Glen's mom

[Islandmomma]

My almost 12 year old was just diagnosed. I am so mad at myself for not spotting the sign s sooner
Glen is a big boy at 7.3kg. He has lost a bit of wait over the last couple of weeks. He has started on 2 u if lantus twice a day. We just started on Thursday. I'm a nurse so not having too many issues with glucose monitoring or giving him his insulin. Yesterday he didn't eat that much and his BG was 3.1 at one reading. I cut his evening and morning insulin in 1/2 (as the vet told me if he didn't eat very much) but today he had a reading of 20.4 about 2.5 hours after injection.

I've gone ahead and given him the full dose tonight so hoping he stabilizes tomorrow.

I am only feeding Glen wet food. Interestingly he quit kibble himself a few days ago. Not too sure what that is all about.

Anyways,I just wanted to say hi from British Columbia, Canada

I am really enjoying all the info available on this forum...

Tammy

 

[MrWorfMen's Mom]

Hi Tammy and Glen and welcome to FDMB from a fellow Canadian and fellow nurse (albeit retired) in Ontario. You've come to the right place for all the help you need to get Glen on the road to regulation and with a bit of luck maybe remission. The amount of knowledge for all things feline on this board is nothing short of amazing and it's a very friendly community.

Like you I kicked myself for not noticing the signs soon enough too. The signs are often subtle and difficult to spot when you are with kitty everyday and even more so in a multi cat household. The signs sneak up on you until one day it becomes clear there is a problem.

For any health questions, you can post in the Health Forum where there is far more traffic and you'll get lots of responses. Normally we don't deal with anything but very general questions here as we are a peer reviewed board and this board is just for initial howdy do's. That said I do want to bring a couple of things to your attention.

2u of insulin is a bit higher than we would normally start a cat on. Usually 0.5 to 1u is recommended. We strongly advocate home testing and I am so glad you are doing so. That is the key to keeping Glen safe. I also see you or should I say Glen, changed his diet to all wet just recently. Withdrawing the dry food can substantially lower BG and in some lucky cases can even be the ticket to remission. The diet change is no doubt contributing to the dip in his BG to 3.1. What kind of meter are you using.....human or pet? On a pet meter a reading of 3.8 is your warning to intervene with food to raise BG. On a human meter that warning reading would be 2.8.

The problem with the 2u dose is that the vet suggested is that it's based on readings taken in the vet's office which are usually elevated and in some cats that elevation can be as much as 5mmol and sometimes more. It's very important that you monitor Glen's BG very closely as that 3.1 reading is likely an indication the dose is too high particularly now that he has decided the dry food is not his cup of tea. With our protocol here, and use of a pet meter, that reading would have earned Glen a dose reduction.

As you know the body has a defense system to overcome low BG and the higher reading of 20.4 could be a bounce (rising of BG following BG that has gone too low or lower than the cat is now use to) because Glen's defense's got turned on to raise low numbers. It's imperative to check his BG before every shot and no food should be given for at least 2 hours prior to doing the pre-shot test. This will tell you if it safe to give insulin. We also test mid cycle to determine how low a dose of insulin is taking the cat and dose is determined by that lowest reading. With Lantus the nadir usually occurs between +4 and +8 hours post shot.

If I am understanding correctly and you just restarted the full 2u dose tonight, I would urge you to keep an eye on Glen, monitoring his BG to ensure he does not dip too low. A bounce, if that's what you are seeing can take up to 3 days (3 cycles to clear) but they can clear much faster for some cats. I also suggest you take advantage of the spreadsheet we use here to track our kitties BG readings. The instructions are HERE and THIS document explains how to use it.

Please come join us over on the HEALTH board and ask any and all questions you might have. I'll be watching for you!

 

[Islandmomma]

Hi Tammy and Glen and welcome to FDMB from a fellow Canadian and fellow nurse (albeit retired) in Ontario. You've come to the right place for all the help you need to get Glen on the road to regulation and with a bit of luck maybe remission. The amount of knowledge for all things feline on this board is nothing short of amazing and it's a very friendly community.

Like you I kicked myself for not noticing the signs soon enough too. The signs are often subtle and difficult to spot when you are with kitty everyday and even more so in a multi cat household. The signs sneak up on you until one day it becomes clear there is a problem.

For any health questions, you can post in the Health Forum where there is far more traffic and you'll get lots of responses. Normally we don't deal with anything but very general questions here as we are a peer reviewed board and this board is just for initial howdy do's. That said I do want to bring a couple of things to your attention.

2u of insulin is a bit higher than we would normally start a cat on. Usually 0.5 to 1u is recommended. We strongly advocate home testing and I am so glad you are doing so. That is the key to keeping Glen safe. I also see you or should I say Glen, changed his diet to all wet just recently. Withdrawing the dry food can substantially lower BG and in some lucky cases can even be the ticket to remission. The diet change is no doubt contributing to the dip in his BG to 3.1. What kind of meter are you using.....human or pet? On a pet meter a reading of 3.8 is your warning to intervene with food to raise BG. On a human meter that warning reading would be 2.8.

The problem with the 2u dose is that the vet suggested is that it's based on readings taken in the vet's office which are usually elevated and in some cats that elevation can be as much as 5mmol and sometimes more. It's very important that you monitor Glen's BG very closely as that 3.1 reading is likely an indication the dose is too high particularly now that he has decided the dry food is not his cup of tea. With our protocol here, and use of a pet meter, that reading would have earned Glen a dose reduction.

As you know the body has a defense system to overcome low BG and the higher reading of 20.4 could be a bounce (rising of BG following BG that has gone too low or lower than the cat is now use to) because Glen's defense's got turned on to raise low numbers. It's imperative to check his BG before every shot and no food should be given for at least 2 hours prior to doing the pre-shot test. This will tell you if it safe to give insulin. We also test mid cycle to determine how low a dose of insulin is taking the cat and dose is determined by that lowest reading. With Lantus the nadir usually occurs between +4 and +8 hours post shot.

If I am understanding correctly and you just restarted the full 2u dose tonight, I would urge you to keep an eye on Glen, monitoring his BG to ensure he does not dip too low. A bounce, if that's what you are seeing can take up to 3 days (3 cycles to clear) but they can clear much faster for some cats. I also suggest you take advantage of the spreadsheet we use here to track our kitties BG readings. The instructions are HERE and THIS document explains how to use it.

Please come join us over on the HEALTH board and ask any and all questions you might have. I'll be watching for you!

Thank you so much!
I am using a human meter. My vet wants me to buy a pet meter of course but I'm not. He was at the vet all day Thursday when he started lantus and they used both my meter and theirs and said that mine was inaccurate.

I have 2 meters: Freestyle and Onetouch. I tested them both on my non-diabetic cat and got 3.6 & 4.0 respectively. I don't think the problem is my meter.

Because Glen's blood sugar was 22.4 & 28.0 (in the vets office) they stated him on the 2 units BID. I am keeping s close eye on him, except for this AM as my hubby let me sleep in and gave him his breakfast & insulin without testing.

I am home for a couple more days so will be monitoring him closely. Thanks for all your help! See you on the other board.

 

[MrWorfMen's Mom]

Tammy, all the reference BG numbers used here are based on human meter readings unless otherwise specified. I use both a pet and human meter (mine is Freestyle too) and can tell you that the difference between your meter and your vet's readings gets greater the higher the BG. At low readings they are much closer as you can see comparing the intervention warning readings of 2.8mmol human vs. 3.8mmol pet. Pet meter strips are very expensive and I myself am switching to a human meter in the New Year. The last price was the last straw!

Looking forward to watching Glen's progress!

Happy Holidays!