New Member - Admiral Ackbar - Starting with basic advice, maybe looking for a new Vet in Northern NJ

EvanVanVan

EvanVanVan

Member
Hi, my 11 year old cat, Admiral Ackbar, was just diagnosed with diabetes a couple of days ago and finished his first BG curve at the vet's offices yesterday. Unfortunately, although I've mostly liked the vet to this point, I'm starting not to trust them when it comes to this diabetic care. :[

I was told to bring pick up the subscription (Lantus) and bring it with me to the BG curve. I naively brought both the insulin and syringes to the appointment thinking the vet was going to instruct me on the basics of injecting, and walk me through the process of caring for a diabetic cat.

That clearly wasn't the plan. The vet that called me up 30 minutes after dropping him off to complain he wasn't eating to start the BG curve was rather annoyed I knew nothing and telling me I *had* to sit down with a vet and go over the care of a diabetic cat.. Yeah, obviously, I figured that would happened when I picked him up.

Anyway, long story long, going to pick him up, the vet technician gave me some basic information but kept having to go out of the room to consult the vet for follow up questions. The final straw that finally got the vet into the room was, when I asked, "I read giving too much insulin or having his blood sugar drop too low can be incredibly dangerous, what are the danger signs I have to look out for?" (The answer from the vet was, if I hadn't had my coffee and mistakenly gave him double shots of 2 units.. he would get sleeply and to give him some karo syrup.)

I said I naively dropped off the syringes with the insulin, because at the end of the night they had lost them! The vet tech tried to hand me a bag of generic ones they had, and when I said it didn't look like enough he pulled a 2nd bag out of his pocket. When I told him it was a brand new month's supply I had brought, he went back to look again for the box. Didn't find it and gave me an entire box to take home.

The tech mentioned to me they were U-40 syringes, at the time I didn't really understand what he said or even know what that meant. But, while he was looking for my box I did notice the Lantus box said "For use with U-100 syringe only". It wasn't until I got home last night and was reading on here, seeing again that Lantus shots should be administered with U-100 syringes that I really put 2+2 together.

The vet showed me and told me to administered 2 Units but that was with U-40 syringes. Now I'm worried about the rest of their "advice." Is 2 Units of U-40 Lantus, too much, too little, hopefully what they found based on the BG curve I just paid for? Do I give 5 units once I switch to U-100 syringes? (Per the 2.5x conversion google mentions)

Tl;Dr:

  1. The vet told me to give 2 Units of Lantus out of a U-40 syringe, while the box says to use U-100 syringes. Is that too much, too little, or correct? Is there an issue with using U-40 syringes?
  2. Admiral Ackbar has been free fed on Iams orange bag to this point. I'm ok switching him over to Fancy Feast Classic Patte. Should I adjust the 2-Units (of U-40) insulin while doing this? I have nothing, no monitor, no experience.
  3. Administer shots immediately after eating? Wait a few minutes?
  4. I haven't looked, but the advice on the main home page seems very dated. What's the best glucose meter I can get today?
  5. Does anyone have a good vet with experience caring for diabetes in northern NJ they can recommend?
I guess that's all for now.. I administered my first shot a little while ago, it went well enough...Admiral Ackbar is just sitting there which has me a little worried but, hopefully is ok...They gave him the same 2units last night in front of me when I picked him up.

Thank you
 
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Hi Evan, welcome, sorry you’ve had to find yourself here and to make things worse, I’m going to give you some homework so folks can help you better.

Read through this link below about setting up a spreadsheet and your signature.
Help us help you

And read about some hometesting basics.
Hometesting tips and links

Now for your questions.

How much does Admiral Ackbar weigh? The vets recommend 2 units, but that is higher than we usually start with here. Did they share any of his current blood glucose levels with you? I’ll leave this for another member to give their input on.

Do the food transition slowly, over the course of a few days or even a week. Too fast can cause stomach upset issues. You’ll want to feed the main meals and a couple snacks throughout the day.

Most people test, feed, then shoot in that order, all within a 15 minute span once you get the hang of it. Some people find it easy to administer the shot while they’re eating. You do want to withhold food 2 hours prior to the shot. And the nice thing about Lantus is you have 2 hours post-shot to get some food on board, so it’s not as critical that he eats immediately before the shot. It is critical however to get a BG test before the shot, that’s how we know it’s safe to give insulin.

“Best” glucose monitoring device you will get mixed answers. Most people here use the ReliOn human meter from Walmart. Cost effective and if you run out of strips at midnight Walmart is open.

U-100 is all I’ve seen recommended for Lantus. Another member will have to comment on the U-40.

There are a few members from NJ. Hopefully they stop by about the vet recommendation. Unfortunately, it’s talked about a lot here that the vets don’t get a ton of training on feline diabetes, so they recommend bare minimum to hopefully keep the cat safe.

Lastly a question for you, did they mention anything about ketones at diagnosis?

