Dosing w/ Overnight job

Discussion in 'Lantus / Levemir / Biosimilars' started by Si am cat mom, Nov 12, 2019.

  1. Si am cat mom

    Si am cat mom Well-Known Member

    Joined:
    Nov 11, 2019
    Hello,
    I currently work 12hour shifts from 7pm-7am. My vet originally said to do the 1 unit of Lantus every 12 hours for a week and then we would reassess after a curve. I didn't do more than 3-4 BG checks the first 3 days ( we just got Lantus on Saturday 11/ 9) although now from what I'm reading I wish I would have. Still working on organizing it all, but AMPS BGs have been high still 369- 405. My midday checks around lunchtime ( +6 - +8) before a snack have been 269-350 and PMPS similar to lunch values.
    I am just wondering if TR would even be possible since I wouldn't be able to check post shot BGs 3-4 days a week and overnight ? I'm trying to do the best thing for him longterm without setting myself up for something I can't maintain. I have a week off coming up at the end of this week when I was going to do the curve at home.
     
  2. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    http://www.felinediabetes.com/FDMB/threads/new-to-the-party.221637/
    Hi and welcome to you both. Above is your welcome post. We link posts so we can read back easily.
    If you could get you SS up and running and put in the data you already have, that would be very helpful. If you can’t manage it, just let us know and someone will do it for you in no time at all.

    Are you testing before every shot of insulin. It is really important you do to make sure it is safe to give the insulin.
    And if you can test during the cycle that will tell us how low the insulin is taking Makoto.
    Also if you can get a before bed test that will tell you if Makoto is likely to drop lower overnight. If the before bed test is lower than the Preshot it will most likely be an active cycle and you will need to set the alarm and test later. I see you work at night so you will need to leave food out for him overnight.
    I think an automatic feeder would be very helpful for you.

    With Lantus we recommend you feed before the shot and again a couple of times during the cycle..... mostly in the first half of the cycle when the insult is strongest.

    Using a solostar pen will not allow you to give smaller doses than 1 unit increments. We recommend going up and down in 1/4 unit increments. To do this you will need to buy syringes which you can buy them at Walmart.
    You will need to buy U/100 3/10ml 30 or 31 gauge 6mm or 8mm insulin syringes with 1/2 unit markings. If you are unsure post and ask for help.
    You can use the vial of insulin from the solostar pen.
     
    Wendy&Neko likes this.
  3. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Hello and welcome. You might find some tips that work for you in this note on Doing TR with a Full Time Job. The tips are useful whether or not you use TR. Doing that curve so you can figure out Makoto's onset, nadir and duration and how he reacts to carbs will help you plan when you you need to test, and when and how much food to leave out. Those automated feeders were a life saver here.
     
  4. Sanda Elena

    Sanda Elena Member

    Joined:
    May 23, 2019
    Hi and welcome!
    I am in the exact situation , working in 12 h shifts from 8 am to 8 pm 3 days/week and so far I follow SLGS methode because it is too stresfull for me to shot and not know what happens for 12 h . We had some days when the BG suddenly droped and that required testing a lot in the middle of the cycle. I put his safety first when I made my choice. You will need an auto feeder to schedule his meals.
     
    Si am cat mom likes this.
  5. Si am cat mom

    Si am cat mom Well-Known Member

    Joined:
    Nov 11, 2019

    Hi,
    I have an automatic feeder as well. I was just hesitant to feed overnight because the vet originally said 2 meals/ day. My little guy used to get lunch (about 1/3 cup dry or 1/2 of a 3 oz can C/D ) and occasionally a later snack of the same if he didn't really finish his 3 oz can for dinner. Now, I've just been feeding 1.5 full 3 oz. cans every 12 ( kitten or low ingredient currently) then broiled chicken brst for lunch with 2 TSBPs of canned. I test before meals and shots - so 3x / day so far - I did 4 BGs yesterday because his midday before snack value was 269. I am giving the injections with the mentioned u-100 syringe, 3/10cc , 29g though- I just pull from the solostar ( it doesn't have a needle just the plunger). 1 unit / 2x day.
    I am off for a week after tomorrow night and I'm planning on getting BGs more throughout the day and overnight as I've noticed my AM readings are still in the 400s. I will set up his feeder for a late night feeding using some ice packs. I'll work on the SS- just didn't have too much information for it yet since we just started on Saturday and I was only doing 3 readings/ day. I can't seem to pull the SS template up on my computer at work when I have my data and the time to do it. I'll mess with it tomorrow night again.
    Thanks for the advice!
     
  6. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    With Lantus insulin you can feed several times during the day and night. Just don't feed for the 2 hours preshots as we don't want the preshot BG to be food influenced.
    It is a good idea to work out a food schedule and use it all the time for both cycles.
    I used to feed at preshot and +2 and +5.. for example both cycles.
    I'm glad you have an automatic feeder, they are invaluable.

