Help Please!

jennifer Peveto

jennifer Peveto

Member Since 2018
It will be faster for me to post numbers and info. in this message then to go and figure out the spreadsheet again...I started it but somehow I can not make any changes to it.....

Started Ralph on Lantus, has been great. My issue is at times his BG is below 100 so I do not dose him and then a couple days later his BG is above 250! I test Ralph in the am before a shot and in the pm before his shot....I stopped for about 3 days because he was getting sick of being poked...anyway I will list my findings below:

12/25- 9am BG 77- no insulin
12/25- 9pm no test or insulin

12/26- 9am BG 198- no insulin
12/26- 9pm BG 162- no insulin

12/27- 9am BG 290 -1/2 unit insulin
12/27- 9pm BG 89- no insulin

12/28- 9am BG 372 -1 unit insulin
12/28 -9pm no test - 1/2 unit insulin

12/29- 9am no test -1 unit insulin
12/29- 9pm no test - 1/2 unit insulin

12/30- 9am no test - 1 unit insulin
12/30- 9pm no test - 1/2 unit insulin

12/31- 9am BG 62- no insulin

He is in good spirits and acting like he feels well...I know it is tough on his body to jump all around like this. Ralph is on wet food and gets about 20 kibbles in the evening which he gets before I test his BG in the evening....
 
Looks like he's doing well! Are you using a human or pet meter? Please add the meter info to your signature.

I'll let lantus users comment on the actual dosing advice.
 
JanetNJ said:
Looks like he's doing well! Are you using a human or pet meter? Please add the meter info to your signature.

I'll let lantus users comment on the actual dosing advice.
Click to expand...
I am using a pet meter...I thought he was low as well so I did not dose him. It is all very confusing and I guess I should go with BG numbers and how he is acting. He is not acting hypoglycemic....he is frisky and picking up old bad habits, like calling to his people at bed time!

I know I am not doing a lot of his care to "standard".... Ralph is a nibbler, so I let him nibble his wet food throughout the day. I know kibble is the "devil" but he is an addict and I let him have some kibble in the evening....

I guess my biggest concern is dosing him inconsistently...is it a huge strain on their little bodies if they are not getting a shot every 12 hours.....? According to my vet, not dosing every 12 hours could bring the apocalypses....
 
We would agree that dosing every 12 hours is ideal. If a dose causes a too low to shoot pre shot test number often the dose is too high. We would recommend lowering it and giving half AM and half PM. The big swings up and down from once a day dosing can make them feel ill and will disrupt the Lantus depot action. Having said that, you'e only giving a half unit as a dose. You could try eyeballing 0.25 u AM and PM to see if that works better.
 
The first thing you need to do is start using the board in a way that allows others to help you best.

1. You have a spread sheet, but if you access it by clicking on your link in the signature line, you won't be able to post in it. You have to log in through GoogleDocs. Find your sheet, make your changes, the link just allows others to read it.

2. When you post on the board, start with the date and the name of the kitty, then post the day's numbers. Look at the headers for other users on the board, and imitate them. Post once per day. If you have a question, use the prefix of a question mark or, if you aren't getting a response, you can add the words "NEED EYES" or "HELP" into the header. Only use the 911 prefix if your kitty is in hypo and is in danger.

3. Add new numbers into the header when you get them. The number before the meal and shot is listed as an AMPS, evening is PMPS.

4. Put additional information in the signature line - access it through your profile. Age of cat, date of diagnosis. Which meter you use, which protocol you use, what you feed. If you have questions about the protocol, you really need to read the stickies at the top of this board. Choose either Tight Regulation (TR) or Start Low Go Slow (SLGS). Don't use a little of both, as that will prolong the treatment and will ultimately be unhealthy for the kitty.

