? 02/06/2022, New Member, Mumu, AMPS 439

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Sisu

Sisu

Member Since 2022
My 8.5 year old male, domestic short hair/Abyssinian (not purebred) has recently been diagnosed with FD.

He was started out on 2 units of Lantus 9am/9pm. At the time I was feeding him Fancy Feast Savoury Salmon Pate 3oz and due to confusion with the vet only 1 can at each 12 hour mark (I now know this is not enough food).

The first day of the 2 unit regime he seemed fine during the day although I had not tested his blood glucose. However in the night I woke up around 4:30 am (his dose again was at 9am and 9pm) to find him sprawled out on the living room floor. I tested his BG and it was at 2.6 mmol/L. I fed him and gave 1mL of corn syrup and he was fine after that.

After speaking with my vet she suggested decreasing it to 1 unit 9am/9pm.

Now I have switched him to Tiki cat Ahi Tuna/Chicken 2.8 oz because of the 0 carbs of which he receives 1.5 can at each 12 hour interval. He usually will eat it all by 9:20am/pm and that is when i will administer the 1 Unit of Lantus.

Now I have been testing his blood sugar and yesterday he was at 24.6 mmol/L at 3pm then 25.3 mmol/L at 9pm.

I am scared to death I am going to lose him and feel a bit in over my head. I cant talk to my vet till next Tuesday as she only works from then till Saturday.

I have read of the Somogyi effect but that cant be whats going on here right? The solution has to be to up his insulin dose?

Any help is appreciated.
 
Welcome. Can you go back to your title and add New Member
To do this to the right you will see Thread Tools tap on that then tap on Edit Title ,add New Member and hit save

,I will tag some experienced members for you, thank god you woke up and tested him, great job in giving him the corn syrup
The members might ask you when he was diagnosed , and if the vet did a fructosamine test to diagnose him.
Has he always been eating low carb wet food ? Any dry food?
2 units seems like a high dose to start with
1 unit might even be too much , I'll let the experts answer that
We feed our cats multiple times during each 12 hour cycles maybe around at +2 ( that means 2 hours after giving insulin, then again at +4 (4 hours after giving insulin)
We don't use times because we are all in different time zones .

Are you using a human meter or pet meter
We also have a spreadsheet where we track our cats BG to see how the insulin is working and how low it's dropping.
Can you test during the day say at +2 or +3, the +5 or at +6 ,same during the night time cycle , more if needed if he drops too low and you need to bring his/BG up to safe numbers
I'll give you the link to set up the spreadsheet it will also explain how it works
We also have what we call your signature it's at the end of everyone's post in gray, it's information about our cats so we won't have to keep asking you the same questions over again.
Try and not to feed fish flavors all the time because of mercury in them. Once or twice a week is fine
Can you tell us where you live , we can give give you a link to a food chart
We like to feed 6% carbs and under.
The higher BG's could be because he's Bouncing
Will be right back with some links

Bounces happen when the BG drops too fast, too low or lower than the kitty has been used to. The body then panics and dumps stored glucose and regulatory hormones into the system and the BG goes up high. Bounces can last from 1 to 6 cycles and thee is nothing you can do but wait them out.

Here is the link so you can read about lantus
https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/

Tap on the blue link to do your signature
Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help.
You can take a look at mine

How to create a spreadsheet, if you need help just ask I can tag one of our members to set it up for you
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

You have found the best forum for diabetic cats, if it wasn't for the members here my Tyler would not be in remission today

I'll go ahead and tag some members for you
@Bron and Sheba (GA)

@Bandit's Mom

@Wendy&Neko

@tiffmaxee

@Sienne and Gabby (GA)

@Suzanne & Darcy

@Chris & China (GA)

Edit should he continue with the 1 units ?

Sisu said:
He was started out on 2 units of Lantus 9am/9pm. At the time I was feeding him Fancy Feast Savoury Salmon Pate 3
Click to expand...

From what is on the Chewy site
It appears to be low carb
How many carbs are in a 3oz can, on a dry matter basis ?
This variety contains approximately 0.6% Carbohydrate content on an as fed basis (2.5% on a dry matter basis
 
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Sisu said:
I have read of the Somogyi effect but that cant be whats going on here right? The solution has to be to up his insulin dose?
Click to expand...
About this , I copied the following that one of our members said
There is actually no such thing as the Somogyi effect. It was a very small study done I think in the 1930s but has never been proven in cats.
What you are seeing with the low and then high numbers is bouncing. Bouncing happens when the BG drops too fast, too low or lower than the cat is used to. This causes the cat to dump stored glucose and regulatory hormones into its system as it thinks it has to save itself. This causes the BG to skyrocket. A bounce can last from 1 to 6 cycles (3 days) and once a bounce starts, there is nothing you can do but wait it out.