Ladies, can you help Evan with his syringes, dosing questions and anything I missed? :)
@Diane Tyler's Mom GA
@Bron and Sheba (GA)
 
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Tim & Pookey said:
Hi Evan, welcome, sorry you’ve had to find yourself here and to make things worse, I’m going to give you some homework so folks can help you better.

Read through this link below about setting up a spreadsheet and your signature.
Help us help you

And read about some hometesting basics.
Hometesting tips and links
Click to expand...
Yeah, I need to dive in to it.. Will do. Thank you.
Tim & Pookey said:
How much does Admiral Ackbar weigh? The vets recommend 2 units, but that is higher than we usually start with here. Did they share any of his current blood glucose levels with you? I’ll leave this for another member to give their input on.
Click to expand...
Honestly, I'm going to follow up with the office today. I said "mostly" liked them. They have a bad habit of doing the entire consultation in the waiting room and taking the cat in the back for the actual exam. That's what I don't like.
Tim & Pookey said:
Do the food transition slowly, over the course of a few days or even a week. Too fast can cause stomach upset issues. You’ll want to feed the main meals and a couple snacks throughout the day.
Click to expand...
I put out his normal dry food this morning and he didn't touch it, I tried a can of fancy feast and he ate pretty much the entire thing...kind of expected him to throw it up he ate so quickly but apparently he hasn't lol.

Tim & Pookey said:
Most people test, feed, then shoot in that order, all within a 15 minute span once you get the hang of it. Some people find it easy to administer the shot while they’re eating. You do want to withhold food 2 hours prior to the shot. And the nice thing about Lantus is you have 2 hours post-shot to get some food on board, so it’s not as critical that he eats immediately before the shot. It is critical however to get a BG test before the shot, that’s how we know it’s safe to give insulin.
Click to expand...
That's good to know. He has seemed lethargic (but it might be all in my head) this morning after 2 units of insulin so I put new/different food out and encouraged him to eat it.

Tim & Pookey said:
Lastly a question for you, did they mention anything about ketones at diagnosis?
Click to expand...
I'm not 100% sure but when the vet told me on the phone a few days ago that there was sugar in the urine, I asked about kidney issues and he said the kidney numbers looked good. I'm not sure if that's related or not.
 
EvanVanVan said:
I'm not 100% sure but when the vet told me on the phone a few days ago that there was sugar in the urine, I asked about kidney issues and he said the kidney numbers looked good. I'm not sure if that's related or not.
Click to expand...
When you talk to the vet ask them about if any ketones were present. If they took bloodwork they’ll be able to tell you.

Here’s some info on ketones.
Primer on Ketones
 
@Wendy&Neko @Sienne and Gabby (GA)

You cannot use U40 insulin syringes with Lantus or any U100 insulin syringe. U100 insulin is 2.5 times more concentrated than U40 insulin. If you use U40 insulin syringes, your cat is not getting the proper amount of U100 insulin.

You absolutely need to get U100 insulin syringes ASAP. Ask the vet for a prescription so that you can buy at a local pharmacy. Lots of people buy from Amazon and Chewy and other online places but it will take a few days to arrive. I think WalMart may sell a bag or two of insulin syringes with no prescription. You want U100 3/10 cc syringes with half unit markings.

Quick search of vets in your area:

https://felinediabetes.com/FDMB/threads/seeking-vet-in-north-jersey-nyc-area.67227/
https://felinediabetes.com/FDMB/threads/vet-recommendations-nj.257117/
 
squeem3 said:
@Wendy&Neko @Sienne and Gabby (GA)

You cannot use U40 insulin syringes with Lantus or any U100 insulin syringe. U100 insulin is 2.5 times more concentrated than U40 insulin. If you use U40 insulin syringes, your cat is not getting the proper amount of U100 insulin.

You absolutely need to get U100 insulin syringes ASAP. Ask the vet for a prescription so that you can buy at a local pharmacy. Lots of people buy from Amazon and Chewy and other online places but it will take a few days to arrive. I think WalMart may sell a bag or two of insulin syringes with no prescription. You want U100 3/10 cc syringes with half unit markings.
Click to expand...
I have to imagine that prescription syringes that they sent to the pharmacy and I bought were the correct U-100s. They just lost them when I brought them in. My only consideration now is, if the vet told me 2-units of insulin AND they conceivably (incorrectly) used U-40s during the BG Curve to determine the correct dosage was 2 units, is the 2 units correct? Or are they basing the 2-units off a spreadsheet provided by Lantus based on BG levels? (Which then would be based on a u100 syringe)

I guess I need to call and confirm.
 
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Insulin can pack a punch. 2 units of any insulin is too much for most newbies to start with. It's way safer for your cat if you start at 0.5 units twice a day and slowly increase as needed based on blood glucose levels that you take at home. You don't need the vet's permission to drop the dose way down.

Do the diet change slowly as removing the high carb dry food has a big impact on blood glucose levels, another reason why 2 units can be too much.

