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Madalina & Mishu

Madalina & Mishu

Member Since 2020
Mishu was diagnosed 2 days ago, he is 8 years old. We are using Lantus, 2ui 1 shot per day, for now i go to the vet for the shot because i don't know how to do it myself. We are not home testing yet, i am still looking for a tester.
Is it nornal for him to be very sleepy? He eats, drinks some water and then back to bed. His ears are cold, his nose is wet, he reacts to sound and last night played a bit with me. Today is our 3rd day, we are going back to the vet in 30 mins, i'm just really worried, our vet said that it may take a while for him to adjust to the insulin.
 
Hello and welcome!

Hmmm.... I am very concerned about Mishu's dosing. 2U is a large starting dose, and insulin is dosed twice per day in cats (they have a very fast metabolism; even an insulin like lantus does not last more than 12hrs). I am concerned that your vet may not be very experienced with feline diabetes (not really their fault; they get almost no training on it in vet school among all the other topics and species they need to cover).

When you say he is "sleepy", is he more sleepy 4-6hrs after the shot, and get more awake after 12+ hours have passed? Or sleepy all the time? I don't want to scare you, just providing information, but in this document there's a list of symptoms of hypoglycemia and how to treat it with high-carb foods ("gravy" varieties of cat food are good, honey or Karo syrup in a severe situation). How to treat HYPOS - THEY CAN KILL! Print this Out!!

Lantus is an excellent insulin for cats, so that's good, it's just a matter of finding the right, safe dosage. We can help with that! I'm very glad you are thinking about home testing, it's the most important thing you can do to help Mishu keep safe and get better!
 
Hello and welcome.
I am also concerned you may be giving too much insulin.
2 units is more than we would normally start a cat on.
Michu would be much better on 1 unit twice a day instead of 2 units once a day.
Giving the insulin is not hard, the vet should be able to show you easily.
And I would strongly advise you to home test the blood sugars. Cats blood glucose is often higher at the vets because of stress so a true reading of the situation is not possible.
Keep asking questions,
 
Hi Madalina and Mishu,

Fellow Romanians Georgiana and Perlutz here :bighug:

I don’t have any experience with Lantus so can’t give much advice, but I agree with Nan and Bron (who are very experienced and well known members here) that the dosing might be too high. It’s always best to start slow with a lower dose and gradually increase if needed.

The sleepiness is something Perlutz had at the beginning when on 2 units of insulin. We started home testing and immediately realised the dose was too high and as soon as we lowered it, he started feeling much better!

Both testing and giving the insulin seem difficult at the beginning, we’ve all been there, but it becomes child play for most once you get the hang of things. It will be easier for both of you to have it done at home rather than at the vet’s as cats stress so much when taken out of their comfort! Stress also raises their blood glucose levels a lot! There are videos that show you how to do both or you can ask your vet to show you.

https://m.emag.ro/glucometru-code-free-01gc110/pd/DBP5V9BBM/ This glucose monitor is used by few people here on the board and I know my old vet in Bucharest used this too. The monitor itself it’s not too pricey and most importantly the test strips are also affordable.

There is a lot to learn but it will be worth it for Mishu! You’ll find so much info on the board and if you have any questions, please ask! The members on this forum are amazing! Bron above stayed up late at night to help me and Perlutz through a potential hypo in our first few weeks into diabetes :facepalm: Thank you, Bron! :kiss:

Glad you found this forum! :bighug::kiss:
 
WELCOME TO FDMB! I see there are many concerns with the dosing of your Mishu. I will let the experts speak to that.
I just wanted you to know that theres a wealth of information here and beautiful, concerned, people to help you decipher it all.

Its a learning curve for sure , but that will just help build that special BOND you and Mishu already share. We care and want you and Mishu to thrive through this early part of the disease that is diabetes.;)
Again welcome:bighug:
jeanne:):coffee:
 
Thank you all for your support and care, Mishu is feeling soooo much better now, he is eating, drinking water, playing a bit and purring. I think that we both are scared and tired because we had a long week of testing and going to the vet for different problems. I jusr ordered a glucometer a few hours ago with strips and seringes and everything we need to start this journey.
 
I also talked to the vet about the dose and he said that after i start testing we will see and adjust the dose accordingly, today i had an old, new and unused glucometer that i had in the house and tried to see if it worked but sadly it didn't. Mishu had 426-427 blood glucose before the shot, is it high? Or low? Or what should i look for?
 
