Neuropathy and increasing dose...THANK YOU...

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Izzy2017

Izzy2017

Member Since 2017
We went to the vet on Monday since Izzy was walking on his hocks and slept all day and all night. Today (Wednesday) he is eating a little better and is up a bit more during the day. He is still walking on his hocks.

Got the results from the vet...Fructosamine normal, Blood sugar high (we knew this), Borderline anemic (This is new) Other numbers all look good, including LFTs.

Weight 14 pounds, up from 12.8 pounds last visit. WOO!

The vet recommended that we increase from 2u 2x a day to 3u 2x a day. We mentioned to the vet that we thought it was a large jump and wanted to know if we could go to 2.5 instead of 3. She said that it would be too hard to read the little line... I hate to go against the vet's advice but nobody will be around during the day to monitor how he is doing.

His preshot is still in the mid to upper 400s. PM preshot on 7/18 was 430. We are going to do a curve Saturday and Sunday but we do not have a chance to do this before hand. Does anyone have any pointers or what they would do in our situation?

Update: We shot at 2.5 instead of 3 for 7/18 PM just to be safe. This morning 7/19 we gave 2u like usual since nobody will be home. We will probably end up going to 3 after a while but I hate to move his dose up while there is nobody to monitor him. Any advice on how to move him up to 3 where the vet wants him while we aren't home during the week?

Edit: He is on Lantus :)
 
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Izzy2017 said:
Does anyone have any pointers or what they would do in our situation?
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We'd all say just about the same thing, especially in light of the effects that FD is having on your kitty: you need to make a different plan to get his BG under better control, regardless of the fructosamine test results. What insulin is Izzy on?

Here's the plan that will help enormously:
  1. Start a structured BG testing routine that includes a test every day before feeding and giving insulin (no food 2 hours before) as well as at least one other test daily between shots or before bed. Fill in the data gaps with extra tests on days off.
  2. Keep your spreadsheet up to date so we can give the best advice based on current and sufficient data.
  3. Buy some insulin syringes that have half unit marks. Yes, you will be able to see them. Buy a cheap pair of magnifying readers if necessary. We're big advocates of fractional increments when changing a dose because the good dose is often between whole unit numbers.
The more test data you have:
  • the better dosing decisions you can make
  • the better you can regulate Izzy's BG
  • the more predictable he'll become
  • the easier it is to trust that you can leave him with confidence while you're at work
  • the better he'll do physically
  • the better the chance of reversing the negative effects of his diabetes.
Yes, this will require you to be more proactive and hands on, do more testing than you like to do and possibly cause you to deviate from your vet's advice. The proof is in the pudding as they say - thousands of FDMB members who live FD 24/7 can't be wrong.

I hope this helps. :)
 
I edited the original post to say he is on Lantus. :)

Unfortunately we fell off the spreasheet and poking train but we are going in with a renewed effort to keep getting the numbers. The syringes we have do have half unit marks and we are doing 2.5.

We have tried poking his ear with the device but can't seem to peg the right spot. When we poke him free hand his ear either barely bleeds or he bleeds all over the place. I've seen the ear poking picture and watched the ear poking video but we can't quite seem to get it down. We give him treats to try and hold him still but once you poke him and the blood wells up he flails around and tries to shake the blood off. :( I think that is the main reason we haven't been consistently getting numbers.
 
Izzy2017 said:
I edited the original post to say he is on Lantus. :)

Unfortunately we fell off the spreasheet and poking train but we are going in with a renewed effort to keep getting the numbers. The syringes we have do have half unit marks and we are doing 2.5.

We have tried poking his ear with the device but can't seem to peg the right spot. When we poke him free hand his ear either barely bleeds or he bleeds all over the place. I've seen the ear poking picture and watched the ear poking video but we can't quite seem to get it down. We give him treats to try and hold him still but once you poke him and the blood wells up he flails around and tries to shake the blood off. :( I think that is the main reason we haven't been consistently getting numbers.
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Poking a black kitty's ear is trickier. Some people have poked the inside of the ear instead. Another suggestion that has been given is to quickly scoop the blood drop onto a clean finger nail and test from there. That way you can release him sooner.