2 units of U100 insulin measured in a U40 syringe is not the same as 2 units of U100 insulin measured correctly in a U100 insulin syringe. The difference is the insulin concentration. @Wendy&Neko @Sienne and Gabby (GA) @Bron and Sheba (GA) can probably better explain why you can't use U40 syringes with U100 insulin.

I wonder if the vet office still has those U100 syringes you brought in? You can ask. Otherwise, you'll have to get another box from the pharmacy. Give those U40 syringes away so you don't accidentally use them by accident. There's a Supply Closet forum here on FDMB where you can post them.
 
Welcome to FDMB.

I'm sitting here wondering how your vet has stayed in business! Losing materials that a client brings to the office is not good. Did they just lose the syringes or did they misplace your insulin, as well? The vet tech not knowing the difference between U100 and U40 syringes is concerning. The cap on the needles are different colors to prevent this kind of problem. The vet's snarky answer would have had me furious. The last time a vet said something inappropriate to me, also in the waiting room, I publicly dressed her down. (She wasn't the vet I typically used in the practice and was not prepared for a client to be as assertive as I was being especially since I knew my cats lab values better than she did. I also had a long discussion with the owner of the practice about how that other vet would never touch my cat again.) Good plan to look for a vet who will work with you and help you to become a well informed caregiver.

In addition to the links for vets above, there are cat friendly vet practices. This is the search tool for finding a practice near you.

What Squeem3 indicated is correct. U-100 will have 100 units of insulin per mL, and U-40 has 40 units per mL. This means that U-100 has 2.5 times the amount of active insulin per mL and is 2.5 times as strong. We do not encourage converting a U100 insulin for use with a U40 syringe. (You can, however, convert a U40 insulin for use with a U100 syringe. If you're internet searching, don't confuse this.) Personally, I would call the vet's office and see if there's a practice manager you can speak with and inform the person of the problem. You may need a prescription to get more syringes -- the need for a prescription varies by state. It would be better if the vet's office replaced the syringes they gave you with the ones you actually need. Just an FYI - Amazon will ship syringes without a prescription.
 
@EvanVanVan
Using syringes with a pen, cartridge, or vial:
  • Full and half-unit syringe scales:

You want the ones with half unit markings since we adjust the doses by 0.25 units at a time

  • Full and half-unit syringe scales:
49823063143_3437e9e997_o.jpg
 
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Walmart, you can get U100 insulin syringes with half unit marks for $12.58/100.
You need to go into the store to get them

Either of these 2 boxes are the ones you want (with a purple stripe). You have to go into the store , can't buy them on line
upload_2024-4-22_23-37-23-jpeg.69946





This was posted by a member and copied it for you
If you're going to Walmart, ask for Relion 3/10ml, 31 or 30 gauge insulin syringes. (Don't mention half unit marks because this tends to confuse them and they think you don't know what you want and will try to convince you that you need 1/2ml syringes---you DON'T)

ALL of the 3/10ml Relion syringes at Walmart have half unit marks. Trust me on this. You will want one of these boxes of syringes (the difference is the needle length...blue box are shorter needles than white box but both work fine). As long as the box has the purple stripe, they are the correct syringes.

The vet I used in New Jersey moved really far away
My Tyler passed so I don't need a vet anymore
I hope someone else from Northern N.J. comes along
Hypo Kit if needed to bring his BG up
Good idea to mark the cans with magic marker how many carbs

. Doesn't have to be Fancy Feast just an example about the med and high carb foods



https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-

10% and under is low carb
11% -15 is medium carbs.

16- 24 is high carb.



Just wanted you to know on Dr Pierson's food chart

the Fancy Feast Gravy Lovers Beef Feast In Roasted Beef Flavor Gravy (which. Dr Pierson’s list says is 20%
Comes back with 14%

These are correct for med carbs
Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs



Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

You can even look at the Friskies for high carb and med carbs
Almost all of us use human meters
Here is the link for the meter and test strips so you don't have to search for them. Most of us use human meters
Relion Premier Classic Meter at Walmart for 9 dollars
https://www.walmart.com/ip/ReliOn-Premier-CLASSIC-Blood-Glucose-Monitoring-System/552134103

The tests strips are 17.88 for 100
https://www.walmart.com/ip/ReliOn-Premier-Blood-Glucose-Test-Strips-100-Count/575088197
At least if you need more test strips you can run into Walmart and pick them up or if you're running low you can just order them from Walmart

Here is a video one of our members made testing her cat. She is using a pet meter why has to be coded so ignore that ,with a human meter you don't need to do that

VIDEO: How to test your cat's blood sugar


Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up
c2b8079a-b471-4fa6-ac36-9ac1c8d6dcca-jpeg.57072
fec17d29-5ab4-44a8-912b-3a91944c3954-jpeg.57073

6. As the ears get used to bleeding and grow more capillaries it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 10 or 20 seconds until it stops
Get 26 or 28 gauge lancets any brand
A lot of us use the lancets to test freehand not the lancing device
I find it better to see where I'm aiming
Look at the lancet under a light and you will see one side is curved upward, that's the side you want to poke with

Try putting a thin layer of Vaseline on the ear so the blood will bead up

Read all the yellow stickys when you get a chance about Lantus

https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/

I also agree with what @squeem3 said
Insulin can pack a punch. 2 units of any insulin is too much for most newbies to start with. It's way safer for your cat if you start at 0.5 units twice a day and slowly increase as needed based on blood glucose levels that you take at home. You don't need the vet's permission to drop the dose way down.

