Hi, new member

[ashley k]

First of all I want to thank everyone on this board bc reading all the posts gave me the courage to follow my gut and fire our vet. I’ll save the story, but we are seeking a new vet and will be monitoring at home until we find one.
I am however not sure where to start. Our cat, Bubba, is 8 years old and was diagnosed with diabetes in May. The vet started him a half a unit of Lantus 2x a day and we have been in every week since then for a glucose test. Each time they had us increase units. We went from 0.5, to 1 then to 2 then to 4 and now we are at 6. He has not been tested in 10 days now.

They argued with us every time we asked about food, and encouraged us to buy the pricey dry diabetes food they sell. However, luckily I read this board and over the past 2-3 weeks have been transitioning him to fancy feast classic pate, which he loves. Since transitioning his food, I have noticed an immediate improvement. This morning when I cleaned out the litter box I noticed substantially less urine, and zero accidents outside the box for the first time in probably a year.

As far as shots, I have frustratingly done a few fur shots (I finally figured out that I think I am accidentally getting the needle all the way through the tent? Any advice on that? I feel like I am doing such a bad job. At a half a unit we had no issues and now with 6 suddenly I suck at the shots!) and he is starting to get annoyed at the shots. Besides that, he is fine and still purrs all day. His dandruff has also started to improve.

All of this said, we bought a meter (alpha trak 2 ) and want to start testing at home, but I really don’t know where to start. I think it’s bizarre that they kept increasing our units without testing him at home. Every time we asked if we could test at home, they advised us against it.

I have seen people mention a form and / or signature and assume I should start there ?

Thank you in advance for all of your help. Our vet has been absolutely awful and last week I found an article online of where they were actually accused of animal abuse! So, we canceled our last appointment and won’t be going back.

thank you so much, looking forward to hearing what I need to do to get this under control.

 

[JanetNJ]

We went from 0.5, to 1 then to 2 then to 4 and now we are at 6. He has not been tested in 10 days now.

yikes that is a HUUUUGE dose. i would cut that back to 3 until you learn to test at home, and even that's a lot. We can help you with that. I have a video in my signature showing how I tested my cat CC at home. I use an Alphatrak in my video as well. it's muuuch safer and easier to find the correct dose. and a lot cheaper than weekly visits. once i started testing at home i didn't go back to the vet for a year.

That diabetic food is not really diabletic... if you read the lable it's diaTETIC. that's because there's nothing better in it than regular food. Most here feed fancy feast classic or friskies pate foods. there are others that are good as well such as weruva or tikicat.

You don't need to push the needle in that far... just far enough that it's through the skin... just the point.

Definitely set up a signature with basic info. click your name on the upper right and go to your name then signature. add info such as your cat's name, date diagnosed, insulin type, food you are feeding, and which meter you are using.

I totally understand how stressful it is... we all do... but it's not a death sentence. cats can live a long, healthy life with it.

 

[ashley k]

Thank you so much! I think I got the signature figured out, and I’ll definitely watch your video. About how long after giving the insulin should I test? (Maybe your video covers this?) should I do 3 units for tonight’s shot instead of the 6?

yikes that is a HUUUUGE dose. i would cut that back to 3 until you learn to test at home, and even that's a lot. We can help you with that. I have a video in my signature showing how I tested my cat CC at home. I use an Alphatrak in my video as well. it's muuuch safer and easier to find the correct dose. and a lot cheaper than weekly visits. once i started testing at home i didn't go back to the vet for a year.

That diabetic food is not really diabletic... if you read the lable it's diaTETIC. that's because there's nothing better in it than regular food. Most here feed fancy feast classic or friskies pate foods. there are others that are good as well such as weruva or tikicat.

You don't need to push the needle in that far... just far enough that it's through the skin... just the point.

Definitely set up a signature with basic info. click your name on the upper right and go to your name then signature. add info such as your cat's name, date diagnosed, insulin type, food you are feeding, and which meter you are using.

I totally understand how stressful it is... we all do... but it's not a death sentence. cats can live a long, healthy life with it.

 

[JanetNJ]

Thank you so much! I think I got the signature figured out, and I’ll definitely watch your video. About how long after giving the insulin should I test? (Maybe your video covers this?) should I do 3 units for tonight’s shot instead of the 6?

