Kathy's Cleo - 2nd Ever Lantus Cycle - Need Eyes Please!

Hi there, Cleo and I had an unfortunately eventful night last night with her first Lantus cycle at home. Thread is http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=74939

I was told to start up a new thread to figure out my next step this morning. Glucose level as of 7:30 AM is 219.

AMPS: 219

So the question is, what is my best path now? Do I give the insulin? If so, how much? Vet had directed 3U but that seemed too high and the too high guess seemed to be shown by Cleo's glucose levels dropping last night until we intervened and got some extra sugar into her...

[Edited subject line]

 

Re: Kathy's Cleo - Need Advice on Lantus Insulin this AM

Hi Kathy

You did brilliantly last night! Welcome back!

Since your (+11) and your AMPS are a surf rather than a rise or drop - can you feed, and stall the shot for a short while? I'd like to know that before I give you my thoughts on dosing.

I'm sure you've also re-checked the previous condo of yours, but just in case: Kathy & Cleo's Condo on 1st Ever Lantus Cycle

The suggestion there was go down to 1.0u, which (tentatively) I still think sounds right. BUT: first - can you feed and stall a bit? Hang on while I see if I see someone else that might have useful thoughts
Jane

 

Re: Kathy's Cleo - Need Advice on Lantus Insulin this AM

Hi Kathy & Welcome!

I read thru your yesterday's thread earlier & just saw your new thread here. You got some great advice yesterday & that is indeed what we do, handhold, & we are happy to do it.

I have 2 kitties on Lantus & tho I am not a dosing expert I have been doing this & been here since 2008 so do have a little experience. Now, that disclaimer having been said (i'm a paralegal, i have to do that, it's in my nature! :smile, if Cleo were one of my cats, & based on the info in yesterday's post, I would under NO circumstances whatsoever give 3u of insulin this morning, even with a ps (pre-shot) # of 219. Here's why:

She could still have some of that sugar (ice cream, syrup, etc.) in her system;
She could be bouncing off the low # of yesterday;
You don't have enough data to safely shoot 3u.

I honestly don't know what to tell you about how much to shoot, tho. If it were one of my cats, I would definitely shoot no more than 1u and in light of what happened yesterday I would probably start with .5u if I decided to shoot at all. I tend to err on the side of caution however and I might even skip the a.m. shot all together and just see where she is at pm time, but of course this can cause all kinds of dilemmas too b/c it could throw off your whole week with making decisions about whether or not to shoot b4 leaving for work.

If you decide to shoot, please make sure you are around to monitor Cleo today. & please don't shoot more than 1u.

You also need to think about your shot time schedule for the rest of the week, remember that Lantus is a 12 hr insulin so if you shoot at, say, 9 a.m. your time this morning that means you have to shoot at 9 p.m. tonight, then 9 a.m. again Monday morning, a work day. This is an incredible balancing act I well know.

Please don't misunderstand: I do not advocate skipping shots, but I do think you need more eyes. I will post a link to your thread here on the LL (Lantus Land) board & hopefully those much better at giving dosing advice will come & take a look.


Desi, Tinkerbell & Tawny

 

Re: Kathy's Cleo - Need Advice on Lantus Insulin this AM

Ah, ok, just got your message I can understand why you don't want to stall. But if you *could*, just 15 minutes, and get a rising number, it might just make for a bit less drama this cycle

Try not to worry so much about timing right now. We'll try to get you to the time you need for your weekly schedule as best we can, but first on the list is to keep you guys safe on a good dose, k?

Next important question, if you *can't* stall: Can you watch this cycle closely and test more if needed?
Jane

 

Re: Kathy's Cleo - Need Advice on Lantus Insulin this AM

Jane, you were posting while I was - a question: if she stalls but feeds won't the feeding throw off any preshot #? I would go with stalling but not feeding myself...what are your thoughts? ~ Desi

 

Re: Kathy's Cleo - Need Advice on Lantus Insulin this AM

Hi Desi, thanks for being here Just posted link to this (Kathy's) condo in Karre's daily thread over on LL, too.

