Whiskers

hello ! my kitty Whiskers who is 7 1/2 yrs old was diagnosed with FD on Monday, Jan 2. We have 2 other cats, Cowboy(6) and Lady Bella (3). I might bombard with lots of questions, please be patient with me, im just another nervous New diabetic kitty momma

 

I'm a newbie here too, have only been a member for a few days. We had our first insulin dose yesterday and I could not have done any of this without the help of the forums members here! You are in the best place for *our situation.

 

Welcome to FDMB.
We have questions, too!
How did Whiskers get diagnosed?
What insulin and dose is Whiskers on?
What are you feeding?
What would you like to know?
.

 

I am learning so many new things on here. When we took out kitty to the vet she told us we had 2 options, insulin or put to sleep and that she recommended euthinizing him she made it seem like treating him was going to be so expensive, given that it is a vet clinic that also helps low income people. My husband said he didn't want to see Whiskers suffer, so he decided he was going to put him to sleep, we were told to bring him home and spend a few days with him and say goodbye and then take him in to be put to sleep. that night when we got home with him, i went online and like crazy looked for information, i ended up finding some awesome people who helped me understand that it would not be expensive, you just have to dedicate time to your babies. I changed his food right away the next day and within 2 days he was more alert, walking right( he couldnt stand on his back legs) and now he is not drinking allot of water nor urinating allot, he lets us carry him and comes and cuddle, something he hadnt done close to a month. today was the first day i gave him insulin (lantus, 2 units per vet) in the morning and earlier i checked his levels before i was going to give him his shot and his levels were 128, so no shot tonight. this is good compared to the 436 he had at the vet on monday, then on friday was 280, yesturday morning was 314 then 291 in evening, this morning was 243 when he got insulin. i just pray i do everything right.

 

he is on wet food Fancy Feast Classics, turkey and giblets only since tuesday, day after diagnosis
no more dry since monday

 

Uh oh. Giving 2 units after dropping the food to low carb may be too much insulin.
How long ago was the shot?
Do you have Karo Syrup?
Could you test his glucose now, please?

 

Lantus takes 5-7 days to build up to a consistent state.
The dose adjustments are made based on the nadir, the lowest glucose post-shot.
This is about +5 to +7 hours after the shot.
If you can't shoot in the evening after a dose in the morning, you need to adjust the dose so you can shoot safely twice a day.

 

I think I read right that she didn't give insulin tonight.

I agree with BJM. Two units will most likely be too much. Certainly as a starting dose. Most people start on 0.5 to 1 unit twice a day depending on the weight of the cat.

Please post here before you give another shot and we can help guide you

 

Just in case... how to deal with a low blood glucose. Please read
http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

This will help you to understand about the starting lantus and adjusting the dose
http://www.felinediabetes.com/start-low-go-slow.htm

My cat remi started on 0.5 unit and we worked slowly up from there with the help of this forum

 

Whiskers level was 128 this morning, i have not given him anymore insulin since that first dose

 

How does that chart work?

 

Oh I am so glad .

I think you need the advice of more experienced lantus members. At the moment he is hanging around normal levels.

First though can I get you to list out all the blood glucose tests you have so far. It needs to be as clear as possible

My understanding is that:

Monday 2/2 blood glucose 436 (at vets)
Tuesday 3/2 change to low carb wet food (what brand??)
Friday 6/2 blood glucose 280 (was that at the vets?)
Sunday 8/2 AM blood glucose 314, PM blood glucose 291 (at home? Before or after eating?)
Monday 9/2 blood glucose AMPS (am preshot) 243- 2 units of lantus given PMPS 128 no insulin given

I think I have got the Sunday and maybe Monday wrong so please can you quote it in your reply and amend and add any other relevant information.

What chart? do you mean the charts we have in our signature? That would make the information much easier to understand

Here is how you set one up
http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/

 

Monday - vet visit levels 436
Friday 280 at 7pm before feeding, this is at home, only vet on monday
Saturday 314 5:34 am before feeding
Saturday 291 8:50am
Sunday 243 7am before feeding, 7:15 first insulin (Lantus) shot 2 units
Sunday 128 7pm, before feeding, no insulin given
Monday 116 6:37 am before feeding
Monday 307 6:51 pm before feeding

 

Here is our grid to record your glucose tests. It will help us give you better feedback. Instructions are here.

Understanding the spreadsheet/grid:

The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning pre-shot test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
and so on.

