Wow, the new BG Equipment & Technique made all the difference!!

http://www.felinediabetes.com/FDMB/...-we-will-battle-diabetes.197437/#post-2209738

 

Hey there Keeper of the fur. I'm glad to see you made it to the Main forum where more members can review the posts and responses from the Introduction forum. Good on you copying and pasting that link into your first post here. You had questions on what to feed, how much to feed. what kind of meter to get, basically how to begin the sugar dance. And you have had excellent responses. If you have any specific or different questions, you can change the title of this thread to reflect that issue. Just upward at the top part of the post where it says Thread Tools and you can change the title there. It's good to have only one thread a day, so it doesn't get confusing between threads, and be as specific in your title as you can, so that will get more immediate attention, for example: what should I feed my kitty? What kind of glucose meter is best.

 

Hi @Keeper of the fur! ,
is your kitty still going to be on Bazaglar(spel?) insulin?
Or Lantus?

I have no experience with Bazaglar but one of our members was using it for a while and successfully. She might have some tips for you.

You mentioned that you were going to buy smaller pen needles and I wondered if you can give Bazaglar by drawing a dose from pen by a syringe? It will allow you to draw smaller dose increases/ decrease by 0.25 unit or 0.5 unit.

@Chris & China

Chris, is it possible to use syringes w/ Bazaglar?

 

Hi and Thanks. Actually according to my pharmacist, Bazaglar is ONLY available in the pen form, of which I have only the ability to select in single units. There's no 1/2 dosing unfortunately. So the pen needles are only for injecting, not for drawing as well.

 

Yes, I had to purchase a package of 5 pens.. of which I'm only through about 1/2 of the 1st pen. It wasn't cheap, so I really need to make them work til the end of them. I realize now that it may not be the best solution only being able to set the injections to increments of 1 though, so I'll have to lean on the experience of others to manipulate his BG by food timing .. etc. (just repeating what I've seen in some care spreadsheets that others are doing to adjust their kitty's levels without adjusting insulin).

 

I see, ok..

I buy Lantus by pens and draw a dose w/ syringe by putting the needle though a rubber membrane on top of the pen.
Are the Bazaglar's pens different? No protective membrane on the top?
@Keeper of the fur!

 

I understand from my pharmacist that Basaglar is a newer version of Lantus and less expensive per shot by far. Though again, the pen and it's 1 increment adjustments, may not be the best choice for Sweetie PD. But I didn't know that when I bought it. Should have been online looking for this FD website BEFORE I committed to what was the lack of detailed guidance to make good choices from my vet... which I'm only learning about now.

 

These are the pens I have. The liquid is already inside in a clear area. The dial at the end of the pen adjusts the amount injected by a screw-based metered measurement. There is a rubber stopper at the end of it that I swab with alcohol prior to threading on the needle. You have to prime the pen each time you use it to remove any air, then reset the dial to the dose you want to give and fire away.
https://www.basaglar.com/en/about?W...VUtbACh3tlQNvEAAYASAAEgJo2fD_BwE&gclsrc=aw.ds

 

ok, I see..

probably the best thing to do is that you to continue on the familiar path until perhaps @Chris & China logged in and responds to the tag...

however, since you were going to buy some things from Walmart anyway why not ask the Pharma counter personnel if they carry Relion or BD insulin syringes 3/10 ml/cc, 8 mm (5/16") length, gauge 31?
My local Walmart charges only $1.26 per a pack of 10.
It won't be too wasteful to get a pack just in case you can use it for the Baz. and alter the dose by 1/4 or 1/2 Unit.
Dosing in smallest increments available helps yo u to pin point the optimal dose w/ (at least) home grade precision.
Better, IMHO, than to over shoot a good dose by whole unit upgrades.

