no expert. I definitely would NOT give the 3u on a number that low!

So glad to see that you tested and posted back here before giving any more insulin. The switch in food will make a big difference. Get some numbers and chart it all so your vet can see that 3u is too high, and the 1u 2x per day will be just fine. (If that is what you choose to do.) My vet and I were going to raise Duncan's dose on the 4th or 5th day and he said, "Let's just give it one more cycle, just to see what's going on." I'm glad I waited! And I am glad I was testing when I made the change to wet low carb food too!

Hope you guys have a great day!!

 

I skipped last nights dosage.

Felix received 1U @ 4:30 am. he tested at 232 at 11 am. How much insulin should i be giving him every 12 hours to keep him regulated?

 

You won't have a stable dose until he has 3-5 days on the same dose every 12 hours AND you have done a curve to see if he goes low enough but not too low.

You've gotten some good responses to what is happening already.
Re-cap:
1) NO insulin if he is under 200 at pre-shot

2) If he is over 200 at pre-shot, 1.0 unit of Lantus and monitor him about every 2-3 hours, because that still could be too much and you want to catch it if he goes too low before it becomes dangerous.

 

Gave him 1u at 6:45pm. Just tested him again and he was at 182.

 

Good luck with this new dosing regimen. It makes sense to me to start low and go slow. Looks like a good start.

 

Just tested Felix and he is at 63. Is this too low?

 

It all depends on where he is in the cycle. 63 is a good number for the lowest point in the cycle, it's too low a pre-shot number for most kitties to receive insulin, and if it's early in the cycle after having given a dose then you want to keep testing to make sure he's not going to go below 50 or 40 when you might need to intervene with some HC food or a very small amount of kayro syrup. So, need more information for sure!

Without a spread sheet it is very hard to help out, and it will be hard for you to see and keep track of kitties patterns and get to know how he does with difference circumstances.

 

Oh i see, but I have forgotten how to use the spreadsheet.

 

How far is he in his cycle when you got that test? 63 is a great nadir, but a scary +2 or +3. You really don't have to worry to much until he gets down to the low 50s and 40s unless it is early in his cycle but probably does merit watching to make sure he isn't still dropping.

Mel, Maxwell, Musette & The Fur Gang

 

Felix's first test and insulin shot were given on the 10th so it has been 11 days since we have begun monitoring and giving insulin to him. I believe that is what you are referring to when you asked about his "cycle". If that is not what you were referring to please let me know

 

No, a cycle is the time between one shot to the next shot there are two cycles per day. Like with Musette I give her shots at 7am and 7pm, so her first cycle would be from 7am to 7pm, her second cycle would be from 7pm to 7am.

Mel, Maxwell, Musette & The Fur Gang

 

Can someone please fill me in on how to use the spreadsheet?

Thanks!

 

Sign onto Goggle. Then go to Google docs, then search templates for FDMB spreadsheet. Once you have chosen the template, follow these directions:

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

It is tricky so if you need help, just ask.

 

Thanks!

 

If Felix just tested at 127 do I need to administer insulin?

 

Usually the rule of thumb when you are just starting out is to not give insulin if they test below 200. You can either stall the shot and not feed and retest in a half hour to see if they have risen enough to shoot or skip the shot for the evening.

Mel, Maxwell, Musette & The Fur Gang

 

I don't use Lantus. Here is the protocol on what to do with a low preshot number.

http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=147

Hopefully a Lantus user will be along with specific advice for you.

 

Hey there,
Once you have a spread sheet going you will be able to see what normally happens in his cycle and you will have a lot more information on if he tends to dive really low during a cycle or stay more even. Once you know that information you can make a decision better. But for now I would agree to stall a little and see what happens and if he is heading more toward 150 go a head with the shot. (I also don't know how much Lantus you are giving, or for how long which also makes a big difference in if you were going to give a shot on a lower number.) If he isn't rising that high I would skip it. Also, if it is borderline and you are going to be around to test and intervene if necessary then you could give it. But the safest thing (especially just starting out) is to skip it.

Even if you can't get the google spread sheet thing to work yet, please keep track of these blood glucose levels on paper so you can gather some information on Felix and see how he's doing over all. I can't live without my spread sheet - those numbers just fly right out of my head. :lol: And there's no way I would know that Duncan can have a low shot because he tends to have an even cycle, and not dive or bounce.