Halfway across the page is the column for PMPS (evening pre-shot)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

It is merely a grid for storing the info; no math required.

 

Hi whiskers and whiskers momma (what is your name?)

Thankyou for the clarification. So it looks like whiskers has gone back up to 307 and so you will need to give insulin. However seeing how low the numbers got after 2 units that is way too much. Most cats start on between 0.5 unit and 1 unit given every twelve hours.

We use two protocols on the forum and they have been shown to have good success at getting cats regulated and even off the insulin

The start low and go slow protocol
http://www.felinediabetes.com/FDMB/threads/lantus-levemir-start-low-go-slow-method-slgs.129446/

Or if you can monitor more often then the tight regulation protocol
http://www.felinediabetes.com/FDMB/threads/lantus-levemir-tight-regulation-protocol.1581/

May I ask how much whiskers weighs. This is usually how we work out a good starting dose?

When remi started out on lantus he was put on 0.5 units twice a day (he had changed over to low carb wet food too) and then after a few days on this dose it built up in his system and we could see that it was bringing down his blood glucose nicely and we just adjusted it as per the protocol. It sounds like whiskers is in a similar situation so you might like to consider this as your starting dose too. I will ask more experienced members of the lantus forum to offer some advice on the dose.

By just giving a larger dose once a day you are risking whiskers going much too low, and then once it has stopped working blood glucose going higher again. Does that make sense?

http://www.felinediabetes.com/FDMB/threads/lantus-levemir-what-is-the-insulin-depot.150/

 

And, 1 kg - 2.2 pounds, so if you have his weight in pounds, just divide by 2.2.

 

If you are concerned about questioning your vets dosage then I would print off and discuss this document with your vet.

http://www.felinediabetes.com/AAHADiabetesGuidelines.pdf

 

My name is Yolanda whiskers weigh 12.06 last Monday, the 2nd when he got weigh at vets.
He is on Fancy Feast Classics Turkey and giblets. but he only eats 1 can thruout the day and one during night.

 

Hi yolanda

So it sounds like remi and whiskers weighs about the same 5.4kg.

So if you want to you have two options you can follow the start low and go slow and give 0.5 units twice a day twelve hours apart or if you follow the tight regulation protocol you could start which a slightly higher dose of 1 unit twice a day.

Have you read the protocols I linked ?

 

You are able to test blood glucose at home aren't you?

 

i think for now i will do the .5 units a day 12 hours apart. yes, i test him at home but i need to see how often to test him, if his levels are up around 233 like this morning do i still give him his insulin? i dont remember if it was 200-250 no insulin?, like some other lady suggested. i want to set a schedule for shots at 7am and 7pm.

 

That sounds very sensible. I would go with 0.5 units as well. Better take it slow and steady. I used to do mine about 6pm and 6 am.

I think the cut off for new members is lower than 200 but will go and check now. Hang on back in a second.

 

Okay I can't see the no shot pre dose number for new members but it is lower than 250. I will ask other members to reply on your thread.

However as important is that you check the nadirs ie the lowest point your cat goes on lantus which is usually near the middle of the cycle.

So according to the SLGS protocol you hold the dose for one week:

• Unless your cat won’t eat or you suspect hypoglycemia

• Unless your kitty falls below 90 mg/dL (5 mmol/L) if kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.

After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours
Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet.

• If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit

• If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose

• If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit

• As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], do lengthen the waiting time between dose increases. If you decide to change another factor (e.g., diet or other medications), don't increase the insulin dose until the other change is complete (but do decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change). Don't be tempted to rush the process along by increasing the dose more quickly or in larger increments-- no matter how high your cat's blood glucose is! Rushing towards regulation will cost you time in the long run, because you may shoot past the right dose.

 

so if i give him a shot at 7 pm his middle of cycle test reading would be done at 1 am?
nadirs is the bg levels right?

 

Yolanda I just started a thread asking people to answer the no shot question over here.

I think you must have seen someone's else's no shot number in their thread but they are using a different insulin and there cat has already gone low so best we check what they say for you.

So once time to take the shot, you take the reading, feed and then give the insulin. With the protocol you are following you don't have to test again during the cycle each time. If you do then most people get a test earlier than +6 hours in. They might do a +2 or a +4. But on the protocol you are following most people do more testing at the weekends when they are home during the day.

