New user - could use some help with dosing, feeling very lost.

[Angelaf44]

Hello everyone, glad to have found this forum.

Henry was diagnosed with diabetes just a few days ago, on 12/30/20. My Vet advised to start with 2 units BID which I did for the first day or so until I bought a meter and started doing my own testing.

After all the reading I've done, it seemed that according to his readings 2 units was way too high. I've slowly decreased this down to 0.25 and skipped his dose this evening as his preshot number was below 8.3 (I'm using the SLGS method.)

I feel very lost and even after all the reading I've done, I have no idea what I'm doing. I've tried to make sense of his numbers using the spreadsheet but he seems to be bouncing around all over the place. I'm terrified of him going hypo so I don't know if I should be shooting him if his preshot number is low?

His diabetes is assumed to be steroid related, the steroid has since been stopped completely. Could an actual remission be possible this early?

Here is his sheet, please let me know if the link doesn't work or you need anymore info.

https://docs.google.com/spreadsheet...itnqaaiZOn2OhwhBBwKsv5XSsSE/edit?usp=drivesdk

Thank you in advance,
Angela (and Henry.)

 

[Nan & Amber (GA)]

That's a big starting dose. He's seeing excellent numbers so far-- safe, not too low-- but I think you are wise to have lowered the dose.

0.5U is the last dose I see in the spreadsheet-- are you planning on reducing to 0.25 next ? I would not shoot if his pre-shot number is as low as 8.3, so well-done there, too. We usually use 200 (11 in non-US numbers) as a starting no-shoot cutoff.

It may be that you'll be able to shoot the lower dose in the future, and gradually reduce that cutoff number, but to answer your question, yes, it is also definitely possible for a quick remission with a steroid-induced diabetes. Fingers and paws crossed for Henry!

 

[Diane Tyler's Mom GA]

The normal feline BG reference range on a human meter is 50-120.



On human meters, the take action number is 50, so going forward, ,this is when you would feed either medium or high carb food to bring his BG up to safe numbers

Anytime you have a question just post

 

[JanetNJ]

Wow looks like your cat is trying to be diet controlled! I'm glad you didn't blindly shoot 2 units! Looks like he may only need 0.25 or 0.5.... But I'll leave the specific dosing advice to the lantus professionals.

 

[Sienne and Gabby (GA)]

Welcome, Angela!!

It looks like you've been doing. your FDMB homework. Congrats on getting started with home testing, getting Henry's spreadsheet and your signature set up, and starting a transition off of dry food.

FWIW, Henry isn't really bouncing around. You're seeing great numbers and your instincts about the starting dose were exactly on point. It takes about a week for the Lantus depot to become established. Everyone who is new to feline diabetes feels completely overwhelmed this early in the process. It will get easier -- I promise.

If you've not done so already, you may want to take a look at the sticky notes at the top of the Lantus board. I suspect you've already given those posts an initial read. You may also want to consider posting on the Lantus board since there's a considerable degree of expertise there when it comes to dosing.

If you noticed, any of the times you put more information in a cell than just a number, it doesn't copy over to the US version of the spreadsheet. If you multiply the number on your meter by 18 (e.g., 4.2 x 18 = 76), you can manually enter it on the US tab of your spreadsheet. That will save those of us who are in the US from having to do the math. Alternatively, you can add a comment to the cell since the conversion can't do it's job if there's text in the cell.

 

[Angelaf44]

That's a big starting dose. He's seeing excellent numbers so far-- safe, not too low-- but I think you are wise to have lowered the dose.

0.5U is the last dose I see in the spreadsheet-- are you planning on reducing to 0.25 next ? I would not shoot if his pre-shot number is as low as 8.3, so well-done there, too. We usually use 200 (11 in non-US numbers) as a starting no-shoot cutoff.

It may be that you'll be able to shoot the lower dose in the future, and gradually reduce that cutoff number, but to answer your question, yes, it is also definitely possible for a quick remission with a steroid-induced diabetes. Fingers and paws crossed for Henry!

Hi there!

Thank you for your response. I actually gave him 0.25 yesterday morning, I think I did note that on the spreadsheet. I haven't given him any insulin since then as he's been under 11. Would you mind having a look at my updated spreadsheet and letting me know if I'm doing the right thing?

He seems fine, my only concern is he's still drinking and peeing more than usual. The numbers say don't shoot, but I feel like I'm doing something wrong.

Thank you, I really appreciate your help.

 

[Diane Tyler's Mom GA]

Hi there!

