11/27 Ozgood PMPS 606

Hi all, new to the Lantus forum. My 8 year old cat, Ozgood, is diabetic. He was diagnosed earlier this year (February/March). He started on Novolin N, then switched to Lantus, then back to Novolin N, and now back to Lantus. He went from 18-19 lbs down to 11.4 lbs on October 14th, but now he's at 11.6 lbs as of November 14th. We're hoping to finally get his bg under control now that he's back on Lantus. Tonight will be his 6th consecutive cycle on 2.5U of Lantus. Oz gets insulin at 8:30 AM and 8:30 PM. Our vet said to wait until Thursday or Friday to increase the dose, but his bg is consistently higher now on 2.5U Lantus than it was on 4U Novolin N. The TR protocol calls for increasing the dose after 3 days if the cat's bg is high and flat, so I'm getting conflicting messages. His SS is up to date as of 6:00PM tonight.

Re: 11-17-14 Ozgood AMPS 473

Yay! You made it!

It's pretty typical for vets to keep doses the same for at least a week at a time. Most people don't home test, and that's one way to manage blood sugar if you're not hometesting.

Great job getting a test in last night! As you go forward, you'll be able to see what a difference it makes to have that evening cycle information. At this point, it probably seems useless to you, but it won't be.

I would go ahead and increase him to 3.0u tonight. Because he was on 4u of Novolin and only getting just under 200 on it, it's pretty likely he's going to have more insulin than 2.5u.

Tilly's Diabetes Homepage

Most cats need to have their dose increased. Do it in 0.25 IU or 0.5 IU steps (0.25 IU if the cat is getting a low dose and/or relatively low BGs, 0.5 IU if the cat is getting a higher dose and/or relatively high BGs). Hold each dose for 5-7 days. However, if the cat is producing continuously high BGs (nadir always >=300 mg/dl), only hold the dose for 2-3 days before increasing it by 0.5 IU.

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As I mentioned in your post on Main Health, you don't want him sitting in high numbers any longer than necessary. His body will get used to them and think they are normal.

Re: 11-17-14 Ozgood AMPS 473

Here's your First Post on Main Health.

I just saw your question about increasing him - if he were mine, I definitely would. With the tests you've got it's pretty clearly not enough insulin. You could increase tonight or tomorrow morning, whenever works best for you.

Many people run into the "do I follow the vet's doing advice or the protocol on FDMB?" issue. All I can say is that the dosing protocol we follow is the only dosing protocol for diabetic cats that has been published in a professional veterinary journal.

Your vet is right that typically you want to give the starting dose time to get to work so you can see what it does, but i think Oz was started too low, based upon the tests you have had with the Novolin at the dose you were using. The protocol gives the option of increasing the dose more quickly if it is evident right away (by constant high numbers, ie, over 300) that the starting dose isn't high enough.

It's up to you, though, how you want to proceed.

Re: 11-17-14 Ozgood AMPS 473

As always, thank you for your replies! Oz seems like a pretty clear case for increasing .5u after 3 days, but after talking to the vet I wanted to ask again. We'll follow the protocol. It makes sense to me. We're going to get a PMPS in a few minutes, then increase him to 3.0u tonight. He's been drinking more water today with these higher bg numbers. I'll update his SS soon.

Re: 11-17-14 Ozgood AMPS 473

sounds like a plan!

Re: 11-17-14 Ozgood AMPS 473

Alex, I forgot to ask you - is the new Lantus from a human pharmacy rather than bought from the vet? Vial or pen?

Re: 11-17-14 Ozgood AMPS 473

Okay, we gave him 3u tonight at 8:30. His SS is updated with PMPS and +1.

It's through the vet, but it isn't repackaged. It's from Wedgewood Pharmacy. It's a vial.

Re: 11-17-14 Ozgood AMPS 473

We gave Oz 3u of Lantus last night and this morning. His bg was 224 at +10 today.

Re: 11-17-14 Ozgood AMPS 473

that's great!

of course the 504 tonight isn't great, but you caught the 224 earlier today, which tells us that he got at least as low as 224 on the 3u. Likely the 504 is a response to the lower numbers earlier in the cycle. I think I gave you the link before on bouncing but i'm not positive, so there it is again. That's the most likely reason for a BG that high after the 224 earlier.

It is possible it's just not enough insulin yet, but we'll be able to tell in the next cycle or two by the blood sugar tests you get. I'll look for your before-bed test tonight - you probably only need that one test in tonight's cycle.

