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JAAshwell

JAAshwell

Member Since 2015
Hi,

I'm Judy and live in Baltimore, MD. I have five cats and two dogs. Emmy was just diagnosed with diabetes at age 12, no ketone issues thank goodness. My burning question (oh I have thousands) is: How long does it take to regulate the BG level?

She's been on Lantus for three weeks - the first week at 2 units 2x a day now on 3 units 2x a day. Her BG was around 466 but when we moved up to 3 units she tested at 366. She eats wet food, mostly ProPlan which I have been been switching out for the Fancy Feast and other low carbs. The vet sent me home with Purina DM dry (the cats will not eat the wet, I tried). I will be cutting out the DM immediately after everything I have read here! I also have a cat with cardiomyopathy and he loves dry so this will be another challenge.

I've been having a lot of trouble with the Lantus pen versus the vial, etc. Everyone tells me something different, including vets in the same office, pharmacists at the same drug store, etc. We are going to start the vial tonight instead of the pen. I found the delivery from the pen with the needle tips to be suspect. It drips every time I give it to her -- is that normal?

We are trying one week at 3 units and then another blood glucose test. The vet is reluctant to try 4 units until we have a week using the vial under our belts. I have the equipment to do testing at home but right now I am completely traumatized by the whole thing and want to give it a week or two before I try learning that skill. I feel so much empathy with those of you who are new to this too. Although I am experienced with animal care, this has really turned my world upset down. We literally had to take the legs off our furniture so Em couldn't hide under the bed, etc. She's a bit of a drama queen. :-) Thank goodness my vet is staffed 24/7.

Thank you to all who maintain this site. I almost cried when I found it.

Judy
 
Welcome to FDMB, Judy, the best place you never wanted to be.

Tip 1: we take the pen cap and needle off and use a syringe to withdraw the insulin.

Regulation takes as long as it takes. Your cat didn't become a diabetic overnight; becoming regulated is likely to take a couple weeks to get everything into a safe, healthy pattern for your cat.
 
Yes, the dripping out the pen needle is normal that is why you are supposed to leave the needle in for at least about tens seconds before withdrawing it.
The drop missing not a concern fro humans who use large doses but is a concern for most cats which use small doses. Also, the pen only doses in 1-unit increments whereas many cats need fine dosing like in 1/4 unit increments. Thus, as BJM said, just draw the insulin out the end of the pen where the pen needle is inserted.
 
Hi

I really would advice from experienced forum members before increasing the lantus up to 3 units especially if you not testing Emmy at the moment and are changing to a lower carb wet food.

Cats tend to start on 1 unit twice a day and then increase in increments of 1/4 of a unit 0.25 to fine tune. The high results on the 2 units may be because Emmy is dropping hard and fast and then bouncing back up. Dosing is based on the lowest point that a cat goes in the cycle and you don't have enough. Data yet to make any changes.

Before you make any more changes please try to test her blood before the next shot and then during the cycle. I will be back to post up some links that may help you
 
Please hold off on any food changes until you are home testing. The amount of insulin can drop 1-2 units and the glucose can drop 100-200 mg/dL. If you don't know that has happened and adjust the insulin, your cat could wind up in hypoglycemia (too low glucose), which can kill quickly.
 
Hi Judy and sugar kitty Emma and welcome to the FDMB.

We surely would encourage you to post on the Feline Health (The Main Forum) with any questions you may have.

I second BJM's suggestions to hold off on the food changes until you home test. Take a peek at my Wink's SS in my signature. Click on Wink's SS and then select the tab for 2013. Look at late January - early February and you'll see how fast Wink was coming down the dosing scale during his transition from high carb dry to low carb wet food. If I had not be testing Wink, his BG levels would have dropped too low, resulting in possible seizures and death. Frankly, I should have been reducing his dose even faster, but was following the advice of the vet and shelter.
 
Hi and welcome

If you dont to mind I am linking another thread from a new members where advice was given about dosing lantus. If you skim down the page you will see that @Wendy&Neko and @Sienne and Gabby both gave advice about the recommended dosing regime.