It's frustrating but worth the practice to conquer the poking issue. It's the best way to get him on the road to a good dose and feeling better.
 
Yong said:
Some even use a tiny flashlight or headlamp to really help see the space between marginal vein and outer ear. :)
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We have a little flashlight that we try to use if he will hold still. It's hard to hold everything at the same time if he is feeling uncooperative. Hopefully he becomes more... compliant. :)
 
Pmps after 2 hour fast is 141.. gave him some chicken treats for sitting nice we poked again to double check and had to hold him down because he squirmed we got 170. Do we shoot 2u like we have been? Or do we not shoot at all?
 
Izzy2017 said:
Pmps after 2 hour fast is 141.. gave him some chicken treats for sitting nice we poked again to double check and had to hold him down because he squirmed we got 170. Do we shoot 2u like we have been? Or do we not shoot at all?
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This is a lovely PS. Two choices: wait 20 minutes, retest and if he's rising, give 2 u OR opt for no shot this time. Aim to get more data so you have a good dose reference encyclopedia.
 
Kris & Teasel said:
This is a lovely PS. Two choices: wait 20 minutes, retest and if he's rising, give 2 u OR opt for no shot this time. Aim to get more data so you have a good dose reference encyclopedia.
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Waiting 20 minutes without food and it rising? Or should we be feeding him right now?
 
I'd also like to invite you over to the Lantus Forum....You'll get the most experienced eyes watching out for you there since everybody there uses Lantus or Levemir

It will help for you to add some more information to your Signature too.....that way we don't have to keep asking the same questions. Usually we like to see:

Your name/Cats name, age, sex, date of diagnosis, type of insulin, type of meter, type of food, any other health problems? and a general location.....add that info as well as your spreadsheet link (like you have now) and it will help us to help you.

Here's some more information on Posting in the Lantus Forum
 
Izzy2017 said:
Waiting 20 minutes without food and it rising? Or should we be feeding him right now?
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Oops! My fault for not saying "don't feed".
Izzy2017 said:
We waited and fed him since we were unsure and he is already having issues with not eating enough. Waited 10 to 15 minutes after he ate and poked him again got 112 so we are not giving a shot.

Aaah this is so stressful!
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No shot for sure. It'll get less stressful once you have a routine in place and more data to study. :)
 
Tested at 9:08 BS 95, was 112 at 7:45---we did NOT give him insulin, but he did eat a little, not his normal ravenous eating, but maybe an ounce of friskies pate. we are feeding him "pure bites" chicken treats and he is eating them up. should we give him dried cat food or something with higher carbs to bring him back up? Or am I freaking out over....?
 
I updated the spreadsheet, but yes the 141 was around 7:00 and we did not give insulin because that was low...then we took it again because we didn't know if it was an error, and it was 170ish (he was struggling/stress and we gave him treats, so that would explain the 30 point difference). We fed him friskies pate and his BS is still dropping, so I'm not sure if we should feed him regular purina dry cat food that we have to try to bring him back up or what to do really at this point....
 
Kris & Teasel said:
Poking a black kitty's ear is trickier. Some people have poked the inside of the ear instead. Another suggestion that has been given is to quickly scoop the blood drop onto a clean finger nail and test from there. That way you can release him sooner.

It's frustrating but worth the practice to conquer the poking issue. It's the best way to get him on the road to a good dose and feeling better.
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Hi just adding about freehand ear pricking with a black cat. I did Sootie's near the edge of the inside side of her ears. In the beginning I used a little flashlight (a pocket or keychain size ) to "orient" myself to where her veins were before starting the ear prick. I found that free hand was much easier and no distracting sounds. Once you get the visual feel/orientation the flashlight isn't necessary (though I always keep a little flashlight handy in case I needed to refresh myself. I always gave her a cuddle and a treat afterwards, in her case her homeopathics (loved to guzzle them from her little squirt bottles) a freeze dried treat or her glandular support tabs. Relaxed us both.