Madalina & Mishu said:
I also talked to the vet about the dose and he said that after i start testing we will see and adjust the dose accordingly, today i had an old, new and unused glucometer that i had in the house and tried to see if it worked but sadly it didn't. Mishu had 426-427 blood glucose before the shot, is it high? Or low? Or what should i look for?
Click to expand...
Over 400 is pretty high but part of it could be due to the stress of being at the vet. It’s advised to always check blood glucose (BG) before every shot to make sure it’s safe to give the insulin. But you get a clearer view on his diabetes from what’s called “nadir”, it’s when the insulin effect peaks and the BG is lower. Ideally you get a curve, higher number in the morning before insulin, then gradually going lower until nadir and then slowly goes back up until it’s time for insulin again.

What is Mishu eating, dry or wet food? I’m not sure how much you’ve had time to read already in such a short time from diagnosis but diet is also very important and some cats can go into remission only from a diet change.
 
Any thing over 300 is considered HIGH. I dont know what the "ideal" number should be. My hubby is diabetic and his number should be around 90. For cats I think about the same.
*PLEASE correct me if I am wrong thinking on this experts.
j
 
Normal numbers for a non diabetic cat is 50-120. If you look at some of the other SS you will see many cats are in the 300s, 400s and 500 s. This is not ideal but is common in an unregulated cat. As you get closer to the best dose for your cat you will see the numbers come down.
The dry food will be keeping the numbers high but it is important that Mishu eats. Transition to the low carb slowly. Here is a link to how t do it
http://www.felinediabetes.com/FDMB/threads/transitioning-your-cat-from-dry-to-wet-food.956/

It is better to be too high for a day than to be low for a minute. Low numbers can kill.
Here is a link for new members which has some useful links within in.
http://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

Keep asking lots of questions
 
Bron and Sheba (GA) said:
Normal numbers for a non diabetic cat is 50-120. If you look at some of the other SS you will see many cats are in the 300s, 400s and 500 s. This is not ideal but is common in an unregulated cat. As you get closer to the best dose for your cat you will see the numbers come down.
The dry food will be keeping the numbers high but it is important that Mishu eats. Transition to the low carb slowly. Here is a link to how t do it
http://www.felinediabetes.com/FDMB/threads/transitioning-your-cat-from-dry-to-wet-food.956/

It is better to be too high for a day than to be low for a minute. Low numbers can kill.
Here is a link for new members which has some useful links within in.
http://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

Keep asking lots of questions
Click to expand...

Thank you!
 
Madalina & Mishu said:
Thank you!
Click to expand...
About the spreadsheet, i saw that there are 2 different spredsheets, one for the US and one for the rest of the world, the one form the US matched the blood glucose format that the vet gave me these last few days (3 digit numbers), i am from Romania, can i still use the US spreadsheet because the BG from the world spreadsheet (2 digit numbers) doesn't match what the vet gave me. At least for a few days until my ordered meter arrives (i should receive it next week)

We went again to the vet today to teach me how to do the insulin shot, i think i did ok, i hope i did ok, Mishu feels well now, still a bit lazy, but he eats ok and drinks water, he is attentive, he meowed all the way to the vet like he always does (when he is not feeling ok he doesn't meow on the way) and moved arround the transport box (he didn't move too much the last few days, he usually moves so much). The vet said that we have to go again tuesday or wednesday.
 
Awesome that you’re looking at setting up the spreadsheet already! You can keep both the US and World tabs, you will only have to fill on the US one and the world tab will update automatically.

Glad to hear Mishu is already feeling better, that’s really great news. Keep us updates pls :bighug:
 
The values on the spreadsheet correspond to the values you get on your meter. In most places outside of the US, the blood glucose (BG) readings are in mmol/L whereas in the US, the measurements are in mg/dL. If you are in a country where the readings are in mmol/L, the spreadsheet will automatically convert your readings and put the numbers on the US tab of the spreadsheet. If you are using mg/dL, you don't need to use the World template. You can use the US template. (@Georgiana & Perlutz -- the World tab will not populate if you complete the US numbers. The conversion only works in one direction.)

If the meters you have aren't working, I'm wondering if you need to replace the battery.
 
Sienne and Gabby (GA) said:
The values on the spreadsheet correspond to the values you get on your meter. In most places outside of the US, the blood glucose (BG) readings are in mmol/L whereas in the US, the measurements are in mg/dL. If you are in a country where the readings are in mmol/L, the spreadsheet will automatically convert your readings and put the numbers on the US tab of the spreadsheet. If you are using mg/dL, you don't need to use the World template. You can use the US template. (@Georgiana & Perlutz -- the World tab will not populate if you complete the US numbers. The conversion only works in one direction.)

If the meters you have aren't working, I'm wondering if you need to replace the battery.
Click to expand...
Thank you for the correction, Sienne. I’m using the world tab but I thought it works both ways.
 
