Newbie. Withholding insulin. Am I wrong?

Dx was a month ago. 2 units lantus (2x daily). I wasn’t home testing. Didn’t know I was supposed to be.

A few days ago my cat became very lethargic and seemed “off”. Vet was closed so I did my own research, found this site and learned about home testing.

Purchased One Touch meter immediately that night (I had a feeling something was wrong)


BG READINGS / DOSAGE

9/3/2021
• AM 2 units lantus given - purchased meter that night
• *** IMPORTANT!!! ***
Very FIRST time testing BG at +9 was 65 mg/dL
*skipped PM dose


9/4/2021
• AMPS 140
• AM 0.25u given (almost nothing)
• skipped PM dose


9/5/2021
• AMPS 139
• AM 0.25u (almost nothing)
• skipped PM dose


9/6/2021
• AMPS 124
• skipped both doses


9/7/2021
• AMPS 121
• skipped AM dose
Do I skip PM again??



MISC. OBSERVATIONS

•still peeing large amounts even though BG numbers are lower and urine strips are negative for glucose (glucose is on the same strips for testing ketones, which I was told to do)

•9/1 — 9/4/2021 seemed to have VERY noticeable increase in appetite (due to possible hypo?), lethargic, looked “off”

•decrease in appetite 9/6/2021 — present

QUESTIONS
Should I keep withholding insulin or am I making a mistake?

What does this all mean? Besides the fact that I got incredibly lucky. This could have been very tragic had I not tested when I did

 

Not sure if it matters, but I do not take food away prior to testing. My cat grazes and goes to the bowl many times throughout the day. USUALLY he eats small amounts at a time, many times a day/night. In general I let him eat whenever he wants. I leave food out overnight.

feeding: fancy feast and friskies pates. No dry food anymore. the diet change was probably the only thing my vet got right. I made the change right after dx. My other cat had to get on board too.

My vet obviously didn’t consider how big of an impact the diet change would make. Unless diet isn’t the reason for his hypo scare. Or was that not hypo? Maybe the dose was just too high. I’m confused and have no clue what my numbers mean.

regardless, I’m not sure what I do from here.

 

Hi Kiera! So 65 was the lowest reading you got? And on a human meter, correct? If so, that number is not technically a hypo number (we say under 50 on a human meter is the “take action” number here), but it is quite low for being new to insulin and can certainly be scary!

I will tag @tiffmaxee for you, who is a lantus user and is on right now.

It would be helpful if you could set up a spreadsheet when you get a chance. This will help people see Bailey’s BG readings more easily and make it easier to help you Here’s the link to the directions. If you need help let us know and we can help you!

https://felinediabetes.com/FDMB/threads/how-to-use-the-spreadsheet.241653/

 

I’m just seeing this. Do NOT shoot. I will be back.

 

Wanted you to see that right away. Cats can become diet controlled. Your cat was started on too big a dose with a diet change. Unless really large most start with 1.0. With a switch from dry even .50. Because the test might have been food influenced you should not give insulin tonight. Did your vet say whether your cat had dka? What is the pmps?

 

I guess I’m bad at explaining things because I don’t think anyone is understanding me.

The BG of 65 was days ago (9/3/21). It was my first time testing. I was trying to say the reading was 9 hours after insulin that morning. That’s what I thought +9 meant.

So 65 at 9 hours after isn’t hypo? I thought it was supposed to be lowest mid-cycle? So closer to 6 hours.

I haven’t been giving insulin (except for the 2 tiny morning doses). I’ve been too afraid after getting the 65.

Can you please tell me what was confusing with my first message so I can fix it? I don’t quite know where I messed up.

I have only been doing 1 test a day. Up until a week ago, I didn’t know about home testing. Since I haven’t been giving insulin, I haven’t been doing additional tests. I just need advice on what to do next.

 

What is dka? If I was giving insulin tonight, it wouldn’t be for 2 more hours. Doesn’t PMPS mean PM pre-shot? Right before insulin?

The only reading I have for today is at 11am. For the past month, I have been giving insulin at 11am/11pm (with the exception of the past few days where I gave only 0.25 or skipped).

I skipped the dose again this morning. Was that wrong?

 

In order to help you we need you to set up a spreadsheet and a signature. You need to test before you shoot every time. Yes that’s amps and pmps. You test to make sure it’s a safe number to shoot. You feed next to make sure they will eat and then shoot. When no to insulin you should not shoot under 200 without someone helping you.

DKA is diabetic keto acidosis. I would hope your vet would have told you if that happened as it’s very dangerous. Did your vet mention if he had ketones?