Yes, feeding would "spike" the pre-shot. But a rising number with stalling & feeding is what we were advised a couple of times, back in 2008, when we were too skeered

Kathy, how's it looking? What are YOU comfortable shooting?
Jane

 

Re: Kathy's Cleo - Need Advice on Lantus Insulin this AM

Ok small update -

(+11 Hrs): 219
+11 Hrs - Gave breakfast (a little more than 1/2 a can of Purina DM)
(+12 Hrs): 230

Tentatively leaning toward giving 1U, per the advice on last night's thread. I can monitor her pretty closely today.

 

Re: Kathy's Cleo - Need Advice on Lantus Insulin this AM

Yup. I'd go with the 1.0u that we suggested earlier. You're there to watch. You got a tiny rise. It's a third of the prior dose. And you're not alone. I'd go ahead and shoot.

Have called for more eyes on this. But that's what I'd do.
Jane

Edited to add: Kathy, remember to make a note of your local time and any stalling time. If it's local time 8:30am for you now, note down that your AMPS was 15 mins later, ok? Helps everyone keep track. You're doing great. BOS coming out already!

 

Re: Kathy's Cleo - Need Advice on Lantus Insulin this AM

Thanks for the update Kathy, looks like you are just now at the +12 mark with the 230, is that right?

If so, one important thing to remember is that the 230 will have a food spike in it since you fed at +11.

How much longer can you stall and not throw off your whole work week shot schedule? I'm not asking bc her # is too low, but it might give you a little more time to get some more experienced eyes over here & give that food spike a little more time to come down...

 

Re: Kathy's Cleo - Need Advice on Lantus Insulin this AM

Desi, Kathy and her husband are trying to pull Cleo's shot time forward so that by the time the work week rolls round, they can soon get to a schedule that suits them - the current shot time would already throw them off a bit! Kathy said just now she doesn't really want to stall much more on account of that. I really wouldn't worry too much about the number being a little food-pushed. (Karre free-feeds and frequently eats close to pre-shot test time.) It was low-carb food, right? So the spike ought to be minimal.

It's a decent pre-shot. We're here, and Kathy will watch. I really am not too worried here.
Jane

 

Re: Kathy's Cleo - Need Advice on Lantus Insulin this AM

Alright, went ahead and administered 1U of Lantus at 8:30 AM PST. I will keep an eye on her and test at +2 and post.

Thanks again!

 

Re: Kathy's Cleo - Need Advice on Lantus Insulin this AM

Jane, thanks to you for being here for Kathy & Cleo too today & yesterday too!

Kathy, I agree with Jane insofar as if you are going to shoot this morning, shoot the 1u since you can monitor Cleo all day. You can always bring her back up like you did last night.

But if it throws your whole work week off, you could skip this morning, shoot the 1u (if warranted) earlier tonight than last night, say, 6 p.m. (which if you shot at 9p.m. last night would be +22 from Cleo's last shot), have several hours to monitor tonight b4 going to sleep, then be on track for 6 a.m. shots during the work week & maybe even have an hr or 2 to monitor b4 leaving for work. Again, I don't advocate skipping shots but if this morning's shot is going to throw off the next 5 days...well, sometimes you just gotta do what you gotta do.

If you can shoot this a.m. tho, go with the 1u like Jane said (& others yesterday). & post lots of #s today so we can help.

Desi

 

Re: Kathy's Cleo - Need Advice on Lantus Insulin this AM

Jane - Yes, it was low-carb wet food (it was the Purina DM). I have read it's not great long term, but so far of the low carb wet foods I've tried (Purina DM, Merrick Cowboy Cookout, Fancy Feast Classic Turkey and Giblets) it's the one Cleo seems most interested in.

 

Re: Kathy's Cleo - Need Advice on Lantus Insulin this AM

Jane, we were cross-posting again, I agree with you 100% & suspected from Kathy's yesterday's posts that their work week schedule was a consideration.

Kathy, I'm glad you went ahead with the 1u. It will give you a good chance to get some good data today. Jane is right about the food spike not being a major consideration here also, Tinkerbell & Tawny often get free fed during the work day & sometimes I get home at exactly the 12-hr mark, test, feed & shoot & therefore have no idea if there is a food spike affecting their #s or not.