The order is test, then feed, then shoot. You want to test without any food for at least 2 hours so that the number is not food influenced. You will be making a tiny prick on the very outter edge of the ear. If you have any questions just ask. Your cat is very lucky to have you!

I would... now it's entirely possible he DOES need a higher dose, but it's rare that they would need that much unless there is an underlying condition. My cat had Acromegly which is a tumor on her pituitary gland causing her to need very high doses. The good news is your vet perscribed a very good insulin for cats.
Let me tag a few others to get more opinions.
@Chris & China (GA)
@Sharon14 @Bron and Sheba (GA)

 

[ashley k]

Oh my gosh you are amazing! Thank you so much. No known health issues, apart from the vet mentioning that he needed some dental work. He said that Bubba wasn’t responding to the insulin and they said it was probably because we weren’t doing the shots right. They made us pay for a second consultation, where they confirmed we were doing the shots right. (I didn’t start missing until after that!)

I watched your video which was so helpful, I feel like I should be able to get it done. So tonight I will test, then feed and then shoot. I will post again here as soon as I get a BG number! Maybe someone will be available and can help me decide what dosage to give tonight. If not, I will try the 3 like you recommended. From what I understand, it’s better to be giving not enough than too much, right?

 

[JanetNJ]

Oh my gosh you are amazing! Thank you so much. No known health issues, apart from the vet mentioning that he needed some dental work. He said that Bubba wasn’t responding to the insulin and they said it was probably because we weren’t doing the shots right. They made us pay for a second consultation, where they confirmed we were doing the shots right. (I didn’t start missing until after that!)

I watched your video which was so helpful, I feel like I should be able to get it done. So tonight I will test, then feed and then shoot. I will post again here as soon as I get a BG number! Maybe someone will be available and can help me decide what dosage to give tonight. If not, I will try the 3 like you recommended. From what I understand, it’s better to be giving not enough than too much, right?

It's definitly more dangerous to shoot too much. Once you start testing you can add a spreadsheet to your signature. We use Google Sheets so that people can see it updated in real time. Here's a link to our template. https://www.felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

Be patient with testing. It can take a little bit to get the hang of it. Ideally you'll want to get a test before each shot and then at least one mid cycle test to see how low Bubba goes. I always tried to get about 4-5 tests a day.

 

[ashley k]

It's definitly more dangerous to shoot too much. Once you start testing you can add a spreadsheet to your signature. We use Google Sheets so that people can see it updated in real time. Here's a link to our template. https://www.felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

Be patient with testing. It can take a little bit to get the hang of it. Ideally you'll want to get a test before each shot and then at least one mid cycle test to see how low Bubba goes. I always tried to get about 4-5 tests a day.

Janet, Thank you so much for all of your help. I was finally able to get a reading today at +8 (after about 10 unsuccessful tries). It was 187. I updated it on my SS but I'm not sure what to give him for his dose tonight. I was scared to go down to 3 but I did go down to 5 this morning. It was over 500 the last time we went to the vet when they put us on 6u. Do you think it's safe to go down to 3 for tonight's shot? I really appreciate your help!!

 

[Chris & China (GA)]

I'm not sure what to give him for his dose tonight. I was scared to go down to 3 but I did go down to 5 this morning.

Between +8 and PMPS is a LONG time (in the diabetic cat world). How long until your usual shot time?

You might want to try to get a +11.5 which would give us a little time to decide on a PM dose.

Do you have urine ketone test strips? (or a blood ketone meter?). We don't want to drop his dose down by half without being able to test for ketones.

 

[ashley k]

Between +8 and PMPS is a LONG time (in the diabetic cat world). How long until your usual shot time?

You might want to try to get a +11.5 which would give us a little time to decide on a PM dose.

Do you have urine ketone test strips? (or a blood ketone meter?). We don't want to drop his dose down by half without being able to test for ketones.

Thank you so much for the response! We usually shoot at 9pm, so another 2.5 hours or so. I'm just not really 100% confident I am going to be able to get enough blood tonight and poor thing has had his ears pricked 100 times today. So I'd hate to risk it in the event I can't get a reading that close to the shot. I don't have ketone test strips, or a blood ketone meter. Is that something I should get? Do you think I should stick with 6u?

