New to managing diabetic cat

Decrease or increase insulin?

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Samantha - Kitty

Member Since 2021
Hello there! I have a wonderful cat named Kitty. At the end of April 2021, I noticed she was starting to drink a lot of water. At first I didn't think much of it till the large urine clumps showed up. Off to the vet we went. Her blood work came back normal except her Retics were 102.8 K/ul (normal 3.0K/ul-50.0K/ul) and then her glucose was 534 - we diagnosed her diabetic. The vet I was seeing said let's try a diet change first. For 30 days I tried to feed her Young Again Zero Carb and wet cat food. She was dropping weight quickly. She typically averages 9 lbs but on May 5th she was around 8lbs. Everything kept getting more stressful. I didn't know what to do or how to manage this situation. I didn't even know I was foolish for thinking I could walk out of the vets office with a number of 534 and think that was normal and a diet change was the right choice. Regardless, 30 days passed as they recommended and we saw no change. We returned June 24th with the same high numbers. We started Vetsulin after that at 1 unit and slowly increased to 2. There was zero changes at all. We returned on July 1st to check her thyroid. The TT4 came back 1.4 ug/dL - normal. That's not the issue. The vet told me her kidney's were failing (without testing her blood and her blood work in May showed ZERO signs of kidney or any other type of failure) and our options were probably going to be euthanasia. My heart sank. I decided I was done with this vet as I had to told them what to test, what to do and I'm completely blind to this. Have no idea what I'm doing. I switched that Friday July 2nd to another vet who wouldn't let my cat leave till we lowered her numbers. She was at 400+ then. She went out on a whim and decided to try Novolin. Her numbers sank to 167! The lowest they have ever been. We went home and continued to give her insulin twice a day. I was not home testing at this time.
Out of nowhere about a week in, she became insulin resistant (at least that's what I'm told) so I did my research and found out that Lantus is the best for cats so we started that Sunday evening, July 18th. Her readings were 500+ and I found out that it was my fault more than likely. I was feeding her as much food as she wanted because she dropped down to a measly 5lbs and weighed 6lbs the week of July 12th. She also was eating Friskies shreds with gravy, her favorite and very high in carbs!
Last night, July 19th, I switched to FF classic pate and her numbers have been much better now! But they are still high. My question is, do I need to lower her insulin or raise her insulin? See attached spreadsheet as to where we are at. A few other things, yesterday she became much more active FINALLY! She peed outside the litter box between the hours of 6pm-12am but then before 7am used the litter box to pee. She didn't pee outside the litter box yesterday at all between 6am-6pm but did have 2 poop accidents but zero last night.
 
https://felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

Here is the link to set up your signature, it's at the end of everyone's post in gray

Look at mine
I'm glad you are home testing and Lantus is a good insulin
Once your signature and spreadsheet are set up and you read how the spreadsheet works you can fill in any BG numbers you have so members can give you some advice
I will also give you the link to read about Lantus

https://felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/
 
Sorry for the late reply! Thank you for the information. I'm presently juggling raising my 5 month old son, a full time job from home and a diabetic cat! I will fill this out a little bit later and provide an update!! :)
 
OK I got the spreadsheet uploaded! I couldn't figure out how to add this information to my signature. It said it was too long.
Samantha and Kitty
DX: Date
Name of Insulin: Lantus
Name of your meter: ReliOn Prime
Diet: combo (wet food Fancy Feast classic pate and kibble Young Again Zero Carb)
Dosing: TR or SLGS or Custom (not quite set up yet)
DKA or other recent health issue - No health issues
Acro, IAA, or Cushings (if applicable) - NA
Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
 
Great job setting up your spreadsheet, I'll tag
@Bandit's Mom Bhooma to help you with your signature, she'll be on tonight
She'll probably sent you a private message so watch for it
I see he was Diagnosed 5-5 21 on your spreadsheet
See #6 Bhooma she might have enough info there for you to see
Thank you Bhooma
 
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@Wendy&Neko

@Sienne and Gabby (GA)

@Marje and Gracie

Hi ladies can you please read about Samantha's kitty , she is asking about her cat ,her name is kitty, she has set up her SS but having trouble with her signature so I tagged @Bandit's Mom

Thank you :cat:
I PMd her about the signature block and can fix it for her. Thanks, Diane.