We talk in terms of + numbers because we come from all over the world. I’m going to guess you are in the USA. Is that right? Lantus is dosed based upon how low it takes your cat. That generally happens between +4-+7. We have two dosing methods we use here.

You can read about them on the lantus forum. I will provide the links. Why did you pick 11 as shot time if I may ask?

 

In order to help you we need you to set up a spreadsheet and a signature. You need to test before you shoot every time. Yes that’s amps and pmps. You test to make sure it’s a safe number to shoot. You feed next to make sure they will eat and then shoot. When no to insulin you should not shoot under 200 without someone helping you.

DKA is diabetic keto acidosis. I would hope your vet would have told you if that happened as it’s very dangerous. Did your vet mention if he had ketones?

We talk in terms of + numbers because we come from all over the world. I’m going to guess you are in the USA. Is that right? Lantus is dosed based upon how low it takes your cat. That generally happens between +4-+7. We have two dosing methods we use here.

You can read about them on the lantus forum.
https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/

Why are you giving insulin at 11 if you don’t mind me asking? Will you able to get mid cycle tests?

 

You are doing nothing wrong. Just finding your feet, is all. Caution is good at the beginning. We've all been where you are now. Feline Diabetes is a steep learning curve. We can help you with that every step of the way.

Is Bailey on any other medications? I ask because some cats become diabetic after a course of steroids.

Not every cat's nadir is mid-cycle. Some cats nadir early. Some late. 6 hours is the average.

Yes, it looks like almost nothing but it can be effective.

Breathe. We can help you keep Bailey safe.

 

If under 200 at shot time you will stall, DON’T feed and ask for dosing advice. Without data and a spreadsheet we can’t tell your cat’s insulin dose. You were absolutely right not to shoot low numbers and to skip. That test before insulin needs to be without food 2 hours before. Other than that he can graze.
I think you need to reduce your dose. I would probably go all the way back to 1.0.

 

What kind of meter are you using, pet or human?

 

It took me awhile to give him his first shot (because I was scared). It ended up being 11:00pm. So I just went with it. Works fine for me because I’m a night person and I work a lot from home. So the time is good for me. Does it matter?

I’ve been injecting for close to a month and didn’t know about pre-shot tests. I can’t go back and undo that now. He started acting lethargic and off in general. Prior to that, he seemed perfectly fine.

When I saw symptoms (on September 3rd), I found this site, got a meter and tested. Since I got the meter, I really haven’t been giving insulin. I’m just not sure if that’s the right thing to do or not. That was the point of my message but it got lost in all the info I guess.

I test for ketones with urine strips - always negative

 

Human One Touch.
Giving 1u would actually be a huge increase from the past few days of no insulin. I listed my numbers and dosage in the first message. Can you please look again? If you have time

 

Breathe. We will help you. I think it best to see how he does without insulin for a few cycles. He might need just .25 or .50. How long has he been eating wet food? Any dry?

 

No other medicine. Should I go back to 0.25 or continue to withhold insulin based on his numbers?

 

Yes. I agree. He might be becoming diet controlled. How about testing at 11 and recording the number. Then test 3 hours later.

 

I answered these questions in my first 2 messages I think. We changed his wet food to LC and removed the dry food when he was diagnosed. He’s been without insulin for 4 cycles right now. How many more should I skip?

 

If he is diet controlled his bg will come down 3-4 hours after eating. Will you set up a spreadsheet? I can link you to the directions. If you need help we have someone that can do it for you.
I thought you were giving 2 units which is why I originally said 1.0. We need to get a few days of tests in to know what dose to give.

 

Ok. And skip insulin again? I didn’t realize how late it was. 11pm is 30min away. He didn’t have any insulin this morning. None the day before or the night before that.

 

Set up the spreadsheet. Test every 3 hours. See what happens. I can’t tell you how long to withhold insulin until I see the numbers. Normal on a human meter without insulin is 50-100.

 

I was giving 2 units, twice a day before he was showing symptoms. Before I found the site. And before I started home testing. This all happened recently but he’s been on insulin for about a month.

 

Would you get a test at 11 and let me know what it is please? Unless it’s high no insulin tonight. Do you need help with the spreadsheet?

 

I just downloaded the app for excel but I don’t know how you get the template that everybody uses. How do I do that?

 

I’ll give you a link. Don’t do excellent. Our spreadsheet is coded. It colors everything. All you supply is the date, bg and dose. Be right back.