I would be happy to set up the spread sheet and enter your numbers you have so far if you want to PM me. Then you can just log in and update it. Do you have a google account for anything else? Send me a private message if you'd like some help.

Have a great day.

 

Felix's Spread sheet: (I sent her a PM with lots and lots of information about a new dosing plan and how to dose Lantus, so she has the immediate information she needs to do this differently so don't bombard her ok?)

https://docs.google.com/spreadsheet/ccc ... E5Yb3V1M3c
Felix's Spread Sheet

 

Hello everyone,

Sara did an awesome job setting up Felix's spreadsheet. I have attached it to my signature so everyone can now see how he is doing. I applaud Sara for her dedication to helping others on this forum and extend my gratitude and appreciation to her and everyone else that has helped.

I now have a new regimen and will see how it works out for Felix. I will not be home to test at the +4/+6 so I will have to do it when I get home.

Happy Holidays everyone!

Much love and appreciation,

Sandy and Felix

 

Just looked at your spread sheet after I got home and that's so good shooting!!
Nice low numbers too.

That 83 so late in the cycle makes me really wonder what he's at +4 or +6. Wondering if you couldn't reduce it further. Well, see what the AM shot time check brings and you will know a lot more then. Hope you are loving the new spread sheet and schedule.

So, this may be a little premature, but cats do go into remission. Some temporary, and some forever or a very long time. It looks to me as if Felix might be chasing that dose down down down to nothing. We'll see. Keep checking, and if you can get a +4 or +6 tomorrow that will tell you a lot.

Hope you had a great day. We did. Good but tiring. Santa's on his way, so I better get off to bed.
-Sara

 

Thanks for checking in on us Sara. I love, love, love the spreadsheet!!! Can't thank you enough!

Will check-in in the morning.

Sandy

 

Felix seems to be doing very well! Even with skipped PM Pre-shot, he tested at 114 this AM. cat_pet_icon

Sandy

 

Wonderful!!!!
I would love to see where he's at in the middle of the cycle. If he's pretty low you could give .25 (just barely draw any insulin) if he's around 120 at the PM shot, or sleep and skip another if he's still doing well and do that tomorrow if you have more time tomorrow, rather than missing sleep.

So, he's been eating normally overnight and woke up after a meal at some point that low?? I bet he will go OTJ and then you just have to watch his food. Make sure he only has low carb wet. I have attached a wet food list that has carbohydrates listed to this post. You will need to stick with food that is less than 10% carbs on this list. I try to even stay at or below 7 personally. There are plenty of flavors less than 7%. I saved it and printed it out to bring with me to the grocery store so I make sure to never feed a high carb flavor on accident.

Glad you guys are doing well!

 

Not feeling comfortable yet doing this on my own. Can someone please take a look at his +6 to see if I should give Felix some Lantus?

Thanks!

Sandy

 

Stick to the shot times, and don't give anything in between. That's still a pretty good number. Remember Lantus is not a rescue insulin it is a 2 times per day regimen. (See my PM.)

 

Felix has been staying in the blue and I think this is good, right? Much better than where he started. When is it a good time to do a curve? Anytime?

Thanks,

Sandy

 

Blues are very good.

Anytime you have a full 12 hours to test every 2 hours from one shot to the next is perfect for doing a curve.

Mel, Maxwell, Musette & The Fur Gang

 

Felix tested at 96 this AM Pre-Shot. Should more tests be done throughout the day before the PM Pre-Shot? I will not be home but my daughter will be home and she will be checking the forum for your replies.

Thank you!

Sandy

 

hi sandy!

i want to welcome you and felix. my last kitter was named felix - he was a moose! 24lbs at one point, 17 after the poor guy getting 1/8 cup of kibble morning and evening for years.

anyway, back to your felix. the spreadsheet link isn't working. can you try again to attach it? you and sara are probably able to see it because you set it up, but clicking on the signature link doesn't work.

i'm a lantus user and hopefully can help you. i'm going to assume that you didn't shoot that 96, since everyone is telling you not to shoot under 200. that's good advice for a beginner. if you didn't shoot it, you don't need to do tests throughout today.