Do the diet change slowly as removing the high carb dry food has a big impact on blood glucose levels, another reason why 2 units can be too much.
 
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To answer a couple questions from above about too much insulin and how you know and what to do:
Most of us don't leave a cat at the vet to do a curve. Cats tend to be stressed at the vet causing their blood sugar numbers to be higher than what they would be at home. You don't want to dose insulin based on artificially higher numbers. Most cats here start on 1 unit of Lantus (or less) as dosed in U-100 syringes. U-40 would mean you are overdosing. 2 units in a U-40 syringe would be equivalent to 5 units of Lantus! Way too much to start with.

We are also strong believers here in home testing our cat's blood sugars, and we use that data to figure out how to change the insulin dose and keep our cats safe.
 
Diane Tyler's Mom GA said:
Here is a video one of our members made testing her cat. She is using a pet meter why has to be coded so ignore that ,with a human meter you don't need to do that

VIDEO: How to test your cat's blood sugar


Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up
6. As the ears get used to bleeding and grow more capillaries it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 10 or 20 seconds until it stops
Get 26 or 28 gauge lancets any brand
A lot of us use the lancets to test freehand not the lancing device
I find it better to see where I'm aiming
Look at the lancet under a light and you will see one side is curved upward, that's the side you want to poke with

Try putting a thin layer of Vaseline on the ear so the blood will bead up
Click to expand...

Thank you for the video, that was very helpful.. I was nervous about doing that.
Wendy&Neko said:
To answer a couple questions from above about too much insulin and how you know and what to do:
Most of us don't leave a cat at the vet to do a curve. Cats tend to be stressed at the vet causing their blood sugar numbers to be higher than what they would be at home. You don't want to dose insulin based on artificially higher numbers. Most cats here start on 1 unit of Lantus (or less) as dosed in U-100 syringes. U-40 would mean you are overdosing. 2 units in a U-40 syringe would be equivalent to 5 units of Lantus! Way too much to start with.

We are also strong believers here in home testing our cat's blood sugars, and we use that data to figure out how to change the insulin dose and keep our cats safe.
Click to expand...
Thank you for these links. I was very concerned on how to fix too much insulin, specifically how much sugar/syrup to give. That first link was very helpful.
Tim & Pookey said:
How much does Admiral Ackbar weigh? The vets recommend 2 units, but that is higher than we usually start with here. Did they share any of his current blood glucose levels with you? I’ll leave this for another member to give their input on.

Lastly a question for you, did they mention anything about ketones at diagnosis?
Click to expand...
Admiral Ackbar weighs 9.5 lbs which is down from like 12 back in November. I went to the vet (more on that later) yesterday and got a copy of his bloodwork results. His glucose was 375 during the test and he was negative for Ketones. BUT, yesterday a different vet (the one I'm generally unhappy with now), said during the BG curve (7 days after his blood was initially taken for the bloodwork) his glucose 328 and he was +1 for Ketones. She chalked it up to the "diabetes running rampant" and with insulin hopes it goes away. Like I said, I'm only hopefully because the results from lab clearly show Negative for ketones.

--------------------------------------------------------------------------------------------------------

So the vet found my syringes, but after I got home and was getting ready to head up there to go pick them up I noticed Beige One (Admiral Ackbar's nickname), was acting weird. Hiding under tables and behind stuff. This was after the Vet tech the night before and I each apparently gave him 5 units of Lantus. Other than general stoic-ness he seemed ok, but it's hard when they can't tell you what's wrong lol. Since I was going up to the vet anyway, I decided to bring him (even though I really didn't want to stress him out again). The vet really tried to avoid seeing me at first, knowing she F-ed up.. After explaining the situation with the wrong needles and expected overdosage, the vet tech was going to bring AA in the back by himself. I said No, I'd like to be there. Then, after getting in a room the tech went in back and came back saying, "the vet says the wrong needles were 'her bad', use the right ones and he'll be fine." I was in disbelief and was adamant I speak to her myself. Those probably were her exact words but the callous nature of such a major f-up was infuriating. In the end she apologized-ish, at first it didn't seem all that sincere, probably mostly out of embarrassment. Since it wasn't even her really and was the vet techs that administered the first shot and gave me the wrong syringes, I wanted assurances that they would be trained better for the future. She gave Beige One a shot of syrup and he perked up a bunch.. I skipped last night's shot even though the Vet told to give him at least 1 unit if wasn't eating, really she advised the full 2. But I don't really trust her and want to get a home test kit.. I'm more worried about this random shooting in the dark trying to control an unknown BG number, up down up down, randomly. Especially since he's really taken to the wet food and only eating that.. I think this morning I'll give him the 0.5 unit.

