Merlin’s getting ready for the real thing

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Merlin’sMama

Merlin’sMama

Member Since 2022
Continued from Merlin’s Saga … https://www.felinediabetes.com/FDMB...ntinued-from-merlin-saga.263536/#post-2953247
Hi Everybody! Merlin is getting psyched for his first dose. The syringes should be arriving some time today. I need to call and get him under the care of a different vet, but I don’t know if I should start dosing first, or get him in first. Should an emergency arise, I want someone I can trust to take him, not the one who ODed him. So I can imagine that the dosing will begin either Wednesday or Thursday morning. I will let you all know in advance and keep you up to date. I say Merlin is psyched, really, he’s just hanging out under his bush with his ratty tshirt on like nothing’s new.
 
Merlin’sMama said:
Continued from Merlin’s Saga … https://www.felinediabetes.com/FDMB...ntinued-from-merlin-saga.263536/#post-2953247
Hi Everybody! Merlin is getting psyched for his first dose. The syringes should be arriving some time today. I need to call and get him under the care of a different vet, but I don’t know if I should start dosing first, or get him in first. Should an emergency arise, I want someone I can trust to take him, not the one who ODed him. So I can imagine that the dosing will begin either Wednesday or Thursday morning. I will let you all know in advance and keep you up to date. I say Merlin is psyched, really, he’s just hanging out under his bush with his ratty tshirt on like nothing’s new.
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Hi Jill
I'd say whichever comes first.
If you cannot get him in to a vet before the syringes arrive then start on the insulin. If they arrive today then i would start first thing in the morning.
The sooner you get him on insulin the sooner he will feel better.
 
Got him in to a total pro vets Wednesday at 12:00! They have even had a tv show, so they must be pretty transparent. Thanks to Tee who found the clinic!! I will feel so much better when I have a reliable place to take him. I gave the receptionist a quick summary of what happened and she will give those notes to the new vet. Now fingers crossed they are familiar with Lantus and wont try to talk me out of it. They may want to do new bloodwork, but I would be ok with that since the original was over a month ago. All going well, we will give the first dose on Thursday or Friday morning at home. I will let you all know.
 
Merlin’sMama said:
Got him in to a total pro vets Wednesday at 12:00! They have even had a tv show, so they must be pretty transparent. Thanks to Tee who found the clinic!! I will feel so much better when I have a reliable place to take him. I gave the receptionist a quick summary of what happened and she will give those notes to the new vet. Now fingers crossed they are familiar with Lantus and wont try to talk me out of it. They may want to do new bloodwork, but I would be ok with that since the original was over a month ago. All going well, we will give the first dose on Thursday or Friday morning at home. I will let you all know.
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That's great news Jill and you sound so much happier now.
 
Merlin’sMama said:
Got him in to a total pro vets Wednesday at 12:00! They have even had a tv show, so they must be pretty transparent. Thanks to Tee who found the clinic!! I will feel so much better when I have a reliable place to take him. I gave the receptionist a quick summary of what happened and she will give those notes to the new vet. Now fingers crossed they are familiar with Lantus and wont try to talk me out of it. They may want to do new bloodwork, but I would be ok with that since the original was over a month ago. All going well, we will give the first dose on Thursday or Friday morning at home. I will let you all know.
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Excellent. Hope it goes well
 
Merlin’sMama said:
Got him in to a total pro vets Wednesday at 12:00! They have even had a tv show, so they must be pretty transparent. Thanks to Tee who found the clinic!! I will feel so much better when I have a reliable place to take him. I gave the receptionist a quick summary of what happened and she will give those notes to the new vet. Now fingers crossed they are familiar with Lantus and wont try to talk me out of it. They may want to do new bloodwork, but I would be ok with that since the original was over a month ago. All going well, we will give the first dose on Thursday or Friday morning at home. I will let you all know.
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That's the name of the clinic? Total Pro Vets? Or what? And you say they have a TV show? Don't necessarily expect them to be familiar with Lantus (we can always hope) but I do hope he/she will be open to learning if not.
 
Suzanne & Darcy said:
That's the name of the clinic? Total Pro Vets? Or what? And you say they have a TV show? Don't necessarily expect them to be familiar with Lantus (we can always hope) but I do hope he/she will be open to learning if not.
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They’re called Gilabbey Veterinary hospital. They featured in an Irish tv show about vet surgeries. They feel like pros to me. As Tee said, they have a bio on each vet at the clinic, unlike the previous vet who was barely even named on their website. Hopefully they will be supportive and willing to learn too!
 