5. If you're feeding dry food still, stop. There are stickies on the main forum health side which link to Dr. Pierson's work on the negative consequences of feeding kibble, particularly once a diabetic diagnosis has been made. The food you give will directly affect the numbers for your cat. I'm linking Pierson's food chart here. Look for wet food that is less than 9 carbs, lower is better. Very little gravy will qualify, and you want to feed the best you can afford.

https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

6. Once you have these things sorted out, set up a schedule and settle on a consistent dose. In general, unless the bg drops below a certain threshold (that number depends on whether you use TR or SLGS), you keep a dose at least 6 cycles (3 days) before either dropping or increasing. Inconsistent doses will result in inconsistent numbers. Lantus is a long acting insulin, which means it takes time to build in the body - that's known as the insulin depot (another sticky on the board can give you that information.) In general, if a dose doesn't show you greens within 6 cycles, you increase - .5 increase for TR, .25 for SLGS. A decrease is earned if the kitty drops below a certain level or if the numbers go into the greens and stay there.

7. Your vet is right about consistent dosing. Cycles are 12 hour increments. If the numbers are low at testing and shooting time, you can ask for assistance. Put the bg in the header, then write "STALLING" behind the number. In general, though, those of us using the TR method will shoot any number under 80 depending on the cat and whether we can be there to test during onset. Have a hypo kit available and don't shoot low if you can't be there.

Keep asking questions, but if you do so using the posting protocol, you'll get better advice.
 
A couple of other things, just to be helpful.

Consider changing meters from an animal specific one to one designed for humans. The protocols developed for this board utilize human meters, and the numbers are hard to make match. In addition, the costs are MUCH lower for a human meter than an animal one.

Many users on the board use the Relion meter sold by Walmart. They are very inexpensive, and the strips even cheaper. I use the CVS meter, others have One Touch or something similar. Your costs will be significantly lower and you can make the numbers work better for you.

You can also find links on the board to the Canadian pharmacy that provides inexpensive insulin, no prescription necessary for cats.

Chewy.com offers good prices on all sorts of food, much of it brands you won't find in stores that will be healthier for the kitty than the food available in the stores.

Good luck.
 
Hroswitha said:
A couple of other things, just to be helpful.

Consider changing meters from an animal specific one to one designed for humans. The protocols developed for this board utilize human meters, and the numbers are hard to make match. In addition, the costs are MUCH lower for a human meter than an animal one.

Many users on the board use the Relion meter sold by Walmart. They are very inexpensive, and the strips even cheaper. I use the CVS meter, others have One Touch or something similar. Your costs will be significantly lower and you can make the numbers work better for you.

You can also find links on the board to the Canadian pharmacy that provides inexpensive insulin, no prescription necessary for cats.

Chewy.com offers good prices on all sorts of food, much of it brands you won't find in stores that will be healthier for the kitty than the food available in the stores.

Good luck.
Click to expand...

Great advice!!

The only thing I will add is that Mark's Pharmacy (in Canada) DID require a prescription for my Buddy's Lantus.
 
Jennifer,

Your situation reminds me of when my cat was first diagnosed back in April. If you look at my spreadsheet, you will see I was doing exactly what you are - skipping and changing doses inconsistently. Intuitively, it seems like that makes the most sense but, the more you read on this board and the more data you collect, you will see it really is not what is best for your cat in the long run.

Also, the dry kibble, really should be removed from the diet. Buddy's numbers plummeted when I finally took him off dry kibble. You cat's numbers are already so low that you might be able to kick him into remission if you remove all kibble and get him on a regular LOW CARB canned food diet. You don't have to buy expensive food - Friskies and Fancy Feast both have very low carb foods. Just remember, if you do change his food YOU REALLY need to grab some additional BG readings because he may drop too low if you remove all high carb foods and keep insulin the same. If you get your spreadsheet set up, ask for help on here if you need advice on how to fully transition him safely. Also, you might look at the 2 different protocols - SLGS or TR. They give specific guidelines for when to adjust dosing. You can find links to them on the Lantus home page.

I can't even begin to tell you how helpful this board will be to you. I was terrified at first but the wonderful people on here have held my hand and built my confidence.

Also, I agree with Hroswitha about switching to a human meter. As she said, the strips are so much cheaper (I get 100 twenty dollars) and most of the people on here that will try to help you are used to looking at human meter numbers. Again, I was scared of using a human meter but, after seeing how many people on here use them, I took the plunge. So glad I did!!

Best of luck and don't ever hesitate to post questions. People on here are incredibly patient and supportive!!
 