Do not up his insulin dose
 
He was taken into the vet because I noticed he was drinking more than usual, his BG was 29 mmol/L at the vet and they did a urinalysis about 4 days later confirming glucose in his urine.

He was on dry/wet his whole life but now he is not.

The Vet has been adamant about the 12 hour interval feeding.

I am using the pet meter Alpha Trak 2.

I am going to try to do a curve but was told to wait a week after this dose is done. I poke him between the outer edge of his ear and the marginal vein but he still cries sometimes so i feel really bad but am testing him now off and on to try to get some sort of picture as to whats going on.

I ordered 2 months supply of the Ahi Tuna/Chicken as it is said to contain 0% carbs. I didn't know the fish flavours contained mercury is there a link?

I live in Ontario, Canada.

Is there a way for me to confirm that the bouncing is happening? That would mean he would need an even lower dose?

I was feeding him the Tiki cat Salmon/Chicken as well before I got the order of the Ahi/Chicken. Is there anyway that the change is spiking his BG? Both wet foods are basically the same carb/protein but higher fat in the salmon.

Thank you so much I will do the signature and look at the links. I just want to figure out what I am doing wrong in regards to his regulation.
 
Sisu said:
He was on dry/wet his whole life but now he is not.

The Vet has been adamant about the 12 hour interval feeding.

I am using the pet meter Alpha Trak 2.
Click to expand...
How long has it been since you took away the dry food, it can significantly drop his BG by 100 points
Don't listen to your vet about feeding only twice a day ,it's makes the pancreas work harder
Are you using 26 or 28 gauge lancets , if you look at them closely you will see one side points upward ,that's the side you want to poke with

You might want to pick up some medium and high carbs foods for your hypo kit
These are probably available in Canada, this is a US food list you can take a look

For your hypo kit you want some
Med and High Carb food and some honey



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 in Gravy 15% Med Carbs

Good idea to mark the cans with magic marker how many carbs

Or any on the food chart.
https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/
 
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Hello and welcome from BC. I hope you came through yesterday's scary winds OK.

Sisu said:
The Vet has been adamant about the 12 hour interval feeding.
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Your vet is perhaps used to older style insulins where it was important to get food in early. Not so much an issue with Lantus which is a much gentler insulin. In fact, more smaller meals are better. Also, don't worry about feeding him 0% carbs. Many of us here feed foods in the 3-6% range, some carbs is actually a good thing.
Sisu said:
am going to try to do a curve but was told to wait a week after this dose is done.
Click to expand...
The vet is wrong about that too. If you had ignored the cat and not tested last night, he might not still be here. People with diabetic infants test them before giving insulin, we need to do the same with our cats.

We'll be better able to help you if you can keep the spreadsheet up to date with insulin doses given on which days, AM and PM and tests you have done. Take a look at ours to see how that works. I have a World tab too. How to Use the Spreadsheet
 
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Sisu said:
I ordered 2 months supply of the Ahi Tuna/Chicken as it is said to contain 0% carbs. I didn't know the fish flavours contained mercury is there a link?
Click to expand...
All I can tell you is about fish flavors posted by a member is
One is due to the heavy metal contamination found in a lot of fish these days, mercury being just one of them. Also, fish flavors are higher in phosphorus because a lot of bones end up ground up into cat food and bones are high in minerals. High phosphorus is harder on the kidneys. The last reason is because it can become "addictive" where the cat won't eat anything else. Fish isn't really supposed to be a normal part of any cat's diet. Few feline species include fish as a food source at all (although a few wild cats might snag a fish out of a river or pond now and then but more because it's something that's moving and triggers the hunting instinct than for actual food value)
 
I should've mentioned the 2 Units was administered at the beginning of the month when he was first diagnosed.

I have updated all of the times i have checked his BG. The Vet has also said no need to check his BG very often but I have these numbers because I am still learning how to do it properly and I want to know whats happening.

He was also diagnosed with asthma but is now off the Flovent unless otherwise needed.

I am just very confused why his BG is so high now compared to when I first started the 1 unit regime. The only change I can think of is the food.

One other thing I have noticed with him is he has got pee on his foot a couple times when going pee, he doesn't cry or strain to pee and I don't see any blood in the litter where he went.
 
Sisu said:
I should've mentioned the 2 Units was administered at the beginning of the month when he was first diagnosed.

I have updated all of the times i have checked his BG. The Vet has also said no need to check his BG very often but I have these numbers because I am still learning how to do it properly and I want to know whats happening.