ETA: I just read yours about bg getting lower. I'm not one to offer dosage suggestions. But until one of the members gets back, is continue to monitor to be sure izzys not dropping more. I see you're using Alphatrack meter (I used human meter). In meantime please don't overfeed; have some med carb and high carb wet food and some honey or syrup (Karo or maple syrup) handy.

What time did you last feed and in relation to the most recent bg the one that was dropping?
 
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Izzy2017 said:
I updated the spreadsheet, but yes the 141 was around 7:00 and we did not give insulin because that was low...then we took it again because we didn't know if it was an error, and it was 170ish (he was struggling/stress and we gave him treats, so that would explain the 30 point difference). We fed him friskies pate and his BS is still dropping, so I'm not sure if we should feed him regular purina dry cat food that we have to try to bring him back up or what to do really at this point....
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He's safe don't panic. He's not going to hypo. He hasn't had insulin since this morning and he's in safe numbers.
 
JanetNJ said:
He's safe don't panic. He's not going to hypo. He hasn't had insulin since this morning and he's in safe numbers.
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errr...when do I officially panic? haha. i think i'm already terrified. since he hasn't had insulin since this morning, is there no way for him to go TOO low?
 
Chris & China said:
No insulin = No hypo

Your "time to act" is if he drops under 50 (68 on the Alpha Trak)...but without any insulin tonight, that shouldn't happen
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So do you think I should keep testing every hour until his BS goes up? Or do you think it is safe to leave the cat to sleep for tonight and test again in the morning?

Sorry for the panic...just want to do the right thing and don't want to just leave him alone if it's going to end badly... We did get him to eat more friskies...lol...he is looking pretty stuffed at this point:)

thank you SO MUCH for your help...
 
HWright said:
ETA: I just read yours about bg getting lower. I'm not one to offer dosage suggestions. But until one of the members gets back, is continue to monitor to be sure izzys not dropping more. I see you're using Alphatrack meter (I used human meter). In meantime please don't overfeed; have some med carb and high carb wet food and some honey or syrup (Karo or maple syrup) handy.

What time did you last feed and in relation to the most recent bg the one that was dropping?
Click to expand...

At 7:00 preshot his BS was 141, then 170 a few minutes later...I fed him at about 7:15, then we did another BS at 7:45 and it was 112, so we gave him chicken treats and tested again at 9:08 and it was 95! So we had him eat some more friskies! and we probably should test him again right now, I guess? I hate to wake him up if it's not needed, but I'm definitely worried.

thanks for the reply! I don't have any high carb wet food, but I do have honey and I do have dry (grocery store/purina) cat food in reserve that is pretty high carb, just in case...
 
Izzy2017 said:
At 7:00 preshot his BS was 141, then 170 a few minutes later...I fed him at about 7:15, then we did another BS at 7:45 and it was 112, so we gave him chicken treats and tested again at 9:08 and it was 95! So we had him eat some more friskies! and we probably should test him again right now, I guess? I hate to wake him up if it's not needed, but I'm definitely worried.

thanks for the reply! I don't have any high carb wet food, but I do have honey and I do have dry (grocery store/purina) cat food in reserve that is pretty high carb, just in case...
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No need to panic. He didn't have a shot tonight, right? There's still some Lantus in the depot and that could be having an effect. You could test again in 30 minutes or so to see if he's still dropping. If he nears 50 that's the time to feed small amounts (2 tsp-ish) of higher carb food. You can add a little honey to low carb food or give a few Purina kibbles.

There's no insulin dose from tonight gradually exerting its effect. The only thing operating right now is the shrinking depot.
 
Your ok. Breathe. He had no insulin today. Check him before you go to bed. Post here.

FYI dry food takes quite awhile to bring numbers up, so it's not the best thing to use if you need a quick acting upper.
 