You are doing great!!!!!

 

Re: Kathy's Cleo - Need Advice on Lantus Insulin this AM

Woohoo! BOS, Kathy! Good girl!! Keep it up.

I know where you're coming from, Desi I also prefer to err on the side of caution! I'm glad Kathy didn't skip the shot, all the same - she can handle this, and she's got help

LC wetfood is fine - we're not so worried about the brand just now. Yes, in the long run, we'll try to see if Cleo will accept the healthiest-possible choices. But for now, as long as you've got a selection of LC wet, HC wet, and the emergency karo etc., we're happy

 

Re: Kathy's Cleo - Need Advice on Lantus Insulin this AM

Kathy (and everyone following), here is the sequence from yesterday, and the start of today's cycle:

Cleo's First-EVER Lantus-Cycle (Starting Time = Unknown PMPS = 8:15pm Local Time) - 14th July
1.75hours before PMPS: BG 161
0.75 hours before PMPS: Fed.
PMPS - Not tested. --- 3u Lantus shot (Vet's Request).
(+2.25) 84
(+3.25) 69
(+3.75) Fed tiny bit karo and 2 tsp ice cream.
(+4) 58 --- This was 12:15am Local Time.
ca. (+4.25) Fed 1/4 tsp honey and 1.5ml maple syrup.
(+4.5) 106
(+4.75) gave about 1 tbsp. ice cream
(+5) 177
(+5.5) gave 1/3 can of Purina DM
(+6) 249

Cleo-s 2nd-EVER Lantus Cycle, 15th July
(+11) 219 --- Fed Breakfast (1/2 can Purina DM)
(+12) 219 --- Stalled 15 minutes
AMPS 230 --- Shot 1.0u

Kathy, do you know how to edit thread titles? It might be a good idea to add a symbol, maybe a star, to attract attention, and to change to the thread title to something like: "Kathy's Cleo (NEWBIE), 2nd-Ever Lantus Dose: Need Eyes" Or something Might be more take-notice.

 

Re: Kathy's Cleo - Need Advice on Lantus Insulin this AM

Jane, wasn't 7/15's amps 230???

 

Re: Kathy's Cleo - Need Advice on Lantus Insulin this AM

Phew! Thanks for that Desi! All fixed

 

Re: Kathy's Cleo - Need Advice on Lantus Insulin this AM

Terrific job so far, Kathy! Great BOS

Is there anything you'd like to discuss, in the lull between tests now? Have you got thoughts on which (+ Hour) tests you want to get, for instance?

Also - assuming the cycle today doesn't give you quite as much drama - Do you think you might be able to try setting up a spreadsheet today? We would give you any help we can, of course - I'm just thinking, since tomorrow is Monday, if you have a busy workweek coming up, today might be a good opportunity to make sure you have the best way to log all your data... Let us know what you think. If you want to try setting the SS up, we'll send you the links etc. that you need. If you did find some way to do it today, it'd also make for the least amount of "combing through past threads for data", which, trust me, takes quite some time

Let us know if there's anything else you need right now, k? It's 630pm here for me, so I can stay with you for a few hours yet (though I might take a break for dinner, but thank goodness for the iphone). You're doing incredibly well, congrats on shooting, again!

Jane

 

Re: Kathy's Cleo - Need Advice on Lantus Insulin this AM

Good morning Kathy!

(Hi Jane too) :smile:

Just like I figured, the troops were all here to help first thing this morning, and it looks like everything is going well so far. I'll be around if needed, but most of the help is coming from people who understand Lantus a lot better than I do, so I'll be watching and learning right along with you.

Carl

 

Re: Kathy's Cleo - Need Advice on Lantus Insulin this AM

Hi Carl, nice to see you checking in Kathy is doing fabulously! Thanks for being around, and for your support last night! Jane

 

Alrighty, thanks for all the input this morning all!

I am calling around to find a vet who has some in depth knowledge of feline diabetes in my area... good luck to me with that, especially on a Sunday morning! We'll see what I can turn up.