Got the syringes! Now, when we talk to the new vets on Wednesday, I’m not sure what to tell them about how we saved him the other night. Should I mention FDMB or should I call you “my old vet in Colorado”? A network of friends who have diabetic cats? What do people normally do about that? I couldn’t claim to have done it all by myself, that’s for sure.
 
The vet clinic looks like it has a lot of specialists there, including one in internal medicine. They'll probably be more knowledgeable, and possibly more pricey. But if you are a regular client in there it looks like you can find all sorts of expertise.

As for what happened the other night, I think it should be fine to say that you were searching for help online cause you couldn't find any other late night help. And you happened upon a message board specializing in diabetic kitties. Of course, I'm one to talk - the locum vet who helped get me onto Lantus from Caninsulin referred me to FDMB (though I was already lurking). When I started going to an acupuncture vet for Neko and even back to her regular vet, I did mention FDMB. It was through people here that she got her acromegaly diagnosis and treatment organized. Basically gave her a much longer and better quality of life.
 
Very happy that Merlin ate 3/4 of a can of gourmet gold pate at what would be PS this morning. I took up all of the food before I went to bed and, lo and behold, he was hungry in the morning! Thing is, I didn’t think he was eating any of that old food because it was all dried up in the morning. And another thing is, he didn’t like pate yesterday or the day before and wont touch melting heart anymore after the honey blending experience. I guess there’s a shade of difference in flavor? Smells the same to me. And yesterday it was a no go. I was sooo worried yesterday that it seemed all he did for food was lick the “gravy” off the chunks. But I know that tomorrow he might not eat the same stuff as today. I wish I could standardize what all three cats eat and have the belief that if they are hungry enough they will eat anything. I think sometimes they would really actually rather starve. I have to order some of that fortiflora but it’s super expensive here, and I bet it will only work once or twice. Even my little Hoover-cat Opal (who is getting chunkier by the day) was refusing everybody’s rejects yesterday. What the heck?? Was it national cat-food abstinence day or something?
 
Hi Jill
Have you started Merlin on insulin this morning or are you going to wait until you have seen the vet?
As for the Lantus, i'm not up on dosing, procedures etc with Lantus but there are lots of members who are familiar with it, i'm only familiar with Prozinc.
I will tag some members who are familiar with Lantus just to make them aware and watch out for you if/when you do switch over to the Lantus board and can help you regarding dosing etc for Merlin.
@Suzanne & Darcy @Bron and Sheba (GA) @Bandit's Mom @Wendy&Neko @FrostD @tiffmaxee
 
I’m waiting til we’ve met the new vet tomorrow. If they want to do new bloodwork, which I think is a good idea, I guess I’ll have to wait til that comes back. If not, we would be ready to start Thursday or Friday morning. I will let everyone know how it goes at the vets.
 
Also, I have a question. I’m confused about BG and food. Isn’t feeding, even LC wet, supposed to bring the BG up? Merlin seems to either stay the same or sometimes go down slightly after eating.
 
Merlin’sMama said:
I’m waiting til we’ve met the new vet tomorrow. If they want to do new bloodwork, which I think is a good idea, I guess I’ll have to wait til that comes back. If not, we would be ready to start Thursday or Friday morning. I will let everyone know how it goes at the vets.
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I would have thought they will start straight away with the insulin going by his numbers, just make sure you show them the Libre readings or your spreadsheet. The spreadsheet will probably be better as it laid out neatly in daily rows showing all hourly readings and easier to read.
We alway show our vet the spreadsheet when he goes for his diabetes check up. Infact she always asks to see it now.
 
Merlin’sMama said:
Also, I have a question. I’m confused about BG and food. Isn’t feeding, even LC wet, supposed to bring the BG up? Merlin seems to either stay the same or sometimes go down slightly after eating.
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I'm not sure Jill, but the difference in numbers in my opinion are very slight. He did go up yesterday at AM+3
How are you checking him in the morning, are you using the meter then using the Libre throughout the day.
 
Hendrick Cuddleclaw said:
I was straight with my vet and mentioned the FDMB and asked if she was familiar with the group, but its up to you of course how you handle
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Yeah, some vets are really negative and think we are Dr. Google. Some vets (at least after they see how well managed the cats are) are really positive. They won't have the time to check us out, of course. I never told my vet "exactly" about the FDMB, but I always showed her my spreadsheet, which after a while she started asking for. I think I may have started showing her my spreadsheet so she would stop asking to do a fructosamine test (which was a waste of money since I had better data on him anyway.)
 