Thank you for your response. I actually gave him 0.25 yesterday morning, I think I did note that on the spreadsheet. I haven't given him any insulin since then as he's been under 11. Would you mind having a look at my updated spreadsheet and letting me know if I'm doing the right thing?

He seems fine, my only concern is he's still drinking and peeing more than usual. The numbers say don't shoot, but I feel like I'm doing something wrong.

Thank you, I really appreciate your help.

Hi the 0.25 is not filled in on your SS in the unit cell

 

[Diane Tyler's Mom GA]

Hi there!

Thank you for your response. I actually gave him 0.25 yesterday morning, I think I did note that on the spreadsheet. I haven't given him any insulin since then as he's been under 11. Would you mind having a look at my updated spreadsheet and letting me know if I'm doing the right thing?

He seems fine, my only concern is he's still drinking and peeing more than usual. The numbers say don't shoot, but I feel like I'm doing something wrong.

Thank you, I really appreciate your help.

I'll tag a few members for you

@Nan & Amber (GA)

@Wendy&Neko

@Sienne and Gabby (GA)

Thank you ladies

 

[Nan & Amber (GA)]

@Diane Tyler's Mom , I can see the dosing in the "World" tab, just not the "US" one (I think Sienne caught that).

I haven't given him any insulin since then as he's been under 11. Would you mind having a look at my updated spreadsheet and letting me know if I'm doing the right thing?

He seems fine, my only concern is he's still drinking and peeing more than usual. The numbers say don't shoot, but I feel like I'm doing something wrong.

You're doing great! And Henry really is looking good, so early in the diabetes journey!

I'm going to second Sienne's suggestion to check out some of the information on the Lantus board. In addition to info about dosing methods, this post: Insulin Care & Syringe Info: Proper Handling, Drawing, Fine Dosing gives some details about dosing very small amounts, which might be helpful in a bit.

Right now, Henry is just a hair over the normal range of BG (most non-diabetic cats spend most of their time in green numbers, typically around 3-4), so he may need just a little bit of insulin support to get all the way to remission.

Another reason to get familar with the Lantus board is that that board is not only full of Lantus knowledge, but also is quite busy. It gives you a little more latitude to start shooting lower numbers when there is almost always someone there to help. In fact, they start off with a lower "no-shoot" number than on the Feline Health board, for that reason.

I see in your signature that you're trying to transition off the dry food. That, too, could be the thing to get him back into a normal BG range, so keep working on that!

Hopefully, the excess drinking and peeing with subside soon. Right now, the numbers he's showing should put him under renal threshold (it's different for all cats, but usually blue numbers are good), so if he continues while his BG is in this range he might need a trip to the vet to make sure it's not caused by something else. Other than that, though, he's looking good!

 

[Diane Tyler's Mom GA]

@Diane Tyler's Mom , I can see the dosing in the "World" tab, just not the "US" one (I think Sienne caught that).



You're doing great! And Henry really is looking good, so early in the diabetes journey!

I'm going to second Sienne's suggestion to check out some of the information on the Lantus board. In addition to info about dosing methods, this post: Insulin Care & Syringe Info: Proper Handling, Drawing, Fine Dosing gives some details about dosing very small amounts, which might be helpful in a bit.

Right now, Henry is just a hair over the normal range of BG (most non-diabetic cats spend most of their time in green numbers, typically around 3-4), so he may need just a little bit of insulin support to get all the way to remission.

Another reason to get familar with the Lantus board is that that board is not only full of Lantus knowledge, but also is quite busy. It gives you a little more latitude to start shooting lower numbers when there is almost always someone there to help. In fact, they start off with a lower "no-shoot" number than on the Feline Health board, for that reason.

I see in your signature that you're trying to transition off the dry food. That, too, could be the thing to get him back into a normal BG range, so keep working on that!

Hopefully, the excess drinking and peeing with subside soon. Right now, the numbers he's showing should put him under renal threshold (it's different for all cats, but usually blue numbers are good), so if he continues while his BG is in this range he might need a trip to the vet to make sure it's not caused by something else. Other than that, though, he's looking good!

Thank you
@Nan & Amber (GA)
That's funny I can see both US and World

 

[Critter Mom]

Hi Angela.

You're already doing famously with Henry, and I see you've had some helpful replies from other members. The only other thing I'd add to the suggestions you've had thus far is to add a daily check for urine ketones (you can get the test strips at any pharmacy). It's a standard general safety precaution for newly diagnosed cats, especially if there's a need to skip some insulin doses.

Hope the diet change will see Henry doing even better (and he's already doing very well!).


Mogs
.