 

Yes nadirs relate to lowest blood glucose. Nadirs is the point in the cycle where the blood glucose is at its lowest.

 

oh ok, thank you so much for your help

 

I have to go to bed in a minute but hopefully others will answer the question- as a newbie what is the 'no shot' number?

I just wanted to give you a couple of other links to read through. This general one on lantus
http://www.felinediabetes.com/FDMB/threads/lantus-levemir-new-to-the-group-please-read.18139/

How to store and handle lantus properly
http://www.felinediabetes.com/FDMB/threads/lantus-levemir-info-proper-handling-storage.151/

You shouldn't push any excess lantus back into the vial. Most people draw up more than they need, knock out the air bubbles by tapping them to the top and then putting the needle up so it is pointing into the air and shoot away the excess and any air bubbles.

Do you have needles that show the marking of the half units? this will make it much easier to get the right dosage. I used to use these
http://www.vetuk.co.uk/veterinary-s...rofine-0-3ml-insulin-syringes-u100-demi-p-296

Hopefully someone will reply before you are ready to give the insulin. When you do give it you might want to start a new thread over in the main section or if you have any concerns please do post over there.

Finally can you amend your signature to include the food you are giving, the insulin, any other medication or conditions whiskers has.

Cheers

 

will do good night and again, thank you for all your help.

 

I think it's 200 until you've got enough data to know your kitty will be safe if you shoot at a lower number. Still fairly new myself, so would prefer confirmation on that though. @Chris & China @Vyktors Mum can you confirm if 200 is the limit for people new to this please?

 

Thankyou @manxcat419 for replying. It is driving me mad trying to find it written somewhere. I can go to sleep now

 

No worries - I can't find it written down either, though I know I've seen it previously or I wouldn't have a number in my head for it at all.

I'm sure someone will confirm on it soon.

 

I've seen the preshot of 200 as cutoff reccomendation for newbies too... here's one example.

http://www.felinediabetes.com/FDMB/threads/newly-diagnosed-11-year-old-cat.103222/#post-1100089


I know I've seen it said several times, but am having difficulties locating the posts.

 

200mg /dL is no shot limit for new users until they have data showing it may be safe to shoot at lower numbers.

 

Hi Yolanda!! Didn't realize this was you from the Facebook group until I saw a name!!

Can we get you to start our spreadsheet? It's really just as valuable a tool as a good insulin, meter and food! Here's "How to get a spreadsheet" instructions but if you have trouble, holler! We have several people who can start it for you and then transfer it to your name

It's important when you start to ALWAYS get a pre-shot test. You wouldn't shoot your child without knowing their blood glucose first, and it's the same with our sugarcats. If under 200 (for now) you'd want to "stall", DON'T feed and post for help. Make sure your subject line says something like "Stalling! Need help!" so people who scan the board for problems will know you need help. As you learn how your kitty responds, the "no-shot" limit starts to come down.....Eventually you'll shoot anytime they're above 50! (but that's only after you've got more data)

Then, during the AM cycle, get at LEAST one other test...sometime between +5 and +7 (5 to 7 hours after shooting), but if you can get more tests in, that's great! It'll help you learn your cat faster!

On the PM cycle, you don't necessarily have to stay up until then. If you can get a "before bed" test in (whenever that is for you) that will tell you if you need to set an alarm to get more tests in later in the cycle.

Keep asking questions! The people here just love to share their experience!! ...and Welcome to the FDMB!!

 

Understanding the spreadsheet/grid:

The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning pre-shot test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
and so on.

Halfway across the page is the column for PMPS (evening pre-shot)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

It is merely a grid for storing the info; no math required.

 

Just checking in to see how you are going. Did you start giving the insulin again? What dose did you go for? How is whiskers blood glucose. Don't forget it takes a few days to build up in there system.

 

He got a morning shot yesturday morning at 6:50am
.5 unit of lantus, his kevek was 247 i checked him again at 9:38 am and it was 264 at 6:30 om it was 174 so no insulin....this morning i was going to test him but my husband fed him....(how long do i have to wait to test him after he eats?) He is on Fancy feast

 

Food affects blood glucose for about 2 hours but I wouldn't give the insulin two hours late. I would monitor his readings and wait till tonight's dose is due if you haven't already given it.

 

You could check around +5 to +7 to see what kind of nadir he is getting and help keep him safe if he is going too low.

