New members - G and Panter - diagnosed last month

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From the bg's you have so far, he has really never been under 13. And with the 4 Units a.m and 3 Units p.m, the nadir period seem to fall between the +4 to +6 hours. 13 is the renal threshold and he has not been in any unsafe numbers so far.
So I don't know if 3+3u would be better.
 
But the road is built as we go - and to sum up so far: I will take the BGtest 45 min to 1 hour before every insulin shot. Food before or after the shot? - after would be easiest as that would be his bribe kind of... but if best before I can do that. I take away the food 2 hours before BGtest. Or more ? - it's here the BG is getting high.
Slight correction on the step by step, as this is an NPH type insulin:
BG test at +11 (So if doing AM test, this actually goes on your SS in the +11 column for the previous day.)
Feed at least 1-2 ounces wet food. 30-60 grams. 3 ounces would be better, 60-90 grams if Panter will eat that much
Wait 45-60 minutes for food to digest
BG test at +12 (Also known as your AMPS or PMPS test)
Insulin shot and feed again. 2 ounce 60 grams (food amounts are approximate.)
Take away food 2 hours before +11 test. So no food after +9

This is my best guess at how much to feed Panter in the early part of the cycle. I have not accounted for all the food he eats each day. Can you give me those food amounts again please? We can adjust food amounts later.

There is more testing at the beginning of treatment of feline diabetes. That is because we are trying to find out how it affects your cat. Need to see when onset, nadir, duration occur. So you test at different times during the 12 hour cycle to find out.

Since this is a NPH insulin, the duration may be really short. From a quick look at the SS, that is what I'm seeing, short duration.

Each insulin has advantages and disadvantages.
p.s. You don't have to put the BG readings in the remarks if you don't want to. They are already in the cells on the SS.
 
From the bg's you have so far, he has really never been under 13. And with the 4 Units a.m and 3 Units p.m, the nadir period seem to fall between the +4 to +6 hours. 13 is the renal threshold and he has not been in any unsafe numbers so far.
So I don't know if 3+3u would be better.
I also don't know if 3U am and 3U pm would be better.

When do you travel next? So we can try to figure out if the food change to all low carb wet food can be done before that.

Thanks Ann for helping here. Valuable knowledge you are sharing.
 
From the bg's you have so far, he has really never been under 13. And with the 4 Units a.m and 3 Units p.m, the nadir period seem to fall between the +4 to +6 hours. 13 is the renal threshold and he has not been in any unsafe numbers so far.
So I don't know if 3+3u would be better.

So this 9 yesterday is nothing to worry about? What does 'nadir period' mean?
 
What does 'nadir period' mean?

The nadir is the lowest point in the cycle. Each cycle is 12 hours and the "nadir" is the lowest blood glucose reading you get in that 12 hour period.

It's usually between 4 and 6 hours from the time you give the insulin (but can be earlier or later...Every Cat is Different)
 
So this 9 yesterday is nothing to worry about? What does 'nadir period' mean?
The 9 yesterday is a nice number! Getting blues is a good response. It does illustrate how that dose of that insulin worked on that day though - the insulin dropped bg quite nicely for the first half of the cycle but then "petered out" completely, ie with no insulin in his system his bg shot up again. The ideal would be a dose that would produce a slightly gentler curve showing nadir about halfway through the cycle and then slowly rises again (if you draw a simple line in the shape of a little smile you'll get the idea).

As Chris has said in answer to your question, nadir is the lowest point in the cycle. The other terms you'll hear in context of how a dose works are "onset" - when it begins to take effect - and "duration" - how long it lasts. The same dose of the same insulin may not work in the same way every day but with regular monitoring you will build up a picture - that's the way to come to decisions about changing the dose or the insulin. Knowledge is power!

Hang in there, you're doing great and have come a long way already :)
 
Slight correction on the step by step, as this is an NPH type insulin:
BG test at +11 (So if doing AM test, this actually goes on your SS in the +11 column for the previous day.)

Hi Deb,

The cells AMPS and PMPS - should I transfer the the number at +11 to these cells?

Food - Panter will eat any amount right now if I let him - he is so hungry - so this is a challenge. So I have been given big breakfast after insulin shot - about 150g wet food, then during the day 150 g wet food (+4 and +8 or sometimes one +6), evening after insulin 100-150 g, night 20g dry RC. And he doesn't gain weight.