 

[Chris & China (GA)]

I don't have ketone test strips, or a blood ketone meter. Is that something I should get?

You can get urine ketone test strips at any pharmacy that sells diabetic supplies. They're pretty cheap too. A blood ketone meter is more accurate, but the strips are about $1 each too.

When considering a big reduction in dose like 6U to 3U, it's just a really good idea to be able to test for ketones since we have no way to know if he really needs that higher dose or not.

That being said, the fact that he's only 2 months past diagnosis makes me really consider that he may very well not need that 6 unit dose. Most cats should start at .5 to 1U and even if you increased by .5 unit per week, we're only up to about 4U so I think it's totally reasonable to try the 3U dose .....we can always fast track him up if we need to.

Have you ever considered trying a Libre? It's in no way perfect, but it would allow you to just scan for test results while you work on your poking technique. At best the Libre only works for 14 days (and a lot of times much less....some cats even get them off within an hour or so of placement and you can't re-attach) but if he'd tolerate it, it'd take some of the pressure off of you.

 

[JanetNJ]

You can get urine ketone test strips at any pharmacy that sells diabetic supplies. They're pretty cheap too. A blood ketone meter is more accurate, but the strips are about $1 each too.

When considering a big reduction in dose like 6U to 3U, it's just a really good idea to be able to test for ketones since we have no way to know if he really needs that higher dose or not.

That being said, the fact that he's only 2 months past diagnosis makes me really consider that he may very well not need that 6 unit dose. Most cats should start at .5 to 1U and even if you increased by .5 unit per week, we're only up to about 4U so I think it's totally reasonable to try the 3U dose .....we can always fast track him up if we need to.

Have you ever considered trying a Libre? It's in no way perfect, but it would allow you to just scan for test results while you work on your poking technique. At best the Libre only works for 14 days (and a lot of times much less....some cats even get them off within an hour or so of placement and you can't re-attach) but if he'd tolerate it, it'd take some of the pressure off of you.

She likes 5, I said 3... Could always cut the difference and try 4. Lol. I don't know. I'll let you lantus experts weigh in. Ha

 

[ashley k]

You can get urine ketone test strips at any pharmacy that sells diabetic supplies. They're pretty cheap too. A blood ketone meter is more accurate, but the strips are about $1 each too.

When considering a big reduction in dose like 6U to 3U, it's just a really good idea to be able to test for ketones since we have no way to know if he really needs that higher dose or not.

That being said, the fact that he's only 2 months past diagnosis makes me really consider that he may very well not need that 6 unit dose. Most cats should start at .5 to 1U and even if you increased by .5 unit per week, we're only up to about 4U so I think it's totally reasonable to try the 3U dose .....we can always fast track him up if we need to.

Have you ever considered trying a Libre? It's in no way perfect, but it would allow you to just scan for test results while you work on your poking technique. At best the Libre only works for 14 days (and a lot of times much less....some cats even get them off within an hour or so of placement and you can't re-attach) but if he'd tolerate it, it'd take some of the pressure off of you.

Thank you so much, I will definitely look into all of this. I really appreciate your response. He went from 0.5 unit to 1 unit on 7/2. One week later they moved him to 2 units. Then 4. Now 6.

What do you think would be the safest amount to give him tonight until I can test him again in the morning? I can’t get any more blood from him tonight.

 

[Chris & China (GA)]

What do you think would be the safest amount to give him tonight until I can test him again in the morning? I can’t get any more blood from him tonight.

Without knowing what his glucose is, there's really no way to know but if he's been getting 6U up until now, how about just doing 2U?

Are you warming his ear up really well before trying to poke? What gauge lancets do you have?

 

[StarburstMom]

Just chiming in here about the Libre. I'm using it on my cat to try and find her dosage fairly quickly as I have changes coming up soon and won't be able to monitor her enough to be changing her doses. In my signature is my cats spreadsheet and we have been using the Libre and advice from here to get where we need to be. The pros- instant BG readings with only a swipe of your phone or reader, can get a real curve and graph. Cons- price (mine was $130 for 2-14 day sensors), durability (these are made for humans and so tend to stop working earlier than 14 days on cats due to movement, my first one lasted 5 days), may need a vet office to install it (mine charges $25 and it takes 10 minutes), also it measures interstitial fluid not blood so rapid changes won't show up as much. However in your situation it may be helpful. Just an option to keep in mind.

