Newbie-dx 9/12/18

Cat-tainJackSparrow

Cat-tainJackSparrow

Member Since 2018
Hello all! Brand spanking new to this, jack was dx a few days ago 9/12/18. Soooo... some background on Jack. I started giving him the exact wet food a diabetic cat should be getting a week before he was dx... friskies paté. Idk how I got lucky with that one. So hes been on a low carb diet for about a week and half. Jack's glucose tested 469mg/dL and Md started jack out with Lantus 2 units BID. I started Lantus and ordered meter that same night he was dx. Meter scheduled to come on Monday so no way for me to check his glucose. Was told the wet food could already lower his glucose but he was already on the wet food when my MD tested him. Been watching him since started injecting and hes been pretty much the same. Only slight change was his appetite but very mild.. he use to eat a whole can (5.5oz) and now he eats like 75% percent of can. Eats twice a day. So my question is.. I've been reading and I'm learning that lantus 2 units BID might be kinda high as a starting dose? Should I just keep injecting blindly? Should I lower? Any advise at all would be amazing! He has had 4 injection of lantus with that dosage so far. TIA!
 
Welcome! This is the the best place you never wanted to be. Sounds like you are already on the right track with a plan for home testing. My inputs are:
Diet change alone can reduce BG. I don't know which Friskies you are feeding, but wanted to make sure you have the reference for the food charts to review carb content.

Most diabetics do well with multiple small meals per day. Sometimes vets suggest only 2 major meals to be timed with insulin shots, but this isn't the best way to do it in reality.

Sounds like you have ordered a pet meter. The protocols here are based on human meters. Pet meters work OK and several members here use them, but the strips can be very expensive. Not sure where in the world you are located, but most in the US will use Relion products from Walmart.

We are very supportive of home testing and strongly discourage "shooting blind". This group is very data driven and will be able to offer you the best advice if you can get started on a spreadsheet to show how Jack is responding to insulin.

An uncontrolled diabetic can be expected to be hungry all the time. Your observation that Jack is not as hungry as he has been suggests that is BG might be much better, but without testing I can't say. I'm just offering this as a possibility. How is his weight - do you know how much he should be eating to maintain?

The next thing for you to do is to select a dose method to follow. The "stickies" cover both SLGS and TR. Your thoughts on how aggressive you want to be and how much testing you can do will help you decide.

I am nervous about anyone shooting blind, so I would feel much better if you would read this important sticky and prepare an appropriate hypo kit to be available if you ever need it. The problem in trying to react is that some (most?) cats can be hypoglycemic with no symptoms at all. This is why it is so great you will be testing.

Again - welcome to this incredible group. I hope you will continue to ask questions because that is how we all learn!
 
Hi and welcome to Lantus and Levemir Land!

Carol has given you some great info. To expound a little: it's not impossible to do this with a pet meter, but it can get a little confusing. If you really want to stick with the meter you've ordered, that's fine and we can help you just the same. Some vets insist on it, but it really isn't any better than using a human meter - you just have to understand the difference between them. As Carol said, strips for human meters are much less expensive and much easier to obtain quickly than for pet meters, which typically have to be ordered.

As far as dosage, how much does Jack weigh? Typically, if following the Tight Regulation protocol, a starting dose of Lantus is based on weight:

  • the formula is 0.25 unit per kg of the cat's ideal weight
  • if kitty is underweight, the formula frequently used is 0.25 unit per kg of kitty's actual weight
Click to expand...

If following the Start Low Go Slow method, you start with .5 units twice a day (if kitty is on a low carb diet, as Jack is).

Did you get the feeling that your vet is very experienced with feline diabetes? Most vets aren't, and sometimes they base the dose more on the BG than anything else.

We don't recommend shooting blind, for the reasons Carol stated. If you feel like you really want to continue to give insulin, you might consider a smaller dose for now, until you get a meter. Are you in the US? If so, and there is a Walmart near you, you could pick up a meter and strips tonight or tomorrow morning and start testing. We'll help you learn how. We can help you set up your spreadsheet, too, if needed.

