How to proceed with dosing tonight!

Good evening. I checked Snuggles BS..375. She’s eating now…she hadn’t had anything to eat since 4pm. She does still eat HC dry food about 1/4 cup twice a day. She also gets about 1/2 ounce HC wet food and some LC wet food twice a day. I’m getting ready to transition her on LC food but the vet’s office didn’t call in right prescription for Lantus so I am still giving her Vetsulin. I’m relying on this site because the vet doesn’t seem knowledgeable in treating feline diabetes. Should I proceed with the 1u of Vetsulin..that’s what she has been receiving..I just started testing tonight. The vet had told me 2u of Vetsulin every 12 hours and no need to test. Thanks to this group I went to 1u not wanting any hypo episodes. Advice please? Thanks! @Sienne and Gabby (GA)
Update-I gave Snuggles 1u of the Vetsulin. I hope that was appropriate since I didn’t get any response. @Diane Tyler's Mom

 

I am sorry no one got back to you.
I see you gave 1 unit of vetsulin after the pre shot was 375….is that correct?
Did you manage to get a test during the cycle? That will tell us how low that dose is taking Snuggles.

I’m going to ask @Bandit's Mom if you can set up your spreadsheet as we really need to see the data to be able to help you. She will contact you.

 

@sandysh66
I see your spreadsheet is set up, great

I hope you get the lantus soon, I saw you said maybe late Monday

 

I am going to switch to Lantus Friday..when I have 3 days off or should I change to Lantus as soon as I get it? I’m just a little nervous because I won’t be home during the days to monitor any possible side effects with the Lantus. Any thoughts? @Diane Tyler's Mom

 

I would wait until you have the 3 days off it were me. Did you do any more tests after the 375 you got?
When was that BG taken was it in the AM before you fed Snuggles?
Can you enter it on your Spreadsheet?
Since you won't be starting Lantus until Friday , do you see on your spreadsheet up top where it say insulin to the left, can you tap on it and change it to Vetsulin/ Starting Lantus on 1-27
Can you do that.
Are you going to test some more today I would try to get as many tests in as you can with the Vetsulin so members can see how it's working , so when you do switch to lantus I would post the day before and ask how many units you should start with ok
@sandysh66

Also just noticed on your signature it says Lantus( prev Vetsulin)
We don't want to confuse members since you aren't starting Lantus until 1-27
Also add SLGS to your signature and spreadsheet where it asks about the method

Go all the way up top to your name tap on it then tap signature I would change it to say Vetsulin ( Starting Lantus 1-27). Then tap save

Did you get the automatic feeder yet?
After you are done transitioning him to all lc wet what is it that you will be feeding

Did Bhooma set everything up for you?

One last thing when you do start Lantus on your spreadsheet make a blank line above that date and put Started Lantus

 

Previous post
https://felinediabetes.com/FDMB/threads/help-im-so-overwhelmed.273129/#post-3037190
I see you said on this previous post
Snuggles has been on 1u of Vetsulin since Monday. I got one BS and it was 360.
Can you enter that number in also and of course the units
@sandysh66

 

That 375 BS was last evening 2 hours after I stopped the food and before she ate supper. She is still on Vetsulin. I clicked on box and edit to correct insulin but I’m screwing it up. I read the info on using the spreadsheet but I still can’t figure it out. I ordered the automatic feeder today..should be here Friday. I will be transitioning her to all LC wet food with LC treats. She loves the Purebites salmon and chicken…I have already stopped the Temptation treats. I have stopped feeding her now so there’s 2 hours without food for testing her this evening. It takes two of us to test her and give insulin. I’m not sure how to enter the BS..I looked at help with spreadsheet but I’m not sure. @Diane Tyler's Mom

 

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. When you get that text it goes in the AMPS block

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 that's where you but that number

+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

OK so you need to put the 375 where it says PMPS , then in the U block you would put 1
Does this make sense to you?

I will ask Bhooma
@Bandit's Mom to fix the insulin on your spreadsheet

I see you said on this previous post
Snuggles has been on 1u of Vetsulin since Monday. I got one BS and it was 360.
Can you enter that number in also and of course the units

Sandy tap on Tyler's spreadsheet at the end of my post
Then tap in where you see 2020 and you will see what I mean
The only reason I want you to tap on 2020 and not 2021 ,2022 and 2023 is because Tyler has been in remission since 1-24-21 so there isn't that much testing to see
Let me know if you have an idea what I mean


To enter numbers on the spreadsheet, you have to open it on your Google Drive. Go to your Google Drive and click on your spreadsheet.
You cannot edit by clicking on the link in your signature.