He was also diagnosed with asthma but is now off the Flovent unless otherwise needed.

I am just very confused why his BG is so high now compared to when I first started the 1 unit regime. The only change I can think of is the food.

One other thing I have noticed with him is he has got pee on his foot a couple times when going pee, he doesn't cry or strain to pee and I don't see any blood in the litter where he went.
Click to expand...
As Wendy has said your vet is wrong about not testing Mumu's BG very often.
I can't tell you why his BG is so high now compared to when you first started the 1 units
About the pee on his foot, I have no idea ,as long as he's not straining, crying,and no blood I don't see anything wrong. Which foot ,his back one ?



Here is the link so you can read about the 2 dosing methods we follow when using lantus for you to choose one that best suits you when it comes to testing
https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/

alphatrak meter. Anything below 68 and you need to give high carb food to bring the BG up higher. Then test again in 20 minutes to see the BG is rising.
 
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Yes his back foot, just thought i would put that out there if anyone else had that issue.

I am a little lost on the lingo to be honest. SLGS? ng?

I guess I shouldn't of bought so much of that food, would I fail him by continuing to feed it? I am so lost not looking for pity just don't know what to do now.
 
Sisu said:
Yes his back foot, just thought i would put that out there if anyone else had that issue.

I am a little lost on the lingo to be honest. SLGS? ng?

I guess I shouldn't of bought so much of that food, would I fail him by continuing to feed it? I am so lost not looking for pity just don't know what to do now.
Click to expand...


SLGS: You hold a dose for 7 days (unless a reduction is earned). You decrease the dose when the BG falls below 90. The aim of this protocol is to keep the cat in the 90-150 range. This is more suited for caregivers who can't test as much as TR requires. You do a weekly curve with SLGS.

TR is a more aggressive protocol with increases as often as every 3-5 days. Reductions are earned when the BG falls below 50. (newly diagnosed under a year ) The aim is to keep the cat in the range of 50-100 (which is the normal BG range for cats). To follow TR, you would need to get at least one more test per cycle in addition to the pre-shot one i.e. 2 tests per cycle or 4 tests per day. You would also need to be feeding only LC canned food and no dry food.

For people using the SLGS method the take action number is 90 on the Alpha Trak

Can you return the fish flavor foods?



By the way do you have the U-100 syringes with the half unit markings, we increase or decrease by 0.25 units. Having the half unit syringes makes it easier to do

I know you are not looking for pity silly, we were all new to this when we started.
Can you add the words NEW MEMBER to your title

Try and read over the 2 Dosing Methods
https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/
 
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Sisu said:
Yes his back foot, just thought i would put that out there if anyone else had that issue.

I am a little lost on the lingo to be honest. SLGS? ng?

I guess I shouldn't of bought so much of that food, would I fail him by continuing to feed it? I am so lost not looking for pity just don't know what to do now.
Click to expand...
The ng was supposed to be the word “wrong”. Some letters were missing/typo (probably phone error)

And SLGS stands for the Start Low Go Slow dosing method.
 
Sisu said:
Yes his back foot, just thought i would put that out there if anyone else had that issue.

I am a little lost on the lingo to be honest. SLGS? ng?

I guess I shouldn't of bought so much of that food, would I fail him by continuing to feed it? I am so lost not looking for pity just don't know what to do now.
Click to expand...
On the food if you call chewy they will most likely give you a credit on the food or tell you how to return it, then you can order a different flavor of the tiki cat food.
 
Yes I do have the U-100 syringes but they do not have the half unit markings.

I can return them actually, so maybe go with the chicken?
 
Sisu said:
Yes I do have the U-100 syringes but they do not have the half unit markings.

I can return them actually, so maybe go with the chicken?
Click to expand...
To add to your title
To do this to the right you will see Thread Tools tap on that then tap on Edit Title ,add New Member and hit save

You can keep the ones you have when you have to give full units

As for syringes in Canada I did a search and found these listed by some members
As for shopping for syringes, I got mine at the local Safeway pharmacy.

I buy the u-100 syringes with half unit markings from https://diabetesexpress.ca/. These ones, specifically:https://diabetesexpress.ca/collections/syringes/products/bd-ultrafine-ii-syringe-3-10cc-6mm-31g
Those have the 6mm syringe length, which is quite short. I think most people prefer these:
https://diabetesexpress.ca/collections/syringes/products/bd-uf-ii-syringe-3-10cc-31g-8mm
 
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So if he was bouncing, how soon should I check his BG to confirm it is going too low, because the earliest I have checked so far is +3.
 