 

https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

 

https://felinediabetes.com/FDMB/threads/how-to-use-the-spreadsheet.241653/

 

I have to manually put in all of the dates? That will take forever

 

Don’t go back. Just fill in the last week.

 

PMPS is 129.

What’s weird is before this I almost started thinking he needed more insulin because none of his diabetic symptoms had improved. And then recently it was like a complete 180 flip and I was no longer seeing the constant drinking (which was the biggest indicator leading to dx). Although strangely when he pees… it still in such LARGE amounts. I don’t know when he could possibly be drinking all this water because I’m not noticing it like I used to. He’s peeing more than he’s drinking… LOL. I know it’s not possible but it seems like it

Then on the 2nd and 3rd of September I saw signs of hypo out of the blue. I didn’t even know that was a possibility until googling his symptoms. My vet never discussed that with me or told me there was a risk

I have no way to know what was going on over the past month. I didn’t know I supposed to be testing or that I was doing anything wrong. I had no idea I was potentially putting Bailey at risk. My vet didn’t even tell me home testing was a thing. I had never heard of it before (never known anyone with diabetes). Vet made it seem so simple. Insulin, twice a day. End of story.

And then I come here and my head is spinning…

 

Ok I’ll fill it out.
The strips I use to test ketones test glucose as well. It used to be the highest color glucose. Now it’s always negative. The complete opposite. Never had any color change for ketones. Not even trace. The vet told me to ignore the glucose part. So that’s what I did. But I still saw the results.

 

Skip. Your story is too common. You are smart snd had the sense to skip. Others come here with cats with symptomatic hypos. My sister and a friend had diabetic cats. They shot blindly and occasionally took cats in for curves. I was shocked to learn I needed to test. Their cats peed all over the house. Clearly not controlled yet they were on and off insulin based on curves at the vet. They thought I was crazy the way I tested. Let’s keep track of the numbers tomorrow and go from there. Get the spreadsheet up and running There’s a chance as Kel said that a tiny amount of insight he needed or he could be food controlled. It’s good the symptoms are going away. Time will tell. Let us know if you need help with the spreadsheet. @Bandit's Mom can help.
Get a test in 3 hours after eating. Don’t let him eat two hours before amps

 

What do I put when I skipped? 0?

 

Great you tested for ketones and negative. That would be the only problem with skipping if that was positive.

 

I don’t understand what ketones are? Or what causes them? I thought I read it’s when glucose is high so I likely won’t see them with these numbers. Or is that wrong? I tested for them about 2 hours ago and it was still negative

 

I can help you set-up your spreadsheet. I need a few details. Will send you a PM. Look for it in the Inbox.

 

I think I have it figured out. There’s not much info to enter. I just don’t know what to put when I didn’t give insulin. 0 or just leave it blank?

 

Put 0 or NS for "No Shot".

Please add the your meter name in you Signature and put the link to the SS in the second line of your Signature.
Thanks.

 

Ok. I’ll figure that out next

 

No rush. Let me know if you need help. Are you using your phone to set-up the SS?

To share the SS and paste the link in your Signature:
Tap the three vertical lines in the upper right. Tap "Share and export" again, tap on "share". You will see "Link Sharing is Off". Tap on this. You will see a green link that states "Anyone with the Link" ; tap on "can view" and make sure it has a checkmark next to it. Tap the back arrow. It should now state "Link sharing is on" and "anyone with the link can view". Right below that, tap on "copy link to clipboard".

Then paste this link in your Signature on FDMB

 

Did I do it right? I think I filled it out correctly. But I am using a phone so it’s hard to see what I’m doing.

 

Should I give a small dose? Like 0.25 and monitor? Or should I just continue to skip? I’m not sure if these numbers are still too high or not and I don’t want his chance at remission to be compromised because I stopped insulin too early but I was just too scared to give anything after seeing that 65 at +9 for my first test ever. The only reason I gave 0.25 the first two mornings was because I wasn’t sure if I could just stop cold turkey like that. But I ended up doing it anyway

 

Perfect!

I think you can try giving 0.25U twice a day and see how she responds to it. The 2 shots should be 12 hours apart.
It's pretty late tonight. Why not start 0.25U tomorrow morning and see?

@tiffmaxee

 

I’m so glad I trusted my gut that night. I just knew something was wrong but couldn’t put my finger on it. I can’t even imagine what would’ve happened if I didn’t test that night and continued with insulin. Who knows if this was an issue for days prior. Can cats stay in a hypo for days? That’s how long I was seeing symptoms. Are there any complications that can result after the fact from hypo (especially if it was a longer period of time, like days or who knows)?

