New member. Jupi, ex-feral. Still getting the hang of this.

[luncanmonica]

Hi, everyone! This is Jupiter, my FIV+ and diabetic kitty. He was rescued in august 2021 as a feral. We ran some bloodwork on him, he was diagnosed with FIV, neutered and then came back to live in my care. He initially seemed to be interested in me, but had random bouts of aggression, so we redid his bloodwork. This time around, he was also diagnosed with diabetes. He's been boarded at the vet for the past two months, because although I run a rescue and can administer shots, fluids etc, I just wasn't able to restrain him and test/ administer insulin on my own.

He's now been back at home for the past week, since our vets have short hours and he wouldn't be able to get insulin 2x/ day there. The plan would be that he remains in my care if I manage to keep up with his needs. So far we're getting along pretty good. He's been biting me a bit and we had to take a trip to the ER on Christmas Eve, since he wouldn't let me give him his shot, but I'm hopeful we'll get better at this together.

I'm still reading up on diabetes and getting data on how his blood sugar varies throughout the day. For his first days here, I wasn't sure if I was administering the shots correctly (have since changed injection site and he's tolerating them better) and also had trouble with dosing since I didn't have the right syringes. Still, we've been seeing much higher numbers than what he had at the vet. I've been told he was steadily at 200-300 while in their care... I've seen numbers in the 400 too. We believe some of it is due to stress. But I also have another issue. Our vet insisted that the best time to administer insulin would be at 7-8 AM since that's when the pancreas is most active. This is just not doable for me. I care for 20 cats at home, out of which 3 are epileptic, 1 has pulmonary fibrosis and asthma, 1 has FIP etc...+ work. I've been doing 10am and 10pm but I'm worrying it won't be enough to give him a chance at remission.

I'm also not confident with shooting low/ hypo just yet. I've seen a 64 number and I panicked. I realize this is fine for most of you... I still text our vet if shooting under 160. I'm now reading more and understanding that I'm not shooting for the preshot number, but for the overall numbers he's reaching throughout the day, so I'm trying to relax. I was instructed by our vet to shoot 2ui Lantus if numbers are over 200 and 1 ui if numbers are under 200.

I'm planning to do a curve soon and maybe work on his dosing, but I'm awaiting a bit more data and I also need to have us both settle into this routine because everything is still very much stressful for the both of us.

So for now, I guess this is an intro post. If you have any advice for us, feel free to drop us a line. <3 I hope our 2nd message will be more confident, but until then, we're still reading everything on the fb group and this one as well.

PS: Sorry for the huge image, it was the only way I could find to attach it. And he's also not eating kibble anymore.

 

[Sienne and Gabby (GA)]

Welcome to FDMB.

I'm shaking my head at some of the advice your vet has provided. The pancreas is most active when you eat. Food, or the end product of metabolism - glucose, stimulates the pancreas to produce insulin which transports glucose into the cells. If your vet's idea about when the pancreas was most active was accurate, what would humans who work 3rd shift do? In fact, Lantus dosing in humans is often every 24 hrs. Bottom line is we have people who dose their cats on what makes sense for their schedule. It's more important that Lantus is dosed as close to every 12 hours as possible.

Rest assured that for members who are new to managing their cat's diabetes, a 64 is scary number. Most people would panic. We encourage members that if they get a pre-shot number less than 150 to not feed their cat and to post and ask for advice. It takes confidence and having a fair amount of test data to shoot lower numbers.

What are you feeding Leo? Given the number of cats you're caring for, is it feasible to get him on a low carbohydrate diet?

I'm also including this link on helping us to help you. It includes some basic information about diabetes management along with instructions for setting up your spreadsheet and signature. The spreadsheet will allow you to track Leo's progress and allow us to follow along. The signature will provide answers to some of our questions about Leo so we don't keep asking the same questions over and over again.

Please let us know how we can help.