 

@Bandit's Mom Hi lady
Sandy won't be starting Lantus until 1-27
because she will have 3 days off then
Snuggles is still getting Vetsulin , she will enter whatever numbers she has up until 1-27
I made her note that in her signature
On her SS it says Lantus , can you please go and put Vetsulin/ Starting Lantus 1-27
Thank you Bhooma, we will probably be asking you to draw a line above the date when she starts Lantus .

 

I think I got the 2 BS in @Diane Tyler's Mom

 

Yay you did it, how many units did you give tonight it's not filled in?
I know it's hard to test and give insulin to Snuggles but you really need to try and get at least one more test in at night if possible because we will never know how low the doses are taking Snuggles which means you won't know when whether to increase or decrease the dose
Did you draw the blank line on your SS?
You can write on it Started Lantus


In one of your posts you said
. The pharmacy quoted me $133 with GoodRX..but she said it’s not a guaranteed price.
I had asked you was that for just one pen or 5?
@sandysh66

 

I just filled it in..I gave 1u tonight..someone else did a line on the spreadsheet. I tried to change the top of the spreadsheet and read the information about using the spreadsheet and I have no idea how to change the top part regarding insulin. How long is a cat on an insulin, on average, before an increase dose is recommended? @Diane Tyler's Mom
When at night should she be tested again? She’s been eating dry food…not LC

 

@B

Yes I asked Bhooma to add the line I'll ask her to change the top part and put SLGS too
Bhooma's the best
I forgot what will be your shooting times again ?
So many members I help I forget
@sandysh66

@Bandit's Mom
Me again Bhooma thanks for adding the line on Sandy's SS
Can you just add where she has on her SS Vetsulin /Start Lantus 1-27
and add SLGS also
She tried but can't do it
Thanks Bhooma

@Bandit's Mom

 

That was for 5 pens…of the generic…guess I will see! I’m getting it either way..whether it’s Lantus or the generic. I’ve been through such a runaround I’m exhausted. @Diane Tyler's Mom

 

Insulin at 730am and 730pm @Diane Tyler's Mom

 

This is from the sticky on the SLGS Method
But I would re read the whole thing again

Hold the dose for at least a week:

• Unless your cat won’t eat or you suspect hypoglycemia
• Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.

After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.

• If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
• If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
• If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit

I would read all the yellow stickys about Lantus ok
https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/

 

So, will it benefit Snuggles to be tested more frequently when she’s being changed to Lantus on Friday? And should she be tested random times without regards to eating? @Diane Tyler's Mom Is there a certain protocol when transitioning to LC wet food in regards to dosage changes? How does that factor in? I’m heading to bed now but I will take any suggestions and advice you have. I feel the vet isn’t experienced enough in diabetes management. I want what is best for Snuggles…she was my mom’s baby and whatever I can do I will try my darndest. @Diane Tyler's Mom

 

If I remember correctly you are out of the house at 9 AM
What time do you get home or am I thinking of someone else lol

 

That's a good price

 

I leave for work around 9am and most days I’m home around 6pm. @Diane Tyler's Mom

 

Yes definitely , Those 3 days that you will be home you definitely need to get the AMPS test to see if the BG is a safe number to shoot.
With new members we suggest not to shoot if the BG is under 200, we suggest to stall don't feed and test again 20 minutes later to see if it goes up on its own
You can post Need Help! Stalling
Now hopefully you will be able to get another test in before you walk out the dorr for work, Say at 8:45 to see what her BG is
I know you said it takes you and your husband to test and give her insulin but you really need to try if you are by yourself to be sure she's not dropping to low
Those 3 days that you will be home try and get a test in at +2 +4' at +6 for both cycles
Cats usually nadir at around +6 that means the lowest point of the cycle but that's not always the case
The next day get one at +3 and at +5 for both cycles
Then the next day around add a test in at +7 and 9
It's like filling in the pieces of a puzzle
Just do the best you can
While she's on Vetsulin still if her BG drops below 90 you decrease the next dose byb0.25 units

 

When you get home after work this week start to rub her ears ,get her used to it.
When you are ready to test put her in the same spot every time give her a treat and test her, then give her a treat right after that even if it's not a success.
Just keep doing it so eventually she will associate getting a treat before and after you test her
Same when giving her the shot
With lantus it's test, feed , shoot this whole process should take only about 15 minutes or less. When Tyler was getting insulin it would take me less than 10 minutes
Some members even give the shot while their cat is eating
is Snuggles a good eater?
Lantus usually starts to kick in around +2
I put Tyler on the couch when I test him him, I sit on the side of him and his head is facing the arm of the couch
Some test on their kitchen counters
I can even test Tyler when he's sleeping , he actually purrs

Part of that process is getting a feel for basic concepts:

• Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
• Peak/Nadir - the lowest point in the cycle
• Duration - the length of time insulin continues to lower blood glucose

Just to be sure while he's still on Vetsulin you know after you test , feed ,you have to wait 30 minutes then shoot.