    That is good you are using the syringes.
    The AMPS (am preshot) is often the last BG to go down so don't worry too much about that.
    I would concentrate on getting a feeding schedule which suits Makoto.....if he is used to eating during the day, then let him. Feeding during the first half or thereabouts of the cycle, is better as that is when the insulin is strongest.
    Also getting the SS up and running. Please ask for help if you are struggling with it.....I had someone help me.
    And getting as many tests in as you can.

    What foods are you feeding? Is it low carb wet food?
     
    Si am cat mom likes this.
  7. Mimis mom

    Mimis mom Well-Known Member

    Joined:
    Oct 12, 2019

    Hi! Dry alone is high carb, and believe it or not the C/D is very high as well (like 30 percent carb from what I read)

    I recommend highly that you check out www.catinfo.org - a website by Dr Lisa Pierson (who has posted on here and everyone knows well)
    About feline nutrition, and everything else related to cat health! it changed how I viewed everything.

    the vet also told me to feed her only twice a day- and when she shot a low number one time (34) to go from 2 units down to 1 because that’s how the pen measured.
    I’m so glad I found this group because they told me to get syringes and draw directly from the pen (which is super easy- the top is just like one of a vial). That way I can do 1/4 increments- which makes more sense for an animal that size!
    I went with a u100 31 G 3/10 cc 8mm (which means the needle is thin and short- also make sure it’s the ones that have the 1/2 unit readings- unit not CC- which I’ve made the mistake of buying!)
    Those have been really nice to shoot her closer to the flank and belly where I can not only see better but it’s easier to rotate spots- because I was only instructed to shoot at the scruff and after my Mimi went DKA- the vet at the ER said she had developed hard lumps (she said a technical name but that’s what they felt like)
    Also the pen needle for the solostar was HUGE- and I made her bleed by accident. I don’t think pens should EVER be used on cats unless they are instructed to use with a separate syringe.


    Anyway, I hope this helped some and welcome to the best place
     
  8. Si am cat mom

    Si am cat mom Well-Known Member

    Joined:
    Nov 11, 2019


    I definitely need to and will up my testing today and tomorrow.
    I am currently feeding canned food- sometimes kitten for the protein because all I had was C/D and Blue Wilderness Salmon originally.
    He's eating 3oz cans of the Purina beyond grain free chicken pate, the Blue Wilderness kitten chicken and trout, and Limited ingredients maybe duck and sweet potato ( I think by Blue also). I do 1.5 cans for AM and PM - which can take 10 mins because he isn't used to such big meals. Then he gets broiled organic chicken for a mini lunch and organic sliced Turkey with his shots.
    I've ordered the Glycobalance canned food to have - he does have issues with struvite crystals and I was " told" that this diabetic diet would help with that now by the vet. I've also ordered the pure bites raw treats - chicken.. . and picked up a few of the Weruva cans.
     
  9. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    You don't need to use a prescription diet, low car canned food is fine.
    Don't make him eat the whole 1.5 cans in one go......separate it into a few smaller meals. Just make sure he will eat a preshot meal though. Have you checked that the food you are feeding is low carb?
     
    Si am cat mom likes this.
  10. Mimis mom

    Mimis mom Well-Known Member

    Joined:
    Oct 12, 2019
    I also wanted to point out that my friend who is a nurse told me that human diabetics are instructed to eat every few hours and she found it odd that the vet would say only twice daily.. I wonder if they do that because they’re thinking if they eat any more than that it will cause weight gain? Not understanding feline nutrition (just like human doctors do not understand nutrition for us). They don’t know that it’s smaller meals more frequent and meals that are low in carb.

    don’t bother with the prescription diet. I’m guessing your kitty is on CD because of bladder issues? Mimi had a bladder stone removed earlier in the year and the vet I went to that saw her afterwards is integrative- meaning both eastern and western medicine and she told me to feed her raw and to add supplements to help keep her bladder healthy. Also add a tsp of water to her wet food (raw or canned) Nothing about prescription diets are actually prescription- it’s all marketing.. it’s sickening actually. Go to www.felinenutrition.org

    the supplement I give her regularly is Vetriscience professional for bladder and urinary tract health)

    I also like the company Daves for canned. Look at Dr Piersons food chart-
    She posted it in the main forum!
     
    Si am cat mom likes this.
  11. Mimis mom

    Mimis mom Well-Known Member

    Joined:
    Oct 12, 2019
    I would stick with (and if I’m wrong someone correct me) one or two brands of food - because I was always under the Impression switching can cause stomach upset or throw off their pH.
    As I said in the other one- and You’ll read from Catinfo.org that prescription diets are pretty much marketing only. How can they say that animal by-products are better than companies that don’t use that- also pork being an ingredient? Cats do better with bird and game- because that’s more natural to them. I mean the ingredients speak for themselves...

    oh and absolutely no more dry food- again you’ll see why on catinfo. That site is unbelievably informative and it makes me angry that other vets don’t know this. (Because it’s not taught)
     
    Si am cat mom likes this.
  12. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

    Joined:
    Jun 15, 2015
    Hi and welcome. We suggest breaking up the calories and spreading the meals out. It is better on the pancreas that way.