Whilst every cat is different @Wendy&Neko talked about the starting dosing based upon weight:

We have two protocols used here for Lantus dosing. For the Tight Regulation protocol, we start cats on .25 units per kg of ideal weight, or actual weight if kitty is underweight. Since Rosa is 8.8 lbs (or 4 kg) that would be a starting dose of 1 unit. In the Start Low, Go Slow protocol, we start at 0.5 units if kitty has transitioned to wet food, 1.0 U if dry food is still in the picture. I would start with either 0.5 or 1.0 units as the dose tomorrow. Better too high for a day than too low for a minute.
Click to expand...

http://www.felinediabetes.com/FDMB/threads/fast-reaction-to-first-ever-shot.131577/

How much does Emmy weigh. For now if you are not testing I would leave dry food down so she can graze if her blood glucose drops too low.
 
Hi Judy and welcome to you and Emmy.

As BJ has advised above, regulation takes time. It isn't simply a question of adjusting dose, it will also take time for Emmy's body to get used to a given dose as I'm sure your vets have already explained (hence keeping the dose the same for several days and then reviewing Emmy's response).

I note that you're looking to switch to lower carb food. It is vital that you are home testing before reducing the number of carbs in Emmy's foods and it may be necessary to reduce the insulin dose when starting the transition. If, like many cats, she responds well to the carb reduction her blood glucose levels could drop a lot in which case the dose she is receiving may end up being too high, thus putting Emmy at risk of hypoglycaemia. Home testing will help you to keep her safe during the transition. Definitely discuss the diet change with your vet before starting, so that the vet can advise you on any dose adjustments that might be needed.

I also note that your vet has been increasing the dose in 1 IU increments. Adjusting doses in large jumps like that can result in the 'goldilocks' dose for a particular cat being missed. Ironically, both too little AND too much insulin may result in high numbers. Adjusting in smaller increments increases the likelihood of homing in on a good dose for your cat. Members here who are treating their cats with long-acting insulins such as Lantus usually follow either the published Tight Regulation protocol or the FDMB Start Low Go Slow protocol, both of which advocate dose adjustments of 0.25IU in the majority of cases. You can find out more about the protocols here. I suggest printing off copies of the protocols and discussing them with your vet. You can also get help with lots of your questions here by posting them in the main Feline Health forum.
 
Thank you all very much. I am really overwhelmed with all of the information - I'm trying to absorb, really I am! I guess I was sensing that my vet was unhappy that Emmy's BG hadn't dropped very much. She asked that I start the low carb. She says that the sooner you can get them regulated within the first few months of diagnosis the greater the chance of remission. Emmy weighs 16 and has lost 4 pounds in the past six months.

I observed one BG test and the tech used a needle to prick Emmy's ear, repeatedly, and then when she couldn't get enough blood, the other ear. I was not filled with confidence and joy. I have just gotten to the place where Emmy will stay in the same room with me (not a cooperative patient); I'm afraid if I start pricking her half a dozen times a day she won't come anywhere near me. I will see the vet again in a week and have them show me how to use my meter (yes, I was a dope and bought the special animal one for $70 from the vet). I wouldn't have an opportunity to do it myself until Saturday. I will hold off changing food and I will go over to the Feline Health Forum - I'm just trying to figure out the difference between this group and the FB group.

Thanks again, I really appreciate it.
 
Hi there. I only just started doing the home testing too. Make sure you have the 26 gauge lancets - I messed around for a full day with the smaller ones and couldn't get a single drop of blood out of Rosa's ear. The first time I tried with the 26 gauge, I got blood. With the right kit and lancet, I certainly haven't had to prick her ear repeatedly to get blood and I'm only just learning the procedure yet.

There are a lot of videos on Youtube showing exactly how people are getting enough blood to test - maybe try watching a couple of those so you can see step by step how it's done. Rosa was feral as a kitten and is always a pain about any sort of treatment...she's an expert at avoiding pill taking and I was dreading having to fight with her every time, but she's been great. Emmy might surprise you too - it really doesn't seem to hurt them much if at all. I've been giving Rosa a couple of low-carb treats to keep her occupied while I do the test as she hates being restrained - it makes her struggle - but she'll sit still for the test by herself if she's got something good to eat. I think the click from the pen bothers Rosa more than the lancet itself!
 
manxcat419 said:
Hi there. I only just started doing the home testing too. Make sure you have the 26 gauge lancets - I messed around for a full day with the smaller ones and couldn't get a single drop of blood out of Rosa's ear. The first time I tried with the 26 gauge, I got blood. With the right kit and lancet, I certainly haven't had to prick her ear repeatedly to get blood and I'm only just learning the procedure yet.