 

Actually, midnight is OK. And then I could slowly get back to 11 by doing 15 min early each time. Right?. He won’t eat now. He had a few bites a half hour ago. He’s always eaten within an hour or two after insulin since this started. He’s just a grazer. I would never be able to get him to eat on demand no matter how hard I tried. I don’t know if that changes things but I would never be able to get on a schedule it he had to eat right at insulin. It’s not an option honestly

 

Since you skipped tonight you can shoot at 11 tomorrow.

 

But tomorrow might be better since I’m not staying up all night to monitor him. What do you think?

 

OK. I was just considering giving him a small dose tonight but that’s fine too

 

Shoot tomorrow morning. Skip tonight. If too low ask for advice. He’s not too high tonight and it’s fine to wait.

 

Put NS for no shot.

 

I agree. Better to shoot tomorrow morning. Pick a time that will let you get tests till +2/+3 without staying up too late.
So if midnight is usually when you go to bed, you might want to shoot at say 8am/pm.

People shoot as early as 5am/pm. Depends on your work schedule and whether you are an early bird or a night owl!

 

And now that you are all set-up and good to go, you can start posting on the Lantus forum. You will get more eyes of experienced Lantus users there.
Lantus / Basaglar (glargine) and Levemir (detemir)

 

What would be too low? Just so I can prepare. I will need to test a half hour early to allow time for a response from someone. Or longer?

Since I’m not giving insulin tonight, do I have to stay up and test later? Can I just wait and test before the shot tomorrow and then test during the cycle? That would make my life so much easier.

The last big thing is taking food away two hours prior to the test. I’m worried that if I do that I won’t be able to get him to eat when it’s time for insulin and I would literally never be able to get on a schedule. He doesn’t like being told what to do and won’t eat on demand. I’ve tried. So it’s much worse to give insulin after two hours of no food and hope he eats soon after than to let him graze and just eat when he wants. Right? Or what’s your thoughts on that? How big of a deal is it is if he eats a little in the 2 hours prior to testing. He may or may not. He eats plenty throughout the day. It’s just on his own schedule. If I have to remove food for 2 hours and then wait for him to eat, it’s going to be a nightmare with timing every single day

 

I’ll actually be up for a couple hours. So it’s not that I don’t have the ability to test him… I made it sound like that intentionally (sorry). Because the truth is.. I just don’t want to.

Please understand. This is SO NEW and we are struggling with these ear pokes. I can do them… But I don’t want to upset him too much too soon. He really hates it. I do too. I’m sure no one likes doing it but it has to be done.

However, I was hoping I could skip doing any more tonight unless it’s absolutely necessary only because I didn’t give him insulin. And I plan on doing the mid cycle tomorrow for the first time.

Am I a bad person for asking?

 

Not at all!! Everything is really hard and overwhelming at the beginning. It's even harder when you reaize your vet has given you bad advice and you go through the scare of a possible hypo.

Let's start afresh from tomorrow morning.

 

Perfect. Thank you!

What about the feeding situation? Is it a big deal if I ignore that rule and not remove food 2 hours before? i let him eat when he wants. It’s what I’ve been doing. His number will never be that hugely influenced I don’t think because he doesn’t eat full meals. Never has in the 11 yrs I’ve had him. Just a tiny bit at a time. He won’t eat on demand for insulin either. But I’ve always been able to get him to eat within an hour after. Sometimes it’s 2 hours but that’s tops. The vet said it was completely fine but now I’m questioning everything

 

Can you tell me what number would be safe to shoot and what number range I should ask for advice tomorrow? Just so I’m prepared.

you suggest only 0.25u, right? It’s so hard to measure less that 0.5 but I can guess like I did before. No clue what I was actually shooting. Just know it was lower that the 0.5 mark.

 

The reason we say no food 2 hours before the shot is because you don't want to give insulin based on a number that is influenced (higher) by food. Especially when you are new and your cat is seeing lower numbers. Are you saying that if you don't feed him when he wants to eat, he will refuse food after?!

If you get the numbers you have been seeing 120-140 at AMPS, give 0.25U. If you get less than 100, don't shoot and post for help.

Do you have syringes with half unit marks? Of 30 unit/0.3ml capacity?
Insulin Care & Syringe Info: Proper Handling, Drawing, Fine Dosing

 

Have you tried warming his ear before a poke? Giving him a treat after?
Do you use a lancing device or free-hand with the lancet? What gauge is the lancet?

