Would appreciate some help!

Hi Everyone, I have a newly diagnosed 12 year old male cat. He's been on Lantus since Friday (~3days). I measured his BG this morning 8am at 68 (with a human ReliOn meter). I did not give a shot. I measured again at 5pm and he came up at 140. Pretty good. The vet said that when his BG tests in between 120 and 180 to go by how he's feeling. He seems to be feeling fine, I would say sleepy after eating (he's sleeping now). So, I'm anxious- should I give a shot since I didn't give one this morning? Or trust that his BG is ok and recheck again in the AM? I'd hate to have to check again tonight because it's unpleasant for him (the he tolerates the shots better lol!). He is eating low-carb over the counter food. (He did not like the Royal Canin prescription and vet said it's more important he eat). If anyone has any advice I'd greatly appreciate it!

 

Hi Laura, just wanted to say welcome to the FDMB! There are a lot of kind, knowledgeable people on this board so when you have a question, ask away!
So your cat was diagnosed on Friday? Was he eating dry food at that time and has been switched to canned now? And how much insulin is he getting? I'm going to tag some of our more experienced people for you @Wendy&Neko @Marje and Gracie @julie & punkin (ga)

 

Welcome to Lantus Land.
What is your regular dose of Lantus?
What food is he eating and how often?

Can we get you started using our grid to record your glucose tests? It will help us give you better feedback. Instructions are here.
And to help you learn how we use it: Understanding the Spreadsheet Grid.

When you have a moment, could you add a few tidbits to your signature? It will help us give you feedback.

Editing your Signature
In the upper right corner of the screen, within the dark blue bar, you will see ID, Inbox, and Alerts
Click on your ID.
On the left, under Settings, Click on Signature.
This is where you will put information that helps us give you feedback. You are limited to 2 hard returns, so separate pieces by | or -.
This is where you paste the link for your spreadsheet, once it is set up.
Add any other text, such as your name | cat's name | date of Dx (diagnosis) | insulin | meter general location (city and state/province) any other pertinent issues like if there are any food issues, history of DKA, hepatic lipidosis, pancreatitis, allergies, IBD, etc.

Click the Save Changes button at the bottom.

 

Hello and welcome to you and your sweet kitty. What is his name?

Since you are new to Lantus and home testing (good job getting those tests!), there is a good chance he's started on too high a dose. If you let us know what dose he's on, and get that spreadsheet up, we'll be able to help you decide where to go next with dose. For the moment, since you are new, I'd recommend skipping the shot tonight.

For testing, it helps to put Neosporin gel on the poke spot after, to help heal it and help with the pain. And make sure you give a low carb treat after every test. Pretty soon he'll look forward to testing (and the treats).

There is lots of good information in the yellow starred sticky notes at the top of this forum. Rather a lot of information - don't worry, we'll help you get through it. Keep asking questions.

 

Wow! Thanks so much for the concern and the quick replies! My cat's name is Weedman (named after the park I rescued him from He was eating the dry Royal Canin Urinary SO for 2 years post bladder stone surgery. The very same food as I understand it contributed to his diabetes because it is high carb and caused him to gain weight! I tried the RX Royal Canin glycolytic canned but he hated it. I even tried mushing it up to more of a pate texture and no go. The vet said the most important thing was that he eat so she recommended some over the counter low carb wet canned brands/flavors. He's been eating Friskies the past few days with much more enthusiasm.

As far as insulin, He is on a low dose, 1/2 unit twice a day. I don't have much data yet, but his glucose readings have been as follows:
5/27 11:07pm (4.5 hrs post eating) 264
5/28 7:15 am (before eating) 191 (did not give an injection as I saw on this board under 200 no injection recommended)
5/28 1:33 pm (6 hrs post eating) 251
5/30 7:26 am (before eating) 420
5/30 5:48 pm 246
5/31 8:01 am (before eating) 68 (did not give shot)
5/31 4:08pm (before eating) 140 (I fed him, and he's seemed pretty lethargic since so I'm going to check again tonight)

(I'm sure there's a better way of keeping track of this- I've just been writing it down by hand for now)

His only really high day was 5/30 AM and that was right after I had a bad scare with him on Sunday 5/29... He would not let me take his glucose in the morning so per vet instructions I gave him his shot which at the time I thought was the right thing to do. The vet had said to give him 1/2 unit in the AM and PM after feeding- without relying on BG testing. After a couple hours I knew something was very wrong and I treated him as hypoglycemic- gave him syrup and fed him. Fortunately he bounced back by the end of the day, and I vowed never to give a shot again without first knowing his BG. I'm so surprised the vet would just say give him his dose and then bring him back to do his curve in a couple weeks- clearly he is more sensitive than that! Anyway, I decided to do the glucose testing on my own because as I understood it's the best chance at remission. And as I'm looking at his numbers, it almost makes me wonder if insulin was premature? He doesn't seem to be that high except for the day after I gave him syrup! I am testing with a human glucometer so the vet also said it's possible that he's reading low. It's been so stressful- I want to do what the vet says and at the same time I fear that I'm sending him into low blood sugar each time.

Thanks for the tip on the neosporin- I'm going to try that this evening and I'm sure it will help!

As a side note, after a $2000 emergency vet bill (I live in Chicago) and the costs associated with insulin etc, I really can't afford to be treating him but I love him so much and the vet said that if I get this under control there's a good chance he could go into remission and even with insulin he can have a great quality of life (he's otherwise very healthy). I so appreciate this board and I know there are folks out there who have been in the same situation. Thanks everyone!