Now to look at those links provided earlier in the thread to find a new vet.

Edit: oh yeah, the last annoying thing is that out of my new box of 100 syringes (2) 10-packs were missing.
 
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Wow… I’m sorry you had to go through that. That’s a pretty big screw up on the vet’s part. But I’m happy you had the syringe information and were armed to stand your ground.

With the wet food transition and 5 units that really could have brought him low. Good luck with getting those first few home tests!
 
Long ago on FDMB, a member's cat died because of a negligent vet and the vet's son (I think?) who was an unlicensed / untrained "vet tech". I believe the cat was given a serious overdose of insulin by the "vet tech". The member has a web site with the story and what she did to get justice for her cat and gives tips on how pet owners who have experienced something similar can take action against their vet http://thetooncesproject.com/

You can file a complaint with your state veterinary medical board. Also with the state board of licensing if that also applies.

https://www.njconsumeraffairs.gov/vet
https://www.njconsumeraffairs.gov/C...terinary-Medical-Examiners-Complaint-Form.pdf

More vet suggestions:

https://felinediabetes.com/FDMB/thr...commendations-in-new-jersey-near-ne-nj.35275/
https://felinediabetes.com/FDMB/thr...fd-friendly-vet-in-central-new-jersey.126741/

You can buy more insulin syringes online. Amazon doesn't require a prescription regardless of what state you reside in. Other web sites may ask for a vet's phone number or a faxed prescription.
 
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@EvanVanVan
Can you please fill out your signature
Here is the information we need for your signature
Just click on your name up top and then tap signature and add this information. It's at the end of everyone's post in gray letters
  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Bexacat or Senvelgo (if applicable) and dates
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

Read all the yellow stickys when you get a chance about Lantus one of them will explain the 2 dosing methods to follow for Lantus. They will tell you when an increase or decrease is needed.

https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/

If are the links to our spreadsheet where we enter our cats BG numbers . If you need help setting it up just ask we have a member thT will be happy to do it for you


How to Create a Spreadsheet

How to Use the Spreadsheet

There is a link understanding the spreadsheet but I'm going to explain it anyway
About the spreadsheet
AMPS - means AM Pre Shot the first test you take in the AM ,you need to withhold food 2 hours before testing so it's not food influenced

Units is where you would put how much insulin you gave
+1 is one hour after giving insulin if you were to test then that's where you enter his _BG number
+2 two hours after giving insulin. ditto
+3 and so on until you get to PMPS - PM pre shot withhold food 2 hours before testing

+1 same as you do for AM cycle

We don't give times because we are all in different time zones that's why we use the + numbers

Tap on any members spreadsheet to see what it looks like

I hope you have the Syringes with the half unit markings :cat:
 
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Sorry, I'll fill out the signature and look into the spreadsheet tomorrow morning.

I just tested admiral ackbar's glucose level for the first time. Had to prick the poor cat like five times in the ear, plenty of nice little blood drops but the relion premier test strips kept returning Er4. The good little kitten was calm the entire time though.

His glucose level is 269 after a 0.5 unit (approximately, unfortunately, the syringes do not have half units) 2 hours ago. That still sounds high? I'm getting more comfortable with this whole thing but there's still a lot to actually learn.
 
EvanVanVan said:
Sorry, I'll fill out the signature and look into the spreadsheet tomorrow morning.

I just tested admiral ackbar's glucose level for the first time. Had to prick the poor cat like five times in the ear, plenty of nice little blood drops but the relion premier test strips kept returning Er4. The good little kitten was calm the entire time though.

His glucose level is 269 after a 0.5 unit (approximately, unfortunately, the syringes do not have half units) 2 hours ago. That still sounds high? I'm getting more comfortable with this whole thing but there's still a lot to actually learn.
Click to expand...
@squeem3
@Sienne and Gabby (GA)
@Bron and Sheba (GA)
@Bandit's Mom
@tiffmaxee
@Wendy&Neko

Hi Ladies if you read his first post there was a big screw up at the vets office about the syringes.They gave him U-40 syringes for Lantus.
He now has the U-100 syringes and gave 0.5 units but he thinks it's still high .
Will be getting half unit ones soon.
Will be setting up his signature and spreadsheet tomorrow. Should he still stay with 0.5 units since this was his first test ?
Per Evan in his intro post
has been free fed on Iams orange bag to this point. I'm ok switching him over to Fancy Feast Classic Patte

Thanks Ladies

@EvanVanVan
I just tagged a few experienced members for you
 
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I had mentioned this before when you have a chance please read about Lantus all the yellow stickys it will explain a lot of questions you might have , be sure to read about the depot and the 2 dosing methods. If your Kitty is still eating dry food you have to follow the SLGS Method. Like Tim said if you are going to transition to a low carb wet diet do it slowly .
It can drop by 100 points so you need to be testing
https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/

@EvanVanVan
 
OK, read up. Signature and spreadsheet done. I guess for right now I'm SL-ing; GS-ing it. Unfortunately, the timing on the diagnosis isn't great (as if it ever could be), I'm going away on vacation for a couple weeks next month and will either need to get a qualified cat sitter or medical boarding. I'll probably attempt TR when I get back. In the meantime, I'll fill out the spreadsheet and collect the data as I go.