Merlin’sMama said:
Also, I have a question. I’m confused about BG and food. Isn’t feeding, even LC wet, supposed to bring the BG up? Merlin seems to either stay the same or sometimes go down slightly after eating.
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This depends a lot on the cat as to how much their BG goes up/does not go up with certain percentages of carbs. It's very individual. You can feed and test to chart it so you will know how it goes with Merlin. This can be very good for you to know in lower BG situations
 
I would encourage you to try and start the insulin as soon you can, as you longer you leave him in those higher numbers the harder it is to get him back down as his body is getting used to them. And then there is the concern about ketones, which I know you are testing for but even so, it is putting his body under unnecessary stress not having insulin. Insulin does other things in the body apart from bringing down the BGs.
 
Teetee (UK) said:
I'm not sure Jill, but the difference in numbers in my opinion are very slight. He did go up yesterday at AM+3
How are you checking him in the morning, are you using the meter then using the Libre throughout the day.
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Mostly, meter first, but this morning he was too wiggly for the reader and I had a migraine, so I just went with the Libre. I will do another meter in a while just to see and not get out of the habit.
 
Merlin’sMama said:
Mostly, meter first, but this morning he was too wiggly for the reader and I had a migraine, so I just went with the Libre. I will do another meter in a while just to see and not get out of the habit.
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It could be the difference between the meter and the libre. Why not experiment between the two, say at AMPS do a meter reading and a libre reading at the same time and then after he's eaten his breakfast check him with the meter and libre at AM +1 +2 and +3 to see the difference between the two.
It would be interesting to know the difference.
 
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In my experience, a lot of cats seem to "top out" at certain BGs when they're unregulated. So the food doesn't really affect things when they're so high, or if it does it's masked by meter variance. Like others said the "carb sensitivity" varies between cats, my cat never really went up more than 30 points from food
 
FrostD said:
In my experience, a lot of cats seem to "top out" at certain BGs when they're unregulated. So the food doesn't really affect things when they're so high, or if it does it's masked by meter variance. Like others said the "carb sensitivity" varies between cats, my cat never really went up more than 30 points from food
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Darcy did not either. But then our boys are/were Acro.
 
Merlin’sMama said:
Also, I have a question. I’m confused about BG and food. Isn’t feeding, even LC wet, supposed to bring the BG up? Merlin seems to either stay the same or sometimes go down slightly after eating.
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He's just got high blood sugars. High is high, you don't want him there any longer than you have to be. It's hard on his organs and the longer he's high, the harder it will be to get him regulated. Staying high and flat is not just an acro thing, it's a "cat on not enough insulin" thing. I agree with Bron, the sooner the better. Insulin provides the food for the bodies cells, including the brain. You might find this post informative: What is Feline Diabetes?

I'd save your test strips until you are actually giving insulin, unless you just want the practice.

Way back when this all started, the discussion was around a 0.5 unit dose of Lantus. He's on wet food, at the time you wanted to follow the Start Low Go Slow method for dosing, so 0.5 units is where you'd start.
 
We had our appointment with the new vet today. She was impressed with how much I knew and how much time I must have devoted to know so much. I had the article from the RVC explaining how glargine is better than Caninsulin, Merlin’s spreadsheet, the full story of the last vet, and the conversion chart from U40 to U100 to prove that the previous vet was clueless. Niamh took her time and truly listened. Then she consulted a more senior vet, which seemed to take ages. He then came in quite concerned about the dosages and the pen (I took the Lantus pen in that the pawpaws vet used to overdose him with). He asked if the previous vet said to click it up to one and what did she use for a needle etc. He was also concerned that the syringes I brought never ever get confused with U40s that they use for Caninsulin for the cats and dogs in their surgery, that I should always ask for Niamh and no one else concerning Merlin’s insulin. His idea was that we should get needles and use the pen to give one unit, once a day, instead of two .5 units. Niamh noticed that I was not comfortable with this, but we let him talk. He also said we could reuse the needles, or the syringes two or three times to save money, and Niamh really noticed my reaction to that. He was nice enough, and very concerned, but I was very glad that he was not our appointed vet because he was obviously more knowledgeable about dogs and said that it’s very rare for cats to have type 2 diabetes and their diabetic cat(s)are on Caninsulin. I explained that the previous vet told us to draw the insulin from the pen with the syringes, but he was concerned that .5 is too hard to see on the syringe and therefore we should just go with 1 unit, one time a day, either from the pen or with a syringe. When he left, Niamh, the first vet, said “I know that you know a lot about this, and I think it’s fine to give him .5 twice a day with the syringe, so lets practice with a vitamin supplement that is orange so you can find the .5” We were both concerned about drawing the insulin out of the pen, and I nearly asked her to order a vial, but I don’t think Merlin should wait any longer.