 

[luncanmonica]

Hi, Sienne! Thank you so much for the reply! I did get the signature done first thing. I'm happy to hear about the fact that not everyone doses in the early hours of the morning!

Jupi is on wet, low carb food (Animonda Carny Adult, the ones with 2.5% carbs). The 64 wasn't a PS, it was a +4 number. I fed and tested again at +5 so I could go to sleep.

I'm not sure what I need help with right now. I'd like to wait a few more days on the low carb food (I've only taken Jupi home when I started the spreadsheet) and get a few more days of near-perfect insulin administrations before I do a curve. I guess that will give me more info about how he's actually doing and if we need to increase dosage. Does that sound about right?

For now I'm just really happy to meet some people who understand the struggle. I've been reading and stressing a lot, I think I need to keep reading but quit stressing

We're lucky to have very supportive vets though, my main vet has been answering every "his insulin is INSERT VALUE, what do i do???" for the past 8 days very timely and the ER vet just held him down and let me administer his insulin so they didn't charge us

 

[Diane Tyler's Mom GA]

Hi, Sienne! Thank you so much for the reply! I did get the signature done first thing. I'm happy to hear about the fact that not everyone doses in the early hours of the morning!

Jupi is on wet, low carb food (Animonda Carny Adult, the ones with 2.5% carbs). The 64 wasn't a PS, it was a +4 number. I fed and tested again at +5 so I could go to sleep.

I'm not sure what I need help with right now. I'd like to wait a few more days on the low carb food (I've only taken Jupi home when I started the spreadsheet) and get a few more days of near-perfect insulin administrations before I do a curve. I guess that will give me more info about how he's actually doing and if we need to increase dosage. Does that sound about right?

For now I'm just really happy to meet some people who understand the struggle. I've been reading and stressing a lot, I think I need to keep reading but quit stressing

We're lucky to have very supportive vets though, my main vet has been answering every "his insulin is INSERT VALUE, what do i do???" for the past 8 days very timely and the ER vet just held him down and let me administer his insulin so they didn't charge us

@Sienne and Gabby (GA)

 

[Katherine&Ruby]

Hi Monica, welcome to the FDMB! Once you get more acclimated, you may want to post Jupiter's numbers on a daily basis on the Lantus forum. That forum is very active, and there are lots of people (including me) who post nearly every day with their cats numbers to get advice as to what to do with dosing and feeding. You won't need your vet to help you if you have the assistance of members here. I manage my Ruby's diabetes without the help of her many vets (she's complicated as well). It took a while for me to cut the cord--why would I trust a bunch of strangers on the Internet when I have doctors with degrees? But I realized early on that most vets don't understand feline diabetes, treat their cat patients like dogs (they're not the same ), and that the FDMB's accumulated knowledge and experience far exceeds that of even the most seasoned veterinarians. You seem to have it really together, so this ride (bites aside) will be a breeze for you!

 

[luncanmonica]

Hi Monica, welcome to the FDMB! Once you get more acclimated, you may want to post Jupiter's numbers on a daily basis on the Lantus forum. That forum is very active, and there are lots of people (including me) who post nearly every day with their cats numbers to get advice as to what to do with dosing and feeding. You won't need your vet to help you if you have the assistance of members here. I manage my Ruby's diabetes without the help of her many vets (she's complicated as well). It took a while for me to cut the cord--why would I trust a bunch of strangers on the Internet when I have doctors with degrees? But I realized early on that most vets don't understand feline diabetes, treat their cat patients like dogs (they're not the same ), and that the FDMB's accumulated knowledge and experience far exceeds that of even the most seasoned veterinarians. You seem to have it really together, so this ride (bites aside) will be a breeze for you!

haha, thank you for your kind words, but it's definitely not a breeze yet. It's getting better though as I order better supplies and read more experiences here. We've gone from 5-10 pokes for a drop of blood to 1-2 pokes with the sock and rice method. And from an unknown dose of insulin administered each cycle to an exact one, as soon as I changed syringes. I'll move over to the Lantus forum too, soon. Also, may I just comment on how amazing your sheet looks? You seem to have everything so organized! Best wishes to you and your furbaby!