Lol I'm still not used to this whole thing...at 3am this morning I heard a noise and got up to check it out, it was the cat dragging his empty food dish..without thinking I just put in another can of wet food. It wasn't until I laid back down that I realized I probably should have waited a couple more hours until I got and could test him preshot. I'm learning still lol. It's also tough since he probably should have 3 cans a day based on weight, but if he doesn't eat up the can I don't really want to put out another one. So figured I owed it to him.

Anyway, I'm sure this thread is basically ending.. Thank you for all help, see you on the next BG one!
 
You are doing great at home testing. It can be frustrating at the beginning mostly because you need to give some time for the capillary bed along the edge of the your cat's ear to more fully develop. Once it does, the process becomes much easier. Also, until the capillary bed is cooperating, using a wider gauge lancet (e.g., 26 gauge) can help and then you can switch over to a thinner lancet (e.g., 30 gauge).

Feeding your cat in the middle of the night was fine. AA was telling you he was starving! Most unregulated diabetic cats are always hungry due to glucose floating around in their blood vs getting into the cells. It's absolutely fine to provide several smaller meals that are spread out over the cycle versus only 2 large meals per day. The only time you want to withhold food is 2 hours prior to shot time. If your cat's numbers are in a lower range, it can be important to give food even during the 2-hour pre-shot time but that is not typical. (You can always post and ask if you're not sure.)

You want to test at least 4 times per day. Always test prior to giving a shot so you know if it's safe to give insulin. You also want to get a test somewhere around mid-cycle. Just to clarify, at some point you want to get a "curve" -- this means testing every 2 hours for a 12-hour period. The curve will tell you where onset (when the insulin starts working) and nadir (lowest point in the cycle) occur. However, do not take these points as written in granite. Nadirs can and do change -- it's your cat's way of keeping you on your toes. Onset with Lantus is typically at around 2 hours after a shot.

As I was reading your post about the last vet visit, I was sitting here with my jaw dropping. I've been here a very long time and I say this very, very rarely. Please find a new vet. I remember the story of Toonces that Squeem3 noted. Your vet could have killed your cat with a 5u dose. AA's response to syrup tells you that his blood glucose level was likely low. The practice is poorly run. In addition to filing a complaint with your state veterinary board, you can post your experience on Yelp or NextDoor. I hate saying that but how your cat was treated suggests problems that others should know about. The state board will launch an investigation but that takes time. Just for context, consider how anyone would respond if a pediatrician treated a child the way this vet's office treated your cat. You'd be calling a malpractice attorney.
 
EvanVanVan said:
Sorry, I'll fill out the signature and look into the spreadsheet tomorrow morning.

I just tested admiral ackbar's glucose level for the first time. Had to prick the poor cat like five times in the ear, plenty of nice little blood drops but the relion premier test strips kept returning Er4. The good little kitten was calm the entire time though.
Click to expand...

Hometesting tips: https://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

If you're not warming the ear first, do that next time. Warm ears will bleed much more easily and you'll get a nice drop of blood. The "rice sock" is the most popular method. Take a small old cotton sock. Fill with ~1/4 cup or less of uncooked rice or dried beans. If you have a really small sock (child size or baby size), use a few spoonfuls. Tie the sock closed. Heat in the mcrowave until just barely comfortably warm for you to hold in your hand. Try 10 seconds to start and add more time if needed. Apply the warm sock to your cat's ear. Make sure it's not too hot otherwise you'll burn your cat's ear. If the sock is too warm, your cat will flinch so let the sock cool a bit. Wrap the sock around the edge of the ear and hold in place for a minute if possible. Then hold the sock inside the cat's ear to provide a firm surface against which to poke the lancet. You should get blood. If you get too much, not a big deal. Get what you need onto the test strip and hold a tissue to the ear to stop the bleeding. Not enough blood, try "milking" the blood drop to help it bead up more. If you're using a lancet device, adjust the depth setting so you're using the lowest setting that will give you blood.

His glucose level is 269 after a 0.5 unit (approximately, unfortunately, the syringes do not have half units) 2 hours ago. That still sounds high? I'm getting more comfortable with this whole thing but there's still a lot to actually learn.
Click to expand...

So +2 269 after 0.5 units? That's not bad really. High, yes, but you just restarted insulin over again at safer dose with the proper syringes and your cat is newly diagnosed so don't expect to see healthy normal blood glucose levels right away. Have patience :)

Always get a blood glucose reading before you inject insulin. That way you know if your cat is at a safe enough level for insulin to be given. You can't assume it will be high based on previous readings.