    I would also ditch the high carb dry food which will help bring down the BG ,but you will want to do that On a day when you can monitor because the numbers can really come down from the absence of the HC dry .

    If dry good stays in the feeding regime, Start Low Go Slow (SLGS) is your only option.
     
    Mimis mom and Si am cat mom like this.
  13. Si am cat mom

    Si am cat mom Well-Known Member

    Joined:
    Nov 11, 2019
    Hi ! I'm no longer feeding the C/D - that's just what we were on before we got the diagnosis. My Lantus solostar pen doesn't have the needle- I'm using u-100 syringes. It was just much cheaper to buy.
    I have checked out that food chart ....who knew when I was feeding the Purina Beyond Pate I was actually doing a better job of meeting his nutritional needs. I'm in the process of rotating some low carb canned foods in different flavors now.
    Hopefully, once I do a full BG curve, I'll have much more information and be better equipped to make a plan.

    I'm also scheduling an ultrasound- since our liver values have been up and down over the past few years. Now that they are up again...I wanna make sure I'm not ignoring anything. ..
     
  14. Si am cat mom

    Si am cat mom Well-Known Member

    Joined:
    Nov 11, 2019


    Hi ! Not feeding dry since a few days before I got the bloodwork results back...so about a week now.
    I will definitely go back to spreading his meals out- I did 3-4 smaller meals before to cut down on his weight before. I just stopped because when we got diagnosed the vet said 2x/ day with the insulin for the first week until the curve and I didn't know anything else
    Thanks for responding:)
    I'll need all the help I can get
     
    Bobbie And Bubba likes this.
  15. Si am cat mom

    Si am cat mom Well-Known Member

    Joined:
    Nov 11, 2019

    I'm definitely going back to smaller meals...he's not thrilled about trying to eat 4 - 5 oz each meal now.

    The food I'm feeding was 10 carbs on the chart- for the kitten formula which I'll likely phase out this week and another was 8 I believe for the chicken flavor pate I am doing. I like to find something with more protein and less phosphate so I'm looking at the Weruva brand and conparing it to some of the others.
    Someone had mentioned not switching between too many types but would the same brand and a few different flavors- poultry and liver based- be alright because that's what ideally I was thinking. .? ^_^
     
  16. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Yes I think a variety would be fine.
     
  17. Si am cat mom

    Si am cat mom Well-Known Member

    Joined:
    Nov 11, 2019

    About the different food types...he's always eaten the Blue food- just different flavors and types ( pate vs flaked). Originally when I had to make changes, I figured keeping within the same brand and type woukd be good so that's what I've been feeding now - one flavor was just a kitten formula and not adult ( the chicken and trout) Do you think different flavors in the same brand and type woukd be okay or are you saying pick just two period and stick?
     
  18. Mimis mom

    Mimis mom Well-Known Member

    Joined:
    Oct 12, 2019
    From what I understand - you can switch between all of the flavors of the same brand. I think it’s switching brands.
    Look up the brand Dave’s canned. Or have you thought about switching to raw? I have a store here called Bensons and the staff are so knowledgeable in the types of food- hopefully you have something like that there! Again- I think if you read the ingredients you will know
    Things to avoid - byproducts, corn, wheat.
    You’ll know when you start reading labels which ones sound better!
    my integrative vet here recommended Dave’s to me and I was impressed with the ingredients- and they have a HUGE selection. But again- if you looked at Dr Piersons food chart shell list ones that have almost no carbs and that’s what you want to regularly feed him. You also want some medium carb and high carb food on hand - that’s only when he’s testing low numbers (like below 100). .. the experienced members will explain that more!

    If you ask @Marje and Gracie
    Will get you started with a SS - it’s important to have one- I didn’t know until they made me one!
     
    Si am cat mom likes this.
  19. Mimis mom

    Mimis mom Well-Known Member

    Joined:
    Oct 12, 2019
    And I go back to this incredible site again- catinfo.org explains how to transition your cat from dry to wet- because it could be challenging at first!
     
    Bobbie And Bubba likes this.
  20. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    I never had problems mixing up foods between different vendors. Just add the new one slowly, maybe 1/4 of food at first, then increasing to 1/2 etc. It's sudden change that can be hard, though personally, I never had that problem with any of my cats.
    Liver values are often up in newly diagnosed cats. Once she gets better regulated they will improve.
     
  21. Si am cat mom

    Si am cat mom Well-Known Member

    Joined:
    Nov 11, 2019

    His values have been high or high normal since 2014/2015 though...I just wanba double check. Although, I guess it's possible that this has been brewing but
     
  22. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    If you’d like me to do or help you with a SS, please send me a private message by clicking on Marje and Gracie to the left and then “start a conversation”.
     
  23. Si am cat mom

    Si am cat mom Well-Known Member

    Joined:
    Nov 11, 2019
    Okay...I might have to do that. I could barely figure out the signature
     
    Marje and Gracie likes this.
  24. Mimis mom

    Mimis mom Well-Known Member

    Joined:
    Oct 12, 2019
    It’s complicated at first- there’s a lot but once you get used to it it makes sense
     

Share This Page