So now I will - to repeat -
Feed 60-90 grams
wait 45-60 minutes for food to digest
BG test at +12
Insulin shot and feed again. About 60 grams.
Take away food 2 hours before +11 test. So no food after +9
This I will do two times - AM and PM.

Travel - I'm afraid a travel is coming up on Thursday (1,5 week) - so my husband will be the one taken care of Panter. And he is about to learn the insulin shots today (but no worries there). But to take BG test - I do worry. And he worries - a lot...
This is where I need to take a deep breath - and a chocolate. Because I really don't know how we're going to do this.
 
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I was wondering - is there a way to see the SS as a curve, if you know what I mean?
I don't think there is on this particular ss (other people may know for sure) but I have seen other members using their own versions where the time and bg numbers are plotted like a graph. There's nothing to stop you doing that if you want to but you'll find that most people here are used to seeing the colour-coded one - you'll soon start to see patterns.

Ref your husband being wary about testing bg - this is quite common actually, some men are a bit squeamish or just don't want to do it. Really, when you are giving insulin, you do need to be able to test bg, so if you're going away your DH needs to step up.. Can you work out a little learning plan to introduce the process to him gradually so he feels able to test? Maybe a little treat after each attempt?!
 
Ref your husband being wary about testing bg - this is quite common actually, some men are a bit squeamish or just don't want to do it. Really, when you are giving insulin, you do need to be able to test bg, so if you're going away your DH needs to step up.. Can you work out a little learning plan to introduce the process to him gradually so he feels able to test? Maybe a little treat after each attempt?!

I guess I have to be clever here and figure out something...;)
 
What to do - when he is so desperately hungry?? He is up in BG 21.6 and has already got 60 g (after) - but he wants more - he is all over the kitchen searching...
 
It's OK to feed Panter. When blood glucose (BG) numbers are high, the end product of metabolism (i.e., glucose) isn't getting from the blood stream into the cells. As a result, your cat is starving. It's OK to give some food. You don't want to feed Panter 2 hours prior to your shot time since you don't want food to influence the pre-shot test..

I honestly think we are all guessing about which insulin Insulatard is most similar to. With all of the possibilities, it is not most similar to an insulin that we know is recommended for cats. If you can discuss this with your vet, Lantus is available and recommended as a good insulin for cats. We will be able to offer a great deal more help with your managing Panter's diabetes if we are knowledgeable about the insulin you are using.
 
It's OK to feed Panter. When blood glucose (BG) numbers are high, the end product of metabolism (i.e., glucose) isn't getting from the blood stream into the cells. As a result, your cat is starving. It's OK to give some food. You don't want to feed Panter 2 hours prior to your shot time since you don't want food to influence the pre-shot test..

Thanks Sienne! I will talk to the vet on Monday about Lantus.
So if I give more food on this high number (21.6 - with next insulin in 3 hours) - the BG want jump higher? Well no it's too late as I will test in two hours, but thinking more in general.
 
There's no way to know for sure what the effect of food will be. You may want to spread Panter's food out over the first several hours of the cycle when insulin is most effective. You can then increase the amount of food but not feed past nadir which is when the insulin starts wearing off.

I would also try to discontinue the dry food. The RC dry will cause Panter's numbers to rise. Almost all of the RC dry foods are very high in carbohydrates.
 
Yes, discontinuing the dry food would be good, but this insulin is a NPH type insulin. (See post #45 in this thread). Risk with taking away all dry food at this point is that the BG levels will drop very low and risk of hypoglycemia. More monitoring needs to be done, and I'd even suggest dropping the dose of the Insulatard down lower.

Goeril uses an insulin pen, so dose adjustments can only be made in 1U increments for now. She does know about the possibility of using syringes with the pen but has no syringes at this point. She'll want to get U100, 3/10 cc, 30 unit, 30-31 gauge syringes. Those same syringes can be used with Lantus if she switches to that insulin.

She is traveling in 1 and a half weeks, husband does not yet give insulin or know how to home test. Goeril will figure out a way to teach him she said.

Insulatard is a 100 IE/ml NPH human isophane insulin made by the Nordic company Novo Nordisk, similar to Humulin NPH The Swedish Pharmacy products in Swedish https://www.fass.se/LIF/product;jse...dA!-300631965?userType=2&nplId=20021007000385
@Ann & Scatcats provided this info and she has used the Insulatard for her own cat. (Ann, I actually understood about 1 in 4 words in that document from context and knowing German)
 
Yes, discontinuing the dry food would be good, but this insulin is a NPH type insulin. (See post #45 in this thread). Risk with taking away all dry food at this point is that the BG levels will drop very low and risk of hypoglycemia. More monitoring needs to be done, and I'd even suggest dropping the dose of the Insulatard down lower.