 

I do have one technical question though. My personal friend told me that Lantus/Basaglar are both long acting insulin s. As a result of that slow action, he only has to take a single shot per day and asked me to question my vet about this and why the 2 time per day injection. Does anyone know the answer to that? Is a cat's system so different that we give a long acting insulin 2 times a day? Is it more controllable for felines doing that?

 

You know, that makes good sense. If I can shoot out of the Basaglar pen.. I can draw from it too. I will do that! Actually I live way out in the country with no Wally World for at least 30 miles, so my local pharmacist can assist in this plan! That makes me feel better you bringing up that I could still use that Pen... and I bet even more efficiently, simply because when they tell you to "Prime the pen before each shot" you essentially waste 2 units of Basaglar, whereas if I draw from the pen with a separate syringe, I can tap the air out of the syringe prior to giving him the shot and not waste insulin. Wow. that can increase the amount of shots I can give with the pens I've already got, by double the amount of shots! THANKS!! You just KNOW the manufacturers design-in that feature so that you have to purchase more pens simply because you have to prime them to use them properly. Huh!

 

Ah, good question!
Lantus (again, I have no experience w/ Baz) is long acting insulin which
is the most effective is given consistently 12 hours apart and in the same dose.

The thing about long acting insulins is the understanding that once you gave a dose you do not see its effect immediately because Lantus (and Lev) stores its deposits within fat tissues of the skin in crystallized form and releases itself gradually over the time. The potency of a Lantus shot growth from the onset time (could be as early as one hour after the injection!) down to nadir - it's peak performance and then gradually raises the BG up until the next shot time. Some cats experience 8-12 hours duration and others 12+ hours.
For precisely that reason it is asked from the Lantus users to hold on to a dose for at least 6 cycles - 3 days x 12 hours cycles ea. to make sure that the insulin depot (crystallized deposit reserve) is full and established and the patient reaction to the dose is the indicator to the dose adjustments. We all here keep Spead Sheets to track such things.

Giving one dose per day based upon the preshot reading is ok for other, non long acting, non depot styles insulin such as ProZinc or Caninsulin, for example. With them one bases a dose on the pre-shot BG value.

However, w/ Lantus - or perhaps the Baz, too? - you base increasing/ decreasing of a dose on how low you cat gets on it - i.e. what is you cat's nadir on that particular dose.

I hope it makes sense.
Ask any Q you have.

 

HERE is the link to a page that instructs on drawing smaller doses but again - it was written for Lantus!
@Keeper of the fur!

 

Basaglar is the bio-similar of Lantus and is dosed the same.....which should be equal doses every 12 hours. Pretty much everything you read about Lantus pertains to Basaglar

You should be using plain insulin syringes to pull the insulin out of the pen.

All these syringes have half unit markings (very important when you're doing microdosing) and are the correct syringes for U100 insulin and are available from ADW online:
UtiCare
Monoject
Carepoint
Sure Comfort
B/D

They're also available at WalMart if you have one near you. Their Relion brand 3/10ml, 30 or 31 gauge, 6mm or 8mm insulin syringes all come with half unit markings and are only $12.58 for a box of 100 (although a lot of them don't realize they DO come with half unit markings!)

 

Not exactly a "newer version", but it's not a real "generic" either....both are Glargine.

You can also save a lot of money by ordering Basaglar from Canada like we do our Lantus. A 5 pack of Basaglar is only $124.99 plus $25 shipping

Information on buying insulin from Canada

Marks Marine has been a Godsend to a lot of us

 

PERFECT for the smaller doses link. I've got a lot of reading to do tonight. And what great info on how to purchase and use these micro syringes. I probably will not even buy the Pen needles, I'll just purchase the syringes with the ultra fine needles.

Yes my vet said that she didn't care which one I used, as long as it was Glargine.

Canada? OMG. You're kidding? I just paid $360.00 for 5 pens :-( !! Isn't that sad? And I shopped around too!! Crap!