 

If I put food in front of him (even if he’s hungry) he walks away. I always joke that he doesn’t like being told what to do and won’t eat or do something only because I want him to.

Basically, when I keep food down at all times, I know he’s either had a little food in the past hour or 2. Or if not, he will eat in a reasonable amount of time after insulin.

My concern is that if I withhold food for hours prior, it’s still impossible to get him to eat right when I put food down. It’s very annoying. So that would mean, with no food in his stomach, I would have to pretend not to care about the food (I’m not even kidding). Then, wait until he eventually decided to eat before I could give insulin. So maintaining a set schedule would be impossible. Do you understand what I mean? I guess if you have never dealt with a cat with weird behavior like this, you probably wouldn’t be able to relate. But short of force feeding him, there’s nothing I can do.

The only compromise I can make is no food for 2 hours prior to AMPS. That test would need to be at +11, not just before insulin. It would give me an hour window to make sure he ate first. Again, to maintain a schedule, I would give insulin on time regardless if he ate 5 minutes after +11 or just before the insulin. Is that better?

When I explained this to my vet, he said it was fine as long as Bailey was eating enough throughout the day.

yes, I do have half unit markings. There’s no way to get it exact but it will be close enough. I understand where it needs to be.

Thanks again for your help! Should I post my AMPS here or create a new thread? I’ll prob get the reading an hour before the shot. Unless you have another suggestion?

 

If he ate 2 hours before AMPS and you tested at +11, you would still get a food influenced number so I am not sure how this solves the problem.

Let me share an actual example from this morning. A CG got an AMPS of 94, but she felt her cat had eaten in the 45 mins prior. She decided to skip the shot (for this reason and others) and it was good she did because he was 76 after an hour - once the food bump had worn off.

Just to clarify, he can eat at any time except 2 hours before the AMPS and 2 hours before the PMPS. In case we have our wires crossed.

If you are shooting a food influenced number, plus can't test him very much and you are new and unused to handling lower numbers you could be endangering him. I don't mean to make you feel like you are a bad parent - I just want you to be aware of the risks involved while giving insulin so you can take an informed decision.

I know we have been throwing a lot of information at you and I understand it seems like it is all too much to handle. We have all been where you are and we want to help, but we honestly cannot give you advise on whether to shoot or not without correct information.

 

He doesn’t have to eat a lot before insulin as lantus usually doesn’t start working until +2. You test to be sure it’s safe to shoot. Things can change in an hour. We feed to make sure they will eat later in the cycle if their bg drops. Then you shoot. Quite often cats are too low at +11 and high enough by shot time as the previous dose wears off.

 

Any testing? Did you shoot?

 

I didn’t see these messages until right before I was going to test and give insulin and wasn’t paying attention to food.
So I delayed 2 hours

2 hours later than usual but no food and he was 120. Normally I would’ve given 0.25 as suggested but it was too late of a time. I had no choice but to skip. Without insulin, my tests won’t mean as much like I was hoping for today.

When should my next test be? Or is there no point since he didn’t get insulin. I’ll obviously test PMPS.

To clarify, I can withhold food for 2 hours and give insulin without him eating anything as long as he eats afterwards? How much of a time window do I have? An hour after? Less? He won’t eat even a little right when I put the food down so it’s going to have to be given without food. Or my schedule will never be maintained

He ate some food exactly 42 minutes after I tested today. I put the food down immediately after AMPS. This is my exact problem. Would that have been fine if I gave insulin with the number 120 and him eating when he did?

 

Lantus onsets, kicks in, usually at +2. You do want him to eat at least a few teaspoons when you shoot. Is there any food he loves that he will eat no matter what?
You don’t need to test again until pmps.

 

It's normally test, feed, shoot and more often than not it works. But sometimes cats don't eat before the shot or eat a whole lot before the shot.

The onset of Lantus can be anywhere between +1 and +3. Differs from cat to cat. So depending on when your cat's onset is, you have time till half an hour before onset to get food in.

Wow! He really watches his food bowl so closely that removing it for some time would make such a difference? Can you add some topper to the food to entice him?

Since you skipped you needn't really test, but it would be interesting to see if his BG drops 3 hours after food. If his pancreas are working, they would produce insulin in response to food and lower his numbers. So if you can get another test...any info is good to have info!

 

I’m not in the habit of taking food away. I forgot again tonight but remembered when I saw him eating. It’s been an hour and 20 minutes since he’s had food. I’m going to delay insulin time to make sure his number is 2 hours without food. So that’s 40 minutes from now. Will you guys be up?

