New member! Help!

Hey there! My name is Khora. I run a small cat rescue that previously only really took in special needs kittens. I’ve just ended up with a diabetic 10 year old, and have another one coming tomorrow!!!!

Charlotte is a 10 year old black cat, currently on 2 units of Lantus once a day (Given at 10AM, it’s currently 8PM). I have purchased a glucometer on the way home with her and want to get her into remission! She’s currently on a rx diet that’s 14% carbs, I plan on moving her onto a food that’s 11% but eventually rotating or mixing it with raw food.

I do not know when to test, when to feed her, or how to adjust insulin doses for her based on the glucose readings! I’m very new to diabetic cats. Any advice (especially on what to do RIGHT NOW because I don’t know if I should be testing before I feed her or....?) would be super appreciated! I’m reading through as many files as fast as I can but I feel lost.

 

Hi Khora - the many experienced sugar kitty parents on here will give you all the help you could ever want. As someone else fairly new to all this I just wanted to say welcome to the best and friendliest site you could ever help to find.
Also thank you for taking care of all those kitties who need help and love.

 

WELCOME TO FDMB!
Boy you have your hands full! Well you're about to jump into the deep end! The good thing is this is completely doable.
First of all Lantus need to be administered every 12 hours. Splitting that 1 unit into half every 12 hours
You should test before each shot to make sure its safe to admin insulin.
Let kitty eat. An uncontrolled diabetic is ravenous. They cant metabolize their food properly.

I'd like to give you a proper welcome but I'm in the middle of saving dinner
I will BBL

 

Thank you for what you do! Everyone here will get you all set.

 

Hi and welcome to the forum. Thank you for rescuing diabetic cats...that is wonderful.
Can you tell us what type of meter you bought. Human or pet meter?
Lantus works best when given twice a day 12 hours apart. I would split the 2 units and give 1 unit in the am and 1 unit at the pm dose to start with
We recommend testing before every shot to ensure it is safe to give the insulin, and again during the cycle to see how low the dose takes the cat. Around +4 and +6 are good times but you can change that around a bit as well. Also if the blood glucose (BG) Is dropping or low, you will need to test again to ensure it is not dropping too low.

We recommend going up and down in 1/4 unit increments to make sure we don’t go past the best dose and to keep kitty safe.

It is a steep learning curve in the beginning so take one day at a time, keep asking questions and posting every day as you learn. We will help you.
Here are some links to get you started
https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/


tips on home testing
https://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

Food chart. Look for foods 10% or less. Most of us use around 5%
https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

 

I bought the “one touch verio flex” human meter!

thank you all so so much for the help. I really appreciate it!

 

Uuuggghhh I just discovered I was supposed to buy “control solution” as well. I wish the pharmacist had told me!

 

That’s good! A human meter is cheaper to run and it is the meter that our dosing methods are based on.

 

I also meant to mention that you test the BG first, then feed, then give the insulin in that order.
In the beginning, if the BG is under 200, you stall, don’t feed and ask for help and test again 20 minutes later. Hopefully the BG will have gone up on its own and you will be able to give the dose.
So feed about half the allocated day food before the shot and then give the rest of the food in two lots around +2 and +4 or 5 and the same with the pm food. Is that doable for you or are you out of the house at work?

 

Not sure how expensive those strips are, but you can always switch to Walmart’s ReliOn later. It’s $9 and 100 strips cost $17. With 2 diabetic cats, every little savings will help.

don’t worry about the control solution. You shouldn’t need that right away. Nice to have but not a must.

Bron is 100% right, split the dose and give Lantus every 12 hours, x2 a day. It only lasts about 12 hours so if you give it once a day only your cat is not covered for the other 12 hours of the day.

less than 10% carbs food. Most of us feed fancy feast pate or Friskies. They’re perfectly good foods and low in carbs.

Thank you for taking them in and welcome!!

 

Thanks Bron and ...EVERYONE!
Ale
and THANK YOU Khora What a blessing you are to ALL your kitties
You're in good hands now. lol Ive been here since 3:30 am and am fading fast.
I love this FAMILY

jeanne

 

Thank you that’s all very helpful!! Not sure if it matters but i am in Canada so not sure if brands may be different.


I’m really having trouble finding the file on reading the numbers on the glucometer. I don’t know what the ideal range is!