Samantha…we usually hold the starting dose on Lantus for 10-14 cycles but since she’s been on another insulin and is pretty high, we might want to increase her before then. I’d hold the dose through tonight and let’s see how she does….probably high.

Do you how many units of Normalin the vet gave her when it dropped? After that you were giving her 2u bid, correct?
 
I do not know how many units of Novolin but take a look at my SS! She is doing MUCH better today. No accidents in 24 hours now! Still drinking quite a bit of water but she also isn't eating like a maniac. She actually takes breaks and stops when she is full which is very new development He poops have finally became solid now as well which is great. Still large clumps of urine which is expected since she's still 200+ but she's finally starting to see a decline today. Let me know your guys thoughts!
 
I do not know how many units of Novolin but take a look at my SS! She is doing MUCH better today. No accidents in 24 hours now! Still drinking quite a bit of water but she also isn't eating like a maniac. She actually takes breaks and stops when she is full which is very new development He poops have finally became solid now as well which is great. Still large clumps of urine which is expected since she's still 200+ but she's finally starting to see a decline today. Let me know your guys thoughts!
Yes….better!

Actually, because she is still eating dry food, you will need to follow the Start Low Go Slow method of regulation as the other one has a prerequisite of no dry food. SLGS has you hold each dose for an entire week, unless the BG drops below 90, at which time you reduce by 0.25u. If she doesn’t drop below 90 during the week, you do a curve after the week and adjust the dose, if necessary.
 
I PMd her about the signature block and can fix it for her. Thanks, Diane.

Samantha…we usually hold the starting dose on Lantus for 10-14 cycles but since she’s been on another insulin and is pretty high, we might want to increase her before then. I’d hold the dose through tonight and let’s see how she does….probably high.

Do you how many units of Normalin the vet gave her when it dropped? After that you were giving her 2u bid, correct?
Thank you Marje :cat:
@Marje and Gracie
 
If you check out my SS this morning, she is doing much better! We somehow are under 200 this morning! :woot: I cannot believe it! This is the lowest I've ever personally been able to get her! Question though, yesterday she pooped outside the litter box in our bathroom. I left from 9:30am-2pm and the accident happened during that time. Since she is so covered in poop on her paws right now and I don't want to stress her and bathe her daily, we have to close our bedroom at night. She jumps into bed with me and sleeps with me! :) It's so hard to lock her out but this morning she pooped in front of our door. Which sometimes I think it's behavioral but maybe it's just her glucose still. Does anyone happen to know when the accidents stop? I want to bathe her this weekend, mop the entire house, clean her litter box area with special cleaners but I want to ideally wait to do this till she stops having accidents.

Another thing, she keeps having spikes typically between 8pm-6am, does anyone happen to know why that is? Or is this completely normal to see? I'm going to slow down testing her I think. Now that her numbers are dropping, she's starting to get very angry at me and growl! She is not enjoying this anymore. ;) I still plan to do prior to feeding/insulin and then an hour after. Unless you all think I should do this all differently! I'm learning so much about diabetes in such a short amount of time!
 
Hi Samantha great numbers today, I'm going to tag
@Marje and Gracie for you, Hi Marje :cat:
I would at least get a test @+3 and @+5 to see if she's dropping.
I know she's getting angry at you but you want to make sure she's not dropping too much , sorry can't help you out with the poop problem
 
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I can handle that! I'm having a tricky time getting her to bleed enough on the first poke. Is that normal as she gets better and better? I feel so bad for her. I have to poke her a few times to get the right spot! Do you have any advice for that? :)
 
I can handle that! I'm having a tricky time getting her to bleed enough on the first poke. Is that normal as she gets better and better? I feel so bad for her. I have to poke her a few times to get the right spot! Do you have any advice for that? :)


What size lancets are you using?
Look at the lancet ,you will see one side curves up, that's what you want to poke with, on an angle. Are you using a lancet device or free handing
It will get better

Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up
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6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand
I find it better to see where I'm aiming
 
I got them on Amazon - CareTouch Twist Top Lancets 30 Gauge and I use the lancet device mostly because I'm nervous, trying to hold her down and she doesn't mind the sound! Just hates that I can't successfully poke her the first try. I typically have to kind of move throughout her poor little ear and if I absolutely can't get enough blood (even with milking) I will try her pad on her paw which sometimes works better too!
 