So we will begin the .5 dose of Lantus from the Solostar pen tomorrow morning at 9:00 am. Can anybody come?
 
Teetee (UK) said:
That's great news Jill and i'm really pleased Merlin's finally going to start on Lantus in the morning.
Can you post a picture of your u100 syringe please just to be sure.
I will tag in a few members for you to see if they are available to help or give you some advise as i have no experience with Lantus.
@Suzanne & Darcy @Bron and Sheba (GA) @Bandit's Mom @Wendy&Neko @FrostD @tiffmaxee
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Merlin’sMama said:
We had our appointment with the new vet today. She was impressed with how much I knew and how much time I must have devoted to know so much. I had the article from the RVC explaining how glargine is better than Caninsulin, Merlin’s spreadsheet, the full story of the last vet, and the conversion chart from U40 to U100 to prove that the previous vet was clueless. Niamh took her time and truly listened. Then she consulted a more senior vet, which seemed to take ages. He then came in quite concerned about the dosages and the pen (I took the Lantus pen in that the pawpaws vet used to overdose him with). He asked if the previous vet said to click it up to one and what did she use for a needle etc. He was also concerned that the syringes I brought never ever get confused with U40s that they use for Caninsulin for the cats and dogs in their surgery, that I should always ask for Niamh and no one else concerning Merlin’s insulin. His idea was that we should get needles and use the pen to give one unit, once a day, instead of two .5 units. Niamh noticed that I was not comfortable with this, but we let him talk. He also said we could reuse the needles, or the syringes two or three times to save money, and Niamh really noticed my reaction to that. He was nice enough, and very concerned, but I was very glad that he was not our appointed vet because he was obviously more knowledgeable about dogs and said that it’s very rare for cats to have type 2 diabetes and their diabetic cat(s)are on Caninsulin. I explained that the previous vet told us to draw the insulin from the pen with the syringes, but he was concerned that .5 is too hard to see on the syringe and therefore we should just go with 1 unit, one time a day, either from the pen or with a syringe. When he left, Niamh, the first vet, said “I know that you know a lot about this, and I think it’s fine to give him .5 twice a day with the syringe, so lets practice with a vitamin supplement that is orange so you can find the .5” We were both concerned about drawing the insulin out of the pen, and I nearly asked her to order a vial, but I don’t think Merlin should wait any longer.


So we will begin the .5 dose of Lantus from the Solostar pen tomorrow morning at 9:00 am. Can anybody come?
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I will be there, and I bet I won’t be the only one

. And you do know how to draw the insulin from the pen, right. Don’t insert any air into the pen like you would with a vial. Just put in the syringe and draw back the .5 unit. You probably already did this at the vet.
 
Suzanne & Darcy said:
I will be there, and I bet I won’t be the only one

. And you do know how to draw the insulin from the pen, right. Don’t insert any air into the pen like you would with a vial. Just put in the syringe and draw back the .5 unit. You probably already did this at the vet.
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You're an angel Suzanne :bighug:
There is a video on how to draw insulin from a pen on this Lantus Insulin Care & Syringe Info: Proper Handling, Drawing, Fine Dosing sticky
https://felinediabetes.com/FDMB/thr...info-proper-handling-drawing-fine-dosing.151/
 
This is where you need to draw the insulin to on the syringe for 0.5 unit. I know you will already know this but i'm just double checking.
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Suzanne & Darcy said:
I will be there, and I bet I won’t be the only one

. And you do know how to draw the insulin from the pen, right. Don’t insert any air into the pen like you would with a vial. Just put in the syringe and draw back the .5 unit. You probably already did this at the vet.
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Yay! Thank you, Suzanne! We had some more practice at the new vet today. One thing I worry about is going all the way through the tent to the other side, like I often do with the ear pricks. I guess it’s about grabbing a thick enough chunk of skin to make the tent. It would be such a shame if this first one was a fur shot! But we are going to start on the shaved skin that was under his first libre that didn’t work. My daughter Ivy (21) has volunteered to do the first shot, and she feels totally confident after practicing at the vet. John does too. It’s just me who is a little hesitant. And I’m the one doing the ear pricks!
 
Merlin’sMama said:
Yay! Thank you, Suzanne! We had some more practice at the new vet today. One thing I worry about is going all the way through the tent to the other side, like I often do with the ear pricks. I guess it’s about grabbing a thick enough chunk of skin to make the tent. It would be such a shame if this first one was a fur shot! But we are going to start on the shaved skin that was under his first libre that didn’t work. My daughter Ivy (21) has volunteered to do the first shot, and she feels totally confident after practicing at the vet. John does too. It’s just me who is a little hesitant. And I’m the one doing the ear pricks!
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Y'all are a great team!
 