 

Okay so ReliOn won’t be available for you there. Ideal range in a regulated cat would be 50-120 on a human meter but Charlotte likely isn’t with Lantus once a day. Just be patient as it can take weeks or months to start to see good numbers on a diabetic cat. As we always say here, feline diabetes is a marathon not a sprint!

 

I’d suggest reading all the yellow sticky notes in the Lantus forum. Lots of important information on how Lantus works, the dosing protocols we use here, dosing, etc. very helpful. I’d bookmark it as well:

https://www.felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/

 

For a human meter the normal range is US numbers 50-120 or if you use the world numbers 2.8-6.6 mmol/l

I’ll tag @Wendy&Neko as she lives in Canada

 

The Onetouch is a good meter. I must admit I didn't get control solution right away. You will probably be OK with it. Not sure what size blood drop the Verio Flex needs, the old OneTouch needed quite a bit larger blood drop, so I started out with the Freestyle Lite, smallest blood drop requirement. I just looked it up, the Verio Flex is much better than the old Onetouch for size of blood drop, you should be good.

For cheaper test strips, check out eBay, many people find good prices there.

 

I tried lancing her ear (following all the instructions in the links!) and now she is very angry and hiding under the bed, and I didn’t get any blood out. OOF it’s going to be a rough night. Ill try again in a few minutes... hopefully she calms down. She’s a very touchy, reserved, distrustful cat. She came from a humane society.

 

If you haven't got any yet, get some Polysporin Complete (black and yellow box). It helps sooth the ears.

What size lancets do you have? In the beginning, it helps to have larger lancets (small gauge numbers), around size 26. Make sure you warm the ears first, it really helps. And above all, make sure you reward her with a nice treat (low carb) whether or not you succeed in getting blood.

 

Our lancets are 30g..... so we may need larger.

ok thank you! I will give her some freeze dried liver and try again in a bit, warming the ear more first.

 

I have a video in my signature showing how I test my cat CC at home. In in the US, so my numbers will be different from yours. If looking at numbers from the US you will want to divide by 18 to see numbers more in line with what you are going to be using in Canada. So normal on a human meter is 50-120... So you will so 2.8-6.7 ish on your meter.

 

Couldn’t successfully test her BG last night, because I couldn’t even get her to come out from under the bed. Finally got a reading this morning thanks to my partner distracting her with a treat, and it was at 15!!! I gave her a unit of insulin, how long should I wait before I re-test?

 

Maybe try to get a reading at 3-4 hours after the shot.

 

Hey Khora, is your rescue foster-based or is there a physical location like a shelter? Managing a diabetic cat in a location with lots of cats can be very tricky; they're a lot more prone to infections than the average cat and infections can be life-threatening for diabetic cats. I oversaw feline medical at a rescue for almost 4 years; we had over 20 diabetic cats during those 4 years. There's a steep learning curve, but it's doable

 

I wonder if you would consider setting up your signature. It will really helps all of us help you MUCH quicker:

• Click on Signature. This is where you will put information that helps us give you feedback.
  • There is a limit of two lines which may include two links; you may separate pieces with commas, dashes, | etc. This is where you paste the link for your spreadsheet, once it is set up.
  • Add any other text, such as
  • Caregiver & kitty's name (optional)
  • DX: Date
  • Name of Insulin
  • 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)
  • 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.

thanks
jeanne

 

Waving to you from Ontario. Thank you for taking in diabetic cats. The whole process will become second nature quite quickly.

 

Thanks everyone! I will set up the signature.

We’re a foster based rescue. This kitty is staying with me personally until the 30th, and then was supposed to be moved into her foster home (as long as she’s good about the blood testing and things are going well).

 

I’m in Ontario as well! Queen St. Cats rescue, Peterborough. Charlotte was transferred from Thunder Bay.

 

It should help trying to get her used to just playing with her ears aside from testing time. You’re giving a treat right after as a reward too right? Warming up the ears as well? It does get easier and the larger gauge lancets like a 28 or 26 should help too!

And aiming for the sweet spot right?

 

Hi there.

Thanks for all you do to help kitties in need.

Here is the method I use to home test. Perhaps it might give you some ideas to add to your own testing technique, particularly if you want to try using the lancet freehand.

1. Fold a sheet of kitchen paper in four lengthwise and cut it up into 1" strips. You will use these to cushion and support the ear during the test.
   