In the meantime, Jane you brought up tons of great questions!

Yes, I was debating between doing tests every 2 hours for this cycle or every 3, especially since I will need to run out to pick up a few things (low carb cat treats, a back up package of test strips and lancets, and insulin syringes, since I could not get those yesterday without a prescription). My vet only gave me 2 syringes to take home, so I need to pick up more today to be able to give any insulin tonight or tomorrow AM. Anyhow, every +2 this cycle, or every +3 do you think? (assuming everything looks good and we don't get any scares like last night).

I'm totally open to setting up a SS today. I have one started already on my computer, but not on Google docs or whatever you guys have found best to share the SS publicly. Also, I doubt I have it in the best format. I was thinking of re-aligning my data to be a bit more like how you've been having me post the timelines. I'd love help getting that started.

 

Re: Kathy's Cleo - Need Advice on Lantus Insulin this AM

Good morning! I hope you got some decent sleep after all the excitement last night. Nice shooting this morning! You are official!



While you have time today look through the food lists and go out to get some medium carb ()10% - 15%) and High carb (16% and up) food to deal with the lows if they come again. I know you didn't have any last night. It's always good to be prepared. I'm surprised that Cleo is eating the DM, most cats hate it. One brand you didn't mention is Wellness. Most of their grain free line is about 4% (Turkey, Chicken Chicken & Beef). They also had food in pouches w lots of gravy. That's what I use for Tess when i need to feed a higher carb food to get her up. It's pretty easy to strain the gravy out for a boost up.

If you need to buy syringes it helps to get the ones w/ half unit markings, I think Walmart Relion are they only ones usually available in stores. I'd call to see if your local Walmart has the. You shouldn't need a Rx in CA. If not CVS has sold me packets of 10 syringes for about $4, pricy but it will tide you over until you can order a box. Most of us get them online, lots cheaper.

 

I would get a +2 test (test 2 hours after you shot) and then a +5 unless the +2 dictates testing sooner. If all looks good, you can then continue to test every 3 hours.

Here's the link for the spreadsheet we all use: FDMB spreadsheet. The instructions for attaching the spreadsheet to your signature are also included.

 

Ok, here we go On the testing this cycle: Since we can't be totally sure of when onset really hits home for Cleo, but it doesn't look like she's a very-earky-onset kitty, *and* she's "only" on 1.0u this cycle, I think you could be ok with skipping the (+1) and getting the (+2) instead, if you wanted to use that time to go buy supplies For the record, if it was me, I'd get both the (+1) and the (+2) and then see if it was ok to wait until (+4) - but I'm a chicken More data = more safe advice, of course. But that's how I'd assess this, for this cycle. Then, once you're around (+4), you'll just have to make it dependent on her numbers. Thank heavens it's SUnday and you can watch! Good timing, Cleo!

Next, the SS. The links I have from the Tech Help Forum. How to start a spreadsheet on googledocs and publish it in your FDMB signature:
http://www.felinediabetes.com/FDMB/view ... =6&t=18207

Another few links (in the few non-testing hours you'll hopefully get today) to help you work the ins and outs of FDMB as you're setting up:

FDMB Frequently Asked Questions for when you’re just starting out:
http://binkyspage.tripod.com/faq.html
A glossary for the jargon often used on FDMB:
viewtopic.php?f=25&t=19609
How to create and publish your FDMB profile:
http://www.felinediabetes.com/FDMB/view ... =6&t=17766
Another thread to help with signatures, links, avatar photos and so on:
http://www.felinediabetes.com/FDMB/view ... ?f=6&t=486
Info on how to educate your vet:
http://www.felinediabetes.com/FDMB/view ... =14&t=2508

NO NEED to go through all these right now, please don't feel overrun, ok? Just so you've got them So, if that SS-Help link does indeed help you, great. If not, let us know, so we can find others that will. We are on Googledocs with Karre, and there are several templates available that you can use --- DOES ANYONE HAVE THE LINKS TO THOSE? --- And Karre's SS isn't exactly standard, so not the best to use as a guide, sorry! Still: See how far you get with the Tech Forum link, ok? Then, if you need more help, post back here, and we'll find it for you. It's great that you've been logging all the data. The "Remarks" section on an SS is really useful for those just trying to "read their way in" to Cleo's story and progress. (That's one thing we love about Karre's SS - detailled remarks

Right. Hope this helps already. See how you go with this new info, and post back for whatever else you need, alright?
Jane
P.S. SOrry about all the typoes. Trying to type fast

 

https://drive.google.com/templates?q=fdmb&sort=hottest&view=public
I think you have to have an account at google docs before you can search for templates, but when I search the templates for "fdmb", that is what comes up.