Sisu said:
Yes his back foot, just thought i would put that out there if anyone else had that issue.

I am a little lost on the lingo to be honest. SLGS? ng?

I guess I shouldn't of bought so much of that food, would I fail him by continuing to feed it? I am so lost not looking for pity just don't know what to do now.
Click to expand...

Hi and welcome to the FDMB. Here is a link to the FDMB glossary explaining some terms quoted frequently on this forum, I found this very helpful as a new member myself: https://felinediabetes.com/FDMB/threads/fdmb-glossary.194472/

It is under Health Links / FAQs about Feline Diabetes - this whole section has tons of very helpful information when you get a chance to read.
 
I'll go ahead and tag some members for you again

Can you please read Sisu's post, and skim through the rest of the them
His signature and SS is set up, His cat already went hypo, using Alpha Trak
from Canada, should he reduce the dose of lantus, what should His no shoot number be
Also he has questions about bouncing ,I told him that's probably what happened and that's why he's seeing higher BG"s now, but it's past 6 cycles already
Thanks everyone
@Bron and Sheba (GA)

@Bandit's Mom



@tiffmaxee

@Sienne and Gabby (GA)

@Suzanne & Darcy

@Chris & China (GA)
should he continue with the 1 units ?
 
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Sisu said:
So if he was bouncing, how soon should I check his BG to confirm it is going too low, because the earliest I have checked so far is +3.
Click to expand...
I would still check around +6 and maybe +9 to just see how he's doing, the more data the better so members can help you out
Don't forget to check during the night cycle a few times
I know you said the testing is not going that great
Are you using 26 or 28 gauge lancets , if you look at them closely you will see one side points upward ,that's the side you want to poke with

A favor when someone replies back to you can you tap the like word that's to the right of the posts just so we know you read it :cat:
 
28 Gauge.

I have read everyone's comments and appreciate all of them so everyone knows!

I will be heading out now as life calls but I will be reading through again tonight, a lot of information to take in and I also have a condition that makes that harder for me so please bear with me.

Thank you again.
 
As Wendy said we need to see all info on the spreadsheet to give dosing advice. Lantus is dosed based upon how low it takes a cat which is often between +5-7. It can be earlier or later too.
 
If it's possible, it's really important to get a test in the PM cycle or after the PM shot as well. Many people get a "before bed" test, if it's at least 2-3 hours after the shot. Many cats go lower at night. We determine how to change doses based on how low a dose takes the cat. Besides changes to food, you've also lowered the dose a lot. Cat's are sensitive to small changes in dose, we change dose by 0.25 units at a time. Don't worry about picking a dosing method just yet, but it is something you will have to think about soon.

Syringes can be bought in almost any pharmacy. In BC I found Safeway the cheapest, but shop around, prices vary quite a bit from store to store. That online reference Diane gave is one of the more expensive. Some people buy at Shoppers for Shoppers points - I didn't because Shoppers prices are so high here.
Chrispooky12 said:
On the food if you call chewy they will most likely give you a credit on the food or tell you how to return it, then you can order a different flavor of the tiki cat food.
Click to expand...
Chewy doesn't deliver to Canada, but most pet stores will return food for refund or at least credit.
 
I actually just got back from shoppers here and the pharmicist said they wouldnt have anything like that, i will stop by the other shoppers to double check.

I did some brainstorming while out and would stopping the dose and doing a full curve sound like something to do to rule out the bouncing or to rule out somewhere along the line his BG is dropping too low and I am missing it.

I recorded his BG the days after he had the hypogylcemic event of which he was on 0 units and his BG wasnt this high. At that time he was eating the FF savoury slamon which has more carbs than 0 as well.

I just dont understand why his BG is this high with 1 unit and 0 carb diet.

I was thinking to either do that or continue take a reading tonight and do a full curve tomorrow.
 
I am by no means trying to sound like I know anything about this stuff or am experienced. I am merely just trying to make sense of this.

I ended up giving him his 1 unit along with his food. I checked his BG before feeding ( updated SS ) and will check again in 2 hours.

I will do a full curve tomorrow as it has been 7 days on 1 unit and the vet wanted it done as well so I will update that tomorrow.

One other question, I have noticed sometimes when I give him his insulin he doesn't mind but other times he cries and I am doing the same method as I always do? Make a tent, push needle in, pull back to see no blood then inject. I am trying the best I can but honestly feel like I am failing ( and going a bit crazy).
 
It’s not only about carbs. His pancreas is not working properly right now and he’s used to having high bg. So he needs insulin to help his pancreas heal and get used to normal bg again. It’s very likely that 1.0 units is not enough insulin right now. As Wendy said we adjust in .25 increments. The curve will be a big help.