I'll have a better look at the spreadsheets soon, i put in the info i have but it's not much, still waiting for the glucometer to arrive.

Mishu is really active today, he ate a lot and moving so much arround the house, we have our own little ritual when he is in the mood he raises his butt for me to gently tap him on the sides, i don't know why he loves this so much but i comply every time he hasn't done this for almost a week if not more, today he surprised me .

Thank you for making the time to talk to me, i still haven't fully processed this yet ... Today the vet let me do the shot for the second time, tomorrow is our first time all alone ... Hope it all goes well.
 
I want to thank you for your kind words and your support, Mishu is doing so well, i learned how to give a shot (with a mountain of anxiety, but i am doing it better than last week) still trying to home test, i asked my mom to help me out with home testing because i can't do it, i am nervous and i make Mishu nervous as well. We are going one day at a time, for now we are still trying to get Mishu to say still at the sound of the lancet clicking (i tried free handing, it ended nasty for all of us) we give treats each time we try even if we don't get blood or a good result. Please keep your fingers crossed for us, soon we will try with a needle in the lancet to see if we can get a blood drop. Thank you once again for everyting and good wishes for you and your sugar babies ♥️
 
I have good news and a question (again).

First the good news: me and my mom finally took a blood count today from the ear! Thank you for everything it was pretty easy, with treats and a sock filled with rice with the lancet, he didn't even notice. It was 393. We will try again in 2hours.

Yesterday we went to the vet and his blood count came HI 3 times (our meter can't show the results) and we brought him home really stressed out and not quite himself. This is what made us try again with home testing. The vet wants to try again another curve and i don't want to leave Mishu again at the vet's for so long, he doesn't cope well so me and my mom are trying our best to do it at home. He said that if we (or the vet) can't get a curve it could mean that the blood count is too high from either the stress at the vet, either that i didn't give the shot as i should (full dose) or that the insulin isn't working (we use Lantus 2 units 1 shot). We talked about the Freestyle Libre, he said that we can try to install it, i found someone who delivers here, it should arrive in a few days.

Question: it is normal for the ear to swell a bit where the lancet pinched? I will post a photo because i'm really worried. We are at 3.5 with the lancet, we tried with 2.5 and no blood came out, with 3.5 now it gives a nice drop of blood with which the meter worked like a charm.
If you need photos from another angle please let me know.

Thank you!!!
20200606_164745.jpg
 

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Applying pressure to the site will help with the swelling. Just hold the site between thumb and finger for a few seconds . You can also apply neosporin OINTMENT NOT cream. to the site. ;)

It DOES sound like Mishu gets too stressed at the vet (cant blame him there). You are already home testing and CAN do your own curve at home. Theres nothing written in stone that says it has to happen at the Vets.
 
Diane Tyler's Mom said:
Still concerned that you are giving 2 units of lantus once a day
Lantus is given twice a day, rather see you give 1 unit twice a day
Good you are going to be testing at home
You can do the curve at home as well
Have you read the sticky about lantus yet
Click to expand...

This is how the vet told me 1 shot 2 units... I'll try to get a curve and after he sees the numbers we will see what happens.
 
I have to agree with Diane. Ive never seen a Vet prescribe Lantus like yours has. I know you want to trust your vet. I hear that. BUT consider this, Vets only get a few hours of training for feline diabetes in school thats IT. Unless your cat has some kind of unique problem, I think this current protocol will make it much harder to get Mishu regulated. Thats just my summation. I know others will chime in on this and PLEASE dont feel like we are ganging up on you ok? Its going to be ok.:bighug:
 
What can i do? I can't go to the vet and tell him we have to do 2 shots... He first said that we have to do 2 shots when he prescribed Mishu a different insulin but i couldn't find it in any farmacy, so we got lantus, and after we got lantus he said to do 1 shot per day. I can only hope that it keeps Mishu well enough for a while untill we figure out if it is working for him or not and do a blood curve so the vet can see what to do next. I ordered the Freestyle Libre, hope it will help the vet realise what is the best way that we should do this...
 
Diane Tyler's Mom said:
Still concerned that you are giving 2 units of lantus once a day
Lantus is given twice a day, rather see you give 1 unit twice a day
Good you are going to be testing at home
You can do the curve at home as well
Have you read the sticky about lantus yet
Click to expand...