 

..tell me how is not a highway robbery?!
Here is the link to the Canadian Pharmacy : https://rxcanada4less.com/

On the positive: The manufacturers data on to how long Lantus stays effective is overly cautious - it says 28 days upon opening but in reality is lasts effective for weeks ans weeks longer. Pen's life starts to count only upon its opening. So with pens you 'll get longer life v. single vial use.
For instance I kept my last Lantus vial refrigerated, drew via syringes and it lasted for about 7 months.
It would have worked longer but I got paranoid and ordered pens instead (from Canada).
Each pen since then was used to the last drop - it was kept in the fridge, upper far shelf, placed in a glass cup to avoid undue shaking/ dropping, etc. My cat Ducia is on a small dose so I rely on the pens to sustain us for the remainder of 2018. You might have the same good mileage on your B. pens.

 

Hi all, I'm feeling awfully blue tonight. I went to my local pharmacy to ge the syringes you recommended and they didn't have them. I did get a low blood sample volume glucose meter free from him and 50 test strips for $19 bucks, and 50 tiny lancets for $2.50, so I can at least try to get a sample tested tonight. Then when I got home to clean his cat boxes up, during the course of the day he had piddled outside his box on my litter pad, several times. He gets to the sandbox which is very large with the side cut down to get in to easily, then goes in, but once he's in, he piddles outside the box. I'm just getting worn out mentally and physically and need to here from someone that has started at this point because I'm really losing it right now.

He ate at 7pm tonight and I normally give him his shot at 8:15 -8:45pm (morning and night), when should I be taking the glucose reading tonight, he's already eaten? I'm just trying to read everything your sending me but I'm pretty overwhelmed absorbing what I should be doing first. Maybe a BG reading better than the 501 my vet told me about last Thursday, would make me feel better. Anyone out there?

 

Sorry was offline. I'm sorry you feel down tonight, it's ok. I know you are trying to absorb everything as fast as you can. He's eaten and there isn't 2 hours before injection. In the morning, make sure no food for 2 hours, then feed, shoot. I dont know about that insulin, I don't know what time it is where you are. I'm going to tag a very experienced person to have a look and see what she says. @Chris & China
Hang in there, you try to rest, you are doing everything you can in this moment.

 

Take one step at a time....Nobody learns everything overnight....It was about 6 months before I felt I understood enough of what others had taught me to feel comfortable making my own decisions (and I still verified that my decisions were good ones for awhile longer!!)

In a perfect world, we don't want them to eat for the 2 hours immediately before shot times so that the Pre-shot test isn't influenced by food.....of course this isn't a perfect world so you do the best you can!!

You Test/Feed/Shoot…...Test to make sure they're high enough for insulin at all, Feed to make sure they're at least willing to eat and not so sick they refuse and Shoot (usually while they've got their head in the bowl)….it usually only takes about 5-10 minutes from Test to Shoot (I think I can do it in less than 3 but I have a lot of experience testing)

Other than those 2 Pre-shot tests, you can feed normally.

Basaglar is dosed exactly the same way as Lantus....it's a bio-similar of Lantus

 

Good morning all, thanks for the words of inspiration and direction you sent last night. I had already gone to sleep before you answered. Last night I studied the video that someone had shared with me yesterday of testing her cats ear, so I thought I had that down. Then I studied my new BG meter instructions and did meter set-up and got everything ready for this morning's test. This morning I attempted to take the test. PD was upset that I wasn't feeding him first as we've done all his life, but he sat for me. I used the lancet not once but twice on his ear and couldn't get blood. The 3rd time I did it, I moved the cotton ball behind his ear to discover that I did get blood that time, but it was on the underside of the ear absorbed in to the cotton ball. So I gave up on that attempt and let him eat. Now that I've read your directions, I'll try to take his BG reading for my first home test baseline. Then I'll get back to you on my result and where I go from there next.