There are a lot of videos on Youtube showing exactly how people are getting enough blood to test - maybe try watching a couple of those so you can see step by step how it's done. Rosa was feral as a kitten and is always a pain about any sort of treatment...she's an expert at avoiding pill taking and I was dreading having to fight with her every time, but she's been great. Emmy might surprise you too - it really doesn't seem to hurt them much if at all. I've been giving Rosa a couple of low-carb treats to keep her occupied while I do the test as she hates being restrained - it makes her struggle - but she'll sit still for the test by herself if she's got something good to eat. I think the click from the pen bothers Rosa more than the lancet itself!
Click to expand...
Thank you!
 
You're very welcome. Like I said, I'm still learning everything myself, but the testing was worrying me too especially when I couldn't manage it at all with the smaller lancets - yet it turned out to be a breeze once I had the right equipment and information. :) Everyone here is great - I've had so much help already so only too happy to be able to pass along anything I can to help others.
 
Hi

I know all the information can be overwhelming but you are halfway there:) You have your cat on a good insulin and are thinking about hometesting and changing food. We are just concerned about not hometesting when the lantus dosage is high and then you are also thinking about swapping food.

The problem with just going on an occasional blood test from the vet is that cats can drop maybe 100 blood glucose points when they are home and not stressed. Swapping food to a low carb food can also drop they blood glucose in the same way. This will drop the amount of insulin they need and sometimes too much insulin can look on a blood glucose reading the same as too little. My cat started on less than one unit and only got up to 1.25 before his blood glucose readings told us he didn't need as much anymore.

Here is a link all about hometesting. http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

Once you get into the swing of it it really isn't as bad as you think. I have found that it is best to get all the meter ready, heat the ear with a rice sock and then using a big gauge lancet prick the ear and then gently apply pressure either side of the area you have pricked with your fingers.

Personally I would get a human glucometer as they are much cheaper to use every day. Perhaps keep the vet one (alphatrak ) for occasional use. Most people use the accu chek relion I think. Hopefully someone else will advise. It is recommended that you test before each insulin shot - so test, feed and then give insulin and then ideally once again in that 12 hour cycle. I know you work full time and do do I. I would make sure that I could test at shot time and then would get another test in an hour later before I went to work. I could get home at lunchtime sometimes and so would do it again then.

With regards the difference between fb and here. This forum is the main place for people to help and comment but I actually think @Critter Mom was referring to posting on the main part of this forum as more people check that section and you will get more answers.

I know its a lot of info but did you read those the link I sent before. There is some great info in it and links?
 
phlika29 said:
Hi

I know all the information can be overwhelming but you are halfway there:) You have your cat on a good insulin and are thinking about hometesting and changing food. We are just concerned about not hometesting when the lantus dosage is high and then you are also thinking about swapping food.

I know its a lot of info but did you read those the link I sent before. There is some great info in it and links?
Click to expand...

Hi - yes, thank you, I have read all the links and downloaded a lot of the information to read more slowly again and for reference. I need to document the chronology of Emmy's dx and treatment and then I will have next step questions I'm sure. I completely get the importance of hometesting - I can't stress enough how stressed out Emmy is right now. This morning was a "drag out from under the dining room table" morning. And even then I apparently screwed up the shot so I have to go over to Lantus to ask about that. She has been on 3 units 2x since one week after diagnosis, which is now either three or four weeks, and is still testing high. We have only changed out her dry food. Thanks again for all your help!
 
Hi Judy!

Just real quick....the difference between the FB group and here is that the FB group is more for "social" things, support and getting people started and over here on the message board.
Since Facebook is so popular, the message board has a group there so we can hopefully find as many sugarcat mom's and dad's as possible and get them the information they need to take care of their "extra sweet" kitty!

The message board is "peer reviewed", so you get the advantage of having lots of people watching out for you, offering their experience and advice. If someone were to give you unsafe advice, others would be able to explain why it was unsafe or explain what else might work better.