Carl

 

Good point Carl! Yes, I believe on has to have a google account. We just got the standard "gmail" email account to join, and then we could go straight on to set up the SS.
Jane

 

Ok, here's the timeline with the latest:

Cleo's First-EVER Lantus-Cycle (Starting Time = Unknown PMPS = 8:15pm Local Time) - 14th July
1.75hours before PMPS: BG 161
0.75 hours before PMPS: Fed.
PMPS - Not tested. --- 3u Lantus shot (Vet's Request).
(+2.25) 84
(+3.25) 69
(+3.75) Fed tiny bit karo and 2 tsp ice cream.
(+4) 58 --- This was 12:15am Local Time.
ca. (+4.25) Fed 1/4 tsp honey and 1.5ml maple syrup.
(+4.5) 106
(+4.75) gave about 1 tbsp. ice cream
(+5) 177
(+5.5) gave 1/3 can of Purina DM
(+6) 249

Cleo-s 2nd-EVER Lantus Cycle, 15th July
(+11) 219 --- Fed Breakfast (1/2 can Purina DM)
(+12) 230 --- Stalled 15 minutes
AMPS 230 --- Shot 1.0u
(+2) 211

So, we're still high, but not horribly so and not swinging as wildly as last cycle. I will test again at +4 since she seems happy and stable at the moment.

I'm planning to work on the spreadsheet next and then I'll go out for my errands after the +4 test.

 

Nothing unexpected here. That's great, Kathy! He'll probably be coming into Lantus-Onset nowl, which is fine since he has a beautiful cushion with that (+2) number. Good luck working on the SS, and shout if you need some input.

If you're comfortable, I'd go and have dinner now, and I'll be back in an hour. But I have my iphone with me and will be checking in, if there's something urgent just post, ok? You're doing a terrific job.
Jane

 

Thanks for all the support Jane! I think all is quiet on the Western Front at the moment, so please go enjoy your dinner!!

 

Hi Kathy, what an exciting condo and amazing help. You're doing great! I was waiting for a little break before I posted on the meter situation. If you're comfortable using the Relion Confirm, I'd stick with it. Ann & Tess asked me to comment on the meters. I know my Vet feels the same way as yours in his preference to the animal meter. I think it's great he referred you to this site for info and help. I've used the ATrak since early 2010, but just switched over to the Relion Confirm yesterday. Abbott just recently came out with a new updated AT meter, and I find it reads even higher than my old meter. It also just got to be too much financially for me. I think the meter might cost around $200 from the Vet; I'm not positive. If you're testing a lot, it's just so expensive with the strips and why most here use the human meter. I was going to send a link of the U. of Queensland protocol that discusses the animal meter and human meter for you to show your Vet, but I read in one of your posts that you're looking for a second opinion Vet. If you have more questions on the AT, let me know. I've been following your condo. Enjoy your dinner.

ETA: Thought I would send the link anyway where both meters are discussed., first page.
http://felinediabetes.com/Roomp_Rand_2008 dosing_testing protocol.pdf

 

Just got the info from the vet's office about the readings they got on the mini-curve they had her for and I filled them in on the SS. Also talked to a very nice vet who is on duty today who seems way more interested and supportive of home testing and absolutely backed all of your advice on treating the low blood sugar last night and dropping to 1U today. Very pleased with my chat with the 2nd vet at the office. She is also willing to work with me via email and look at my spread sheet etc, so this is great news!

I also have all the info in the FDMB template SS and it's attached in my signature. Please let me know if it looks like I've got it working right and you can access the info!

