New member 12/21/21

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leomusmusculus

leomusmusculus

Member Since 2021
New to forum, have already learned so much. Thank you all. Leo is a 1 year old kitten tomorrow, dx 7/22/21. We feed LC wet only and use Lantus BID. Last month we’ve switched to the Alphatrak from Freestyle Libre to take more frequent readings. Leo recently underwent a bout of trace ketones in his urine following his neuter at the end of November. Since, we’ve upped his insulin (3-4 units per cycle) but have not managed to get his BG under control. He’s consistently above 400 pre-meal and mid-high 300s post-meal (even at the 5-7 hrs post meal). Looking for advice with how to proceed. Will surely take a look at the Lantus forum more deeply. Appreciate it.

Also, what is PMPS and AMPS, can’t find these definitions anywhere. Thank you!
 
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Hi and welcome to you and Leo. He is very young to have diabetes.
Happy birthday for tomorrow Leo!

If he has had ketones in his urine it is really important that you are testing for the ketones at home. You can do this by buying a bottle of Ketostix from Walmart or a pharmacy and testing his urine. I would suggest testing daily if you can. It is a simple test.
Also because he has had ketones it is important he eats lots of food as food, insulin and fluids help keep ketones at bay.

Not sure why you swapped to the alphatrak from the Freestyle Libre so you could get more frequent readings……the alphatrak meters strips are far more expensive than the freestyle meter ones.

We have a spreadsheet here which you might like to set up. Then we can certainly help you proceed.
The AMPS is the am preshot BG and the PMPS is the on preshot BG.
We recommend always testing before every shot and again during the cycles to see how low the dose is taking Leo as Lantus dosing is based on the nadir or lowest point in the cycle.

How often are you feeding Leo? Are you giving him a preshot meal and then some snacks during the cycles?

HELPUS HELP YOU has links to the spreadsheet, the signature (which tells us all about Leo and stops us asking questions about him all the time) and the hypo box and other useful information.

FOOD CHART LINK check this out to see if you are feeding foods with 10% carbs or less.

Look at all the yellow stickies at the top of the LLB PAGE

Can you tell us how you reached 3 or 4 units a cycle. How did you go up? Was it in 1 unit increments or less?
Looking forward to hearing about Leo
Bron
 
Bron and Sheba (GA) said:
Hi and welcome to you and Leo. He is very young to have diabetes.
Happy birthday for tomorrow Leo!

If he has had ketones in his urine it is really important that you are testing for the ketones at home. You can do this by buying a bottle of Ketostix from Walmart or a pharmacy and testing his urine. I would suggest testing daily if you can. It is a simple test.
Also because he has had ketones it is important he eats lots of food as food, insulin and fluids help keep ketones at bay.

Not sure why you swapped to the alphatrak from the Freestyle Libre so you could get more frequent readings……the alphatrak meters strips are far more expensive than the freestyle meter ones.

We have a spreadsheet here which you might like to set up. Then we can certainly help you proceed.
The AMPS is the am preshot BG and the PMPS is the on preshot BG.
We recommend always testing before every shot and again during the cycles to see how low the dose is taking Leo as Lantus dosing is based on the nadir or lowest point in the cycle.

How often are you feeding Leo? Are you giving him a preshot meal and then some snacks during the cycles?

HELPUS HELP YOU has links to the spreadsheet, the signature (which tells us all about Leo and stops us asking questions about him all the time) and the hypo box and other useful information.

FOOD CHART LINK check this out to see if you are feeding foods with 10% carbs or less.

Look at all the yellow stickies at the top of the LLB PAGE

Can you tell us how you reached 3 or 4 units a cycle. How did you go up? Was it in 1 unit increments or less?
Looking forward to hearing about Leo
Bron
Click to expand...

Hi Bron and Sheba, thanks for your quick reply and warm welcome. I meant to say I swapped to the AlphaTrak to check his levels more consistently rather than just for the 5 days before he licks off his Freestyle sensor. also,we have got the urine test strips to keep up with his ketone levels and have been checking, but not daily. thanks for the tip.

Last time he had ketones he refused to eat anything, but this time he is at least trying to eat so hopefully they subside.

I feed him two times a day (1.5 ish cans of 3 oz LC FF pate) and only give him an arbitrary few treats pre shot. also yes, he is really young to have diabetes but he has had it since he was around 4 months old. He was born with it, unfortunately :(
 
Welcome to FDMB.

I think Bron was suggesting you consider a human meter vs the AlphaTrack. The strips for the AT meter run about $1.00 per strip. If you opt for Walmart's Relion meter, you will be paying less than 20 cents per strip.

I'd also suggest feeding your cat more often. Kittens eat a lot! And often. It is no problem to feed a diabetic cat multiple small meals per day and kitten food is typically high in protein and low in carbohydrates. What are you feeding Leo? Not all kitten foods are low in carbs and not all "prescription" diabetic foods are low in carbs, either.

I'd also suggest adding water to Leo's food. The additional liquid is good with regard to keeping the ketones at bay and it's also good for his kidneys.

Can you tell us a little more about how you arrived at the dose that Leo is currently on? We tend to raise doses in small, systematic amounts (e.g., 0.25 to 0.5u) and track progress on the spreadsheet that's in one of the links Bron provided.
 
Sienne and Gabby (GA) said:
Welcome to FDMB.

I think Bron was suggesting you consider a human meter vs the AlphaTrack. The strips for the AT meter run about $1.00 per strip. If you opt for Walmart's Relion meter, you will be paying less than 20 cents per strip.