Lantus is an insulin that likes consistency. 2 shots, same dose, 12 hours apart. you are getting such good numbers that i wouldn't be surprised if felix's need for insulin is very brief, but we want to keep him safe during this process. a preshot number of 96, or less, tells us that 1 unit is too much for him. i would suggest you should drop it to .75 or .50 units tonight, then make sure and get a test after 3-4 hours to see where it's going. i check punkin about then and i also check him about 6 hours after the shot because i know that's when he gets the lowest.

when a cat is starting on insulin a lot of what we are doing is looking for how that particular cat reacts to insulin. Once you see the pattern, you can adjust testing times to fit. the lowest point in the BG cycle on Lantus is generally somewhere 3-7 hours after the shot. since this morning's shot was skipped, you may seem some wonky numbers for tonight and the next day or so. skipped shots make for crazy numbers.

i don't want to give a lot of advice without seeing the spreadsheet, but i do think you need to drop the dose. in general, you want to try to catch the lowest point of a cycle with a test and then you can ease up on testing until the next shot. i do most of punkin's testing between the shot and 6 hours later because that's how he works.

so - for your daughter's sake i'll sum up:
- if he didn't get a shot this morning, he doesn't need tests until his preshot test tonight.
- drop the dosage to .75, or .5 if you would be more comfortable
- shoot only if he's over 200
- post here or in the Lantus Tight Reg support group for help if his preshot is lower, or if you need help. there is a lot of traffic on that forum and almost always someone is on who can give advice and immediate feedback. we welcome new people.
- catch tests in the +3-+7 range (3-7 hours after his shots) to see how low he is going

keep posting here or there to get quick advice.

 

To fix your spreadsheet, go back to the url in your signature. Highlight the whole thing and then choose the URL button at the top of the box. (it is in the row with B, i, u Quote etc.) It will add some brackets and url to the front and back of your ss url. That should let us see your spreadsheet.

 

Hello,
This is Sandy's daughter Brittini
You are correct we did not give him a shot this morning since his number was 96.
Thank you for your advice! I fixed the link for the google doc, so hopefully everyone can view his numbers now
We have been giving him .5 in the morning and night and so far he has been responding really well!
Thanks again everyone and let me know if the link is still being temperamental

 

Hi Brittini! how lucky for sandy that she has a daughter that will help!

yes, i can see felix's spreadsheet now. what we're seeing is very close to normal non-diabetic numbers. he still needs a decrease in dose. i thought from the previous posts that he was on 1.0 unit. it's critical that you know how low he is getting so he doesn't become hypoglycemic. i would suggest you could likely go ahead and give him .25u tonight, as long as he gets tested and monitored over the next 7 hours. because you skipped the shot this morning you can change the shot time tonight. if you need to shoot earlier so he can be watched, this is the time to make that change.

if you can't monitor him after the shot, i think i would skip. he's very close to going off of insulin, but he will have the best chance at making it permanently if you give him a tiny bit of insulin for support for a little while longer. we like people to go to .25u and then even .1, which you measure by practicing drawing up a half unit and squeezing out drops. count the drops. then when you're giving a tiny bit, you repeat that to get just a drop.

that sounds ridiculous, but we have seen cats that just need 1 drop for a while. it's all about that particular cat and what works with it.

take a look at this link, about 3/4 way down the page, for pics of these tiny doses.

http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=18139

so summarizing again:

- if you need to change his shot time, tonight's shot time is the perfect time to do it.
- drop the dose to .25 u
- monitor for the next 7 hours or so after his shots - ie, check his BG every 2 hours and post for help if he goes below 50.
- his BG will likely have a continuous drop from about 2 hours after his shot until it hits the lowest point and then it will curve up. if you see lower numbers right away, you may have to test more frequently than 2 hours.

if you tell me what time and what time zone you're going to be shooting, i'll make sure to be on. you could post your preshot test and we can talk about what dose and what's next if that would be helpful. i'm on the west coast. i'm going to make sure a couple of other users experienced with Lantus are available to help you also. i also like input from others - more brains work better than one!

 

Hello,

I'm on the west coast as well. If I change his PM Pre-shot to an earlier time, does this mean we have to do the AM Pre-shot 12 hours later? So, in other words, if we change his PM Pre-shot from 8:30 PM to 5:30 PM, do we need to get up at 5:30 AM to test and shoot?