   
2. Put a thin film of Vaseline or Neosporin ointment (not the cream!) onto the edge of the ear to help the blood sample bead up instead of wicking into the fur. (Wipe off any excess.)
   
   
3. To get a blood sample you need to increase the blood flow to the ear, so make sure the ear is really, really, really warm (but not hot) - especially in the early days of testing. (Note: With repeated 'poking', more capillaries form in the test area, so it becomes easier to get samples reliably.)
   
   
4. Once you have the testing area of the ear well warmed, wrap a strip of folded kitchen paper round your index finger then place finger under the sweet spot area of the ear you're testing to support it during the poke.
   
   
5. Use your thumb and middle finger to lightly but firmly grip the ear and paper strip in place so that the edge of the ear is taut but not overstretched; the little bit of tension will make it easier for the lancet to break the skin surface (and it helps to keep kitty's head from moving around too much).
   
   
6. When using a lancet 'freehand, make sure the bevelled side of the lancet is facing upwards. Hold the lancet at a slight angle to the ear similar to the way you hold a pen when writing, not perpendicular (easier to see where you're aiming and also makes skin prick easier).
   
   
7. When it comes to the actual poke, prick the sweet spot on the edge of the ear in a similar way to how you might quickly prick a balloon with the tip of a needle to make it pop.
   
   
8. When using the glucometer, bring the test strip to where it j-u-s-t comes into contact with the blood droplet and hold it there. The strip should then 'sip up' the amount it needs to run a valid test. Most meters beep or give a visual cue to let you know that enough blood has been collected on the strip.
   
   If your cat is a wriggler, try collecting the blood sample on the back of your (clean) fingernail and test it from there.
   
   
9. After the test, fold the paper strip over the edge of the ear and apply gentle pressure to the test area for about 15-20 seconds to minimise bruising.
   
   
10. Keep praising your cat throughout the process and reward with a favourite diabetic-friendly treat.
    

With a bit of time and practice you'll be able to work out a technique and a routine that works best for you and your cat.






Mogs
.

 

Thank you! I was able to get the sample today by massaging the ear for a while first before applying the warm compress. The hardest part has been that this is an older cat who I’ve never met before, and she doesn’t trust me that much. So last night when I tried it I got attacked, and then she hid! This morning was much better though.

Unfortunately the only thing that keeps her still long enough to do it is Churu tubes, which are about 15% carbs (dry matter basis). She hasn’t liked any other treats, and hasn’t been eating all that much since we got her in last night.

 

It’s important she eats. did she have a vet checkup? Would you know if she’s under weight and needs to gain?

She’s dealing with a lot right now. New people and new environment. I might give her a bit of time to adjust it all. I wouldn’t push too much testing on her just yet. If you can get the preshots for now, that’s great. Then slowly maybe after a week add a midday shot and an evening +2 @Critter Mom do you agree?

 

She’s eating a little, just not tons yet.

she came from a shelter where she was pretty well cared for, hasn’t had a vet check up since arriving last night.

she’s at a good overall body condition score, but has a little bit of muscle wasting in areas. Decent fat padding but limited muscle.

At the shelter she was on varying Amounts of insulin, but most recently 2 units once a day. I’ve moved her to 1 unit twice a day, but upon retesting her blood (3 hours after insulin) she’s still at 10.7.....

she’s doing a LOT better today as far as temperament. Last night was hard for her, but she’s already started to associate needles with treats to that’s good I guess lol. She saw the lancet just now and looked around for her churu tube.

 

How big is a Churu tube? (In UK, so haven't a clue.)

Also, do you know how much she weighs?


Mogs
.

 

.5 ounces. It’s like kitty crack lol!

https://www.chewy.com/inaba-churu-g...tqAK0bAL85ahBDI5HmK1qv82PeSPntQgaAnO3EALw_wcB

 

She weighs almost 4kg.

one churu tube is about 14 grams.

 

Wow, that is SO great. Good for her and you! So we say a good rule of thumb for daily calorie intake is 20 times ideal weight but we’re using pounds when we do the math. So Minnie for instance is 16 pounds times 20 means she should be eating about 320 calories a day. If she needed to gain about 20% more than that. I’m sure you’ll find her favorites soon and she’s going to be more relaxed and will therefor eat more as well!!