Kelly and Buddy said:
Jennifer,

Also, I agree with Hroswitha about switching to a human meter. As she said, the strips are so much cheaper (I get 100 twenty dollars) and most of the people on here that will try to help you are used to looking at human meter numbers. Again, I was scared of using a human meter but, after seeing how many people on here use them, I took the plunge. So glad I did!!

Best of luck and don't ever hesitate to post questions. People on here are incredibly patient and supportive!!
Click to expand...

The CVS meter I use now offers 200 strips for $16 if you order on line. It's even better than the Relion prices, but it depends on what you feel comfortable using.

You MUST test more often. My sugar kitty is in OTJ trial, which means we can reduce the frequency of testing. However, look at the spread sheets of other kitties, and you'll see testing before every shot, and often, if they're trying to figure out a dose, they'll get onset numbers, nadir numbers, and numbers as they approach the next shot. That would be onset (+2-+3), nadir (usually around +4 to +7), and end of cycle (+11). This is why cheaper strips are better all around.

In addition, as I mentioned before, the numbers you'll get on the Alpha Track will not easily translate into the human based meters used by most of those advising and posting here. The protocols were designed for a human meter, not animal. If you switch, you'll save money, have more strips on hand (a minimum of 100 is recommended at all times), and be able to test frequently.

Read the stickies on this board. Read the information on the two protocols, the info on Lantus and how it works, how and when to increase and decrease doses, and get the spread sheet figured out. It's your absolute best tool for regulating your kitty's glucose. Without it, we cannot make dosing advice as no data means we could be killing your kitty.
 
Hroswitha said:
The CVS meter I use now offers 200 strips for $16 if you order on line. It's even better than the Relion prices, but it depends on what you feel comfortable using.

You MUST test more often. My sugar kitty is in OTJ trial, which means we can reduce the frequency of testing. However, look at the spread sheets of other kitties, and you'll see testing before every shot, and often, if they're trying to figure out a dose, they'll get onset numbers, nadir numbers, and numbers as they approach the next shot. That would be onset (+2-+3), nadir (usually around +4 to +7), and end of cycle (+11). This is why cheaper strips are better all around.

In addition, as I mentioned before, the numbers you'll get on the Alpha Track will not easily translate into the human based meters used by most of those advising and posting here. The protocols were designed for a human meter, not animal. If you switch, you'll save money, have more strips on hand (a minimum of 100 is recommended at all times), and be able to test frequently.

Read the stickies on this board. Read the information on the two protocols, the info on Lantus and how it works, how and when to increase and decrease doses, and get the spread sheet figured out. It's your absolute best tool for regulating your kitty's glucose. Without it, we cannot make dosing advice as no data means we could be killing your kitty.
Click to expand...
Hroswitha said:
The CVS meter I use now offers 200 strips for $16 if you order on line. It's even better than the Relion prices, but it depends on what you feel comfortable using.

You MUST test more often. My sugar kitty is in OTJ trial, which means we can reduce the frequency of testing. However, look at the spread sheets of other kitties, and you'll see testing before every shot, and often, if they're trying to figure out a dose, they'll get onset numbers, nadir numbers, and numbers as they approach the next shot. That would be onset (+2-+3), nadir (usually around +4 to +7), and end of cycle (+11). This is why cheaper strips are better all around.

In addition, as I mentioned before, the numbers you'll get on the Alpha Track will not easily translate into the human based meters used by most of those advising and posting here. The protocols were designed for a human meter, not animal. If you switch, you'll save money, have more strips on hand (a minimum of 100 is recommended at all times), and be able to test frequently.

Read the stickies on this board. Read the information on the two protocols, the info on Lantus and how it works, how and when to increase and decrease doses, and get the spread sheet figured out. It's your absolute best tool for regulating your kitty's glucose. Without it, we cannot make dosing advice as no data means we could be killing your kitty.
Click to expand...

I did not know about the CVS meter. Those test strip prices are amazing!!! Have you compared it with any other meters to see how accurate it is? For the price, I think I will pick one up and compare it with my current meter. I can live with it reading high or low, as long as it provides consistent readings so I can see patterns.
 