 

Kathy,
Your SS is working perfectly. Good job getting it set up so quickly!
I'm thinking if we'd had access to those vet curve numbers last night, the evening may have been a little bit less hectic. ;-)
Carl

 

Kathy, you're a star! The SS works fine for me and I'm sure will for the others. Fantastic work! And congrats on Vet #2!! Sounds VERY promising!

Terrific progress.

Ok. What's next on your mind?
Jane

 

Ok, +4 was 241, so actually up a bit. Talked to another vet at my vet's office (liked her more than who I'd been seeing actually) and she said from the info so far, she thought Cleo might be a late nadir cat, so it's not entirely surprising that her glucose level is still pretty high. Also, we had a bit of a fight to get the sample for +4, so we might have had a bit of a stress spike.

SS is updated.

 

Wow, great that your vet is trying to think outside the box! Really great! It might be a tiny bit early to deduce patterns after a cycle and a half But it's good to see a vet trying hard to consider Cleo as an individual and her relationship to Lantus just as individual! Very promising!

It's no big surprise to have Cleo be a bit high this cycle. The effects of the last one may take a bit to clear. No stress. And yes, if Cleo was annoyed at the testing process, that can have added to a spike. Again - nothing unexpected. You're both still adjusting.

You're doing great. From what you've seen of the cycle so far, how do you feel about the 1.0u? Good feelings for the PM cycle? You've earned some good feelings!

You could start considering joining the LL forum, too, to post your daily condo there. There are two for Lantus/Levemir insulins. One is for those doing TR (tight regulation). We post there. And there is one called Relaxed Lantus, for those who can't or prefer not to watch the cycles and numbers quite so closely. Have a browse over there on the LL groups, if you feel ready. We'd love to welcome you there too

Post-dinner tea brewing
Jane

 

Kathy,
From yesterday's AM cycle, I can see where they might draw that conclusion. If that is so, you'll see that pattern develop over multiple cycles on Lantus. Way too early though to draw any conclusions.

Carl

 

Catching up on things here, and very glad Cleo's BG didn't go any lower, and very glad you seem to have found a better vet. Hope to see you over in Lantus Land shortly.

MJ

 

Hi, Kathy,

I live about 20 miles away from you. I also use Lantus Solostar Pens, and the Relion meter from Wal-Mart.

I'm sorry to see that you had such a bad night last night. I just got home from a two week trip Friday night, and I'm checking the board for the first time today. It just goes to show what a wonder this board is that you had people from all over the country helping you keep on top of the situation last night. Thank goodness you were testing. I wish I had been in a position to help you, but at least now you know how to handle a hypo.

I'm glad to see that you have a vet at the same office you were using who appears to be more knowledgeable and reasonable. We continue to see the same story on this board over and over with cats being overdosed by vets who would lose their licenses to practice medicine if they did the same thing with a human child. I just can't fully understand it except that they must not be diabetics themselves, and aren't aware of the dangers. As you can imagine, there have been tragedies because of these mistakes, and that is one of the main reasons why FDMB exists.

I have been dealing with a difficult case of diabetes for my 16 year old cat since February, and we are finally seeing good numbers consistently. It has been very challenging, but certainly worth it to see him feeling so much better.

You are welcome to Private Message me if you need to. If there is anything (not in conflict with the policies of the board) I can do to help you, please feel free to ask. (There is a board policy against giving advice "off board." We like for all members of the board to see the advice that is being given and have the opportunity to chime in if they disagree. It's a type of peer review policy.)

Good luck today, and I hope you can relax a little now.

 

Kathy, it looks like you've got reinforcements arriving It's getting late down here in Africa, so I'll be moving towards bed now, hope that's ok with you!
Keep breathing and remind yourself how tremendously well you've done fo far! Cleo is very lucky to have you! I'm sure you'll have a good handle on how to deal with her FD very soon, and then hopefully, you'll soon start seeing great progress!

Think about the Lantus-specific groups, ok? They're worth checking out (and into) I'm glad you've had a response from someone even living so close to you! (Hi Dale! Thanks for stopping in!)

