Missy's Spreadsheet

Hoping that I did this right and you will find Missy's spreadsheet attached to my signature.

 

And......guess I didn't get it right :-( I will try again. If anyone has tips on what I did wrong, PLEASE let me know. Thanks!

 

Just use this:
https://docs.google.com/spreadsheet/pub ... utput=html

 

Larry, you are a lifesaver! I am NOT the most computer-savvy person in the world...obviously hope it works this time. Thank you.

 

Looks great!

If you can get a +3 in the evenings, then we can get an idea of both the daytime and nightime curves.

 

Sam, Thanks. I would really love to do a curve on her, now that she has been on the increased dose a couple days. I am still waiting for the teststrips, they should be here tomorrow or Thursday. I don't think I have enough to do a + 3 in the evenings, just now. I am thinking I may get a RelION meter and not have to do this online ordering of test strips.
I started her on Clavamox last night, for her chin acne. I didn't want to up her dose and then start her on meds at the same time. Maybe I am a little paranoid, but I am glad I didn't because she started vomiting this morning. She vomited 4 times and I am a little bit concerned. Twice it was just grass, but twice it was food. She just ate a bit ago and it seems to be staying down. (fingers crossed.) I called my vet and they want me to put her on 1/2 pill of the Clavamox and see how that works. She was on it when she was originally dxed, and had a UTI and the Clavamox didn't seem to bother her..at least no vomiting. But, she has lost almost 5 pounds since then, so maybe we DO need to decrease her Clavamox. I even put some of that Forti Flora on her breakfast, because I was told it could upset there tummies, but she still puked.
She has had the last bit of food down for about an hour, so that is better than before. Maybe she will keep it down. It scared me because I am so low on strips and I know vomiting and not eating can mess with her BG.
So, when I get the new test strips I will do a curve.....and try to get a +3 in the evening.....but since I do mine late (DH a second shifter) it would be checking her at 1AM. I guess that isn't as bad as it sounded...I am usually up till then, anyway
Also, getting a new vial of Lantus, as tomorrow the one I have will be open for 28 days. I need to talk to my vet about a scrip for the pens, I think.
Well.....wish I could figure out how to make the link say 'Missy's SS' but at least I got it done! Now I need to go read about the BBCode and stuff so I can figure out how to get her pic on as my avatar and use the smilies.
Thanks for looking at her SS!

 

New User
Antibiotics & Diabetes

Hi mare!

I've gathered your different posts up together to try and keep missy's story all in one spot. it's ok to keep using one post and adding questions on while you're getting organized.

A couple of things you've asked that maybe are still out there -

yes, it's ok to give cats human probiotics. often people give plain (no sugar) yogurt with active culture to their cats to improve diarrhea. if you're in Seattle, perhaps you have Nancy's yogurt? something like that is ideal.

you said you have fortiflora - go ahead and use it. i've used it for as much as 6 weeks straight while punkin was on antibiotics. it works really well to re-establish the right flora & fauna in their guts.

it's natural to wonder why missy was off of insulin and is now back on. if you have ruled out an infection then i wouldn't spend too much mental energy trying to figure it out. it happens. if there is an underlying issue it will show up.

i'm a little concerned about missy's weight and weight loss. i saw she's a hefty babe and also that she's lost 5 lbs. with cats it's really important that they not lose weight too quickly. i don't know what the ideal weight loss plan is, but losing weight too fast can cause serious other problems. a slow weight loss is ideal - others here would know more than me about the best rate and we can help you with that.

you've asked a few times about why an increase in dose might make missy's numbers time. i looked through all the posts but am not seeing that answered. It's really important for you to understand how Lantus works - a lot of what we do on the Lantus forum is teach that. when you understand how it works you'll be able to apply what you learn to helping missy.

Lantus is injected as a liquid, but it forms a crystalline micro-precipitate (think tiny crystals) under the skin after injection. then those crystals dissolve slowly. when you start out on lantus at first it's nearly all crystallizing, so not much is available to work on the glucose in the cat's body. as shots continue the lantus precipitate increases in the cat's body and more of the earlier injections is dissolving and becoming available to work on that glucose. you're injecting it in, it's forming crystals and the crystals are dissolving, all at the same time - so a constant supply and release system is being created.

getting an image of how it works?

at some point you reach the "sweet spot" in dosing and now you've got enough being released from the precipitate, and enough being injected in, so that the kitty's blood sugar is evening out and becoming regulated.

