I really need some help :)

Tamala Poljak

Tamala Poljak

Member Since 2019
Hello, my sweet kitty Carter is newly on insulin. She is bouncing all over the place and going quite low mid day. I work very long hours so I can't check her that often except for AM and PM, but i was able to check her over the weekend. I assume I should only give her 1/2 the dose (the vet said to give her 1 unit AM and PM) when she is under 200? I am having a really hard time finding a vet that can help me... so any insight is appreciated! Thank you for being here!
 
I don't see any entries on your spreadsheet for the last four days; has she been getting insulin, and have you been testing before every shot? I'm not an expert, but I really don't see any numbers that would warrant skipping her insulin. What protocol are you using? If you're using SLGS, you only need to get a curve once a week.

I don't think that skipping shots is helping; if anything, it's likely what's causing her to bounce so much. If you're concerned about her dropping too low during the times you're unable to test, you might want to consider dropping back to 0.75, but since Lantus is a depot insulin, it needs to be given consistently. This means every 12 hours, the same dose AM and PM, unless her nadirs are dropping too low.

I'm using TR, so I'm less familiar with the SLGS guides, but I'm sure someone more experienced will respond. In the meantime, please re-read the stickies for both the TR and SLGS protocols, and also regarding the insulin depot.

ETA: the SLGS guideline says that you should immediately reduce the dose by 0.25 if the nadir falls below 90. This hasn't happened yet, the nadirs you've recorded have been 90 and above, so according to this you should maintain the current dose of 1.0 unit, AM and PM.

Please fill in the missing data on your spreadsheet, so folks here are better able to advise you.
 
Thank you so much. I don't know about "protocols" so I don't have one to follow? Is that something you can help me understand? I think maybe I am being too paranoid about giving her too much insulin because I haven't found a way to understand all this yet, so still learning! Thank you!
 
Sorry, I guess I was assuming you understood more than you do; I've forgotten already how overwhelming all of the information can feel. At the top of this forum are several threads that are marked with yellow "stickies"; these contain a wealth of information about understanding feline diabetes and how to manage the care of your diabetic cat. A protocol is simply a set of guidelines that you choose to follow that helps you know how much insulin to give, how to keep track of kitty's blood glucose, and how to decide when to make an adjustment to the dose.

There are two main protocols that most folks use - SLGS stands for Start Low, Go Slow. Since you're not able to test during the day, this is probably the one you'll want to follow. Complete guidelines are given here:

http://www.felinediabetes.com/FDMB/...-low-go-slow-slgs-tight-regulation-tr.210110/

This will help you make decisions about how to handle giving insulin, so please read it, then re-read it, and keep doing so until you understand it completely!

One thing to understand is that Lantus is a "depot" insulin - in the pen, it is contained in a slightly acidic liquid. Once it is injected under your cat's skin, into a neutral environment, the insulin precipitates out and forms a deposit of insulin that is taken up into the bloodstream slowly over a period of 12-14 hours. So even if you give a shot in the morning, it will continue working throughout the next 12 hours. When you reduce doses, it will take a few cycles before you can tell what effect the change has, because there is still insulin in the depot being used up.

Again, at a very minimum, read the stickies about the Insulin Depot and about the dosing methods (SLGS and TR). You can do this, from what I see on your spreadsheet, Carter doesn't appear to have been in any danger. Best thing you can do is get him on a consistent dose, monitor when you can (always test before shots!), keep your spreadsheet up-to-date, and get a curve when you're home on the weekends.

Please come back with any further questions you have - it takes a while to internalize all of this - and good luck!
 
The Glucocard meter is a human meter sold at ADW Diabetes and is the equivalent of one of the Relion meters recently discontinued by Walmart. The numbers provided here are correct for the human meter Tamala is using. :)
 
MrWorfMen's Mom said:
The Glucocard meter is a human meter sold at ADW Diabetes and is the equivalent of one of the Relion meters recently discontinued by Walmart. The numbers provided here are correct for the human meter Tamala is using. :)
Click to expand...
Thanks I looked up the meter and they offered pet supplies at ADW.
Opps, I'm glad you know your meters Linda. :cool:
 
Do you have syringes with half markings? I think it would be a good idea to start over with 0.5u so you can consistently give insulin AM and PM.

We also encourage you to grab a "before bed" test. You are missing half the picture with no PM tests after PMPS and before AMPS. Most cats like to go lower at night.
 
Thank you so much! This is so helpful! I will read up tonight :)


Erin & Scott said:
Sorry, I guess I was assuming you understood more than you do; I've forgotten already how overwhelming all of the information can feel. At the top of this forum are several threads that are marked with yellow "stickies"; these contain a wealth of information about understanding feline diabetes and how to manage the care of your diabetic cat. A protocol is simply a set of guidelines that you choose to follow that helps you know how much insulin to give, how to keep track of kitty's blood glucose, and how to decide when to make an adjustment to the dose.

There are two main protocols that most folks use - SLGS stands for Start Low, Go Slow. Since you're not able to test during the day, this is probably the one you'll want to follow. Complete guidelines are given here:

http://www.felinediabetes.com/FDMB/...-low-go-slow-slgs-tight-regulation-tr.210110/

This will help you make decisions about how to handle giving insulin, so please read it, then re-read it, and keep doing so until you understand it completely!