Night tests are important , cats seem to drop lower at night.plus when transitioning from dry food to wet food only thevBG can drop 100 points so that's why you need to keep up with glucose




Part of that process is getting a feel for basic concepts:

• Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
• Peak/Nadir - the lowest point in the cycle
• Duration - the length of time insulin continues to lower blood glucose

Just so you are aware
On a human meter, 50 is your “take action” number meaning it's time to intervene with food to bring the BG up , always postb if you need help such as posting the low number
If I am ever not around you can always tag
Bhooma,or Bron if it's very late at night Bhooma lives in India and Bron lives in Australia so they are around
You can always tag Elise , Suzanne , Wendy and Sienne
Bhooma would be the @sign then
Bandit's Mom

Bron is Bron and Sheba (GA)
Elise is tiffmaxee

Suzanne is Suzanne & Darcy

Wendy is Wendy&Neko

Sienne is Sienne and Gabby (GA)

After you tag a member to be sure you did it correct it will appear in blue after you tap post

 

S

Since she’s on Vetsulin a few more days when should I test these next few days? @Diane Tyler's Mom

 

Snuggles is a very good eater. I’m going to slowly transition the food starting Friday also. Is that ok? Snuggles will not let me touch her ears. The first day she was hesitant and now she will not let me touch them. I’ve been doing the great thing with no success but I’m still doing it. I have been following those instructions you have here with the Vetsulin. I’ve been researching a lot on here and I’m scared and worry about Snuggles getting DKA with the high blood sugars. @Diane Tyler's Mom

 

I’m definitely going to do my best! I’m going to go through all these messages this week and write down all the information and make sure I understand everything. @Diane Tyler's Mom

 

Any time you can like I noted above. You said you leave for work by 9 AM try to get a test in at 8:45 before you leave
You said you get home around 6 or little after you will test his PMPS # feed , wait 30 minutes then shoot while on Vetsulin
Try and get a +2 test and maybe a +4
I don't know what time you go to bed you can get a +6 also

 

You probably won't want to hear this but some members have to burrito their cats
Found this posted by some members

You can try wrapping him in a towel like a burrito if that helps. When I have to give difficult meds I kneel on the floor with my heels together and knees apart, burrito the cat, slide him between my legs. Heels prevent him from going backwards, burrito helps keep the claws at bay and from running off.

 

Ok! I wasn’t sure if you meant with Lantus or Vetsulin. Snuggles ate at 7 and I gave her the Vetsulin at 730 tonight…my times have been 730am and 730pm. I forgot to tell my husband to take the food away at 5…it’s my own fault and I feel horrible…@Diane Tyler's Mom

 

That would be ok for testing but giving the shot isn’t easy either! @Diane Tyler's Mom

 

While Snuggles is still on Vetsulin you need to wait 30 minutes to give Vetsulin after Snuggles eats
When you start Lantus you test , feed and can shoot right away
The whole process should only take about less then 15 minutes

 

Give the shot the same way after Snuggles is done eating after 30 minutes

 

Yes..I do wait 30 minutes after she eats to give the insulin. The process is actually easy…I’ve been doing the treat thing each time. @Diane Tyler's Mom

 

So I do or don’t wait to give Lantus 30 minutes after she eats?sorry, I’m a bit confused. I’m not sure what you mean the same way…

 

With Lantus you can feed and give the insulin straight away as the onset of Lantus in about two hours. Don’t forget to give snacks during the cycles.

 

If you are concerned about DKA I would recommend you buy some ketostix from Walmart or a pharmacy and test the urine daily. Ketones precede DKA. Also watch for things such a lethargy, not eating, vomiting, diarrhoea, drinking a lot.
Also make sure Snuggles is eating plenty of food and is drinking water and don’t skip doses of insulin. If you are ever concerned about if you should give the dose or not, post and ask for help. We are always here to help you.

 

I will be transitioning to LC wet food. Right now she eats Hills c/d .5 oz and FF LC .5 oz before insulin and she eats about 1/4 cup HC Rachael Ray dry cat food every 12 hours. I did order an automatic feeder with 2 openings. Thoughts? Sorry for all the questions! @Bron and Sheba (GA) @Diane Tyler's Mom

 

What is considered plenty of food? Right now she’s drinking a lot and has been urinating more…which is the reason I called the vet. @Bron and Sheba (GA) @Diane Tyler's Mom

 

@Diane Tyler's Mom i finally got the insulin gargline from the pharmacy tonight. At first the cashier said $549.00. I said isn’t it the generic…oops sorry she said..I didn’t see that. Anywho, it was $150. Yay! I’m satisfied with that.