 

[Chris & China (GA)]

Thanks @StarburstMom ! It's great to hear from actual users! (no such thing when China was diagnosed so I have no personal experience)

 

[ashley k]

Just chiming in here about the Libre. I'm using it on my cat to try and find her dosage fairly quickly as I have changes coming up soon and won't be able to monitor her enough to be changing her doses. In my signature is my cats spreadsheet and we have been using the Libre and advice from here to get where we need to be. The pros- instant BG readings with only a swipe of your phone or reader, can get a real curve and graph. Cons- price (mine was $130 for 2-14 day sensors), durability (these are made for humans and so tend to stop working earlier than 14 days on cats due to movement, my first one lasted 5 days), may need a vet office to install it (mine charges $25 and it takes 10 minutes), also it measures interstitial fluid not blood so rapid changes won't show up as much. However in your situation it may be helpful. Just an option to keep in mind.

Thank you so much, this is great information!

 

[ashley k]

Without knowing what his glucose is, there's really no way to know but if he's been getting 6U up until now, how about just doing 2U?

Are you warming his ear up really well before trying to poke? What gauge lancets do you have?

Hi Chris, I was worried to adjust it by so much and I stuck with the 5u last night. This morning not enough blood to register for the test so went with 4 units. Tried again for the test at 7pm (+10) and he is 117. So, I definitely now feel comfortable lowering it for tonight. Do you still think I should go for 2u? Testing was much easier tonight and I think we are getting into a bit of a groove. I wonder if I am not putting it on the right place on the strip - it seems like it takes a *lot* of blood to get it to register, a few times I felt like there was plenty of blood but it wouldn't register. Thanks for your help.

 

[Chris & China (GA)]

I wonder if I am not putting it on the right place on the strip

Where are you putting it? On the AT, you just barely touch the blood drop where the black part on the sides of the strip is. It will "suck up" the blood itself. If you drown it, or place the blood "on top" of the strip, you'll get an error

 

[Chris & China (GA)]

Do you still think I should go for 2u?

Let's see where he's at in 2 hours. A lot can happen between +10 and PMPS

 

[ashley k]

Where are you putting it? On the AT, you just barely touch the blood drop where the black part on the sides of the strip is. It will "suck up" the blood itself. If you drown it, or place the blood "on top" of the strip, you'll get an error

wowwwww thank you so much, that was SO much easier! I was definitely putting it on top. For tonight's PMPS he is 179. Got it on the first try and he purred the whole time. What do you think I should give him for his shot tonight?

 

[Chris & China (GA)]

I think you could go ahead and try 2U tonight. If we need to we can fast track him back up but without any historical data, it's going to be a guess no matter what we decide.

I'd plan on getting at least a +2.....a lot of times that can almost predict what's going to happen later in the cycle

 

[ashley k]

I think you could go ahead and try 2U tonight. If we need to we can fast track him back up but without any historical data, it's going to be a guess no matter what we decide.

I'd plan on getting at least a +2.....a lot of times that can almost predict what's going to happen later in the cycle

Thank you so much for your response! I am going to take your advice and do 2 and try to test again at +2.

 

[Chris & China (GA)]

wowwwww thank you so much, that was SO much easier

Glad to hear! The weird place on the strip is one of the reasons I never liked the AT (of course the $1 per strip was the main killer!) I don't know why the manufacturer makes them like that. Pretty much every other meter has you touch the tip of the strip, not the side.

 

[ashley k]

Glad to hear! The weird place on the strip is one of the reasons I never liked the AT (of course the $1 per strip was the main killer!) I don't know why the manufacturer makes them like that. Pretty much every other meter has you touch the tip of the strip, not the side.

I accidentally fell asleep last night but was able to get the AMPS on the first try again - wow I can't thank you enough for the tip on the strips, total game changer. He has eaten a little bit already but tested 171. Do you think I should do another 2u for this morning? I am so grateful for all of your help, thank you again.