Would you edit the first post of this thread and in the subject line, update it with today's info, please? So it would read:

11/18 Oz +8/224 pmps 504

There are quite a few people who scan the main page and look at the subject line to see if folks need help.

Re: 11-17-14 Ozgood AMPS 473

Just stopping in to say Welcome to Lantus Land! You're doing a great job with testing - lots of good data in that SS !! Keep asking questions....this is the best place for both moral and technical support...a very special group of very generous folks!

Re: 11/18 Oz +8/224 pmps 504

Yup, I remember you talking about bouncing. I will check out the link as well. I won't have a before bed reading tonight snice I haven't been able to test him by myself We're planning on doing an early morning test; about +7. I'll keep you updated, thanks.

Thanks for the welcome Amy! I'm sure I'll have plenty more questions!

Re: 11/19 Ozgood +11/409 pmps 396

Okay, updated with a +7 after last night's shot (about 4am this morning), +11 from this morning's shot, and PMPS tonight. Sunday we are going to test every couple hours all day long. Do you agree I should wait until I have the results from the curve before adjusting the dose? We don't have much mid cycle info since Oz has been on 3u.

What I had originally entered in the SS as 11/18/14 +8/224 is actually 11/18/14 +10/224. I corrected the SS tonight.

Re: 11/19 Ozgood +11/409 pmps 396

what numbers you have are still really high. I can't encourage you to increase the dose, though, without a little more information. Do the best you can at getting both preshot tests in. Are you still having trouble with testing him?

Here's some Testing & Shooting Tips - I hope something there is helpful.

Happy to not see any blacks, though!

Re: 11/19 Ozgood +11/409 pmps 396

We don't have any problems testing when we're both here to do it, but neither of us can do it alone yet. I run out of hands, lol. I'll keep working at it. I'm hoping to get home earlier than normal tomorrow and see what his bg is at around +8.

Re: 11/21 Ozgood pmps 527

Oz is still pretty high. On Sunday we're going to do a curve. We'll figure out what he's at mid cycle so we can adjust his dose accordingly.

Re: 11/21 Ozgood pmps 527

sounds like a plan, Alex!

Re: 11/21 Ozgood pmps 527

Welcome, Alex and Oz!

Just wanted to say hello. Clare and I are relatively new to Lantus Land, and are from WI also. The folks here are very caring and knowledgeable and are here pretty much 24/7 to help if you have a question or concern.

Clare is a "bouncy" cat and my husband and I still do a lot of the testing together. You'll find lots of good information here to help Oz get healthier and to make each day a bit easier.

Looking forward to getting to know you all,

Georgette and Clare

Re: 11/21 Ozgood pmps 527

Thanks for the welcome What part of WI? Oz and I are about 3 hours NE of Madison.

We're doing the curve on Oz today. There has been more green and blue than anything else today

I updated his SS. His +6 was 64 and I fed him about 3oz of canned chicken after the +6 reading. His +6.5 (3:00PM) was 78.

+10 - 443 eek!

Re: 11/23 Ozgood +6/64 +6.5/78

Here are a couple of tricks that might help when you're testing alone.

We sat on the right end of our sofa with all the testing supplies in a large bowl on the arm of the sofa. Got the meter ready with a strip partway in it. Had the lancet device ready with a new lancet ready to be sprung. Then we got punkin and put him facing out between whoever was testing and the arm of the sofa. He wasn't trapped, exactly, but in the early days i might've crossed my leg so one went in front of him so he couldn't just slither out. You'll get to the point where you can move quickly but without conveying any anxiety/alarm.

Push in the test strip, get hold of Oz's ear, quickly lance it and as soon as there is enough blood, put the test strip up to the blood spot. If he can't hold still for that moment, you can sweep the blood drop off onto your fingernail and test it from there. Then staunch it by applying pressure between your fingers over the poked spot. That extra few seconds will cut off any bleeding, preventing bruising that makes it hurt on the next tests.

For getting preshots, if you can't make the above scenario work, get his testing supplies ready (like above) and set them on the floor right next to his meal spot. Get the syringe ready and set it down too. Put the food down and as soon as Oz's head is in the bowl, grab a test first thing and then shoot.

It takes at least 15 minutes for most cats to show the carbs with an increase in blood sugar, so you have a few minutes to get this all done in. If you need him to take longer to eat, you can spread his food out around his plate. At one point I tried adding a ping-pong ball into the food so punkin would have to work at it. Didn't work great for us, but it's an idea for you if you think it would help.

Glad to see he's getting to green in the middle of today's cycle! The goal is to get him to spend as long as possible in normal numbers. Often when we see those red and black number cells, those indicate a cat is going too low somewhere and bouncing. It's so very, very common for cats to go lower at night, that the before-bed test is one of the most important tests you can do.