What are you feeding your cat? The right diet is important for diabetic cats just like it is for Human diabetics. The right diet is low carb canned food. No dry food at all. Raw and home cooked are also options. Prescription food is not needed at all.

I just remembered - a friend of mine used to work as a vet tech in northern NJ. I'll ask her which vet and if she recommends them.
 
Sienne and Gabby (GA) said:
You are doing great at home testing. It can be frustrating at the beginning mostly because you need to give some time for the capillary bed along the edge of the your cat's ear to more fully develop. Once it does, the process becomes much easier. Also, until the capillary bed is cooperating, using a wider gauge lancet (e.g., 26 gauge) can help and then you can switch over to a thinner lancet (e.g., 30 gauge).

Feeding your cat in the middle of the night was fine. AA was telling you he was starving! Most unregulated diabetic cats are always hungry due to glucose floating around in their blood vs getting into the cells. It's absolutely fine to provide several smaller meals that are spread out over the cycle versus only 2 large meals per day. The only time you want to withhold food is 2 hours prior to shot time. If your cat's numbers are in a lower range, it can be important to give food even during the 2-hour pre-shot time but that is not typical. (You can always post and ask if you're not sure.)

You want to test at least 4 times per day. Always test prior to giving a shot so you know if it's safe to give insulin. You also want to get a test somewhere around mid-cycle. Just to clarify, at some point you want to get a "curve" -- this means testing every 2 hours for a 12-hour period. The curve will tell you where onset (when the insulin starts working) and nadir (lowest point in the cycle) occur. However, do not take these points as written in granite. Nadirs can and do change -- it's your cat's way of keeping you on your toes. Onset with Lantus is typically at around 2 hours after a shot.

As I was reading your post about the last vet visit, I was sitting here with my jaw dropping. I've been here a very long time and I say this very, very rarely. Please find a new vet. I remember the story of Toonces that Squeem3 noted. Your vet could have killed your cat with a 5u dose. AA's response to syrup tells you that his blood glucose level was likely low. The practice is poorly run. In addition to filing a complaint with your state veterinary board, you can post your experience on Yelp or NextDoor. I hate saying that but how your cat was treated suggests problems that others should know about. The state board will launch an investigation but that takes time. Just for context, consider how anyone would respond if a pediatrician treated a child the way this vet's office treated your cat. You'd be calling a malpractice attorney.
Click to expand...
Ty, I'm much more comfortable getting real data and numbers to work off of rather than just blindly injecting him with 2U twice a day for the rest of his life per the (dare I say, idiot) vet's advice. Regarding the vet, yes, I absolutely want to find a new one. It'll probably end up being Maywood Veterinary Clinic. I really wish I could just do everything and learn it all myself, but I guess I still need a vet to call prescribe the insulin...

When I read what happened to Toonces from the link Squeem3 shared, it was very distressful. Fortunately, AA's issue was "only" 2.5x the correct dosage and not 10.. and he's OK. Other than being withdrawn, no other serious symptoms. I should probably call them out and make a big deal of it, but hopefully they realize what a close call it could have been and don't make that mistake again. FWIW, they are a fairly large practice with a couple of locations in Bergen and Morris counties.

squeem3 said:
Hometesting tips: https://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/
So +2 269 after 0.5 units? That's not bad really. High, yes, but you just restarted insulin over again at safer dose with the proper syringes and your cat is newly diagnosed so don't expect to see healthy normal blood glucose levels right away. Have patience :)

Always get a blood glucose reading before you inject insulin. That way you know if your cat is at a safe enough level for insulin to be given. You can't assume it will be high based on previous readings.

What are you feeding your cat? The right diet is important for diabetic cats just like it is for Human diabetics. The right diet is low carb canned food. No dry food at all. Raw and home cooked are also options. Prescription food is not needed at all.
Click to expand...
Yeah, it's going easier and I feel better already. I'm not sure how he feels getting poked and pricked so often :/ but I keep telling him he's going to feel better too, I promise!

He's been very happy eating exclusively FF Tender Beer Classic Pate. And honestly, for months now I've been trying to track down why his poop have been dry, single little pellets..I assumed dehydration, but with the amount he would drink and urinate (not knowing that was the diabetes), I couldn't figure it out. Today was the first day cleaning out the litter box that I saw a healthy one in a long time.
 
I always add water to my cats' food. It was a practice I began with my diabetic cat given that diabetes is tough on the kidneys. In addition, cats (sat least non-diabetic cats) don't have a huge thirst drive. Adding water will help.
 
FF is good :)

Is your cat constipated? Dry poop can mean dehydration or not enough fiber. You can add extra water to the FF. Canned pumpkin puree is good for fiber but some cats may not like it. Some people give a probiotic for gut health.

My cat is a pincushion :D Some days he gets poked multiple times. His diabetes isn't regulated yet but he's got other health issues going on and meds for those so I don't expect him to ever go into remission.

I basically manage my diabetic cat on my own but I've known my vet for over 20 years now so he's comfortable with letting me do my thing. He just writes the prescriptions and advises when I have questions and concerns.
 