I have a dry kibble addict. She won't even look at wet food! It has been so stressful. I feed her Young Again Zero Carb. there is also Dr. Elsey's clean protein chicken kibble which is low carb. I bet changing your kitty to low carb kibble would make a world of difference!
 
Mom2SweetPea said:
I have a dry kibble addict. She won't even look at wet food! It has been so stressful. I feed her Young Again Zero Carb. there is also Dr. Elsey's clean protein chicken kibble which is low carb. I bet changing your kitty to low carb kibble would make a world of difference!
Click to expand...

Changing kibble addicts to wet food eaters can be difficult, but not impossible. It's not just the carb load, but the moisture that will be an issue, particularly as your kitty is 9. I have lost 2 cats to CKD around that age, both were dry food only eaters.

Dr. Pierson has posted stickies on this board on how to transition a cat from dry to wet. It was really hard when I did it, as not all my cats were on-board, but patience and persistence pay big dividends. All the cats lost weight, gained energy, their coats got softer. Please reconsider shifting your sugar kitty, and your bg numbers will reward you.
 
My apologies - I misremembered the CVS test strip prices. It's $16 for 100 strips, $30 for 200. Still a savings even over the Relion strips.
 
Thank you all very much for your help! I am trying to get him away from kibble, do more testing etc. I also want to try and balance his needs and my own needs....meaning, he is a kitty and does not appreciate being stabbed on the ear, poked with a needle and all the other wonderful stuff that comes with this diagnosis. I will not just give up on him but it stresses him out more to do all the things associated with controlling diabetes......just trying to be realistic and pragmatic. I chose him to be our pet so I need to do the best for him but he is a cat who wants to kill his catnip carrot and stare at the bird not be manhandled and poked...ugh. God bless you all that are sharing the wealth of knowledge you have obtained fighting the fight!!!!
 
It's surprising how routine all this becomes to both owner and kitty once you're well practiced and kitty is well trained. Until then, anxiety and stress make it seem impossible and destructive to the bond you have. Do you use low carb treats like freeze dried chicken? Rewards go a long way in making this easier. Kitties, including fractious ones, readily learn to associate testing and shots with treats over time, usually quite quickly.
 
My Yemala was resistant to ear pokes at first, but we have a routine, now.

She never gets food unless she gives me blood first. At meal times, she will present herself on the dining room table - with 8 cats in the house, the kitty with special and expensive food gets some degree of isolation from the mob - and wait reasonably patiently for the stick. She used to pull her ear away, but now holds still while I test. As soon as she is tested, she gets her special food or boiled chicken, depending on whether it's a meal time or snack.

It does get easier. You have to test before shooting - that one is an absolute. Anything other than that is unsafe for the kitty.
 
Hroswitha said:
My Yemala was resistant to ear pokes at first, but we have a routine, now.

She never gets food unless she gives me blood first. At meal times, she will present herself on the dining room table - with 8 cats in the house, the kitty with special and expensive food gets some degree of isolation from the mob - and wait reasonably patiently for the stick. She used to pull her ear ay, but now holds still while I test. As soon as she is tested, she gets her special food or boiled chicken, depending on whether it's a meal time or snack.

It does get easier. You have to test before shooting - that one is an absolute. Anything other than that is unsafe for the kitty.
Click to expand...
Until The Ralph was diagnosed with diabetes, he was an amazingly patient kitty with meds, pills and the occasional shot....given I was not poking him twice a day on the ear and again on his body....when he started feeling better is when he decided he has had enough! And I admit with shame that he gets a kibble as his treat for the ear poking.... Ralph also has scaring around the tips of his ears(adopted with it)so I am unsure if that makes a difference. But you all are correct, it is a journey and a fight. Trying to figure out this puzzle, thank you for loaning me some pieces!
 
I buy 10 lb bags of chicken hind quarters at Walmart for under $6. I bag them up two apiece, and freeze them. When needed, I throw them into a large pot and boil them until the meat is cooked through. Once the meat is removed from the bone, it makes dandy low carb treats. Mala gets that sometimes as her reward for ear pricks. She has to share it with the panther boys I'm fostering, but there's more than enough. A bag cooked lasts about 2 days - unless they eat it all, which happens.

You might try that.
 
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