lantus is a slow-acting, gentle insulin. because of its slow action, we have to be patient in waiting for it to work in a cat's body. when i increase punkin's dose by .25 (that's 1/4 of 1 unit - a teeny tiny amount) i then wait about 3 days before i even consider making a change in his dose. that's a very safe way to change doses. if a kitty has sustained blood sugars of over 300 all the time we have the option of increasing by .5 units. we never change by a whole unit unless a cat has a diagnosed condition that changes the game plan. for the majority of cats we change doses by .25 units.

there is also something we call New Dose Wonkiness It's counter-intuitive, but when a dose is increased, sometimes the cat's blood sugar raises and it might take 3 days for that to pass. we wait for it to pass before we change doses again.

also because of how Lantus works, the lowest point of the 12 hour cycle determines dose changes. that's why Sam is suggesting a test 3 hrs after her evening shot. a lot of cats have lower blood glucose at night, for some reason. so we don't know when that lowest point is going to be, but we chase after that elusive number so that we can adjust doses properly.

one last little teaching point - most of us feed our cats in the first 3-4 hours after their shot. there is a waning action in the second half of the 12 hour cycle, so if you're giving food at that time there isn't as much insulin available to deal with the carbs. unless a cat is in a crisis (ie, not eating, diabetic ketoacidosis, etc.) we usually don't feed anything within 2 hours of the next shot. that lets us see clearly what the "real" blood sugar is that isn't affected by food when we're checking to see if it's safe to shoot. there are times when a cat is in a crisis that eating trumps everything else, so this doesn't apply all the time, but as long as missy is overall doing ok, not feeding her in the second half of the insulin 12 hour cycle would be helpful. shooting consistently (ie, trying to shoot as close to 12 hr intervals as possible, having an appropriate dose so you don't have to skip shots, etc.) will also help missy get stabilized as quickly as possible.

You can see there's a lot to learn. since you've got the hometesting down and you've got a spreadsheet, you're ready to come over to the Lantus Support forum and you'll find people more than willing to teach you what you need to know.

by the way, i use the Freestyle Lite and the strips can be purchased without going bankrupt! it's a good little meter - i really like it and it has good reviews from Consumer reports. You can go to mrrebates to sign up, then click on a link on that site to go to American Diabetes Wholesale. mr rebates will send you an 8% cash rebate and ADW has decent prices on diabetic supplies.

and Sam, just fyi, punkin gets 14.25 units right now. high dose kitties go as high as it takes to keep their blood sugar in safe ranges. at least one of our FDMB kitties was at 96 units per shot at one point. that's a diagnosed high dose condition - so it obviously doesn't apply to all cats. but it does happen. the key there is appropriate diagnosis, a lot of education from mentors, and safe increases.

 

Wow, Julie, thanks for doing all that!
It was REALLY nice to learn how Lantus works. Since I self-inject my MS meds (probably helped me deal with this a little easier, since I am used to handling needles and measurements on syringes, etc) I have always wanted to know what I am putting in my body....how it works and why. I get that insulin is THE thing for diabetes and how it makes food available on the molecular level, but I didn't understand HOW it did that. That was really interesting AND helpful. Also, it was nice to know 4 units isn't 'off the charts'. I was feeling kind of like I was doing something wrong. I understand what you are saying about increasing dosages more slowly. It makes perfect sense.I won't ever do that again!
As for Miss' weight loss, yes, she IS a hefty babe. I am embarassed we let her get so heavy. She has been on EVO and I have been watching her calories for almost exactly 6 months. She hasn't lost 5 full pounds, it really is 4 lbs and some ounces. (I bought a baby scale, so we can keep on track.) My vet has been happy with the loss and she hasn't acted like she is deprived.....until right before this relapse.
She seems better today, no vomiting since yesterday afternoon. Back to normal, bright eyed and has a good appetite. Poor bugger was wiped out last night :-( My vet halved the dose of Clavamox. So, we will see how that goes....and hopefully get her chin cleared up, once and for all. I like the yoghurt idea....I imagine she will, too
My test strips will be here tomorrow, so can't get additional readings until then. I actually have a Freestyle light meter....maybe I will start doing comparison testing and switch over. I hate worrying about having enough. Of course I should have factored in the 3 day w/e, so that was my bad.
Well, again, thanks. I might venture over to the Lantus group, but I wasn't feeling really ready for that, yet. I am not positive (still haven't read in depth) I want to do TR. It seems like the right way to go, but I still feel bad testing her, even though she doesn't seem all that bothered. I need to wrap my head around it all.
I guess I am still hoping for a miracle and she will remit again soon :-(
Well, thank you for doing all that pulling together of Missy's story. I will do a curve and get it posted ASAP.