 

We always test before shooting, so it's test, feed, then shoot insulin. You want to make sure he's safe to give insulin. Like this morning - good catch! Some kitties just need little bits of insulin, like a .25U.

Most of us use human meters here, due to the cost of the strips. And the two methods we use for dosing, the Tight Regulation Protocol or the Start Low Go Slow Method, both use values from human meters.

The spreadsheet referred to above is a great tool for keeping track of numbers and spotting trends. I also keep track on paper.

 

A quick update- I just testing him again 2 hours post eating and he's at 213... so I'm unsure- do I give him a shot at all today? Or wait and see how he's doing in the AM?

 

Laura, sounds like you are doing a fantastic job so far keeping an eye on Weedman! I'm still new here as well, and the members here are wonderful. My vet had the same attitude about just doing curves in the office. I am so glad I started testing at home and Jack now comes when he hears me get the meter out since a treat is coming. The last time I was at the vet we compared meters(I'm using the Relion micro) and mine read 20% lower then the alphatrak the vet uses FYI. The spreadsheet really helps the more experienced members see how Weedman is doing on the Lantus and give better recommendations on the dosing. I've learned a lot looking at other sheets even though every cat responds differently to insulin.

Keep up the good work and welcome to the group. Hopefully he can go OTJ(off the juice), sometimes just feeding a good low carb food can be enough to keep their glucose numbers controlled.

 

You have a couple of options. I don't know how long after your normal shot time this is, but option 1 is to shoot insulin now. I'd try for a .25 unit dose as .5 seemed to get him too low (there are pictures in the second sticky note down on how to do smaller doses. However, this option only works if you can do your shot tomorrow morning at the same time as now. You can move your schedule back by 15 minutes a shot, or 1/2 hour once a day, until you get back on time. Option 2 is to skip tonight and resume tomorrow with that smaller dose.

 

You have to eyeball 0.25 units as no syringes measure in that increment. Some folks use calipers to make sure they dose consistently.

 

Hi Laura and welcome to the Lantus and Levemir Forum, the best place you never wanted to be! There is a wealth of information here and everyone is so very nice. Ask all the questions you need to as that is how we all learned. Good luck tonight if you decide to shoot. As Wendy said, if you do, your shooting schedule will change but you can reel it back in each day by 30 minutes.

 

Hi Laura,

You're off to a good start - and while your vet didn't recommend home testing (most don't) he was very smart to start Weedman on a low dose. We have cats arrive here with all kinds of doses, and your vet's dose was pretty good for a start.

Can you get the spreadsheet going that BJM mentioned? The test results are all most clearly read when they are in the context of the spreadsheet. It shows us at a glance how many hours after the shot and that's important for analyzing what's going on.

I agree with Wendy about reducing to 0.25u. If you haven't shot yet tonight, you might be better off just waiting and shooting in the morning at your regular time. The later it gets from your regular shot time, the harder it can be to get back on schedule without just skipping a shot.

Keep asking questions and let us know how we can help.

Oh - and the Neosporin you want is the ointment with pain relief. It's all about the pain relief, not about the antibiotic. The pain relief is really great - i've tried it on myself when the cats scratched me.

Here is a thread that can serve as a bit of an index to this site, including lots of links to good discussions: Where Can I Find?
This section is specifically full of people's tips on starting out. I'm thinking you might be interested in the Testing and Shooting tips at the bottom.

Starting out with a diabetic cat:
Counting Cycles
Dawn Phenomenon
Expectations, Why You Should Manage Expectations
Pet Specific Glucometers, discussions about pet meters vs human meters: spreadsheet conversions: Pet Meter to human glucometer spreadsheet and AT/Merck value spreadsheet ; Low numbers on pet glucometers
Lantus, repackaged by Wedgewood Pharmacy
Shooting Schedule, getting back on time
Somogyi, latest research disproving its existence: ; Somogyi, Bouncing, Overdosing, Charlie
Spreadsheets: Whole Cat Report and Spreadsheets, Spreadsheets - Jigsaw Puzzle Analogy, Coleman: Adding a new year to the ss
Testing & Shooting Tips: here and here ; Dosing with Calipers
​

Glad to have you and Weedman here!

 

Welcome from me too. We really use the spreadsheets a lot to give advice. If you have any problems getting it started there are members who will gladly help.

 

Another Welcome from Chris & China too!!

If you have any trouble with the spreadsheet, feel free to send me a private message and I can set it up for you (It really only takes about 30 seconds so it's no big deal)...just click on my name and choose "start conversation". If you missed the link, here are the Instructions for getting the FDMB spreadsheet again

You will need to have a Google account

Once you get used to our spreadsheet, you'll see it's every bit as valuable a tool in this fight as your insulin and blood glucose meter!

Another handy tip since you're using Lantus...You've probably noticed it's crazy expensive!! Most of us here are buying from this pharmacy in Canada since it's 1/3rd the price it is here! Just something to think about if you end up needing it....but for now, as long as you care for it carefully, a vial could last you up to 6 months (and if you happen to buy the Solostar pens, they are good until the expiration date..usually at least 2 years)

 

Welcome from us too, as Julie usually says, the greatest place you never wanted to be. You are doing a super job, getting tests and giving insulin. Weedman is lucky to have such a caring bean.
Liz