 

[Wendy&Neko]

Hello Angela - waving at you and welcome from B.C. As Nan pointed out in the 9th post here, we do have some information on shooting smaller doses. At some point you might want to consider what we call a 0.1 unit dose, just to see if you can get some insulin support, without him going too low for you to shoot. Just because of Henry's quick response to Lantus, you may have to lower that no shoot number a bit and we can help you do that over on the Lantus forum.

 

[Angelaf44]

Welcome, Angela!!

It looks like you've been doing. your FDMB homework. Congrats on getting started with home testing, getting Henry's spreadsheet and your signature set up, and starting a transition off of dry food.

FWIW, Henry isn't really bouncing around. You're seeing great numbers and your instincts about the starting dose were exactly on point. It takes about a week for the Lantus depot to become established. Everyone who is new to feline diabetes feels completely overwhelmed this early in the process. It will get easier -- I promise.

If you've not done so already, you may want to take a look at the sticky notes at the top of the Lantus board. I suspect you've already given those posts an initial read. You may also want to consider posting on the Lantus board since there's a considerable degree of expertise there when it comes to dosing.

If you noticed, any of the times you put more information in a cell than just a number, it doesn't copy over to the US version of the spreadsheet. If you multiply the number on your meter by 18 (e.g., 4.2 x 18 = 76), you can manually enter it on the US tab of your spreadsheet. That will save those of us who are in the US from having to do the math. Alternatively, you can add a comment to the cell since the conversion can't do it's job if there's text in the cell.

Thank you very much for the help. I haven't spent much time in the Lantus forum, I will post there.

I appreciate you explaining the spreadsheet to me to, I didn't even realize there was a US option on there people could refer to. I've got it all fixed up now.

Thanks again!

 

[Angelaf44]

Hello Angela - waving at you and welcome from B.C. As Nan pointed out in the 9th post here, we do have some information on shooting smaller doses. At some point you might want to consider what we call a 0.1 unit dose, just to see if you can get some insulin support, without him going too low for you to shoot. Just because of Henry's quick response to Lantus, you may have to lower that no shoot number a bit and we can help you do that over on the Lantus forum.

Hello! I will head over there and make a post tomorrow morning, as I've already decided to skip his shot tonight again because I'm getting green numbers this evening.

I'd be very interested in learning about smaller dosing. I don't feel confident with it yet. I can barely draw up 0.25 in the syringe I have no idea how I'd manage 0.1

So glad I found this group. Thank you very much![/QUOTE]

 

[Angelaf44]

@Diane Tyler's Mom , I can see the dosing in the "World" tab, just not the "US" one (I think Sienne caught that).



You're doing great! And Henry really is looking good, so early in the diabetes journey!

I'm going to second Sienne's suggestion to check out some of the information on the Lantus board. In addition to info about dosing methods, this post: Insulin Care & Syringe Info: Proper Handling, Drawing, Fine Dosing gives some details about dosing very small amounts, which might be helpful in a bit.

Right now, Henry is just a hair over the normal range of BG (most non-diabetic cats spend most of their time in green numbers, typically around 3-4), so he may need just a little bit of insulin support to get all the way to remission.

Another reason to get familar with the Lantus board is that that board is not only full of Lantus knowledge, but also is quite busy. It gives you a little more latitude to start shooting lower numbers when there is almost always someone there to help. In fact, they start off with a lower "no-shoot" number than on the Feline Health board, for that reason.

I see in your signature that you're trying to transition off the dry food. That, too, could be the thing to get him back into a normal BG range, so keep working on that!

Hopefully, the excess drinking and peeing with subside soon. Right now, the numbers he's showing should put him under renal threshold (it's different for all cats, but usually blue numbers are good), so if he continues while his BG is in this range he might need a trip to the vet to make sure it's not caused by something else. Other than that, though, he's looking good!

Hi! Thank you for all the detailed info. I plan to head over to the Lantus Forum and read all I can.

Transitioning off the dry is definitely helping, I had no idea how bad it is for cats. My main issue is, I have two others (so three kitties total.) One refuses to eat anything canned, the other likes some canned (but not the low carb Tiki Henry eats. She is also FIV+ so the search continues for higher quality canned for her). They all like dry, that's why I've kept it simple in the past. Splitting everybody up for separate feedings has been a bit of a disaster (my place isn't big) but it'll get more routine as I go on, and hope to have Henry strictly on canned once I get better chaperoning everyone's mealtimes.

I'll keep an eye on the urination and drinking. Vet didn't mention checking urine when Henry was there but he's probably due if this continues. Thanks for all your help, and the reassurance!