 

[Bron and Sheba (GA)]

Hi Monica and Juniper and welcome to the forum. I love the photo of Jupiter.
You certainly have your hands full with all those kitties.
I see you have the SS up and running. That’s great.
Just want to comment on the doses you are giving….Lantus is a depot insulin and it likes a consistent dose. Giving one dose in the morning and a different dose in the afternoon will just mess up the depot.
So I think for now I would split the difference and give 1.5 units am and pm. Are you using syringes to give the insulin.?
If that dose drops the BG too low you can lower it. We increase and decrease the dose in 0.25 unit increments so as not to go past the best dose and for the safety of the kitty.
I would post for a few more days on the main health page until we get things sorted out for you before moving to the Lantus page.
Bron

 

[luncanmonica]

Hi Monica and Juniper and welcome to the forum. I love the photo of Jupiter.
You certainly have your hands full with all those kitties.
I see you have the SS up and running. That’s great.
Just want to comment on the doses you are giving….Lantus is a depot insulin and it likes a consistent dose. Giving one dose in the morning and a different dose in the afternoon will just mess up the depot.
So I think for now I would split the difference and give 1.5 units am and pm. Are you using syringes to give the insulin.?
If that dose drops the BG too low you can lower it. We increase and decrease the dose in 0.25 unit increments so as not to go past the best dose and for the safety of the kitty.
I would post for a few more days on the main health page until we get things sorted out for you before moving to the Lantus page.
Bron

Hi, thank you so much for your reply! I don't mean to give two different doses, but his BG kept fluctuating. The initial guidelindes from the vet were to give 2 ui if BG was over 200 and 1 ui if BG was under 200. So basically 2 ui would be his dose, the 1 ui would be just 50% a dose if the pre shot value was less than we'd like for a full dose. The only insulin syringes we have widely available here are 1ml. You basically can't even dose 1 ui correctly with those, since they have markings only for 2 ui. So we've struggled with that initially. For the first few days, I had no idea if I was giving 0 ui, 1 ui or 2 ui. I tried my best, of course, but I was still adjusting to the fact that I have to handle a cat that can randomly be aggressive alone. We've changed injection sites too and that improved.

Then I found a provider for U100 syringes... they're only available from one provider in the whole country, it's insane. But we switched to those. There have been a lot of changes in the week that he's been here (changed food, changed syringes, changed doses from what he was receiving at the vet). I want to adapt the dose to better suit his needs too, but right now, I feel like I'm not working with a lot of data. I want both of us to settle in a little bit and then do a curve next week to get a better understanding of how the insulin is affecting him. For instance, AMPS today was 118. I wouldn't really feel comfortable shooting 1.5 ui in this scenario.

Edit: PMPS 112 with 1 unit shot AM. this is the best he's ever kept his BG... but I wasn't able to test throughout the day, i'll test at night to see how low he's dropping.

We have a hypo kit and an ER 15 mins away, i'm planning to also get some sq glucose for emergencies, but it's just really stressful, because it's not a disease I have any experience with and I've had to learn everything in like 2 days.

 

[Bron and Sheba (GA)]

don't mean to give two different doses, but his BG kept fluctuating. The initial guidelindes from the vet were to give 2 ui if BG was over 200 and 1 ui if BG was under 200. So basically 2 ui would be his dose, the 1 ui would be just 50% a dose if the pre shot value was less than we'd like for a full dose

Glucose levels fluctuate all the time. The dose is not based on the preshot BG but on how low Jupiter goes during the cycle. The preshot is done to see it is safe to give the dose.
Lantus does not work with using a sliding scale for dosing….the vet is incorrect to advise this.
Lantus works best when a consistent dose is given.