 

[Chris & China (GA)]

Do you think I should do another 2u for this morning? I am so grateful for all of your help, thank you again.

Good shooting! I'd get a +2 if you can and see how he's doing.

I'm happy that my tips were helpful and you're more comfortable with testing now! It's a win for you both!

Homework assignment: Read the information on Dosing Methods and think about which method you think you want to try. You're not locked in...if you choose one and it's not for you, you can always change. Let us know if you have any questions about the 2 different methods!

 

[ashley k]

Good shooting! I'd get a +2 if you can and see how he's doing.

I'm happy that my tips were helpful and you're more comfortable with testing now! It's a win for you both!

Homework assignment: Read the information on Dosing Methods and think about which method you think you want to try. You're not locked in...if you choose one and it's not for you, you can always change. Let us know if you have any questions about the 2 different methods!

Oh, wow that is great info, thank you so much. I will be reading up on this today. I was able to get a +2 just now and it's up to 263.

 

[ashley k]

Hi everyone. I’m hoping someone could take a look at my spreadsheet and offer some advice. Bubbas Preshot Bg tonight was 145 and I am stalling, leaning towards skipping. (Still need to add that to sheet) I’m a bit confused reading the info on TR and SLGS bc it says not to use a pet meter and I’m using the alpha trak 2. So I thought I had been doing pretty good but now I’m not sure after reading that again, maybe my numbers are actually off. What are the numbers we are aiming for? I thought it was 80-120 mg/dL but am now confused.
Anyway I think that tomorrow I am going to lower to 2u for both shots and would just love someone to confirm that sounds right? Could I maybe go even lower? And am I doing the right thing by not shooting tonight? I’m just confused on the pet / human meter variances / what the metrics are for the pet meter. Thanks for your help.

 

[Chris & China (GA)]

What are the numbers we are aiming for? I thought it was 80-120 mg/dL but am now confused.

All of our dosing methods were developed using human meters because when they were developed, there was no such thing as a pet meter! The main difference is the "time to act". On a human meter, it's when they drop below 50. On a pet meter, it's when they drop below 68.

Anyway I think that tomorrow I am going to lower to 2u for both shots and would just love someone to confirm that sounds right?

I'd definitely decrease the dose until you learn more about proper treatment. You really need to get at least a "before bed" test on the PM cycle. Most cats go lower at night so it's important to know it's safe to go to sleep!

Most cats should start at .5 to 1.0 unit so you're already giving a lot more than we'd recommend. Why did you go from 2U to 4U back on 6/30?

As for tonight, if you can't stay up to test, your safest bet is to skip.

 

[ashley k]

All of our dosing methods were developed using human meters because when they were developed, there was no such thing as a pet meter! The main difference is the "time to act". On a human meter, it's when they drop below 50. On a pet meter, it's when they drop below 68.



I'd definitely decrease the dose until you learn more about proper treatment. You really need to get at least a "before bed" test on the PM cycle. Most cats go lower at night so it's important to know it's safe to go to sleep!

Most cats should start at .5 to 1.0 unit so you're already giving a lot more than we'd recommend. Why did you go from 2U to 4U back on 6/30?

As for tonight, if you can't stay up to test, your safest bet is to skip.

Thank you, it is really hard to test at all these different times with our work schedules. We are doing our best. I thought since the numbers are mostly blue and green with just a couple of yellows, that everything has been seeming pretty good, but it seems like based on your response it hasn’t been? I wish I understood this better, because I thought we were headed in the right direction / things were looking good. If you could point me in the right direction to know what the “goal” numbers are that would be really helpful. I’ve read through the links provided earlier and I’ve combed through hundreds of posts. I don’t know what I am missing to figure this out. I didn’t think he needed to start all over again at 0.5 with SLGS considering we have just recently been there and it wasn’t enough. Going from 6 to 0.5 in less than a month feels like a big drop. So I thought I was doing more TR by keeping him where he was at and reducing dose after a few cycles based on his numbers. So I went to 4 for awhile then 3 and now was going to try 2 since he seemed to be improving. I guess I am going to lower to 2 for a few cycles and see how it goes. I just wish I knew what numbers I was looking for, if it’s not the blues and greens.