On Facebook, it's too easy for one person to "overtake" things, and you have no way of knowing if the person advising you knows what they're talking about or not. Here, you can go back and see how long someone's been here as well as see if they're active on the message board. Most people here who aren't comfortable giving advice will say that they're not, but will still offer you as much support as they can in other ways.

Very Happy to see you over here, and don't worry! It DOES get easier!! And the people here will be with you every step of the way!
 
JAAshwell said:
I give up. Where is the spreadsheet example? I'm at work and don't have all my bookmarks. Gracias.
Click to expand...

I was completely the same at the beginning I could never find the links I needed.
Here is the spreadsheet link.
http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/

As I am always reading on the forum this is not an event it is a process so please don't stress about trying to make everything perfect at once. You are already doing more than many people with diabetic cats by even considering home testing and diet change.
 
phlika29 said:
I was completely the same at the beginning I could never find the links I needed.
Here is the spreadsheet link.
http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/

As I am always reading on the forum this is not an event it is a process so please don't stress about trying to make everything perfect at once. You are already doing more than many people with diabetic cats by even considering home testing and diet change.
Click to expand...
Thank you, now I'm tearing up at work. I'll get it - My previous cats passed at 19, 17 and 16, I'm not letting Emmy go at 12! :-)
 
*HUGS* I know how you feel. I spent the first 2 days crying on everyone and everything in the house. And it still isn't taking much to send me over the edge with it into tears or panic or both. I agree, my Rosa is a couple of months from turning 12 herself and it is way too young to be going anywhere for a long time yet. We'll get there and get our kitties stable just like the other people here have - and we're being helped by their experience and all the great information they're giving us too. :)
 
Remeber to breathe!
Exhale first; you can't take a full breath in otherwise.
Slowly inhale.
Pause.
Exhale slowly and completely.
Continue for a good 15-20 minutes.
 
manxcat419 said:
*HUGS* I know how you feel. I spent the first 2 days crying on everyone and everything in the house. And it still isn't taking much to send me over the edge with it into tears or panic or both. I agree, my Rosa is a couple of months from turning 12 herself and it is way too young to be going anywhere for a long time yet. We'll get there and get our kitties stable just like the other people here have - and we're being helped by their experience and all the great information they're giving us too. :)
Click to expand...

I wanted you to be the first to know. I did it!!!!!! I got a BG test!!! It wasn't as horrible as I thought! Thanks so much for the "newbie" moral support!
 
YAY:):):)

Come on then don't keep us waiting ;)What was the result?

I think someone already explained

AMPS= am pre shot blood glucose result
+1 = means a blood test 1 hour after the shot
+2= means 2 hours after the shot
Etc

Don't forget to post it in your lantus thread.
 
Thank you. It was 423 -- this is with Em missing her morning shot; so I just made a note in the spreadsheet - didn't know how to show +24. I went to the vet and had them show me again and I came home, fed her a very light meal and then did the test. Shot isn't due until 7:30 ET; I will do another test right before bed. My vet and the techs there were very encouraging of me testing at home, so that was great. Thank you all, it's a weird thing to be happy about but I am. Going to Lantus thread.
 
That's great news. Well done - the first one is the hardest by far. Now you KNOW you can do it instead of just thinking you probably can! :D
 
Of yes ofcourse. Not sure how you best note that on the spread sheet but well done anyway. As everyone is on different time zones that is why we just put +1, +2, etc

So just to confirm you should try to get a test in before each insulin shot. This is how I did it. About 15 minutes before lantus shot was due I would test, I would then get my syringe ready, then put down the food, allow my cat to ear most or all of it and then give the insulin shot. Some people give the shot whilst their cat is eating and they hardly notice but remi would sometimes stop eating and so I would wait until afterwards. Then I would try to get another test at +2 (sometimes +1). You should ideally post the results in your lantus thread.

Then repeat in the evening. Ofcourse most people have more flexibility in the evening to get in different tests within the cycle.

As I work I found shooting at 6am and 6pm allowed me the time to get in a +1 or +2 in the am cycle and in the evening be able to test much later in the cycle if need be. Whatever works for you. If you do move the shooting time you must only do it 15 minutes per shot.
 
Congratulations to Judy on getting that first BG test on her extra sweet kitty Emmy.

Welcome to the Vampire Club!
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