Gotcha! I will have to try and swing out this weekend. :) If I lived in town it would be so much easier but I'm a half hour drive out and overloading myself a bit too much lately with too many things!
 
OK update! I just tried your method. I didn't use the lancet device, just to hold the needle. Poked the outside of the ear and boom! Easy peasy test! She even purred the whole time! I just tested which is about 6+ hours and she's at 50! What does that mean for tonights insulin?!
 
OK update! I just tried your method. I didn't use the lancet device, just to hold the needle. Poked the outside of the ear and boom! Easy peasy test! She even purred the whole time! I just tested which is about 6+ hours and she's at 50! What does that mean for tonights insulin?!
That's great news do you have syringes with half unit markings on them?


I see @Marje and Gracie mentioned this in her post #11
So tonight you would reduce by 0.25 units so shoot 1.75 units for tonight
The take action number on a human meter is 50 which means feed her some low carb food now and test again in 20-30 minutes to make sure he's coming up, then post it



Yes….better!

Actually, because she is still eating dry food, you will need to follow the Start Low Go Slow method of regulation as the other one has a prerequisite of no dry food. SLGS has you hold each dose for an entire week, unless the BG drops below 90, at which time you reduce by 0.25u. If she doesn’t drop below 90 during the week, you do a curve after the week and adjust the dose, if necessary.
 
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Wait, do I decrease by .25 units or wait a week? I don't want her levels to dip too low but I also know a human meter is much different in numbers than a pet meter! :) She just picks at the dry food a little here and there. She eats about 2 cans give or take of FF pate a day. She actually gets full now and needs to quit eating!
 
Wait, do I decrease by .25 units or wait a week? I don't want her levels to dip too low but I also know a human meter is much different in numbers than a pet meter! :) She just picks at the dry food a little here and there. She eats about 2 cans give or take of FF pate a day. She actually gets full now and needs to quit eating!

Anytime she drops below 90 you reduce, doesn't matter if it's a human or pet meter
You have to try and get her to eat something ,you don't want her dropping any lower
 
@tiffmaxee
Hi Elise can you help me out, I don't want to give her the wrong info , her kitty just dropped to 50 @+6, see #11 and #24 and #25
Her kitty does eat some dry food

would you mind looking at Samantha's SS , I gave her some advice #15
Her kitty has been on 3 different insulin's , now on Lantus
There is a lot of info about her kitty #1

Tagging @Marje and Gracie

And
@Sienne and Gabby (GA)
@Chris & China (GA)





The dry isn't entirely helpful, it takes a while to hit the system and even longer to leave it.
 
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She's been picking at her hard food this afternoon. I'll give her a half can of wet food! She's not over weight and never has been so that will keep her up :)
 
I have not tested again!
You don't want her to get full in case her numbers keep dropping, just give her a teaspoon of FF Pate, and test her in 20 minutes
For the future
The dry isn't entirely helpful, it takes a while to hit the system and even longer to leave it.
Just want to be sure you have med and high carb wet food and honey at home
Fancy Feast Gravy Lovers
Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs



Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy. 15% Med Carbs




Fancy Feast Gravy Lovers Turkey Feast in Gravy. 15% Med Carbs


Fancy Feast Gravy Lovers Chicken and Beef Feast in Gravy 15% Med Carbs

Or any other ones from the food chart, here is the link
@Samantha - Kitty
 
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I gave her a half can of FF (didn't see your response before I fed her) but I still have some Friskies Shreds with gravy at home. I'll test her in 6 minutes here and let you know. If it's still low, I will just prepare to give her some Friskies Shreds instead! Thank you for the info on the hard food! I have Karo syrup in the cupboard!
 
I know she can get too low so I really appreciate the help! Seriously, you have no idea. My vet gave me her cell phone number and I texted her this morning and she said no more testing because my kitty wasn't liking it but I listened to you all instead and now we are hitting too low of numbers! So it's so helpful to have this group of people who have experience in this very unique illness in pets. To think just a month ago, another vet was telling me to put her down. What a crazy journey it's been already!
 