Where do your shoot? I never pulled back the needle. Just insert and push the plunger.
 
I was told to pull back to check and see if there is blood incase i hit a vessel. I shoot around his shoulders/neck but always make sure i pull his skin up into the tent. I vary the area in hopes im not making him sore.
 
I’ve never been told to pull up and check for blood. I think the whole time Max was on insulin I saw blood once. It doesn’t cause any issues. That may be why your cat sometimes feels pain.
 
No i mean pull the skin up into a tent, push the needle in pull back on the needle to see if there is blood in the syringe then inject.

It is the exact way the vet told me so i am very confused now.
 
Sisu said:
I was told to pull back to check and see if there is blood incase i hit a vessel
Click to expand...

It's really not necessary. With longer needles, like the ones used for vaccines, antibiotics, etc. there's a risk of hitting a blood vessel but with the tiny, short insulin needles, they don't go deep enough to hit anything of any concern. You may occasionally nick a capillary and see a little blood on the end of the needle, but it's not anything to worry about.
 
I have never pulled back on the syringe to check for blood, I have always injected the insulin in the scruff area, pull up on the scruff and you will feel the indentation there then just shoot
 
Ok so now im a bit worried, this is the first time ive checked in the pm his BG was 23.2 mmol/L at injection time. I checked again at +1.5 and it is at 17.4 mmol/L. Is this a normal drop or is it way too fast?
 
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Sisu said:
Ok so now im a bit worried, this is the first time ive checked in the pm his BG was 23.2 mmol/L at injection time. I checked again at +1.5 and it is at 17.4 mmol/L. Is this a normal drop or is it way too fast?
Click to expand...
OK so his BG was 417 PMPS and 313 @+1.5 I would feed him about a teaspoon of his low carb food and check again around +4
Tagging members to see what they think, can you add the 313 to your spreadsheet
Put 313 @+1.5

@tiffmaxee

@Wendy&Neko

@Bron and Sheba (GA)

@Chris & China (GA)

@Suzanne & Darcy
 
I don’t see any tests on your spreadsheet. Would you please update it and also the US spreadsheet as most of us use US numbers and if you fill in the world one the US will automatically work.
 
Ok. That’s a big enough drop to cause a bounce but he’s nowhere near danger territory. That would be 68 on the pet meter. Sorry to have so many requests but please add that you are using an AT meter to your signature when you have a moment.

I’d feed a little of your regular food and get a before bed test.
 
Yes he went down 5.8 mmol/L in 1.5 HR.

I am not sure how to do the spreadsheet right now.

So i should feed him right now and test again in +1.5?
 
Hi Elise does he need to set up a world spreadsheet also? I didn't even notice that he didn't add the Alpha Trak to his signature. One question when you said that would be 68 on a pet meter, he is using a pet meter ? I'm confused
@tiffmaxee
 
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Sisu said:
Yes he went down 5.8 mmol/L in 1.5 HR.

I am not sure how to do the spreadsheet right now.

So i should feed him right now and test again in +1.5?
Click to expand...
Yes feed him a little of his low carb food now, on your spreadsheet you need to manually co!or in that 313 pink. We can worry about setting up the world spreadsheet later if needed.
 
Ok I fed him about 2 tablespoon roughly, when should I check his BG again to be safe?
 
AT is a pet meter Diane. I’m not sure what spreadsheet this is as it does not look like the world exactly. I caught the type of meter on the spreadsheet.

Sisu, pet meters test higher than human ones. If you change to a human meter the time for hc is 50.
 
tiffmaxee said:
AT is a pet meter Diane. I’m not sure what spreadsheet this is as it does not look like the world exactly. I caught the type of meter on the spreadsheet.

Sisu, pet meters test higher than human ones. If you change to a human meter the time for hc is 50.
Click to expand...
I know the AT is a pet meter I am confused as to why you said that would be 68 on a pet meter when he is using a pet meter #37 ,so since he's in Canada he should set up a world SS
 
Sisu said:
Yes that is the one i made it.
Click to expand...
Now can't see your SS at all
You have to
To set spreadsheet sharing permission:
* At the top right of the spreadsheet screen click on Share.

* In the pop-up dialog box click on the Get Link section.

* Change link access from 'Restricted' to 'Anyone with the link' and make sure that the permission on the right hand side is set to 'Viewer'.

* Click Done to save the changes.

Are you sure about the link you used to set up the SS
I just taped on the link I just gave you take another look at it

If you're having trouble with it I'm going to tag Bhooma
@Bandit's Mom to help you out
 
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