Goeril uses an insulin pen, so dose adjustments can only be made in 1U increments for now. She does know about the possibility of using syringes with the pen but has no syringes at this point. She'll want to get U100, 3/10 cc, 30 unit, 30-31 gauge syringes. Those same syringes can be used with Lantus if she switches to that insulin.

She is traveling in 1 and a half weeks, husband does not yet give insulin or know how to home test. Goeril will figure out a way to teach him she said.

@Ann & Scatcats provided this info and she has used the Insulatard for her own cat. (Ann, I actually understood about 1 in 4 words in that document from context and knowing German)

Syringes - haven't thought of that I can just draw it from the flexpen, right? What does this mean U100, 3/10 cc, 30 unit?
I'm traveling on Thursday, will be away 1,5 week...
but guess what - my husband took his first BG test a few hours ago! I think I actually underestimated him. And of course when your arm is twisted..;-) So tonight he will do the insulin and another BG. But these 10 days want be max testing of things, more in a maintaining stage I'm afraid. How will that work do you think? Set back or?
 
About the dry food - he only gets about 20g in the night at 00.30(+5) PM through a timed cat mate and now I will close it +9 (to test GB +11) - I can switch it for wet....? What do you think?
 
But these 10 days want be max testing of things, more in a maintaining stage I'm afraid. How will that work do you think? Set back or?
Not a setback. Maintaining is good.

More food is fine. I learned that tørr is Norwegian for dry. Thanks for the notes in your SS in the remarks column. Helps us to see what is going on, and interpret the numbers.

Goeril, I was writing another reply while you were also. Maintain doing the things you are doing now. We will help you when you get back on February 1st.

My recommendation (my opinion) would be to NOT change the insulin at this point from Insulatard to Lantus. Don't eliminate the dry food either yet.

My reasons being:
  • Husband needs to learn to home test. He just did his first test and shot!!!
  • If vet doesn't use lantus for cats, she may need to find another vet that does.
  • If vet doesn't use lantus for cats, but is still willing to prescribe it, vet may not have much experience and may prescribe too high of a dose.
  • Your upcoming travel for work is very soon. (How long are you gone Goeril?)
  • Lantus is different in how it works and the test, feed, shoot sequence is different. Steep learning curve.
  • Ideally, I'd like Goeril and her husband to be home testing before eliminating the dry food from the diet.
With all these things happening in a very short time, I'd be worried. I certainly would not start the Lantus at the current 4U am, 3U pm dose that is being given now.

p.s. Be right back with syringe explanation
 
Okay, Deb. I hear you. Thanks! We will maintain. I can still work on the BG tests up to coming Wednesday. I will be back home Tuesday 4. evening (actually not 10 but 12 days). I will also figure out on Monday if our Vet have any experience with Lantus, so we know till I'll be back.
This recipe of BG testing +11 - food - BG testing +12 - ins + food AM and PM - how many days do we do this?
 
Syringes - haven't thought of that I can just draw it from the flexpen, right? What does this mean U100, 3/10 cc, 30 unit?

U100 is the concentration of insulin you are using. There are also U40 concentrations of insulin. You want to get syringes that match the concentration of the insulin you use.

cc is the capacity of the syringe. Syringes are available in 3/10cc, 1/2cc, 1cc and 2cc. Any syringe more than the 3/10cc capacity is much harder to use to draw up those tiny doses our cats need. 3/10cc and 30 unit is the same thing. They hold the same volume. (My first diabetic cat was a foster cat from my local cat shelter and they gave me 1cc syringes to use. They didn't know any better but I learned from here).

Insulin syringes have different gauges. The higher the number, the finer the needle and the less it hurts. Gauges can be from 27 to 31. Try to find a syringe in the smallest gauge that meets the concentration and capacity requirements.

You also want insulin syringes that have half-unit markings on the syringe barrel (cylinder). Easier to use when you want to dose by 0.25U and 0.5U increments.