I'll be back to check on how you're doing tomorrow morning (same time-ish as today), alright? If something crops up in the meantime, I'm certain you'll have plenty of support.
See you tomorrow!
Jane

 

Goodnight, Jane!
Off to a well-deserved and hopefully peaceful night's rest. :smile:

Carl

 

Holding pretty steady! We're at 235 at +6. SS is updated. We ended up having lunch out so now we're headed to get some more supplies. Back in a bit. Thank you, as always, for all the coaching. Enjoy your hard-earned rest Jane!!

And yes, will be posting tomorrow, a bit earlier. Plan is to try to move back to say shot at 7:45 AM - as late as I can push it during the week.

 

Nice to see your SS up, good work. You can keep pushing the shot time earlier every cycle and soon you will be at a time that works for you.

An important thing to remember about Lantus is that not all of the dose is immediately available. There is a reserve or shed built up that is slowly released over time. That is why we were so worried about the response last night after only 2 shots. It usually takes 5 to 7 days for the shed to stabilize and to start seeing consistent results. So don't worry if the numbers are wonky this first week. Also since you changed dose this morning, that restarts the shed countdown. Another factor that may have been an influence last night was that you said that Cleo didn't eat at the vet, that combined w/ the high dose multiplied her reaction. Vet stress _ not eating is a really good reason to do your own curves at home. Plus saving a lot of money.

Do come over and at least check out the Lantus forums. There are a lot of stickies (permanent posts) at the top of the list that have a wealth of information that are worth reading. It is a ton to get through at first, don't try to take it in all at once, absorb what you can and then reread again later.

The new vet sounds good, it is also great that they have someone there on Sunday.

I know we may seem to come down on them sometimes, but like human doctors they are not infallible. We question our doctors about treatments and research alternatives. Don't feel intimidated by the white coat. Vets have to know how to care for numerous animals, trauma as well as diseases. They get a day or less on feline nutrition and even less on diabetes. You are Cleo's advocate, it is your place to make sure they are doing the best things for her.

Our first vet only lasted a weekend and that long because he was closed Saturday as well as Sunday. :evil: He sold us an insulin that had an FDA warning out and the mfg had issued a release instructing vet to discontinue use! So do i trust everything a vet says implicitly? NO, but if you can sow sound reasoning and research behind your questions and opinions they will respect you for it and hopefully work with you for Cleo's well being. I hope this other vet is open anflexible enough not to be threatened by a client who cares enough to help her learn.

My first cat was named Cleo, I still miss her after 15 years!

 

+8 is 197, all updated on the SS. So a bit of a drop from our +6 number, but nothing that worries me at this point. She seems to be doing pretty well, though she's giving me a little of the cold shoulder and sulking under the guest bed at the moment. I have returned with more freeze dried turkey treats for her to hopefully convince her that ear pricks are good because they lead to treats...

I will be trying to adjust her insulin shot times up 15-20 min at a time to get us to a comfortable time. It shouldn't take too long to get there because we're not *that* far off at the moment.

Ann, thank you for the encouragement to visit the Lantus boards. I had seen that newbies were encouraged to stick to the main forum for a bit before diving into the other forums.

Oh, also to clarify about our scary 1st night - Cleo didn't eat at the vet's, but she did eat at home, both in the morning before I took her to the vet for the first insulin shot, and then she ate dinner at home too, before I gave her the evening insulin. The vet had said not to give her the insulin if she didn't eat, but she ate a full meal so I had gone ahead with the insulin shot.

I know someone earlier had mentioned there were two different sections/types of the Lantus forums - tight regulation and loose? I'm guessing for the moment I need to be in the loose section until we get more of a feel for how Cleo does with the Lantus and we have a few weeks of her processing it in her system?

 

Kathy,
Check out both forums before migrating. The TR forum is the busiest forum on the board, and people seem to be there 24/7. Whether you follow the Tight Regulation protocol or not, you can post in either place.

Carl

 

Great, thanks Carl!! I will check it out.

 

+10 is at 236. Pretty level all day really, just high, but level.