 

Scratch that! I’m feeling like such a failure today!!! Shortly after sending my last message I caught him eating from my other cats bowl. He’s literally never done that before. Luckily; I switched his diet to the same thing after a Bailey s diagnosis. So it was friskies pate.

Now I’m back to having to wait an hour and 45 min. Ugh!!! I’m doing everything wrong! I almost have to laugh about it. Otherwise it’s going to get me feeling too down on myself

I’m literally going to wait and test and then give the shot if needed. Middle of the night here I come! I don’t care about the time. I can lower it 30 minutes every day until I’m back on schedule, right? So it will be an annoyance and inconvenient for a week. That’s ok. Better I’m tired during the week than risk his good numbers slipping away because I messed up. AGAIN!

Can you please give me guideline on what to do tonight since I’m assuming I’m the only one who’s crazy enough to stay awake all night? I’m working from home all week so it’s actually happening at the perfect time. I can make it work. I have to.

please confirm:
-what numbers do I skip?
-what numbers do I shoot?

I think you said to give 0.25 units if his numbers are how they’ve been around 120-140. You also said not to shoot if lower than 100. What about 101-119? What if it’s higher than 140 by a little? What if it’s higher by a lot?

I never thought this would be so much work. It’s like a full time job. One I probably should be fired from

 

I am not sure what time it is for you - are you on the West Coast?
I am in India so it's 11am for me, I will be around all night.

I still think you can skip another night and start tomorrow morning. Set an alarm, pick up all cat food and then test and shoot him two hours later.
His numbers are looking good so there is no harm in waiting another day!

And go easy on yourself! Adjusting to the routine of a diabetic cat does take getting used to. Hoping that it won't be for a long time for you and Bailey!

 

And....start a new post in the Lantus forum tomorrow morning. Thanks

 

I’m pretty determined to stay up and get this done tonight. The new PMPS would be in 1 hour and 20 minutes from now. I just had 2 cups of coffee. Chugged them actually. LOL.

I’m in the US, central time. It’s 12:45am. My new shot time is 2:00am. At this point, I can wait an hour. And then tomorrow I can do AMPS at 1:45pm and PMPS at 1:30, right? If I do this everyday I will be back on schedule in no time. I’ll feel much better than delaying this longer. I can handle tired.

would you like me to post the number tonight here or start a new thread?

I’m a little confused about posting in the Lantus forum. I don’t understand the titles and it seems strict over there. I don’t know understand how I post correctly in that forum. So I’m afraid to

 

Hi Kiera, I can tag @Bandit's Mom ( Bhooma ) for you
I can help you with how to post on the Lantus forum , it's easy
First you put the
Date, then Bailey, the AMPS- number
Then when you test after his AMPS you can add those tests on
I'll give you an EXAMPLE
9-9 Bailey AMPS-140. +2 130 +3. 120 and so on
You can continue posting his PMPS also
When you post on the Lantus always copy and paste your previous days post
where you would start to write something
Everyday you do a new thread (post)
Do you understand this
By the way Bailey is so darn adorable that face of his

 

Kiera if you ever need help you can always tag someone, look back and see you might have helped you before. To do this after the last word you type do a space then put @ and the first couple of letters of the person you want to tag and a drop box will come down then tap on the name
Example @Kiera always make sure it's blue when you tag

 

Hi! Thank you for the info! I’m not sure if you read the previous messages. I just tested now (2 hours after food). His PMPS is 110.
I have already skipped the last 6 cycles. Can you please recommend what I should do? Continue to skip or give a small dose? Like 0.25? I don’t know where these numbers are coming from without insulin. A month ago he was very high and exhibiting literally every symptom of diabetes. We did one curve at the vet and my doctor was considering increasing the dose! Glad I didn’t!

I have been giving 2u, twice a day and didn’t know about home testing.

I got very lucky and tested him just in time. It’s possible I was overdosing him and causing him to remain hypo for a few days. That’s when I started seeing him act strange and I knew something was wrong. I’m still having nightmares about it.

My knowledge on diabetes was less than zero. Plus, I trusted my vet. I didn’t consider he was putting my sweet boy in danger. I wasn’t even aware of hypo. So my vet really dropped the ball.

anyway, He was either on too high of a dose or he’s somehow already in remission or heading there… but I don’t know if I should be giving insulin or not. I don’t want these numbers to be temporary and go back to high again for stopping insulin too soon. Please help

 

I’ve only had help from this post so far. It’s my very first time making a thread.