 

Ask as many questions as you like.!
I would feed a good meal before the doses of insulin and then 3 snacks during each of the cycles
A snack is about 1 or 2 teaspoons of wet food.
Is she over/under weight?
If she is eating dry food she will be drinking more than on a wet diet.
When you swap to wet food you need to be aware that the BGs could drop quite a lot so you need to be testing the BGs

 

Snuggles is 13.5#. I’m worried when I go to work her BG will drop. Should I transition to LC wet food over a period of time? What’s your suggestion? I just don’t know what a good meal is…suggestion? I plan on starting her on the insulin glargline 1u..the vet told me 2u and also what’s on the box. @Bron and Sheba (GA)

 

Yes I would. Then you can see how the food is affecting the BGs over time.

I would work out how much she needs in a day and then divide that amount up into 2 main meals and 2 or 3 snacks during every cycle.

There is very little in your SS to go by as far as recommending a starting dose for lantus.
Have you been regularly giving her 1 unit vetsulin twice a day?

 

Yes I have been giving Vetsulin 1u twice a day..the vet had ordered 2u twice a day and I did that for a few days until I found this site and it was suggested I only give 1u twice a day. A cycle is the 12 hours between giving insulin right? What do you mean work out how much she needs in a day..by calculating weight or by checking BG? It was suggested on this site by a few people to only start Lantus at 1u and check BG. @Bron and Sheba (GA)

 

A cycle starts with giving the insulin dose and ends at the next shot….12 hours later.

If you are going to be feeding a dry food diet when you start Lantus I would start at 1 unit.
If you are going to be feeding a wet food diet I would start at 0.5 unit.

Check her weight. A normal adult cat needs between 20 and 33 calories per lb of body weight a day…depending on their energy levels.
You will need to make sure she has food available for when you are not there, especially in the first 7 hours after the dose …so up to +7.
That is when the auto feeder will come in handy.
I would wait until you are home for a few days to start the Lantus.

 

I

I will be doing wet and dry and transition over to all LC..hopefully within a few weeks be all wet LC. I will be off this Friday, Saturday, and Sunday so I will start Lantus Friday and do lots of BG at times suggested on this site. Thank you for your time! Any thoughts on this info? @Bron and Sheba (GA)

 

Do you have the correct U100 syringes with 1/2 unit markings to start the Lantus? The syringes are different to the ones you need for vetsulin.
I would start off on 1 unit of lantus …make sure you test before every dose to see it is safe to give the insulin and then try and get at least one test in around the +4 to + 6 mark to see how low the dose is taking her. I know you are having some troubles with testing.

 

Not a bad price at all for 5 pens

 

Does anyone know of any LC cat treats that are crunchy? My girls like the Purebites but since I’m transitioning both of them to wet LC food I would like to find a treat that’s got some crunch to it. Thanks! @Diane Tyler's Mom @Bron and Sheba (GA) @tiffmaxee @Sienne and Gabby (GA)

 

Found this posted by one of our members


freeze dried minnows, made by Vital Essentials. I also buy the ones made for dogs. They're the same as the freeze dried minnows for cats. just cheaper. They also carry other freeze dried treats. I ordered mine through Amazon.

I think the vital essentials are more of a crunchy texture than the purebites

If you cat likes any of these you can buy the bigger bags for dogs they are the same ,you will get more for your money just break then up into smaller pieces

The vital essentials come in different flavors , just Google them





.

 

Thank you! I’m trying to limit seafood and organ meat foods. Shouldn’t these only be given sparingly? @Diane Tyler's Mom

 

I'm sure they come in different flavors too

 

To tell you the truth Tyler never ate treats , I'm sure besides using them for testing and giving insulin you can give some more throughout the day. I would post and ask about it

 

They do come in other flavors
https://www.vitalessentialsraw.com/cat/treats-snacks/

Just see where you can buy them


Chewy and Amazon has them
@sandysh66

 

Is the Purina ProPlan Classic Urinary Tract Health Classic ok? I can’t find the Classic in that flavor on the food list. I just ordered chicken, turkey, and shrimp treats. I will use the shrimp ones once in a while. Thank you! @Diane Tyler's Mom

 

Yes the classics are fine, which flavor were you looking for
Yes I see some said gravy on them like the chicken and some say classic , they are both fine

 

Ok! Thank you! I would like to get the chicken classic and chicken and beef gravy but I see the chicken flavor may be out of stock. @Diane Tyler's Mom

 

Vital Essentials treats come in many different flavors and are 100% protein. They look like dry kibble so much so that my current two don’t think they are edible as they eat only raw.

 

Thank you! They say cats are finicky! @tiffmaxee

 

I’m trying to get everything ready for my three days off…on day 3 can you clarify what times I should get BG…you said to add a test at +7 and +9…do you mean both cycles and add to what times? @Diane Tyler's Mom

 

Just try to mix up the times you test , doesn't have to be exactly what I said but it's close. Yes these are for both cycles