BD, Monoject, Sure Comfort are 3 of the manufacturers that make insulin syringes in the US. Not sure what you have in Norway. Not sure if you need a prescription from your vet to buy syringes or if you can walk into a pharmacy to buy them. Different rules, different countries, different rules for different states here in the USA even. (Drug epidemic concerns)

p.s. you are 2 fast for me. Replies on other questions in next post from me.
 
Okay, Deb. I hear you. Thanks! We will maintain. I can still work on the BG tests up to coming Wednesday. I will be back home Tuesday 4. evening (actually not 10 but 12 days). I will also figure out on Monday if our Vet have any experience with Lantus, so we know till I'll be back.
This recipe of BG testing +11 - food - BG testing +12 - ins + food AM and PM - how many days do we do this?
Keep that schedule for now with the insulin you are currently using. Every day until you change insulin.

Ok to increase the amount of food if Panter wants to eat more.
 
About the dry food - he only gets about 20g in the night at 00.30(+5) PM through a timed cat mate and now I will close it +9 (to test GB +11) - I can switch it for wet....? What do you think?
No, do not change to wet food now. Risk for hypo (hypoglycemia) with food change to lower carb and high dose of insulin.

Linking a few documents for you to read. (You seem to want to/need to know so much but it takes time to learn all this. Glad you are so interested.) Don't know if you have a printer, but printing out these 3 documents could help you next time. The old boy scout motto "Be Prepared".

How to treat HYPOS - THEY CAN KILL! Print this Out!!
jojo and bunny's HYPO TOOL BOX
New? Seeing Low Numbers? How You Can Help Us Help You

Just in case the power goes out, or your cell phone doesn't have a charge, or you get those lows and ask yourself "Now what was I supposed to do if I get low numbers?" Or you can't sign on to the message board for some reason.
 
Great! I will read! :-) I'll bring it with me on my travel. Thanks!
To make sure - (sorry my need for taking it in with a 'teaspoon' as we say in Norway..) but you want me to BG test 4 times a day - before and after food that are given before insulin morning and evening until we change insulin. That means my husband has to do this as well... oi...
 
You can change the title on your post at any time. Go to the top right of your 'thread'. This one you are in now. Over on the right hand side, you will see "Thread Tools, Edit Title". Click on that. A smaller window pops up on your screen where you can change the title on your post and to the left of that title is a box where you can change the prefix on your post. No prefix is fine for most situations but that is where you can select the Question mark icon or the 911 for severe emergencies. Save your changes. you might want to try this.

For now Goeril, "Please, pretty please, pretty please with sugar on top." Keep all your posts in this one thread. It's easy for us helping you to look back through all that has been written. Would you also add your first name to your signature? I might be helping multiple people at the same time and that helps me not to mix things up.

You can always change the title on your post if you would like some guidance when you get those first low numbers. I'm not up that late at night, but there is often someone on the board later. Not always, but often enough. And people do scan the boards for people in more immediate need. You could also post over in the Lantus forum, since there are often more people hanging out over there later at night (and during the day too). Simply a fact of more people using lantus.

Write something like… “BG level xxx, 1st low number <100 (5.5), please HELP” to alert people to your situation. If you don't get a response, reply to your own post with the word 'BUMP', to move your post to the top of the list. Posts are all in order by the most recent timestamp on the post, so your post may have fallen farther down in the list but needs more attention sooner than others.

If you get a BG under 30 mg/dL (1.6 mmol/L) on a human meter, change the prefix icon on your post to 911. That really gets people's attention. "Using the 911 prefix. The 911 prefix in the subject line should only be used for emergencies such as symptomatic hypos, very low numbers (below 30 on a human meter), and /or a very sick cat potentially needing ER care."

It's like calling your police, fire, medical emergency number for help for humans. It will get our hearts racing and coming to you and your cats rescue.

Did I leave anything unanswered? More questions? Understand everything? Take your time and read back through everything. There is a lot here. It's good you want to know so much, but you have other responsibilities too as do all of us here. My cat is begging for more food in fact. :)
 
Great! I will read! :) I'll bring it with me on my travel. Thanks!
To make sure - (sorry my need for taking it in with a 'teaspoon' as we say in Norway..) but you want me to BG test 4 times a day - before and after food that are given before insulin morning and evening until we change insulin. That means my husband has to do this as well... oi...
Yes. Testing 4 times a day. And maybe more testing if you or your husband notice some of those hypo(hypoglycemic) symptoms.