I know she can get too low so I really appreciate the help! Seriously, you have no idea. My vet gave me her cell phone number and I texted her this morning and she said no more testing because my kitty wasn't liking it but I listened to you all instead and now we are hitting too low of numbers! So it's so helpful to have this group of people who have experience in this very unique illness in pets. To think just a month ago, another vet was telling me to put her down. What a crazy journey it's been already!
If it wasn't for the members here Tyler would not be in remission,
 
I'm hoping for remission but we shall see! Right now all that matters is she is finally getting better. Now just to adjust her dosage!
 
She gets her insulin at 7pm MST which I usually test somewhere between 6pm-7pm before I give her insulin. Should I still do 1.75 or lower?
 
She gets her insulin at 7pm MST which I usually test somewhere between 6pm-7pm before I give her insulin. Should I still do 1.75 or lower?
Yes still shoot 1.75 units , I'm eastern time, I want to know how many more hours till PMPS
Samantha where you have the 69 @+8 tap on it . and add to the same cell or square 90 @+8.5 and color it manually if you have to dark green like it is now
@Samantha - Kitty
 
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I think it would be a good idea if tomorrow morning you start posting on the
Lantus Forum, there are a lot of Lantus users there
I'll tell you how to do it
Go to the Lantus Forum then hit post new thread it's to the right
Put the Date 7-23 Kitty AMPS- her BG New Member

Then where you would start to write whatever you need to then link the post you did on the Health Forum , you would go all the way up to the of it , it's above the pic of the pic of the cat


You will copy that , then go to back to the Lantus Forum and paste it
That's so the members can go back to it and see what was going on

You can go back to your Title in the Lantus Forum and add the next test to it
Example
7-23 Kitty AMPS #/ @+2 BG/ @+6 BG/ PMPS BG etc
How to add to the Title to the Right hand side it says Thread Tools , then a drop down will appear hit Edit Title do what you want to add then hit save


Samantha just looked at your remarks , we live in all different time zones so putting the times you fed and tested don't help us

You have to put fed @+ whatever it was like +4 and so on
You don't need to put the BG when you tested we can see that on your spreadsheet
 
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She gets her insulin at 7pm MST which I usually test somewhere between 6pm-7pm before I give her insulin. Should I still do 1.75 or lower?

We recommend testing immediately before feeding/shooting with Lantus. So it's Test/Feed/Shoot. You Test to make sure she's high enough for insulin at all, Feed to make sure she's at least willing to eat, and Shoot, usually with their head in the bowl. The whole thing usually takes 5-10 minutes.

With Lantus, it doesn't usually start to "kick in" for 2-3 hours after it's given, so if Kitty wants to take her time with her main meal, it's OK...as long as you know she's willing to eat.

You definitely want to shoot a smaller dose tonight. I just scanned the other posts...do you have syringes with half unit marks?

You might want to grab a test at +11.5 (6:30pm) which will give us some time to think about what dose to go with tonight.

Also, you should know about stalling....if the Pre-shot is lower than you're used to, you can stall, don't feed and test again in 20-30 minutes. Use that time to post or update here. Usually, if the number goes up without food, it's OK to go ahead and shoot (remember, she'd be eating plus the shot won't be kicking in for awhile)
 
We recommend testing immediately before feeding/shooting with Lantus. So it's Test/Feed/Shoot. You Test to make sure she's high enough for insulin at all, Feed to make sure she's at least willing to eat, and Shoot, usually with their head in the bowl. The whole thing usually takes 5-10 minutes.

With Lantus, it doesn't usually start to "kick in" for 2-3 hours after it's given, so if Kitty wants to take her time with her main meal, it's OK...as long as you know she's willing to eat.

You definitely want to shoot a smaller dose tonight. I just scanned the other posts...do you have syringes with half unit marks?

You might want to grab a test at +11.5 (6:30pm) which will give us some time to think about what dose to go with tonight.

Also, you should know about stalling....if the Pre-shot is lower than you're used to, you can stall, don't feed and test again in 20-30 minutes. Use that time to post or update here. Usually, if the number goes up without food, it's OK to go ahead and shoot (remember, she'd be eating plus the shot won't be kicking in for awhile)
I guess I'm not quite sure what you mean here. If I should feed feed her or no?
 
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