EvanVanVan said:
Fortunately, AA's issue was "only" 2.5x the correct dosage and not 10...
Click to expand...

I know this is not the right format to call attention to my spreadsheet, but as a newbie it is kind of wild to see +6 97 after only 0.5u (and a little scary to think about the 'what if', not knowing what his BG level was after 5U :eek: ) (which actually is 10x:eek::eek:).. But, it's also lunch time!

squeem3 said:
Is your cat constipated?
Click to expand...
I never saw him struggle, but i'll keep and eye on it now that he's on wet food.
 
EvanVanVan said:
at 3am this morning I heard a noise and got up to check it out, it was the cat dragging his empty food dish..without thinking I just put in another can of wet food.
Click to expand...
Might have been a good time for a blood sugar test. He was telling you he needed more food - smart kitty!
 
Tim & Pookey said:
Hey Evan, how’s it going? I see some missing shots in the units column the last couple days.
Click to expand...
Lol, sorry, going well. Still 0.5 every day. I'm better at remembering to log the BG level than I am at remembering to enter the (same) 0.5 units every time.

I was ready to post a thread in the correct format in the lantus group earlier today but my computer had started updating and restarting.

I've been trying to rotate the injection site per the picture of the cat and and his scruff, and the side of his chest, and his flank, and his belly. But I've had mixed results. It doesn't seem as though the insulin shots have been as effective (as seen in the spreadsheet) a few hours after injecting as in other locations. It's possible that I'm just missing the correct layer where I'm injecting I guess. I don't think they are fur shots.
 
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EvanVanVan said:
Lol, sorry, going well. Still 0.5 every day. I'm better at remembering to log the BG level than I am at remembering to enter the (same) 0.5 units every time.

I was ready to post a thread in the correct format in the lantus group earlier today but my computer had started updating and restarting.

I've been trying to rotate the injection site her the picture of the cat and and his scruff, and the side of his chest, and his flank, and his belly. But I've had mixed results. It doesn't seem as though the insulin shots have been as effective (as seen in the spreadsheet) a few hours after injecting in other locations. It's possible that I'm just missing the correct layer where I'm injecting I guess. I don't think they are fur shots.
Click to expand...
Awesome! Yea, you’ll get more eyes on him in the Lantus forum with a fresh post, so that’s good. I know some people have mixed results on the different locations just based off what I’ve seen in spreadsheets where they log the shot location under each day. Personally, we use the area between his shoulder blades and just move in a “box” type pattern. But that would be a good question to ask over there.
 
@EvanVanVan
Hope to see you over in the Lantus Board
Date Admiral AMPS number and any additional tests after that, you can continue with the PMPS in the title and any additional tests after that.

To add those tests in the title click on Thread Tools that is to the right then tap on Edit Title add them and tap save

You can introduce yourself and Admiral and say it's your first time posting on the Lantus Board.

If you start this tomorrow we always like to link your previous post to your new post. So you would link this one you posted


To link your previous posts
Your previous days post will always be in the URL all the way up top ignore where it says insert or cancel I'm just trying to show you where your previous days post will be
Just ignore where it says insert and cancel
Just copy your previous days post and then paste it when you do your new post new thread





Like I said
your previous days post it will be the one all the way up top, above the pic of that cat and the picture of a bottle of insulin there, let me know if you understand it, only way I can explain it :cat:
 
Diane Tyler's Mom GA said:
@EvanVanVan
Hope to see you over in the Lantus Board
Date Admiral AMPS number and any additional tests after that, you can continue with the PMPS in the title and any additional tests after that.

To add those tests in the title click on Thread Tools that is to the right then tap on Edit Title add them and tap save

You can introduce yourself and Admiral and say it's your first time posting on the Lantus Board.

If you start this tomorrow we always like to link your previous post to your new post. So you would link this one you posted
your previous days post it will be the one all the way up top, above the pic of that cat and the picture of a bottle of insulin there, let me know if you understand it, only way I can explain it :cat:
Click to expand...

Will do eventually, but I haven't really seen a need yet? Idk, there's a lot going on in that forum and I haven't felt it necessary to add to the confusion, or take attention away from people/cats that do really need help!

I'm giving him his 0.5u every day and logging the numbers.
 
Agreed, I was going to mention that in the last post but understood that's the type of thing that belongs in the LANTUS forum. lol :facepalm: That was actually this mornings test (the 3/16 and 3/17 dates were repeated in the last column.. fixed now).

That was the first test that worried me a bit. But, he also really hadn't eaten much. The first couple of days he loved his FF Tender Beef Pate**, now he barely touches it. When I saw that 95 I begrudgingly got out a new can of Turkey in Gravy (didn't realize it wasn't Pate when I bought it) with an almost full can of Beef Pate sitting there, and felt better when he ate some of it. Unfortunately, I went to work and haven't tested him since. He's happy on the couch, purring, currently though.

Headed to a new Vet this evening..fingers crossed
 
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