 

I hold the cotton ball on the back of the ear, because like PD, Idjit has dark fur on his ears. So I poke on the lighter inner ear, outer edge so I can see what the heck I'm getting. Since Idjit is OTJ, we don't test all the time, usually once a week or a bit longer. His ears are not readily giving up the drop like before. You are trying, and you will succeed. I think it's time to get the signature done so that members can see info on PD, like what kind of insulin, meter, etc. You are going to have more questions as time goes on, and having that information attached to your posts is going to be very helpful. Please consider it.
http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/
I think you are doing great, it's a great deal to learn. We've only been here since April 3, and that's why I defer to the more experienced members on many matters. Plus, PD loves you, what more can you ask?

 

I go through this with Cleo too. She's blind, so she can't see the box. As far as she is concerned, if she can feel litter under all four paws, she's in the box. Her fuzzy little butt isn't over the box though and she pees over the side of the box onto the floor. I hate it, but I can't fight with her over this. She's an old lady and she really is trying her best. I put puppy pads under and around the litter box. At least she is peeing less now that her diabetes is regulated.

Cleo gets her insulin around 8:30 AM and PM. What I do is to feed the cats as soon as I get home from work. Then I take the food away after they've eaten. That gives us a good 2.5 to 3 hours before the PMPS test. In the morning, I test her as soon as I wake up. Then I give both cats their breakfast.

 

Ya, I know... that mat that I have in front of the litter box is light gray and you're right.. probably feels like he's on litter and away he's going. :-(.

Can someone tell me how to get a hold of the webmaster? I can't change my password and even when I ask for a new password reset(done many times now), even that new reset password won't let me change it. And I keep getting bumped off even though I asked to stay logged in.. of course maybe my internet is dropping out. I'm on DSL and I am lucky to get 2.5Mbps only if the wind is above 15mph and from the NW!

 

Got my first BG reading by myself! 388... Yup high, but it was not on any schedule I was just practicing. Plus I expected that high level because of the way my vet had me caring for him. His reading at her office last Thursday was 501. But this is all going to change for the better now. I'm empowering myself to take control of my Sweetie PD's health and safety... Thanks to all of you out there! Tonight, I will take a pre-shot pm reading, then feed, then give shot tonight! I'll study more of your spreadsheets to get the rhythm of this.

Question: I'm going to call my vet and discuss what is going on now as she doesn't know I've started the testing route. Though I see that others have discussed increasing/decreasing their insulin shot amount themselves, I'd best not do that. I know I need to change the amount of Basaglar I'm giving him and she should know about that and base her recommendation on my baseline readings I'm getting for a week or so... correct?

 

With Glargine, you hold the starting dose for 5-7 days before making any changes UNLESS they drop too low, indicating they need a reduction in dose.

It takes that long for the "depot" to fill and start to "release" enough insulin back into the bloodstream over the cycle to equal the dose you're giving.

Example (just for helping to understand...NOT the way it really works):

shot 1.. you give 1U. Of that 1U, .25 goes into the bloodstream to start and .75 goes "in the depot" and slowly releases back into the bloodstream but by the end of the cycle, the total amount actually IN the bloodstream is only .5

shot 2...you give 1U again....another .25 goes into the bloodstream and .75 goes "in the depot"...but because the "depot" now holds more, it will slowly release more by the end of the cycle.....so let's say .75 total by the end

shot 3...give 1U and the same thing.....but now, the depot is holding more, so as the cycle goes on, it's able to release more into the blood....by the end of the cycle, it's released .9

shot 4....same 1U dose....but now the depot is "full", so it's going to release the amount of insulin equal to the dose amount....by the end of the cycle, the total dose actually in the bloodstream is 1U

Again, this is just an example to help understand how the depot works....it actually usually takes 5-7 days to get that depot completely full.

Once the depot is full, dose adjustments are made based on how LOW the dose is taking them. This is where it gets tricky because you will need to make a decision on which dosing method you are most comfortable with.