Good job with the curve today! It's helpful to see that he is getting into normal numbers but just not staying there very long. When you've got the preshots and a before bed test added on, I think you're going to be amazed at how much information it's going to reveal.

Re: 11/23 Ozgood +6/64 +6.5/78, PMPS 526

Thanks for the tips! I'm going to try the couch trick at 11:30 for the +3.

Yes, the middle numbers were the lowest we've ever seen. We even had 2 digits instead of 3! He shot up like a rocket near the end of the cycle and through the PMPS. Probably because he was in the 60's at +6? Should I be concerned about him getting that low? I gave him about 3oz of chicken after the +6 test, and by +6.5 he was at 78. His bg kept climbing after that. I just wonder if he would have went lower if I hadn't fed him?

Re: 11/23 Ozgood +6/64 +6.5/78, PMPS 526

It's a good idea to feed a little low carb food when he gets to green numbers. It can help a cat surf along in green numbers. Did you give him cat food or people food with that canned chicken? No you don't need to worry about 60's.

Re: 11/23 Ozgood +6/64 +6.5/78, PMPS 526

I tried to test him by myself using the couch last night. I couldn't get it. He'll sit with me if I'm holding him, but as soon as I take a hand off him to get the lancet, he tries to take off. I thought about sitting on the floor and putting him between my legs to help hold him. He's such a sweetie when we both test him! When one can hold him and the other can do the actual test, he's as good as can be.

It was people food canned chicken.

What a change from yesterday! His lowest bg was his AMPS/239. Otherwise he's been in the mid to high 300's all day. He's been on 3u since 11/18. I don't really want to increase the dose because of how well he was doing yesterday.

Re: 11/24 Ozgood AMPS 239, +3/360, +6/350

No, you wouldn't want to increase his dose yet. Remember that Lantus dosing is based upon how low the dose gets the cat's blood sugar. Yesterday's great green run tells us that we want to give this dose a little bit longer. His high numbers right now are because he's bouncing from yesterday's green numbers.

Just hang on until the bounce clears and let's see how low he gets to then. Might be as long as 3 days, might be sooner. He might need a dose increase at that point, but the numbers will tell you.

The only thing to be careful of with the people canned chicken is whether or not there is any onion/garlic in the broth (toxic for kitties). I'd also wonder if the sodium might be too high, although if it was just a bite it might not matter.

Keep trying with the testing. At some point it's going to click and then you'll have it down. We had to burrito wrap punkin in a large towel for 2 weeks before he gave up fighting. I bound the little guy up very tightly in the towel - he looked like a giant shrimp - but i could move him and test him easily. There are youtube videos on how to do that if you're interested.

Re: 11/24 Ozgood AMPS 239, +3/360, +6/350

We just got his PMPS and gave him his insulin. PMPS was 385. He's stayed pretty flat today anyway. Also, both his AMPS and PMPS today were the lowest we've ever seen for PSs. I'm hoping once he clears this bounce he won't get hypo low. Is there much of a chance of that happening?

No onion or garlic in the chicken broth I've wondered about the sodium as well. I've thought about (more than likely will) replacing his canned chicken meals with Fancy Feast.

I think I'll have to check out the videos on burrito wrapping. If he wasn't able to squirm away, testing on the couch would work fine I think.

Ozgood's bg has still been pretty high again. I haven't been on the desktop to update his SS, but I will Friday night. Anyway, tonight his PMPS was 606. Could it still be the bounce? He had such good bg numbers on 11/23.

It can take up to 6 cycles to clear a bounce. Without seeing if he went low again it's hard to say for sure, but I would lean towards no, it's not that. But...every cat is different. More likely, he has some glucose toxicity and so Oz's body thinks high numbers are normal. His body has to basically retrained to recognize green is good. Only way to do that is to keep him in those normal numbers as often as you can.

~Suzanne

Hi Alex and Oz

Welcome to Lantus Land. Two things to ask you, please. One is that we do a new thread for each cat each day. It makes us easier to keep track of what's going on and the thread doesn't get too long. The other is it helps us immensely if you keep his SS up to date. I'd love to give you some suggestions but there is no entry for a couple days so I can't really give you an idea of what might be the best thing to do or whether he's bouncing.

Here's an important post on Making the Most of your Lantus ISG Experience[/url}.

Glad you found us!

Marje and Gracie said:

One is that we do a new thread for each cat each day.

Click to expand...

Started a new one