Is that possible for you to do? Let us know if anything does not work for you and we will try some other ideas.
 
While you are away for work, your husband could post here. Just have him let us know he is the one posting on behalf of your cat Panter. Use the same user name, have him sign on using your account. Bookmark this thread. Have him try it first, before you go away.

It's only noon here. You are 6 hours ahead of where I live in the USA, east coast.

Black eared kitties can be so hard to test and see the blood. Do you need any tips to help with that?
 
Good idea. I will introduce him to the site. And yes, I appreciate all advises - and right now in this moment - yes please - for some tips about GBtesting. We do manage, but it's not really smoothly. I found some advice on the net - so I do use this rice bag to warm up his ear to draw the blood more to the surfus - and I can see the bloodline around his ear, and I stick the needle - and no blood - or too little - sometimes too much - so my poor buddy peeps for every needle stick - but actually sits more or less still. He is so far very helpful...thanks for that! But yes - if it doesn't work on the first try - I get a little stressed... and that doesn't help. So we are all practicing...puhh
 
First the different insulins,

Picture 1 - Our Insulatard vial/flaska

Picture 2- Our Lantus vial/flaska

Picture 3 - Our smaller Lantus Ampuller.i.e cartridges

Picture 4 - Overall picture Insulatard, Lantus, Lantus cartridges


If you shift to Lantus you should ask to get the presciption for the 5 small Lantus ampuller.
This is because while Insulatard lasts for 5 weeks before it gets old, Lantus last for 4 weeks before it gets old, and it becomes more expensive with the big bottle of Lantus when we never use that much insulin as such a big whole Lantus bottle.
Therefore we get the prescription for the 5 small Lantus ampuller and draw up the insulin we need from one small ampull with a syringe and we hardly use a full small Lantus ampull in 4 weeks. It becomes cheaper with the 5 small Lantus ampulls.
 

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Insulin syringes

Picture 1 - What the syringe brand BD Micro-Fine + Demi with Half-Unit markings Insulin syringes box looks like. They are also thinner needle, 30 gauge, and the shortest needle 8 millimeter, so they don't hurt so much.

Picture 2 - .The different needle thick and needle length BD Micro-Fine insulin syringes.
To the left is the thinner needle, 31 gauge, and shortest needle length 8 millimeters.
To right is the thicker needle, 29 gauge, and much longer needle length 12,7 millimeter.
I first used the longer syringe but changed to the thinner and shortest for Simba's sake so it didn't hurt so much.

In Sweden we need prescription for the insulin syringes too.
And BD is a big diabetics brand, so you can check with your Norwegian pharmacy if they have these BD Micro-Fine syringes.
 

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Ann, Those pictures will be very helpful to Goeril.

In picture 2 of the syringes, you can see the difference in how close the lines are in the 30 cc volume syringe (on left) and the 50cc volume syringe on the right.

I highly recommend the 30 cc volume (3/10 cc) syringes. Insulin doses are hard enough to measure in the tiny units we give our cats.

Needle length is a personal choice. The syringes with the half unit markings are a higher priority in my opinion than the needle length. But the slightly longer needles can be useful if you have a longer haired cat.
 
And yes, I appreciate all advises - and right now in this moment - yes please - for some tips about GBtesting. We do manage, but it's not really smoothly. I found some advice on the net - so I do use this rice bag to warm up his ear to draw the blood more to the surfus - and I can see the bloodline around his ear, and I stick the needle - and no blood - or too little - sometimes too much - so my poor buddy peeps for every needle stick - but actually sits more or less still. He is so far very helpful...thanks for that! But yes - if it doesn't work on the first try - I get a little stressed... and that doesn't help. So we are all practicing...puhh

Oh yes! When it's winter time in the cold north and the temperature is below 0 C (32 F) warming up the katt's ear is essential. Before BG testing. Especially if your cat has been outside. Where it is even colder. (Like 5F (-15C) when I got up this morning.)
Basics
  • Warm the ear with a rice sock or a warm washcloth wrapped in a plastic bag.
  • Either freehand or use a lancing device; new members usually start with a larger gauge lancet such as 28g or 29g until the ear learns to bleed; then progress to a 31g or 33g which are finer. If you can find a lancet that is labeled "for alternate site testing" you can sometimes find them in a 26g. I never switched from 28g (g is the gauge) The smaller the number, the bigger the metal needle part you use to prick the ear.
  • Be sure to poke in the "sweet spot" and not the major vein that runs along the length of the ear. Poking the vein will not only hurt, but will result in a lot of blood. The sweet spot is on the edge of the ear.
  • Here is a diagram of the best place to poke a cat's ear.
4395c545-36bf-4aba-bec7-4392fcdb191c-jpeg.48119