Thanks!

 

yes. lantus definitely works best at 12 hr intervals. you can make changes if you don't have a choice, but for now, yes, you would want to be able to shoot at the same time tomorrow morning.

 

Well then, based on your answer, 8:30 works best for us. However, we will be up so we can test after the PM Pre-shot. I will post on here or his number can be checked on the spreadsheet.

Thanks so much for your help!

 

Great suggestions from Julie but I think it would be good if you could post a +11 number so we can see where he is as he approaches shot time. That gives a little more time to make a plan.

One thing I'd like to clarify from this previous post is that 54 is a normal number. It is not an unsafe number nor is it a hypoglycemic number. Do you want to watch it as the cycle progresses? Absolutely. But many of us lantus/levemir users allow our cats to "surf" in the 50s. Obviously, I would not recommend that you shoot a number anywhere near that until you have a TON more data. But...54 or 57 midcycle like Felix was is great...it should be monitored...but it's really awesome!

Here is my other thought...as Julie said, lantus likes consistency and so we like to shoot every 12 hours as much as possible. One of the ways to do this is, if we get a low pre-shot, to not feed but stall a bit (if you are able) and see if the number comes up on its own. If the bean has the latitude, we might stall for a couple hours testing every 20 minutes to catch the rise so the kitty keeps some insulin in it.

You've shot some low 120 numbers...good for you!!! But we'd also like to see a little more mid-cycle testing so we can see what Felix is doing with that insulin. You may have that info but just haven't had a chance to put it on your SS.
I have a link in my signature block to dealing with low numbers and handling low pre-shots....that info might be good to print and have on hand since Felix seems to be on a mission.

Great job....keeping fingers crossed for Felix!!

 

sounds good. thanks for checking in marje! i'll look about 7:30pm to see if you've been able to post a BG test #. then we can make a plan based upon what he's doing at the time.

 

hi sandy - haven't seen an update from you, and i've gotta go do some other things. hopefully things are ok with felix.

if you need quick help, post a new thread here in main health or over in the Lantus Tight Reg support group and people will give you a hand.

 

I just got home and tested Felix. He is 115.

I wasn't home all day and my daughter was helping out. Thank you everyone for your support!

 

i think this is your call on whether or not to shoot. if you shoot, he needs to be checked in a few hours to see how low he goes.

if he were mine, i might skip and check him again in the morning.

what do you want to do?

 

This is Sandy's daughter Brittini again We have decided to skip the shot, so should we test him at some point before his morning test? Also, if we needed to give him a morning shot, would it be at 9:30 am or our normal 8:30 since we did not give him the night shot and therefore did not change the shot time?
Thanks!

 

If you didn't shoot, you can pick whatever time you want in the morning to get on a schedule. So you have the latitude to pick 8:30 or 9:30 and then shoot 12 hours from then.

Again...I'd recommend you post a +11 in the morning and ask for help if he is low.

 

Felix is at 132 should we just go back to shooting at .5 ?

 

We have decided to shoot .25 per Julie and Punkin's recommendations. We will be monitoring him over the next several hours, checking his sugar levels about every 2-3 hours. I will let everyone know what happens with the new dosage and it will also be entered into the spreadsheet.

Thank you very much

 

This is Brittini, Sandy's daughter. I filled the needle to the first line on the syringe, which is above the line for our old .5 dosage. I am hoping this line represents .25, am i correct or is that a different dosage amount?
On our needles to the right is full units starting with 1 unit and the left is half units staring with .5.
We have 3/10 syringes.
Thanks!

 

Not sure which way you are looking at the syringe, but there isn't a line for .25u.

If you are looking at the syringe with the needle pointing up at the ceiling the very first line from the tip of the needle is the zero, then the first small mark down from that is .5u so to get .25 you need to try to hit about halfway between that first and second mark, or between the zero and the .5u mark

Mel, Maxwell, Musette & The Fur Gang

 

Ok thank you!
So far at +2 Felix is at 122.