 

Let me tag Bhooma for you I'm not experienced enough to give dosing advice
I know she's still up
@Bandit's Mom

 

Honestly you lost me. But I can read this again tomorrow when I can focus. It’s late

 

I figured she was busy because I didn’t get a response to my last message. She’s been very helpful and don’t want to keep bugging her…

 

She doesn't mind I'm sure. Hi Bhooma just in case she doesn't come I see she said in post #69 it would be ok to skip another night. So I would skip
@Bandit's Mom

 

I will have to skip if I don’t hear back soon. I’m already WAY past my normal shoot time. Hours. I decided it was worth it and I would slowly get back to schedule by 30 min every day. But now it’s getting close to the point of unmanageable. I’ll give it another 10 min. Thanks for your help!

 

Sorry. Only just seeing this. I don't mind. You can ask as many questions as you want. If you shoot, you would have to be up to test 4-5 hours after the shot.

Sorry I'm on my phone so keeping it brief. Also getting motion sick if I read when moving!

 

I would skip

 

No need to apologize. I guess I just don’t understand what my numbers mean. Should I shoot? Would you? These numbers seem good to me without insulin but am I wrong? I wish I knew the logic or how to interpret this stuff.

I can set an alarm and test again. I think. This is brand new to me so I’ve never tried in the middle of the night.

 

I would skip and start fresh in the morning

 

I’m worried that his numbers are only temporarily low because he was so low for the one day I know of and likely the two prior as well. If I’m understanding things right, he was very likely hypo and in the danger zone but I didn’t know. Could this be him still recovering from those days he spent in hypo?

while I’m on the subject, are there any complications from being in a hypo for a day or several days? He’s still been acting so lethargic. I may just be over analyzing things and seeing a problem that’s not really there because I’m paranoid.

I can’t help it! I just learned about all of this and it’s very scary to know I was putting his life at risk every day (totally clueless to it)

 

OK thank you. Are you suggesting that because of the time or because of his numbers? I’m willing to make the sacrifice and sleep a lot less this week until I’m back on schedule if needed. I was doing wrong by him for so long without knowing it. I’m trying to make it right

 

Please go to bed. Don't shoot. I will send you a long message answering all your questions in a bit. If you can set an alarm and pick up food in the morning.

 

Thanks Bhooma

 

I’m going to go back to my 11/11 schedule. So no need to set an alarm. I will take away food (from both cats—everyone suffers together LOL) 2 hours prior to AMPS.

I really appreciate you taking the time to answer my questions. I do have one other one question… If you don’t mind or even know. If you do, can you include it with your message later please?

I’m having issues with my other cat but it’s not related to diabetes. Are you familiar with a site as wonderful as this for other cat related health issues? I realize now that my vet is completely incompetent. Angry doesn’t even begin to cover how I feel about the horrible advice he gave me. Plus all the very important things he left out. I don’t even know what to do about it. I don’t trust anything he says about anything anymore. We are better off getting help from strangers.

I’m not one to stir up trouble but I’m worried he’s going to give the same horrible advice to other people about their cats after dx of diabetes and they can be killed as a result. It’s really bothering me…

Anyway, thank you so much for everything and I look forward to your message!

 

Thanks to both of you!

 

So here goes my magnum opus!

The normal numbers for blood sugar for cat is 50-100 mg/dl on a human meter. A cat is considered in remission when it's BG stays in the normal range without insulin for 2 weeks. While 100-120 is a just a little higher than normal, for a strong remission, you want numbers to be below 100 before you stop insulin.

The onset of Lantus is typically between +1 and +3 and then nadir between +4 and +6. We ask people to try and figure out (with tests) what their cat's behaviour on Lantus is - onset, nadir etc

Lantus is dosed twice a day with 12 hours between shots. You want to fix your shot time such that you can test till +2 wihout staying up late and on occasion (when the numbers dip lower) till +4 or even +6. If you shoot at 11am/11pm, you may be up most nights testing! Like I said earlier, most people shoot between 5am/pm and 8am/pm depending on their work schedules and whether they are night owls or early birds.

Lantus is a depot insulin and the depot take a few days to build and to empty. The 2U depot from giving shots twice a day could have affected his number for 3 days after you stopped. However, considering that he hasn't had insulin since the AM of 9/5, it is safe to say that his current numbers are not due to insulin or temporary. His numbers have come down due to a combination of a change to a low carb diet and possibly insulin for a month. It looks like he does need some more insulin support to get him into normal numbers (below 100) but we don't know how much.