 

it might be helpful if you understand a little bit about how insulin works in general.

i had the idea that i would find the perfect dose for punkin. kinda like a math equation - take one 14.3lb punkin, add 3 cans of fancy feast per day at set times, stir in x units of insulin and VOILA! a regulated cat.

no.

insulin is a hormone. do you have daughters? can you remember you at age 13?

you can't control all the factors with hormones - bodies are all sunshine and smiles one moment, slamming doors at the next, yelling and tears . . . i could go on - i have 2 daughters 19 & 25 . . . but you remember and you get the point. that's more what it's like.

testing is necessary because the same dose of insulin can produce different responses in the kitty's body. testing keeps them alive. seriously. if you were diabetic, you would never give yourself insulin without knowing your BG number - and a cat is the same way. you're not hurting her, you're keeping her alive and giving her the chance to get healthy again.

it might also be helpful to understand that cats don't have a lot of nerves in their ears. think about cat fights - cats always get their ears in the tangle. it's not like they completely don't feel, and he does flick his ear away from me, but in all honesty, punkin purrs through the tests now. people told me he would and i'm thinking "right. i have to fish him out from under the sofa to test him, wrap him in a beach towel so he can't get away, and you think he's going to come when i call him for this? ever?"

but, just now, i called him and he came up a flight of stairs to come to me and be tested. he purred through the whole thing and i gave him a beloved piece of boiled chicken breast afterwards to console him for the whole thing. he was totally fine.

be brave. she needs you to do what's best for her - and if you didn't want to, you wouldn't even be here. you can do it! :YMHUG:

 

I used to have to wrap Bandit up in a blanket, put him in a basket, and half sit on him while I tested, because he growled and bit and clawed at me. If you had told me that a year and a half later he'd run to me, plop himself down in front of me and start purring while he waited for me to do his test, I would have told you that you're out of your mind because you seriously don't know how difficult Bandit is. Well, that's what he does now when he hears the meter beep on.

Julie is right that testing does not hurt them. Their ears are not very sensitive at all. What they don't like is being restrained/wrangled at first, but with treats after every test they learn pretty quickly that that they will gladly tolerate it if it means they get something especially yummy afterwards.

 

I guess I was a little 'spoiled' on my first introduction to feline diabetes, since she went in to remission so fast. I didn't really have time to even think about TR before she went otj. I am trying to be less emotional about it this time and more logical, but I still feel bad when I see the poke marks on her ears. She is such a sweet cat, she purrs through her testing, too, and doesn't really resist. The worst thing she ever does is stealing the Live-a-Littles if I'm not watching. I am serious when I say SHE reminds me it's test time in the evenings I think it almost makes it worse because she is so good about it all. But, I do know it is best for her. After the time she was in the 40's (the nurse just happened to ask me to get a midday reading) I learned a huge lesson about testing. And, if I am checking her 3times a day, now, how much harder can it be to step it up a bit?
I have learned from this board, not to feed her before testing.....and we are on a very regular schedule (the is no snooze button on a cat who wants breakfast) so, I think we have that stuff down, I just have to step up to the plate on testing.
I guess I just feel bad because, from her point of view she is probably thinking 'with her, it always something....' Pills, pokes, shots, chin treatment...
I was kind of down the last few days, with my father in law not doing well with heart disease (and we lost a special, special kitty to heart disease after 18 years and f-i-l has many of the same symptoms) and then Miss starting to vomit after taking the Clavamox.... It was so hard watching our 'old man cat' going downhill and wondering if we were being kind to him.... Missy and her brother were such a joy, it was wonderful to have healthy young cats, again. And I know nothing is fair, but she IS so sweet and her brother is a pill to her. I hate to see her have to deal with all this.
Wow....rambling again! Sorry. The sun is shining, my cats are great, I am not working, so I have time for this... what am I complaining about? I'll pull it together, eventually. Thanks for all the info, it really is helpful to learn this stuff and it is so great to have people around who know where you are coming from and so willing to listen and to help.

 

I'm very happy to hear that Missy is doing better today. Cats not eating is scary to me...

On the poke marks: I found that if I squeeze the spot firmly for ~10 seconds after I take the measurement, the blood stops immediately and there are no marks. If I don't, I get bruising.