One thing to understand is that Lantus is a "depot" insulin - in the pen, it is contained in a slightly acidic liquid. Once it is injected under your cat's skin, into a neutral environment, the insulin precipitates out and forms a deposit of insulin that is taken up into the bloodstream slowly over a period of 12-14 hours. So even if you give a shot in the morning, it will continue working throughout the next 12 hours. When you reduce doses, it will take a few cycles before you can tell what effect the change has, because there is still insulin in the depot being used up.

Again, at a very minimum, read the stickies about the Insulin Depot and about the dosing methods (SLGS and TR). You can do this, from what I see on your spreadsheet, Carter doesn't appear to have been in any danger. Best thing you can do is get him on a consistent dose, monitor when you can (always test before shots!), keep your spreadsheet up-to-date, and get a curve when you're home on the weekends.

Please come back with any further questions you have - it takes a while to internalize all of this - and good luck!
Click to expand...

So strange re: not seeing the last 4 days on the spreadsheet
as I have been updating it every night and morning... including today
Erin & Scott said:
Sorry, I guess I was assuming you understood more than you do; I've forgotten already how overwhelming all of the information can feel. At the top of this forum are several threads that are marked with yellow "stickies"; these contain a wealth of information about understanding feline diabetes and how to manage the care of your diabetic cat. A protocol is simply a set of guidelines that you choose to follow that helps you know how much insulin to give, how to keep track of kitty's blood glucose, and how to decide when to make an adjustment to the dose.

There are two main protocols that most folks use - SLGS stands for Start Low, Go Slow. Since you're not able to test during the day, this is probably the one you'll want to follow. Complete guidelines are given here:

http://www.felinediabetes.com/FDMB/...-low-go-slow-slgs-tight-regulation-tr.210110/

This will help you make decisions about how to handle giving insulin, so please read it, then re-read it, and keep doing so until you understand it completely!

One thing to understand is that Lantus is a "depot" insulin - in the pen, it is contained in a slightly acidic liquid. Once it is injected under your cat's skin, into a neutral environment, the insulin precipitates out and forms a deposit of insulin that is taken up into the bloodstream slowly over a period of 12-14 hours. So even if you give a shot in the morning, it will continue working throughout the next 12 hours. When you reduce doses, it will take a few cycles before you can tell what effect the change has, because there is still insulin in the depot being used up.

Again, at a very minimum, read the stickies about the Insulin Depot and about the dosing methods (SLGS and TR). You can do this, from what I see on your spreadsheet, Carter doesn't appear to have been in any danger. Best thing you can do is get him on a consistent dose, monitor when you can (always test before shots!), keep your spreadsheet up-to-date, and get a curve when you're home on the weekends.

Please come back with any further questions you have - it takes a while to internalize all of this - and good luck!
Click to expand...
 
Hmmm . . . I wonder what others are seeing - the last entry I see is for 2/16, AMPS and a dose of 1.0 given. What do you see when you click on the link in your signature?
 
Thank you all for reaching out!! Something is going on with the spreadsheet because I do an AM and PM test every night and post on the spreadsheet. I just tried re-uploading the spreadsheet. Please let me know if it's posted ok??
 
Are you all saying I should do a second PM reading? I am doing a 9:30AM and 9:30PM glucose reading before the shot. Tonight she was 177 and I gave her .5 unit. hopefully it's showing up on the spreadsheet now. Thanks for bearing with me! I'm new to this and really trying to learn :)
 
You need to click on Share, choose "Anyone with link can view" and then copy that URL into your signature. The URL that is there now is one you use to edit the sheet.
 
Tamala Poljak said:
I think you should be able to see it now ?? Thank you!!!!
Click to expand...

Nope...still says I need permission

Go to the Share and make sure this is where it's set
upload_2019-2-21_1-12-10.png
 
You should not have to upload the spreadsheet from your computer (phone? tablet?). You should be able to directly edit the online version of the sheet from your web browser (or from Google Sheets on your tablet or phone).

If you upload a copy from your computer/phone/tablet, then you will have to redo the sharing link, like you just did.

Hope this makes sense. I'm pretty new to Google spreadsheets myself.
 
Welcome to the group!

There is a a huge amount to learn and it's completely overwhelming so you're exactly where you ought to be in this process. The good news is that this is a devoted group of caregivers who are very supportive and willing to share their knowledge and experience.

You've gotten your spreadsheet up and running and even better, you're home testing. That's the first big hurdle. You've also been feeding Carter a low carb diet. That's a lot to have done given that your kitty is so recently diagnosed.

The next hurdle is reading the sticky notes at the top of the board. That's when you will really become overwhelmed. There's a huge amount of information in those posts and the associated links. Reading over the dosing methods will help you to select an approach to managing your cat's diabetes. There's Start Low Go Slow (SLGS) and Tight Regulation (TR). You can do either approach given that Carter is on a low carb, raw diet. TR is a bit more aggressive. With either approach, you will need to do a bit more testing -- at the very least during the PM cycle and when your not working (e.g., weekends, holidays). Also, if you happen to get home from work early, are leaving late, etc., I'd encourage you to get a test. All of the testing allows you to have a better understanding of what the AM and PM cycles look like. As others have noted, getting at the minimum a before bed test every night will be helpful. You will want to consider doing a curve on days when you're home. A curve gives you information about when Lantus onset starts, where the nadir falls, and how much duration you're getting. Because Lantus dosing is based on the lowest point in the cycle (i.e., the nadir), knowing how low Carter's numbers are going is important. You want to know when to reduce the dose and you want to keep her safe.

Please let us know if you have questions. We're here to help.
 
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