I'd also suggest feeding your cat more often. Kittens eat a lot! And often. It is no problem to feed a diabetic cat multiple small meals per day and kitten food is typically high in protein and low in carbohydrates. What are you feeding Leo? Not all kitten foods are low in carbs and not all "prescription" diabetic foods are low in carbs, either.

I'd also suggest adding water to Leo's food. The additional liquid is good with regard to keeping the ketones at bay and it's also good for his kidneys.

Can you tell us a little more about how you arrived at the dose that Leo is currently on? We tend to raise doses in small, systematic amounts (e.g., 0.25 to 0.5u) and track progress on the spreadsheet that's in one of the links Bron provided.
Click to expand...

Thank you Sienne and Gabby! We will surely look into the Relion meter. Do we use it just like the Alphatrak, with the BG numbers that come out comparable to the Alphatrak? Is the procedure the same?

Do you recommend a mid-day meal and keep insulin BID with his AM and PM meal? We give Leo various flavors of fancy feast pate.

We started at 0.5u and minitored him on the freestyle libre, increasing it by 0.5u until Leo was on 2u BID. We did these based on the vets recommendations which worked well up til his neuter. Now we’re trying to see what to do with his insulin to get his numbers back to ar least the 200s. We have been using our own spreadsheet/google form to track, but will transition to the spreadsheet of this forum. Thank you again, really appreciate it.
 
You use any blood glucose meter in exactly the same way. The only difference between the AT and a human meter is that they are calibrated slightly differently. The AT meter's numbers are a bit higher than a human meter especially at the lower end of the range the the difference between the two types of meters gets larger the higher your cat's blood glucose. (For example, in one study, a 50 on a human meter was equivalent to a 68 on an AT meter. That 18 point difference gets much larger as the test result numbers are higher.)

If it's in any way possible to move a week or two of numbers onto our spreadsheet, the context would be very helpful.

Is there any chance Leo had an infection after the neuter? Any source of infection or inflammation can cause a rise in BG numbers.
 
Thank you so much! I think we’ll transition to the human monitor once we run out of the AT strips. Does that mean the human tracker will always consistently give lower results? It doesnt compromise accuracy? Going to move some of the data into this spreadsheet now. Be in touch. Thank you so much again!
 
Hi again. I see you are getting lots of great advice.
The human meter gives BG numbers a bit lower than the alphatrak meter but it doesn’t compromise accuracy at all. Our dosing methods are based on the human meter and most of us use the human meters. Up until several years ago all vets used the human meters because there were no alphatrak meters.
Are you giving a good meal before the insulin each cycle?
I would suggest also giving him a snack at around +3 and +5 or +6 every cycle as well as the main meals. Kittens need a lot of food anyway and a diabetic kitty who has ketones in the picture also needs extra food.
Does he ask for extra food? Just don’t feed him for the 2 hours before the preshot so it isn’t food influenced.
 
Thank you! The information you’ve provided really convinces us to transition to the human meters. We’ll start with giving half a can at +6 tomorrow and we’ll keep you updated with how he does with it!
 
Thank you all for all your help so far. About a week's worth of data is in our Spreadsheet, now in the signature. We've started giving him a half can lunch at +6 which he enjoys so that's going well! Thank you Bron and Sheba for that.
What do you all make of the 400+ pre-shot values on 4 units per cycle? He's eating about 1.5 cans of fancy feast pate in the AM and in the PM, and 0.5 cans at +6. Again, appreciate all your help so far. Happy holidays!
 
Are you able to get some tests in during the cycles.? Both am and pm cycles.
Cats can be high at preshot, drop low during the cycle and then be high again by the next preshot. Unless you are testing, we won’t know. If you increase the dose when this is happening, you are risking a hypo. That is why midcycle tests are so important. Lantus dosing is based on the nadir or lowest point …another reason why we need to see those midcycle tests.
Do not increase the dose while you are not getting midcycle tests.
Are you testing the urine for ketones. This is a good idea when your kitty is in higher numbers. Details are in post 2 above.
 
Thanks so much! Will definitely work on getting those mid cycle numbers. From what I've read, should we focus on the +6 numbers as that's when Lantus should give him the lowest glucose numbers? Or just shoot for the whole range.
And yes after we noticed a change in his behavior and found out he had ketones in his urine, we have been keeping an eye on them. Now we use strips once every day/two days which looks negative for ketones and also lately his behavior is much better than when he had ketones in his urine (more active, playful). Thanks again Bron and Sheba! Keep in touch as soon as we get more of those numbers.
 
If you could get a mid-cycle test or two that would help a great deal. Most people get a test before they head off to sleep (aka a "before bed" test) nightly to ensure their cat is in safe numbers. With a history of ketones, we tend to be a bit more aggressive about the dose. I wouldn't want to suggest an increase without some spot checks since, as Bron noted, numbers could be lower than you might think and then spiking back up at pre-shot times.
 
Thank you all so much! We'll get some of those mid cycle measures. Regarding food, sometimes it's hard to get him to eat. Previously we have had to spoon feed him and coax him with treats in his wet food. He's doing much better now, with less spoon feeding and usually finishes his 1.5 cans per meal. Has been devouring his mid cycle lunch, which is good. Thanks again!
 
Hi all. Happy new year! Some new numbers in the Spreadsheet, now on 4.5 BID with a transition to new human glucometers. I have a question: how should his increased appetite be interpreted? He ate 5 cans yesterday of wet food (2 in AM, 1 at lunch +6, and 2 in PM). He woke us up this morning screaming for food too! Let me know your thoughts, thank you so much in advance!!
 
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