 

PROGRESS! is beautiful

KEEP UP THE GOOD FIGHT!

 

Should I be worried about her still high glucose level? Or is there nothing really to do until tonight’s insulin?

edit- glucose before insulin was 15, 3 hours after was 10.7

 

Wish you had a spread sheet would you be interested in setting one up? here just in case...
FDMB SPREADSHEET INSTRUCTIONS

@Critter Mom
@Aleluia Grugru & Minnie will come answer your question.

 

Lantus is a depot insulin, meaning when it is first injected, some goes to the depot and some to the blood stream (simplifying things here). It also means it can take 5-7 days for the depot to build when you first start insulin. Only one shot a day means the depot has been in flux. It also means that her numbers may get better after you've been on this dose a few days of two shots a day.

We've all rather data focused and used to using that spreadsheet that Jeanne linked for you when we comment about dosing specifics. If there's anyway you could set that spreadsheet up, it'll really help us help you. If you aren't as computer technical, we've got people who can help, so give us a shout.

 

Ok I’ll do that! Thanks!!!

 

Regulation occurs gradually. In the initial stages you'll see high numbers, but as you gather more BG readings you'll be able to safely adjust the dose in small increments and your sugar kitty will start to move into better and better numbers.


Mogs
.

 

As Mogs said it takes time. It doesn’t happen overnight or even in a few days. It may take weeks or months. It depends because every cat is different. Again, marathon not a sprint. Pace yourself. And yes, once you’ve given the shot nothing to do until the next shot 12 hours apart

 

BTW Pumpkin shirt... CUTE!

 

That's what we do - we sit Mac on the breakfast bar (also where we do his shots) but for the blood test hubby pulls Mac's bottom against his chest and puts his arm around the top part of Mac's front legs - where our biceps would be. This lets him hold Mac gently but by holding across his legs stops him escaping whilst I do the test. We make sure he gets a sniff of the box of tinned tuna first so he knows what's waiting for him then he gets a couple of teaspoons full as a treat after we're done (Mac that is not hubby!)
Bribery - can't beat it !!

 

Such flagrant hubby discrimination!!!




Mogs
.

 

Oh Mogs...you dont know...

I told leo (hubby) I'm going to purchase a Libre and stick it on him in his sleep! (hes diabetic) numbers all over the place. DUE to DIET! Next he gets a collar and joins Zoe on the floor for dinner.

 

For low carb food I hope. Don't forget the velcro wrap to stop him scratching the libre off!

 

Are you selling tickets?


Mogs
.

 

heh heh heh yeahhhhhh

 

lmao good idea!

 

I so appreciate all the help! We have a spreadsheet set up now, and Charlotte is absolutely wonderful about the bloodtesting as long as my partner is giving her a churu tube. she doesn't even notice now! BG is still pretty high, we will take it one day at a time though and hope it comes down eventually. We are also going to try some other foods because she doesn't seem fond of the Tiki Cat we are using... Fancy Feast and raw food will be offered for tonight. Hopefully we can find something she enjoys! It was noted on her file from the shelter that she wasn't very food motivated though....they had her on rx wet and dry.

 

sitting still for a treat, is food driven.

 

Beautiful spreadsheet BTW

 

Cats go off the Purina DM wet quite quickly. The Purina DM dry is at the lower end of high carb. If you were the person who bought the rx food from the vet, you can return it for a full refund. The company guarantees it.

 

She isnt on the RX anymore! That was before we pulled her from the shelter up north. I switched her to the lowest carb I had at my place (tiki cat mousse) but she isn't fond of it. The only things she really loves are those churu tubes! We will keep trying low carb options and hopefully find something she likes.

She luckily isn't a kibble addict! She seems to prefer the wet to the kibble (They sent her with a tiny bit of the kibble which i initially tried to use as a treat for her)

 

a first!

 

Way to go!!

 

Hey!!!! Her BG is 4.8 tonight before dinner. Do I not give insulin then??? Do I re test after dinner??? What do I do?!

 

Do not feed. Test again in 20 minutes.
How long can you afford to be off-schedule?
With Lantus, you can only get back to your preferred shot time by 15 minutes per cycle OR 30 minutes once a day.

 

It is recommended that for newcomers, no shot be given under 200.
It is very important to get some mid-cycle tests in. You don't know how low she went during today's cycle.
Tonight is likely to be a skip.