For now, read as much as you can - the stickies at the top of the L&L page contain an overwhelming amount of information, but the more you know, the better. We were all new and scared once, so we understand and are here to help. The only dumb question is the one you don't ask.

We're glad you found us!
 
I keep trying to reply to the post but I keep getting an error. I attached a picture of the error message.​
 

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Cat-tainJackSparrow said:
I keep trying to reply to the post but I keep getting an error. I attached a picture of the error message.​
Click to expand...
That's a new one on me! Looks like you were able to post a little later, though. If it happens again, click on my name and send me a message. I'll tell you how to get in touch with the site administrator.

Most vets prefer pet meters because that's what they generally use in their office. There is very little difference between a pet meter and a human meter at low numbers, but the difference increases as the BG increases. @Marje and Gracie did a comparison between a human meter and a pet meter and found the results were somewhat different than what I was told by a noted endocrinologist, which just shows you how non-exact this is!! As previously mentioned, our protocols are written based on a human meter, but it is possible to follow them with a pet meter. Most people just can't afford the strips for the pet meters, and find it much safer to be able to get strips quickly and easily. You have to do what you are most comfortable with, so no worries if you want to stick with what your vet tells you. Just be sure you order plenty of strips and keep a good supply on hand. There are few things worse that having a dropping cat and being low on strips.
 
Cat-tainJackSparrow said:
I took a picture of the info I was trying to share with you all.View attachment 38987
Click to expand...

Welcome! Hope you get the meter soon so you can start getting some info. Good job setting up the spreadsheet so quickly... Now you'll learn how to do ear pricks next. Do you have lancets? I find the ReliOn Thin Lancets, 26G, 100 Ct at WalMart a great deal, and they work very well freehand. I always do the ear test, then feed (treat), then shoot insulin while the cat is distracted by food. The ear pricks are the hardest part even though I typically get a sample on the first poke after 76 days of practice. ;)

Here's a pic of the sweet spot on the ear, from a previous thread:

ear_001-jpg.37102


Be sure to get the hypo kit ready as well (linked from THE BASICS Sticky), in case the insulin does "too good" of a job pushing down your cat's blood glucose level.

Good luck with Cat-tain Jack Sparrow! And... on a lighter note... why is the rum always gone?
 
You've gotten great information!

As Tricia referenced, we use 2 approaches to dosing here. The best researched approach is the Tight Regulation Protocol. TR was developed specifically for Lantus and Levemir and was published in a top tier veterinary journal. Start Low Go Slow (SLGS)was developed here and has been used before TR was published. Both approaches can get a cat to remission. However, TR is more aggressive. I'd encourage you to read both over and decide which approach will be best for you and Jack.

Likewise, you'll want to set up a spreadsheet. You'll notice we all have our SS's attached to our signatures. The SS will allow you to keep track of Jack's progress as well as allow us to see how he's doing. Without a SS, it's very difficult to lend you a hand with dosing decisions. We tend to be rather numbers driven so being able to see the numbers is essential.

There is a ton of information in the sticky notes at the top of the board. Well, the reality is there's an overwhelming amount of information there and in the associated links. The reading will help you to get grounded in this new "adventure." Please ask questions. There's so much to know and the people here are very generous with their time and knowledge.

One last suggestion -- if you're going to start to test, get treats. Many of us use freeze dried chicken or cooked chicken (or some other protein). Giving Jack a treat every time you test will help to get him adjusted to testing quickly.