OMG. Okay. I am breathing:) We just tested again (10:35) and BS was 151, so I'm feeling like maybe we are okay!! WHEW. Thank you all SO MUCH, I just don't know what I would have done without your help & input--freaked out even more probably. haha. So we are going to bed now, tomorrow is a new challenge...fingers crossed his BS is NOT 900 tomorrow morning...or 90! Jeesh what a rollercoaster of emotions...
 
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Izzy2017 said:
OMG. Okay. I am breathing:) We just tested again (10:35) and BS was 151, so I'm feeling like maybe we are okay!! WHEW. Thank you all SO MUCH, I just don't know what I would have done without your help & input--freaked out even more probably. haha. So we are going to bed now, tomorrow is a new challenge...fingers crossed his BS is NOT 900 tomorrow morning...or 90! Jeesh what a rollercoaster of emotions...
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When your nerves are more settled and you're able to think more calmly you'll probably be glad you've decided to take the FD bull by the horns, do the testing and learn about good dosing. :smuggrin:
 
It really does get better.....that's why we're so adamant about testing....you'll learn your cat's patterns and eventually you'll be able to better predict what will happen!!

Get some much deserved sleep tonight!! ....and maybe an adult beverage or three!!
 
Izzy2017 said:
OMG. Okay. I am breathing:) We just tested again (10:35) and BS was 151, so I'm feeling like maybe we are okay!! WHEW. Thank you all SO MUCH, I just don't know what I would have done without your help & input--freaked out even more probably. haha. So we are going to bed now, tomorrow is a new challenge...fingers crossed his BS is NOT 900 tomorrow morning...or 90! Jeesh what a rollercoaster of emotions...
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Yes it can be a rollercoaster but you made it through and with some deep breaths too;) yay! Ya did it! :bighug:

Chris & China said:
I'd also like to invite you over to the Lantus Forum....You'll get the most experienced eyes watching out for you there since everybody there uses Lantus or Levemir

It will help for you to add some more information to your Signature too.....that way we don't have to keep asking the same questions. Usually we like to see:

Your name/Cats name, age, sex, date of diagnosis, type of insulin, type of meter, type of food, any other health problems? and a general location.....add that info as well as your spreadsheet link (like you have now) and it will help us to help you.

Here's some more information on Posting in the Lantus Forum
Click to expand...

:bighug: and copying Chris's earlier post with info about and links about the Lantus Forum

And , here's the Lantus land "sticky" about handling hypos:
http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

And the link to an essential to have stocked: your hypo toolbox for just in case:
http://www.felinediabetes.com/FDMB/threads/jojo-and-bunnys-hypo-tool-box.2354/

Hope you and Izzy have s good night sleep!
 
Thanks for that info--I will print tate sticky off tonight. Next time will try to remember to post in Lantus thread!!

I updated Izzy's spreadsheet, tried to make it more readable. His blood sugar was back up to 372 this morning (24 hours after last Lantus dose!) so we gave him his usual 2 units of Lantus this morning. He is eating okay, not his usual "cookie monster" appetite, but even though smaller amounts, is eating consistently so I feel good about that. I'm working from home today so I can watch him closer today.

Thanks again for all the help!!! And the :bighug: !! :) We'll keep trying to get more testing and some curves and hopefully can get Izzy's BS a bit more stable--my heart can't take much more of last night's shenanigans:nailbiting: :nailbiting:<--that was us exactly LOLLL
 
Hope today goes smoothly for you and Izzy. Good that you can be home to monitor. Good day to do some mid cycle bg tests too (helps to note food too). Helps to see how he's working the juice during cycles.

When you do your next thread, it also helps to include link to the most recent thread too.. so here's the link for this thread to add. Some members add link at beginning of the first post on the thread, others at the end. I found it easier to do it at the beginning (e.g., whew that's done!)

http://www.felinediabetes.com/FDMB/...ncreasing-dose-thank-you.180925/#post-2004154
 
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