Tight Regulation gives the best chance at remission, but requires a little more testing. Dose adjustments can be made as often as every 3 days (which is good because if the dose isn't getting them where we want them, we can increase more quickly than on SLGS)

Start Low Go Slow holds the dose for 7 days and then you do a complete curve (testing every 2 hours for 12 hours or every 3 hours for 18) and base adjustments on that curve.

 

He's actually been on insulin since the first week of June, so he should have started up his depot. I do like the looks of the Tight Regulation because he's been and is still out of whack. His BG went from 388 mid afternoon yesterday, to 460 last night. But I'm not doing spreadsheet yet, I'm just recording on my daily log and trying to get a rhythm going between the preshot/feed/shot/clean up cat box area/repeat, ugg.

My latest problem is now since I have the testing kit, and he is so patient with me, the last 2 times I've tried to test him, I haven't been able to get enough ...or any, blood. I'm feeling terrible because the one time I think between both his ears, I must have poked him 10 times and a couple of them he's let me know it hurt. Makes me sick. Last night was I think the first time ever that he growled in disgust at me. I think I saw a thread about not being able to get blood, I'm going to go review that and see if there's anything I can learn and get inspiration from.

 

Hi,
I too like my hand written log better but one of the benefits of keeping the SS updated is that the cells are color coded depending on the current read and I found it very helpful to roll back my chair and look from a distance at the waves of color per day - I get better picture of how low/ high Ducia goes on each dose.

testing will get easier on both of you with practice, hang it there
Giving small treats before and after each test attempt work miracles for many.

I am not saying that is what was going on with PD last night but my cat's ears do not bleed at all if her BG is too low.

 

Morning! It's not that I like the handwritten better, I'm still so new and really not organized yet that I haven't gone through the hoops on google etc, to set it up. Studying time to learn to do all this is tough for me right now and though I know the urgency, it's just been difficult to get it all done as I own my own business too and it all seems to be coming around my ears at once. It's my busiest time of year, though I know that my PD needs to be top priority.

I DOUBT that his BG is too low since it has never been below 300 yet, but I best not guess and keep trying with the blood and get that SS going asap. I am trying to put a warm rag on his ear before too as I think I saw that somewhere or heard it on a video that it will get blood flowing there.

Do you know if the freeze-dried chicken treats jack up his BG? What effect does that particular treat have on sugar kitties? And the boiled chicken, will that have an effect too? How much can I give him? He's still peeing/drinking/wanting lots of food and treats in his high BG levels, that's where I think the tight regulation style would get him regulated fastest. I'm going to call and discuss this with my vet today. I never mentioned this before, I guess I mentioned that she is not only my vet but a best buddy too. She TOO has just gotten bad news and is very distracted, that her husband around 47, has stage 3 colon cancer and has just started chemo, so I have felt her tension which may explain some of the things she has had me do.

 

yes, some dried treats have as much as 20% carbs and does elevate BG. I am not familiar with brands/ carbs content, thou. An extra teaspoon of reg food passes as treat here.

it is very typical of unregulated diabetics to be hungry and thirsty. This will improve with better BG control thou. Feed him what he eats and keep record of his BG, food type and portions - I used to put it all in Ducia's SS/ Remark section on the right side of SS.

Plain boiled chicken has no carbs so it won't affect the BG as dramatically as dried HC treats do.
Many use boiled or roasted chicken as treats / midday snacks just be aware that plain chicken meat is not balanced food and should be used only as a supplement, not main source of food.

Sorry about your vet friend husband, way too young for such things...

I hope your home testing will pick up soon. 3U is rather a larger dose and requires monitoring. Also more people with experience will be able to comment once the SS is up - I for instance feel very disoriented if I cannot see the succession of BG# in the SS format

 

HA! Right now I feel disoriented just LOOKING at others spreadsheets!!

I'm a huge excel user... I'll get it rolling soon! Thanks for the treat info, that helps!

 

I'd be happy to set it up for you....it only takes about 30 seconds.