 
I welcome you here, too, Cat-tain Jack Sparrow. Yes, it is the forum that you never wanted to be a part of, but that will be so helpful for you, as it has been for me these past 4 months. I also had to "shoot blind" for the first few days that Jerry was diagnosed, because I was waiting for the meter to come in. He started out on 2 units of Vetsulin twice a day, and his sugar was 470 when he was diagnosed. I didn't like the idea, but I kept giving him the regular dose, and he seemed to be fine. Now, I wouldn't dream of giving him a shot now without testing first. But don't beat yourself up about it, since he was just diagnosed, and his sugar is very high. I think he will be fine for now. Jerry's numbers have improved greatly, although sometimes the pre-shot reading can be around 200. It had been in the 300's regularly in the mornings for a long time, so we are moving in the right direction, for sure. He is currently on 1/4 can of Fancy Feast turkey/beef pate for his shots, and he gets 1/3 cup of Young Again super high protein and no carb zero mature cat food during the day. They are only supposed to get a small amount, due to the high protein content. He seems to be doing well on this regimen, but it did take a while to get into place. You will find much helpful information on this forum, and very helpful and friendly people who know EXACTLY what you are going through! I, personally, am so happy to have found this wonderful group of people in my time of need.
 
Thank you all for all the info! So I decided to just buy a meter at walmart and have been trying to test every couple hour while at home. Like I said before I am brand spanking new to kitty diabetes, to testing, to using a forum... to EVERYTHING lol. So I've read though the sticky notes at the top numerous times. Have some questions about lantus and using the forum. So about the lantus... so I know I test right before meal and insulin but I don't know what I'm looking for. I know that I test to see if the number is too low before I give him insulin but what number is a number that is too low? In the 100's and under? Question about forum.. I see people posting what looks like date, kitty name and amps.. am I suppose to post every day also? I could really use the help on what all these dang numbers mean. I could really use the help and advise. Do I make a brand new post every day? I read somewhere that I'm suppose to link my old post to my new one but I have no idea how to do that. TIA again!
 
I'm so glad you got the human meter - I think that will make it easier for you!

You are testing before every shot primarily to determine if it is safe to give a shot. Basically, you are testing to make sure his BG isn't already too low to have a shot. The data in your spreadsheet will begin to tell you when the shot takes effect, and how low a dose will take him. If you start out too low, it would not be safe to give the shot.

The number you would shoot varies with 4 things:
1) Your experience - Jack is newly diagnosed within the last year so your number will be higher- date of DX is in your signature.
2) Your protocol of choice - you should choose if you will follow TR or SLGS - decide and put this in your signature
3) Your plans for the day - will you be home and able to monitor through the cycle - state this in your post if you are asking for guidance
4) Jack's appetite and health - is he feeling good and eating? Is there any history of DKA? Any DKA should be noted in the signature, any appy issues detailed in your post if asking for guidance.

Both protocols detail what you should do in reaction to a low pre-shot, however, dose is not determined based on pre-shot - the preshot number is to determine if it is safe to give the established dose.

From shooting low numbers with TR:
New members without much data collected, but are following the TR Protocol in the Lantus, Basaglar, and Levemir Insulin Support Group should ask for guidance when presented with a preshot number less than 150 mg/dL. Once you've collected data to support your decisions, the TR "no shoot" number is 50 mg/dL.

From SLGS:
  • Below 150 mg/dl (8.3 mmol/L), don't give insulin.
  • Between 150 and 200 (8.3-11.1 mmol/L), you have three options: a.) give nothing; b.) give a token dose (10-25% of the usual dose); c.) feed as usual, test in a couple of hours, and make a decision based on that value.
  • Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
  • In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.
  • Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.
Since you are new, it would be great if you would post ever day to get feedback and answers to questions. By sharing your numbers, other members will be able to offer feedback and encouragement. We do suggest a 1 post for each day. To keep everything organized, the convention of date, name, and BG numbers is used. To help understand the history, the link to your last post should be included. To find your last post, click on your name in the upper right corner of the window. Then click on "your content" to see all of your posts. Click on the most recent and copy the URL. Paste it into the current post using the link button.

Hope this helps!
 
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