The reason that diabetic cats feels lethargic/low energy when they first encounter lower numbers is because their bodies have gotten used to the higher numbers and normal numbers feel low - like a caffeine/sugar withdrawal. As they get used to lower/normal numbers they love them and start feeling crappy in higher numbers.

Both. His numbers are good enough that he won't suffer from another night without insulin and like I said earlier, you want to shoot at a time when you can get test up to as last as 4-5 hours after the shot without being up all night. Unless you are the kind who can nap between tests!

If you see this message earlier, I would suggest you shoot earlier so you are not up every night testing till atleast 1am. But if that works for you, it works for us!

If you could tell me what issues, I could you point you in that direction or connect you to someone here who can help.

 

For what it's worth, alot of vets don't know much about diabetes. They learn the basics in school and then learn the rest from diabetic food sales reps. I give him credit for recommending the switch to wet food. Alot of them just prescribe the dry diabetic kibble and insulin and send you on your way.

When I adopted Chucky, the shelter vet told me that he must eat the diabetic food for the rest of his life. She said to just give him insulin and to test his urine if I notice anything off. She did say that if his urine strip is negative, I should withhold insulin and bring him in for a curve, but she didn't explain hypoglycemia or how it happens and advised me against testing his blood at home when I asked.
I know she handles alot of difficult neglect cases at the shelter, so she's obviously a good vet in general. Just maybe not that good at diabetes lol.

If you've been happy with him until now, it may be worth it to talk to him about the stuff that you've learned. He may be receptive to the information, and as great as this forum is, it's ideal to also be in partnership with your vet on this journey. Also, it will help him do better with other diabetic cats that he may treat in the future.
But if he's not receptive to the new information, then you know you need a new vet.

Also fun fact - Kiera is getting her water from the food!!
It turns out that alot of cats who are on wet food don't really drink water. They can be fully hydrated on food that is 70% water, so when they have food that is upward of 80% water, that's plenty for them and they don't really feel the need to drink much, if at all. Especially if you add extra water to the food.

When I first got Chucky, he loved his water fountain but I probably haven't seen him drink from it or any of his supplemental bowls in a couple of weeks lol.

 

So it’s once again later it’s than I had hoped, but still manageable. I’ve been doing pretty good with BG tests but had a hard time this morning. Even after warming the ear, I wasn’t getting enough blood. I’m free handing and usually get it on the first or second try. After 4 failed attempts my cat was no longer having it and decided he was hiding from me after that.

finally got him to forgive me and retested without food. His AMPS is 117. It seems to be a little lower everyday (even without insulin). I have skipped the past 7 cycles.

Do I shoot 0.25u now? Do I need to post a new thread? I’m worried if I do that, people won’t know what’s been going on and it will get too confusing. Thoughts?

I suppose I will post a new thread as well, just in case I’m supposed to. Not sure how the rules work here or where I’m supposed to post though….

 

Thank you sooo much for the info! That was really helpful and I appreciate you taking the time to do it!

I did see your message a lot earlier but I failed to get his blood glucose test so it’s still 1:30. LOL. I’ve excepted the fact that there is a learning curve here and it’s going to take me a while to be able to do this at the time I want. Today I know what I did wrong so I should be fine for my next test. I’ve also made arrangements with work to allow myself to be home for most of the day for at least the next two weeks.

anyway, its 117. So I’m assuming I shoot 0.25 u? He won’t eat and I’ve been following him around with his bowl for the past 30 min. That’s just making it worse. I know he will eat within the next hour or 2. But he won’t eat on demand. I told you! It’s very frustrating. The only thing I can get him to eat right away is something I’m sure he shouldn’t be eating, like a couple teaspoons of skim milk or a tiny bit of cheese. That he will eat every time. Nothing else seems to work. Food with gravy I can probably get them to eat but that’s how I got into this mess in the first place probably.

For my other cat, you said you might know where to direct me for help. Should I send that in a private message so I don’t have off topic info posted on this site? I’m assuming that’s a no-no.

thanks again so much!!

 

He hasn't eaten in 2 hours? Maybe he will eat if you pretend you don't care?

Send me a private message.

 

I’m pretending not to care as we speak. For what it’s worth, I know if I leave him alone he will eat. Likely within the next hour. He typically eats 3-5 large bites every couple of hours. Sometimes more if he’s hungrier. I know he wants food because I took it away and saw him looking for it earlier. He’s just being a brat

 

Thank you! I will later this afternoon

 

How do you only respond to part of a message? I just tried but did it wrong.

 

He’s eating!!

 

You select the part you want to reply to and click on the reply button is black that pops up when you do.

Excellent! Super!