How much food does Merlin need to eat to be safe before the shot? Lately he has been having a like three spoonfuls, going away, and then coming back. Will these spoonfuls be enough, or should I wait til after he comes back to shoot? Also, his BG is now down to 14.1. I don’t think its ever been this low, except on the OD night! How low should I expect it to get tomorrow and how long after the shot should it start dropping? Is it below 5 where we start to worry? I’m still very PTSD after last week, at this very time.
 
Merlin’sMama said:
Lately he has been having a like three spoonfuls, going away, and then coming back.
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What kind of spoonsful? Teaspoons or Tablespoons? I do not think it's a problem either way, really. How long is he waiting to come back for more? This could actually benefit him ... to graze on the food. It probably will take a few hours for the insulin to kick in, so if he's eating during that time, it will be fine. Remember, lots of people purposefully feed small amounts at +1, +2, etc. And Merlin is such a good eater, right? He ate all that stuff for you last week without complaining.
 
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I do like the first vet you saw and glad she agreed with ignoring everything the other vet said. :banghead: You have the exactly right syringes too. Looks like you are all set to go.

Some tips on shooting and testing in this post might help, especially the roll method of shooting: Testing and Shooting Tips

Merlin’sMama said:
Lately he has been having a like three spoonfuls, going away, and then coming back. Will these spoonfuls be enough, or should I wait til after he comes back to shoot?
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That's fine, we have members with cats that are grazers. Long as you know he's not off his food, you are good to go. And even then there is some wiggle room as the Lantus doesn't onset (start to take effect) on average for 2-3 hours later. For brand new people following SLGS, we suggest not shooting below 200 (11.1), until you have some more data. Eventually, with experience you can shoot the full dose at lower numbers.
 
Suzanne & Darcy said:
What kind of spoonsful? Teaspoons or Tablespoons? I do not think it's a problem either way, really. How long is he waiting to come back for more? This could actually benefit him ... so graze on the food. It probably will take a few hours for the insulin to kick in, so if he's eating during that time, it will be fine. Remember, lots of people purposefully feed small amounts at +1, +2, etc. And Merlin is such a good eater, right? He ate all that stuff for you last week without complaining.
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Teaspoons. He has regained some of his pickiness from before diabetes. It’s weird to me that he is not as hungry as he was two weeks ago. I have gone out and bought a bunch of new foods on the list so that he will be less likely to get bored and just lick off the chunks. I cant believe, though, that I have to worry about him not eating after he’s been wolfing down for so many weeks. My other two have gone on strike too. Even the scrappy doo. Maybe he thinks its the cool thing to do.
 
Hi Jill, looks like you are ready to go! Yay!
Very glad you have found a good vet ……very surprising to hear what the more senior vet thought :banghead:
I know you are in Ireland and are going to give the first dose at 9am your time….is that right?
And are you going to post here or on the Lantus forum?
 
Something weird is going on… Merlin was 14.1 earlier. And now he is 10.7. He had a little bit to eat about an hour and a half ago. I wouldn’t shoot if he’s this low, would I? What’s going on???
 
Merlin’sMama said:
Something weird is going on… Merlin was 14.1 earlier. And now he is 10.7. He had a little bit to eat about an hour and a half ago. I wouldn’t shoot if he’s this low, would I? What’s going on???
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It's ok Jill he's 9 hours away from his shot, i would presume he will have gone back up by then. If not then you follow the SLGS procedure and not shoot below 11.1 (200) then ask for advise.
Have you double checked with the meter?
Don't worry Jill help will be there for you.
 
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Teetee (UK) said:
It's ok Jill he's 9 hours away from his shot, i would presume he will have gone back up by then. If not then you follow the SLGS procedure and not shoot below 11.1 (200).
Have you double checked with the meter?
Don't worry Jill help will be there for you.
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Ok…I’m just kind of concerned why it would be dropping so much right now. It has never been this low except in the hypo crisis.
 
Merlin’sMama said:
Ok…I’m just kind of concerned why it would be dropping so much right now. It has never been this low except in the hypo crisis.
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Double check with the meter to see if the numbers are somewhere the same.
He won't drop into hypo numbers if he's not on insulin so don't worry about that.
 
I don’t want to drag him out of his bed and down to the meter, so I scanned again and, having just told Ivy we wouldn’t shoot below 11.1, it read 11.1. Strange. Anyway, I am going to get some sleep and try not to worry so I can be bright in the morning. Thanks for your quick response. :) Nite nite.
 
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