The only insulin syringes we have widely available here are 1ml. You basically can't even dose 1 ui correctly with those, since they have markings only for 2 ui. So

Then I found a provider for U100 syringes... they're only available from one provider in the whole country, it's insane. But we switched to tho

Can you tell us what country you live in? The 1 unit syringes make it more difficult to give smaller doses.
Can you show us a photo of the U100 syringes you are using now please? You will need to copy and paste the photo as the ‘upload a file’ link is not working.
Do you know if the syringe is a U100 3/10 ml syringe?

AMPS today was 118. I wouldn't really feel comfortable shooting 1.5 ui in this scenario.

PMPS 112 with 1 unit shot AM. this is the best he's ever kept his BG... but I wasn't able to test throughout the day, i'll test at night to see how low he's dropping.

With all the changes in dose and not a lot of mid cycle tests done, it is hard to say what the best dose would be.
You were right not to give the 1.5 units with the AMPS of 118. Next time this happens……the best thing to do is stall, don’t feed and test again in 20 minutes to see if the BG is rising. And post and ask for advice.
For now, I think you might be best to stay with 0.5 unit each dose and try and get a test in during each cycle so we can see how low the dose is taking Juniper. If you stay with the same dose, the depot will stabilise and you will get more consistent BGs. If he drops under 90 you will need to reduce the dose.
How does that all sound.

 

[luncanmonica]

Glucose levels fluctuate all the time. The dose is not based on the preshot BG but on how low Jupiter goes during the cycle. The preshot is done to see it is safe to give the dose.
Lantus does not work with using a sliding scale for dosing….the vet is incorrect to advise this.
Lantus works best when a consistent dose is given.




Can you tell us what country you live in? The 1 unit syringes make it more difficult to give smaller doses.
Can you show us a photo of the U100 syringes you are using now please? You will need to copy and paste the photo as the ‘upload a file’ link is not working.
Do you know if the syringe is a U100 3/10 ml syringe?




With all the changes in dose and not a lot of mid cycle tests done, it is hard to say what the best dose would be.
You were right not to give the 1.5 units with the AMPS of 118. Next time this happens……the best thing to do is stall, don’t feed and test again in 20 minutes to see if the BG is rising. And post and ask for advice.
For now, I think you might be best to stay with 0.5 unit each dose and try and get a test in during each cycle so we can see how low the dose is taking Juniper. If you stay with the same dose, the depot will stabilise and you will get more consistent BGs. If he drops under 90 you will need to reduce the dose.
How does that all sound.

Do you mean under 90 during the cycle or as a pre shot value? We've done 0.5 tonight, +4 is 81.

 

[luncanmonica]

Glucose levels fluctuate all the time. The dose is not based on the preshot BG but on how low Jupiter goes during the cycle. The preshot is done to see it is safe to give the dose.
Lantus does not work with using a sliding scale for dosing….the vet is incorrect to advise this.
Lantus works best when a consistent dose is given.




Can you tell us what country you live in? The 1 unit syringes make it more difficult to give smaller doses.
Can you show us a photo of the U100 syringes you are using now please? You will need to copy and paste the photo as the ‘upload a file’ link is not working.
Do you know if the syringe is a U100 3/10 ml syringe?




With all the changes in dose and not a lot of mid cycle tests done, it is hard to say what the best dose would be.
You were right not to give the 1.5 units with the AMPS of 118. Next time this happens……the best thing to do is stall, don’t feed and test again in 20 minutes to see if the BG is rising. And post and ask for advice.
For now, I think you might be best to stay with 0.5 unit each dose and try and get a test in during each cycle so we can see how low the dose is taking Juniper. If you stay with the same dose, the depot will stabilise and you will get more consistent BGs. If he drops under 90 you will need to reduce the dose.
How does that all sound.

these are the syringes I'm using now. I'm based in Romania.