I didn't get to ask you the first time, what sticky? I haven't been on a forum before, have no idea how to use or find anything here :))
 
Madalina & Mishu said:
What can i do? I can't go to the vet and tell him we have to do 2 shots... He first said that we have to do 2 shots when he prescribed Mishu a different insulin but i couldn't find it in any farmacy, so we got lantus, and after we got lantus he said to do 1 shot per day. I can only hope that it keeps Mishu well enough for a while untill we figure out if it is working for him or not and do a blood curve so the vet can see what to do next. I ordered the Freestyle Libre, hope it will help the vet realise what is the best way that we should do this...
Click to expand...
Oh dont get me wrong I totally understand your situation. There ARE documents that will tell your vet in this one little instance that he is not understanding lantus correctly. I was looking for one and have yet to find it. I'm HOPING (I think it was Deb) to find her post with the link. I will PM her and ask her to post it for you. Then you can print it out and let your vet read it.

But for now follow what Diane has posted the stickys are in yellow and there LOTS to learn there beside protocols ok?
 
I started a thread on the Lantus forum looking for dosing protocols of lantus. Hopefully the right person will help us out. Then you can print out and give to your vet.
 
Thank you for your help. Can a curve help the vet understand that we should do 2 shots?(besides the articles we find). Or is it anyway possible for Lantus to work for 24h? I read a study somewhere that it could work for up to 24h. I'm just hoping that maybe one shot is enough... We did the second poke, i'm going to set up the spreadsheet now and i will try to find out how to share it :))
 
Try testing the edges of the ear.
Here is a picture of what is called the sweet spot.
You are aiming for the area between the edge of the ear and the vein.
Hitting the vein sometimes happens and it will bleed a little more. Just hold a tissue to the ear and apply pressure. No big deal.
Shine a flashlight on the inside of the ear and you will get an idea of the anatomy.
Soon it will all become second nature.
sweetspot.JPG
 

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Red & Rover (GA) said:
Try testing the edges of the ear.
Here is a picture of what is called the sweet spot.
You are aiming for the area between the edge of the ear and the vein.
Hitting the vein sometimes happens and it will bleed a little more. Just hold a tissue to the ear and apply pressure. No big deal.
Shine a flashlight on the inside of the ear and you will get an idea of the anatomy.
Soon it will all become second nature.
View attachment 54052
Click to expand...

Thank you!
 
Madalina & Mishu said:
Thank you for your help. Can a curve help the vet understand that we should do 2 shots?(besides the articles we find). Or is it anyway possible for Lantus to work for 24h? I read a study somewhere that it could work for up to 24h. I'm just hoping that maybe one shot is enough... We did the second poke, i'm going to set up the spreadsheet now and i will try to find out how to share it :))
Click to expand...
Here ya go...http://www.tillydiabetes.net/en_6_protocol2.htm
 
No, Lantus does not work for 24 hours in a cat. Cats require 1 dose every 12 hours. For humans, Lantus is given once a day.

From: 2018 AAHA Diabetes Management Guidelines for Dogs and Cats (American Animal Hospital Association)
"The initial approach to management of the diabetic cat is to initiate insulin therapy with glargine (Lantus) or protamine zinc insulin (PZI; Prozinc) at a starting dose of 1–2 units (U) per cat q 12 hr."
 
The original Roomp and Rand study, where the German Diabetes Katzen Forum worked with many pet owners to develop that in conjunction with biologist Kirsten Roomp and vet Jackie Rand of the University of Queensland Australia, could be the article that JT was thinking about.

https://pubmed.ncbi.nlm.nih.gov/19592286/

Or perhaps, she was thinking about this RVC (Royal Veterinary College) London article, about their diabetes remission clinic.
https://www.rvc.ac.uk/Media/Default/small-animal/documents/feline-diabetes-guide.pdf

Veterinary Clinics of North America had a full issue devoted to feline diabetes, back in 2013. Volume 43, issue 2, March 2013.
https://www.sciencedirect.com/journ...-america-small-animal-practice/vol/43/issue/2

University of Queensland press release on twice daily injection of lantus (glargine) insulin and diabetic remission in cats.
https://www.uq.edu.au/news/article/2009/05/new-management-treatment-diabetic-dogs-and-cats

I don't have access to the full articles for most of these. But any vet practice should.
 
@Madalina & Mishu I agree with everyone above that insulin should be given twice a day. If YOU think so too or you are at least willing to try, you can tell your vet that you’ve done a lot of research and you’d like to try giving Mishu 2 shots a day. You are Mishu’s mom and you are paying the vet bills, you should have a say in his treatment. My vet doesn’t advocate for home testing or low carb diet (just 2 examples) but I’ve explained why I am doing it and that I won’t change this and he is fine with it (he’s actually super impressed with the home testing and always curious about the numbers, but I know he still won’t suggest it to other cat owners so as not to overwhelm them...). The only thing I couldn't get him to do is prescribe a human insulin :mad:​
 
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