 

At +4 Felix has dropped to 95. Just fed him and he seems to be doing well
Brittini

 

106 at +7.
Brittini

 

brittini and sandy, those are great numbers. you're doing just super with this.

if he's still in numbers like this by the weekend, you could decrease the dose even further and see if he holds these numbers. just fyi, a vet would have you just go off of insulin at this point . . . my point being if you want to do that it's an option. i would keep it up a few more days to give his pancreas support, but there is more than 1 way to do this.

always what you are watching for is to keep him above 50 - and mid-cycle is when he will go the lowest. 40's are that safety zone that means you need to take action and bump him back up into the 50's with high carb food (gravy) or a dime sized bit of karo syrup. if you can't check him during the day from +4-+6, i'd leave him a snack of low carb food just before that so he can eat if he needs it. check when you leave and as soon as you walk back in the door. also, many, many cats have lower numbers at night for some reason, so you could try getting a +5 or so at night.

i'll keep watching for your posts. i'm back at work and gone during the school day, so won't be able to answer about how low is ok to shoot in the mornings. i don't think you should shoot less than 100, maybe even not less than 120, i'm ambiguous about it - i guess it depends on if you're around to monitor. for sure, if you see less than a 100 in your preshot blood test, just skip the shot and let's see how he does. non-diabetic cats run 40-120ish.

at the point you are at, i'd rather see you skip a shot if you have any doubts. always, always, safety comes first. we'd rather see a cat be too high for days than too low for a minute. felix needs to be monitored during that mid-cycle time.

you are so close i can smell it! :lol: pat yourselves on the back - you're so incredibly lucky!

and just fyi - once he goes off of insulin you must consider he is still diabetic, just diet-controlled. for the first 2 weeks off of insulin, check his BG a couple of times a day - it's easy to continue to check about the same times you were giving shots before. after 2 weeks, check him about 1/week for another month, then you can skip to checking about 1/month. most people continue checking once a month.

a diet-controlled diabetic cat can need to resume insulin if they have an infection or illness, or if they need their teeth cleaned. if you start seeing diabetic symptoms again - excessive thirst and urination, etc., then test him to see if he's still ok.

thoughts? questions? how are you doing tonight?

 

This is Sandy's daughter Brittini again
I have been testing Felix throughout the day as my mom has been away at work. he just tested at 133. The last time we took him to the vet we were told that he did need to have a tooth pulled, he has really bad plaque build up due to eating wet food. He has yet to have the tooth pulled however, so you are absolutely right about the tooth infection being a contributor to diabetes coming back. His diabetes started back up right around the time the vet informed us of his poor little teeth.

Since he tested at 133, does this mean that i give him .5 or .25 at the PM pre-shot?
Thank you!

 

stay at the same dose, .25u.

likely you will need that tooth removed/cleaned before he will stay off of insulin then.

 

Bummer on the tooth thing. The vet wants to see a curve first and then they will treat the tooth. Does anyone think that today's testing could be used as a curve and given to the vet?

 

I would think today's testing should give a vet a cear enough picture of Felix's BGs to be considered a curve.

Hopefully they will think so as well and you can get the tooth problem addressed sooner rather than later.

Mel, Maxwell, Musette & The Fur Gang

 

yes - that was definitely a curve.

it's well-established that any infection or pain will raise blood glucose levels. i would think he will do better as soon as his teeth issues are resolved. if he's feeling pain, that alone could cause increased BG levels. cats are notorious for hiding their pain. and with my own cat, being given a painkiller has immediately dropped his numbers. if your vet won't address his teeth, perhaps there is another vet who will.

 

Thank you everyone for helping my daughter today. It's so tough when I work 1-1/2 hours away from home and have to endure commute traffic and also worry about a kitty at home. Thank goodness my daughter is home during college break. I don't know what I will do when she is gone!

I will give the vet the curve tomorrow and also make the appointment for teeth cleaning. I hope his tooth doesn't have to get pulled :cry:.

Thanks again for everyone's concern and wonderful assistance!