  • Poke twice, right next to each other to get a slightly bigger blood drop.
  • Do you hold the lancet in your fingers or are you using a holder for the lancet? Sometimes called a lancet device or pen.
  • Angle, the lancet bevel side up (see picture below) if free handing (holding the lancet in your fingers).
  • Hold the lancet device straight or flush against the ear. Some lancet devices have a depth adjustment. As you get better at testing, you can change the depth.
  • Do you use something firm against the opposite side of the ear? Many people use a small piece of facial tissue or kleenex folded over many times to provide a more solid backing for the ear. Cat ears are thin and this will give you a firmer surface.
  • Do you test on the inside or the outside of the ear? Inside may be easier to see, unless you have a long haired kitty with lots of ear hair.
  • Strong light, a little flashlight you can hold in your mouth, your cell phone light, a clip on light you can shine and aim down at the ear. Good lighting let's you see the vein and the 'sweet spot' area better.
  • Panter has black ears. Black ears make it difficult to see the blood drop in the fur. You could try shaving a tiny spot on the ear with a safety razor. Very, very lightly as you don't want to nick his ear as you might when you shave your own legs.
"But did you also know there is a particular way for the lancet to be used? It has one side that is beveled so the sharpest part goes in first, if used correctly. In the photo below, you can see the lancet is angled. When you poke the ear, it should be held in the position shown below so the longest side of it is on the bottom. Lancets should only be used once to ensure they are at their sharpest." It's ok to use the same lancet for the same test time. Or even the same test cycle (a cycle is 12 hours)
2417e86c-bae9-43b4-8612-c49c88d2c0ac-jpeg.48120



I copied these 2 pieces of information from this document: Marje and Gracie's Testing and Shooting Tips

Let me know if that helps.

p.s. Deb, the Reference Librarian, is what I've been calling myself on the message board lately. I know where to find things.
 
You are just amazing! Thank you so much! I feel really pampered. Feels great!

On the flexpen I use needles 29g 12mm. And right now anyway, it feels good that they are a bit long, then I know I get through, kind of. And I use the same needle for about three days before changing it. When you use the syringe - you draw up only the morning/evening dose right - do you then have to switch needle everytime or?

Just hits me - I feel reliefed about that the insulin shots feels easy. The BG test not so easy yet, better and better though.

I will look for these needles at the farmacy. Dont need prescriprion here in Norway. Thanks again!
 
Hah..amazing yes - and I hadn’t even read this last one! And I had got it wrong - I thought I should go for the vein, but the sweet spot. Alright! I use free hand lancet. Same as flexpen 29g 12mm. I’ve been using the rice bag on the opposite side. You say; ‘Angle, the lancet bevel side up’ - does this mean straight down or little angled to the skin? And no, haven’t thought of the angled head of the needle. Great! Thank you!!
 
You are very welcome. We like to give personalized attention to each new member. It's why for now, we want to keep you posting in only this thread, your first thread here on FDMB. Ann and I want to keep our attention on you and keep helping as much as we can.

There is a lot of information to understand here. Re-read when you have some down time, some free time.
  • Insulin pen should have new pen needles used each time. Risk of infection in your katt and of contaminating the insulin. It's so easy for a tiny bit of air with some bacteria to move back into the insulin cartridge (mini-vial) that you use after injection.
  • Insulin syringes are one use only. The needle gets dull with time, very quickly. Higher risk of contaminating your insulin if you reuse needles. Bacterial contamination mostly.
  • With a cloudy type insulin like the Insulatard you are using, it can be hard to see if it's contaminated. With a clear insulin like lantus, you can look for floating particles.
Insulin is very expensive here in the US. And some supplies too. Stories of people rationing and dying because they can't afford insulin. Hopefully insulin is not as expensive where you are in Norway.

Your thirst for knowledge is incredible. Don't try to learn everything in one day. You are doing a fantastic job helping Panter.

Lunch time here. Going to have a late lunch myself and give my cat a mid-afternoon snack.

p.s. Snow storm with high winds for us here tonight. Might lose power here. Hopefully not, but Ann and other people will be around just in case.
 