I'd need some information from you first so you'd need to send me a PM (click on my name and choose "start conversation"

It looks a lot more complicated than it is

 

Chris and China have been gracious enough to get me up and running with a Spread Sheet. My conversation with my vet today and the fact that today is the last day the PD is going to get dry Rx food, she recommended that I wait for 7 day's for PD's system to get accustomed to just eating the canned food, then begin my charting and doing a curve. She was great helping outline how she would do the curve and I will follow her instructions. She also asked for this website info and the Canada link for insulin because they are of added value to her FD customers. She sounded like she was having a better day too as she gets situated in her own battle as he husband is on his 2nd chemo treatment out of 4 months worth. I'm thrilled I heard a bright spot in her voice.

So, stay tuned, I probably won't be charting much for days on the SS... and if I don't start hitting the blood in my "Poke and Hope" trials soon, there won't be much for charting either!! Ha! I will start using that warm bottle to get his ear ready for the prick. EEeeuuuuu. Sorry PD!!

 

I'm so excited I just had to post!! I've been struggling unsuccessfully for days to get a blood sample reading on the Sunmark True Metrix meter I bought, then I spent 2 1/2 hours on HOLD with them last night to finally email them telling them their tech support sucks... So this morning I had had enough after trying it one last time and again got the dreaded E-0 alert.

No BG reading again, so I put that testing "Junk" away and I drove the 30 miles to my nearest Walmart and bought the ReliOn Micro + 100 Test strips... and I LOVE LOVE LOVE this machine. I should have done that in the first place when everyone on the site was telling me to get the ReliOn. I just took his BG level and he's at 92 pmps!!! YEAH!!!

I guess I wouldn't know how nice the ReliOn tester is, unless I had such bad luck with that first meter, SO ...any newbies who read this should just go buy the ReliOn kit that's packaged with the lancet device already in it for $14.88, and the 100 Strips were $35.88, and be done with it!! This new meter has great features, is fast and easy to handle, and it gives you up to 5 minutes (after you've pushed the test strip in all the way), to get the blood test taken. And if you need to, you can just take the strip out and just put it back in again. That other meter was like a slot machine, you put the strip in... it would maybe give you a BG reading, then tease you for 10 times after that thus trashing all those the test strip$$ with good blood samples in them, your nerves and feelings that you are hurting your cat, and the trust of my poor Sweetie PD!! I always felt like I needed to have a 2nd set of hands helping me because the meter was definitely clumsy compared to this little beauty!

In addition to that great news, I'm now using the u100, 3/10th's syringes with 6mm 30gauge needles and I'm drawing insulin out of the Basaglar Pens.. saving me a ton of money/insulin not having to "prime the pen" and making giving shots a breeze now! Wow, I've been on a tough nerve wracking learning curve but I'm feeling good now!.

The other thing I'm doing different, is that tonight I actually started using the Lancet tool/needle verses poking PD's ear by just using my hand with the lancet/needle. I put the clear end on the device and then took a black marker and darkened that inner little circle so that I could see my target in that hole easier (thanks to whoever showed us that in the videos!!) and VOILA!! BLOOD!! Just amazing! FIRST TIME! No Stress, No Muss.. No Fuss!

I'm feeling redeemed now and will actually start charting!! There's hope man! Thanks everyone!

 

Yeah for success!!!!

Sounds like you're well on your way now!!!

 

There is a learning curve to the east testing. Try not to get discouraged. I had many failed attempts the first week. It gets easier as you get the techniques down and as your cats eat starts to form new capillaries.

 

BTW... Cheap place to buy syringes online... Adwdiabetes.com

Look for 31 or 33 gauge, .30 ml, with half unit markings u100

 

Thanks for that tip... last week I bought them at my local pharmacy for .. ouch... $26.00 for 100!! Crikey!

 

31 is the thinest gauge for insulin needles. The insulin pen needles come a little thiner, smallest is 32 gauge.