Going to be giving Cleo her dinner in a little less than an hour and then do another test for the PMPS level. Planning to give 1U tonight assuming her level is about the same at the PMPS test.

Hurrah for a drama-free day!

 

Edited - got her to eat 1/3 of dinner and confident she will snack up the rest in the next couple hours. Gave 1U Lantus and will do 2 more tests before bed.

 

Good! Tonight was supposed to be drama-free Sunday. :smile:
I was going to suggest that as long as you felt you could convince her to eat, even after the shot, you would have been okay. But that's an "iffy" thing, especially after last night's events. Glad to see she decided she was a little bit hungry.

Carl

 

+2 for the PM dose and we're at 197. I'll do one more before going to sleep, but so far today has been far less full of the dramas!! Woohoo.

 

Good morning Kathy!

Considering Cleo's dramatic start on Lantus, this really was a perfectly fine cycle. Well done on shooting and staying so calm

Speaking of which: You mentioned seeing that newbies are encouraged to post on Health first, until they get "situated", set up with their SS, and familiar with the jargon and theory behind using whatever insulin they give their cat. The reason I suggested you come and look at the Lantus group(s) is that you've adjusted incredibly well and very quickly indeed. SS - check. Better vet - check. Better dose - check. Fantastic!

The TR (tight regulation) group bases its workings, as its name suggests, on regulating the cat's BG and dosing quite strictly. (You'll be able to pick up the difference in style to the "Relaxed Lantus" group once you've browed around and compared a bit.) On TR, it's not as much to do with how definite your feel is of how Cleo deals with Lantus, but more about how closely you'll be watching as she develops, and how you're going to make your dosing decisions. Our suggestion to reduce to 1.0u, for instance, was based on a specific set of guideline for dosing (called the Roomp/Rand-Protocol - here is one of the links posted earlier explaining a bit about that: Tilly's Diabetes Homepage). You remember - 0.25u per kilo of ideal weight. We'll watch how Cleo does progress, of course. But to me, it sounds like the TR Lantus forum might suit you quite well, given how your own progress has been and what your style in regulating Cleo seems to be showing so far.

Browse them both, if you like. You might find you feel comfortable in one of them right away. Or, of course, you start in one and change to the other if you like. Karre and I (and Jack, my husband) are based in the TR forum, but if you did decide after all that you would like to post in the other Lantus group, I'll still check in on you there too of course As will others.

I'll look around for your morning condo now!
Jane

 

Very nice (+2) there, too! Great job!

 

At +4 on the evening cycle she's at 174 - nice and stable. I can go to bed unworried tonight

Planning to do another 1U of insulin at around 7:45 AM PST tomorrow assuming numbers are looking good and she eats!

 

Looking great! Enjoy your unworried sleepus, Kathy

Sticking to the dose sounds like the right plan, I agree. I remember you mentioning that you knew not to move shot time by more than about 15 minutes, which is great - best to stay as safe as possible. I'm sure you'll soon be at your desired shot time.

Looking forward to your next condo!
Jane

 

I think we're looking good again this morning!

The +10 from last night's PM was 199, and then after eating breakfast our AMPS is 219... went ahead and gave 1U of Lantus. I waited as long as possible to give the insulin, so we have an adjustment back of about 20 min. Best I can do.

Should I start a new thread for each day, and here or in the Lantus area? Just not sure how you guys prefer it... SS is updated! Unfortunately, today is a work day, so I can't do as many checks on her today.

 

Hi Kathy! Lovely AMPS Cleo's looking great.

It's less confusing when there's a daily condo, so I'd open a new one for today. Remember to link to yesterday's. I'd love to see you posting in Lantus already! A few folks are aware of you and Cleo already, and I'm sure they'd all be pleased to welcome you too. It's up to you, but I personally think you're ready for Lantus-specific condos

Jane

 

Yes, come on over to Lantus Land http://www.felinediabetes.com/FDMB/viewforum.php?f=9
And we await a photo of the now famous Cleo.

MJ

 

Ok, ok!! I listened - we're over in LL now.

Here's a link to today's condo: viewtopic.php?f=9&t=75121