 

So I didn’t realize I shouldn’t feed, she did eat and I just retested and she’s at 8.7. I was under the impression I should be giving the shot when she was above 6.6......

I didn’t see the response till now. Her usual time is 9:45 for test and then shot.

Someone else had mentioned not to stress her out by trying to get tests in between just yet, and just to make sure we got the preshot test in so I had not been worrying about testing during the day.

 

the 8.7 (156) could be food influenced.
did you shoot?

 

i did not give a shot. She ate one can of fancy feast for dinner tonight. Usually I give her another one before bed, do you think that’s a good idea tonight? I assume it’s too late for insulin?

 

Testing during a cycle is very important, esp. since you are seeing lower numbers at shot time

number could be food influenced. we just don't know, without testing, how charlotte reacts to carbs.
i suggest skipping tonight.
and feed as you normally would.

apologies. wonky laptop. a number of keys do not work.

 

Thanks so much. I’ll add more testing times. What’s the ideal time during the day? 6 hours after?

 

a +2
and a mid-cycle test to start.

Example of an ACTIVE, but NOT necessarily typical Lantus/Basaglar cycle:
NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus/Basaglar cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. Onset begins around +2 for most cats. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Often lower than the PreShot number.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Basaglar/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.
NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus/Basaglar cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.
+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. Onset begins around +2 for most cats. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Often lower than the PreShot number.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Basaglar/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.​

 

Khora – I understand from your earlier posts that this foster is due to go to another home soon. It is important that more testing be done during the cycles. I'm worried that the dose may be a bit too high given the low blue preshot numbers Charlotte has been seeing.
Tagging a few experienced Lantus users.
@Critter Mom
@tiffmaxee
@Wendy&Neko
@Sienne and Gabby (GA)
@Aleluia Grugru & Minnie

 

I agree with Kel but the only way to know is to figure out how low 1.0 is taking her is to get some mid cycle tests. Cats often drop lower at night.

 

You got a 83 at +7, so I’d try to alternate +5,+6,+7 to see what you get. A +2 if your preshot number is under 200 is a good idea because you want the numbers to be going up at that point. If they’re not, you’ll need to test more because that’s going to be an active cycle for her.

Since you’re getting mainly blues at pmps, can you try to get a +2 every night? Same concept, you want that number to be going up

 

I have a slight correction to the above. You don’t want to see the +2 going up. If it’s is lower than the preshot it means you will likely have an active cycle and need more tests. If a lot higher it won’t be an active cycle so no more tests will be needed. The insulin will kick in around +2-3. The nadir will be between +4-7 for most cats but varies so testing each cycle at different times to try and catch it is a good idea.

 

@Khora Tatyana
The morning test of 49 on the 28th tells you that Charlotte's dose is too high. On a human meter, 50 is the take action number. Please reduce the dose to 0.75 units and please get some mid-cycle tests in. You don't know how low she went during the night of the 27th/28th.

• How to treat HYPOS - THEY CAN KILL! Print this Out!!
• jojo and bunny's HYPO TOOL BOX

A preshot number that seems higher than usual is likely a bounce from low numbers or because the shot during the previous cycle was skipped for safety reasons and dosing should not be based on these higher numbers.
Dosing is based on how low a cat goes during a cycle.

 

Sorry it’s a bit hard to follow the numbers because I’m Canadian! I use the “world numbers”... I’ll have the foster do some more testing, and see if we can reduce the dose.

perhaps the syringes I’m using are different, but how do you reduce by .25??? It’s such a tiny amount to begin with! I had to put reading glasses on and stare at it for about 5 minutes to get it right lol

 

bump

 

@Critter Mom
@tiffmaxee

can you pleas advise?

 

typing.

 

THANKS KEL

 

World numbers x 18 = US numbers.
The take action on a human meter in US numbers is 50. In World Numbers, that's 2.7.

Since you and the foster are new to this. I suggest you take a reduction in dose if any test is under 90 (5). Usually at the beginning, we ask that a person not shoot a preshot number under 150 (8.3) until there is a lot of midcycle data to draw upon.

Dollar store magnifying reading glasses help.
Play with some coloured water and a used syringe. Once you have what you consider is a good 0.75 units, place that syringe aside so you have a reference.
Are you using 3/10cc syringes?