 

Ok i will do that...he was a bit grumpy this morning...he has been more hungry yesturday and today

 

I usually feed him one can in morning and another at night but i have out out another during day as he seems hungrier

 

Hi

Can you give us a round up of the last week. Have you been giving insulin each day? And have you taken a glucose reading before each dose? Did you many many during the cycles? If you could list out each day that would be great. Ideally you would fill out a spreadsheet as it makes it much easier for everyone to look at and give advice. @Chris & China linked it in his post.

Most members don't just feed twice a day but feed little meals throughout. The only time we say no food should be given is two hours before each dose so that the reading you take will not be affected by food.

As BJM said if you can get a mid cycle reading at +5 or +6 this will help tell us how effective the 0.5 dose is.

In the future I would advice posting specific questions in the main health forum as you will get a lot more people looking at it quicker than in this forum.

 

how do i post the spreadsheet on here?

 

Put your cursor on your name (on the top right side of the page) and a bunch of options come up. Choose "Signature"

A new page will come up with a box for whatever you want to put in it (like the information below in mine about China)

We like to have your name/cats name, date of diagnosis, type of insulin, type of meter and any other health issues listed along with the link to your spreadsheet

 

You have to publish it to the web. There should be a button that says publish. Then you click on the button that says copy entire link.

Scroll to the bottom of this link again to http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/

Once you've done that you have to click on your name here at the top of the page and then edit your signature. Open it up and press past. Your link will then appear. Then add details of your insulin and the dose and any other issues.

Any problems then @Marje and Gracie can help sort them out.

 

alright, i think i got it, thank you sooo much !

 

I clicked on the link but it says I need to have permission to see. Have you clicked on the publish button- to the internet?

 

In Google Drive:
There's a button on the uppef right which says share.
And in the menu, you select File, Publish to Web

 

Do not use the "share". That is incorrect. Please PM me if you are having problems.

 

I do both, just to make sure it works!

 

ok i just choose the publish to web option, hope it works

 

Hmm sorry no it hasn't @Marje and Gracie can we have your help here

 

Might I suggest again, that you also click on the Share button in the upper right.
Set the dialogue box to allow others to view.
And copy that link, from the dialog box, into your signature.

There's a reason I do both the Share and the Publish to Web; it seems to improve the success rate.

 

I set the new SSs up so this is not necessary.

Yolanda...please PM me and I can fix this in 2 seconds.

 

I use the link generated by 'Share' option too, BJ. I don't know whether anything has changed recently in Google sheets, but I found that using the "Publish" link produces a file where the column headings scroll off the page as one moves down the spreadsheet. The 'Share' link set for read-only access by others seems to keep the column headers in place and only the data scrolls as one moves down the sheet; something that I find much more helpful.

 

Well done. I can see it now. It's great that you are testing and you have done so well. Now hopefully @Chris & China and @BJM or anyone else can comment.

I had a look but am just not experienced enough to advise. I see that you skipped the shots when the pre shot reading was less than 200 as advised. I also see you think you had a fur shot or two which happens. The lantus takes a few cycles to build up its deposit and so you might not yet be seeing the full effect of this dose due to the skipped dose and fur shot.

 

thank you, i was freaking out a bit...lol for now he only lets me check his levels, he is actually my husbands cat but he is being a sweety with me and wants nothing to do with his daddy, even though my hubby said whiskers was going to be mad at me cause im the one that pokes him, its the opposite

 

The low carb treats help I think. And funnily enough they like the routine. Plus I think they know when you are trying to help them. I talk to my cat and tell him what I am up to and why.

 

I firmly believe that they do fathom out that the poking and prodding has a lot to do with feeling better.

 

Do you think the fur shot was just bad luck, there are different techniques you can try. I used to take the blood glucose, feed and then encourage remi to sit on my partner. He would make a fuss of him and I would sneak up behind. Lift a bit of skin with my thumb and forefinger, make a 'tent' by pushing in the bit of skin in the middle and then insert the syringe, let the skin fall back down and then slowly remove the needle.

 

Not sure if you have seen this link but towards the bottom is a description of where you can give the injection

http://www.felinediabetes.com/FDMB/threads/lantus-levemir-new-to-the-group-please-read.18139/

 

She also posted in LL yesterday...did you see that I replied Yolanda?

http://www.felinediabetes.com/FDMB/threads/fur-shot.133250/

 

Oh I missed it. Will pop across and have a look now.