Sandy

 

punkin had 3 teeth taken out last march. they cope fine without it.

but if you want advice on things that will help him cope with the anesthesia, especially if he is still on insulin at that point, just post here. people can give you tips that will minimize barfing, get appropriate pain meds and antibiotics, etc.

by the way, good idea to make a note now - metacam is still being used by some vets but it has a black box warning on it from the FDA saying not to use it on cats because it can cause organ failure and death. there are regular posters on FDMB that have had cats die from metacam. it's tough to get a good painkiller for cats that is safe for them, but there are some that are safer.

also, there is a new antibiotic called convenia. it was developed for skin infections and is most effective only on those. it mostly isn't very effective against other infections, but the reason it's become attractive is that it is a one injection, lasts 2 weeks drug. the problem arises if a cat is allergic to it. imagine if you were allergic to penicillin and got an injection of it that would last 2 weeks . . . it's only a problem if you're allergic, but how do you know you are until you get it? combine that factor with the fact that it only works on skin infections. we like to educate people on that so they can make an informed choice.

anyway, that's more than you wanted to know at this point, but i'm on a roll! :lol:

hope you have a great evening!

 

just checking in - felix's ss looks great. i don't think i mentioned that when he's not getting insulin shots, it's really good to give him frequent small meals. if he normally eats 2 cans of cat food a day, for example, feed 1/4 can about 8 times a day. use your amounts, of course, i'm just trying to illustrate the point. it's easier on his healing pancreas that way.

 

Thank you very much for the tip!
Brittini <3

 

hi sandy & brittini - just keeping an eye on felix's spreadsheet. looking great!

the way lantus works it's best if you can give the same dose shot every 12 hours instead of a "larger" dose once a day. not that .25 is large, because it's not. i'm just saying that once a day dosing isn't the best.

can you reduce it to less than .25 so you're shooting the same thing every 12 hours? you're so very close . . .

 

Hello!
Yes we can reduce his shot down more (Yipee less juice!), however the reason he is getting a shot once a day is based purely on what he tests at. We went from 1 unit once a day to .5 morning and night, then lessened to .25 morning and night. Should i shoot for consistency over numbers? What is the lowest number that is high enough to shoot? I'm guessing that if the dose is smaller then his number at shooting time can be slightly smaller as well?
Brittini

 

i would simply drop the dose to the .1 and give it twice a day and see what happens. what you want to see is all the numbers under 120. and not to repeat myself endlessly and drive you nuts, but being new and you being here where other lantus users are not also tracking you, and you're not familiar with the lantus dosing, i just have to say it again - safety is our foremost concern. we don't want felix to become hypoglycemic and be alone.

an experienced user would shoot less than 100 . . . but i just am uncertain what to tell you regarding preshot minimum numbers.

i want to get someone else's opinion for you as well and would feel better about more eyes on you. hang on while i seek some help.

 

Normally, I would say at these numbers, IMHO, the kitty should continue to get .25u twice a day because on the days you do have mid-cycle numbers, he hasn't dropped that low. However, because you are not able to do more testing during the day, I think Julie is spot-on in recommending that you drop to .1u (read one-tenth unit) twice a day for safety. Remember,too, that we dose on nadir, not pre-shot numbers, and because we can't see what his nadirs are doing daily, it's best to take him down.

His green day on 1/4 was most likely due to his "shed" from the .25u dose. Lantus builds an insulin depot (often less formally called a storage shed) under the skin. The shed must fill before kitty starts using the daily injections. That's why we suggest holding the starting dose and increases for several cycles so the shed can fill. Because of the shed, a dose can affect up to three cycles after you give it.

ETA: Your question:

I don't want to side-step your question but I don't feel I can offer you a number without you testing more. You don't have to be a testaholic but a few more mid-cycle tests every cycle would really help. We really don't have a good idea of what Felix does mid cycle and one or two curves is not enuff to determine that.

My best suggestion is for you to move this discussion to Lantus Insulin Support Group where there is a lot more activity. That way, when you get a preshot number, you can post and there are generally more people around who could walk you through it. So it isn't just a question of what is high enough to shoot but it's also a question of what you are comfortable shooting, is safe, and you can monitor.

I think if you were able to shoot consistently and monitor, you might be surprised at how fast Felix might go off insulin....just speculation but he's looking pretty good.

 

marje is right on - and i'm reminded that dosing on lantus is based off of mid-cycle tests, not the preshot tests. i have been remiss in not reminding you to get mid-cycle tests. we need to know how low felix is getting on insulin. pretty much every cycle, ie, once in the day, once in the evening, we need to know how low he goes.

this is why more brains are better than one.