Last night he didn't eat his RC dry food - the feeder is open from 0.30-4.30am - so no dry food involved in the next GBs... but he did eat a big fat mouse just before I went to bed...he came in with it and wanted to trade it for some more Felix...

...and his BG is up from +11:25.2 to +12: 27.6 after food... thats one step from black cell..Oh...
 
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We talked about this already, but if Panter does not eat his dry food, the BG levels could drop dramatically. 100 basis points or more (5.5 mmol/l) Just wanted to reiterated that. You may need to do more testing to see if Panter is dropping very low in the middle of the 12 hour cycle.

Be careful and keep a close eye on Panter. Watch for hypo (hypoglycemia) symptoms.
 
We talked about this already, but if Panter does not eat his dry food, the BG levels could drop dramatically. 100 basis points or more (5.5 mmol/l) Just wanted to reiterated that. You may need to do more testing to see if Panter is dropping very low in the middle of the 12 hour cycle.

Be careful and keep a close eye on Panter. Watch for hypo (hypoglycemia) symptoms.

I will! It's just that suddenly it seems like he is not so hungry as he has been... today was the first time in a long time that he has turned up his nose to food so I had to change his bowl to something else... but he did it that... might be a good sign or...?
 
...to add...strangely - he did not eat the RC dry last night - and his BG was up in 27.6 +11 this morning... what in earth is that?
 
I will! It's just that suddenly it seems like he is not so hungry as he has been... today was the first time in a long time that he has turned up his nose to food so I had to change his bowl to something else... but he did it that... might be a good sign or...?
You know your cat better than anyone else. Know what to look for if he seems unwell. Maybe he was too full from the mouse. Does he eat them, or only bring them inside to say "Look what I brought you mom! I'm such a good hunter. We'll never go hungry as long as I'm here to provide for you."

Cats are cats. They can change from one minute to the next. If Panter had refused to eat any food, that would have been more of a concern.

...to add...strangely - he did not eat the RC dry last night - and his BG was up in 27.6 +11 this morning... what in earth is that?
"Bouncing" maybe.

"Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's,(11's mmol, 16's mmol) or higher for a long time, then even a BG that drops to 150 (8.3 mmol) can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast. The pancreas, then the liver, release glucagon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles)."

Panter may have had a low. Doesn't have to be a hypoclycemic low, just a BG that was lower than his body was used to.
 
Sent my curves and questions - among other about Lantus - to the vet today. Have to admit that I was somehow kind of nervous for her reaction...but totally without reason. She was rather impressed by my work. Puhh...very nice to know that we have a vet that is willing to cooperate. She suggests to go down on insulin to 3+3u. And we will look into Lantus when I'm back. She also briefly mentioned something called acromegaly even though too early to say - I googled it - not so good - but we take no worries in advance.
 
Sent my curves and questions - among other about Lantus - to the vet today. Have to admit that I was somehow kind of nervous for her reaction...but totally without reason. She was rather impressed by my work. Puhh...very nice to know that we have a vet that is willing to cooperate. She suggests to go down on insulin to 3+3u. And we will look into Lantus when I'm back. She also briefly mentioned something called acromegaly even though too early to say - I googled it - not so good - but we take no worries in advance.
Glad to hear you have a supportive vet, it really does make all the difference. I wouldn't worry about acromegaly for now - that's a condition that does usually require high doses of insulin, it's true, but it's not as if the doses Panter is getting now are doing nothing - he does drop. A different longer-lasting insulin might suit him better so that's something to hang on to and hope for!
 
Glad to hear you have a supportive vet, it really does make all the difference. I wouldn't worry about acromegaly for now - that's a condition that does usually require high doses of insulin, it's true, but it's not as if the doses Panter is getting now are doing nothing - he does drop. A different longer-lasting insulin might suit him better so that's something to hang on to and hope for!

3+3u starting from tomorrow - sound good to you? At least it's less worries for big bouncing or what?
 
Glad to hear you have a supportive vet, it really does make all the difference. I wouldn't worry about acromegaly for now - that's a condition that does usually require high doses of insulin, it's true, but it's not as if the doses Panter is getting now are doing nothing - he does drop. A different longer-lasting insulin might suit him better so that's something to hang on to and hope for!

...and yes - we will not worry yet for acromegaly. I believe what you say about changing to a longer lasting insulin.
 
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