NEW MEMBER May. 30 When to skip insulin injection?

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MissSarahJean

MissSarahJean

Member Since 2022
Hi everyone!
I’m new to the site :)
I’ll try to give as much info as possible!
My kitty Alice has been diagnosed with diabetes since the beginning of April. We’re on Lantus, my vet currently has her on 6 units every 12hrs. At the beginning of diagnosis we started with 4 units. We’ve done 2 glucose curves at home and I have another one to do in a few days. She’s been on 6 units of Lantus since May 19th.
Her numbers have gotten much better but I was never advised as to which numbers to look out for as being too low to administer insulin. On Thursday her morning reading was 6.3 so I made the call to skip her morning dose as that was the lowest I’d ever seen her blood sugar. Yesterday her morning number was 8.1 I was unsure but gave her her dose and everything was fine. This morning she’s reading 7.1. Her usual injection times are 8am and 8pm. I haven’t given her shot this morning because I’m afraid of putting her into hypoglycaemia. So what numbers should I be looking for as too low to administer insulin? I was going to call my vet today but they are not open yet.
Thank you all in advance!!
 
https://felinediabetes.com/FDMB/threads/when-to-skip-insulin-injection.263945/#post-2957454

Welcome SarahJean can you add this additional information to your signature
  • Caregiver & kitty's name
  • DX: Date
  • Name of Insulin (do not include dose or frequency)
  • Name of your meter

  • Dosing: TR or SLGS or Custom (if applicable)
  • DKA or other recent health issue (if applicable)
  • Acro, IAA, or Cushings (if applicable)
To add this tap in your name up top, tap signature add this and tap Save
I am no expert but by looking at your spreadsheet we do not increase by whole units ,we increase and decrease by 0.25 units .
Some members might say 4 units was a lot to start with
You need to be testing more often during each 12 hour cycle , especially at night.
What we're food are you exactly feeding and dry food?

I see on your SS Alice didn't receive insulin due to no one being at home about 8 times, Lantus likes consistency, I'll give you the link to read about Lantus below
Do you have the U-100 syringes with the half unit markings?
Do you have a hypo kit set up in case Alice drops too low and you need to bring her numbers up to safe numbers








 
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Hi Diane! Apologies, I’m so very green to this site. Which additional information is needed?

*Edit
I see it now! Sorry about that it wasn’t loading in properly on my end :)
 
No problem at all I've added some info to my post please go back and read :cat:
You need to be testing more than you have been so we can see how the insulin is working for Alice and how low she's dropping during the cycles.
 
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Diane Tyler's Mom said:
https://felinediabetes.com/FDMB/threads/when-to-skip-insulin-injection.263945/#post-2957454

Welcome SarahJean can you add this additional information to your signature
  • Caregiver & kitty's name
  • DX: Date
  • Name of Insulin (do not include dose or frequency)
  • Name of your meter

  • Dosing: TR or SLGS or Custom (if applicable)
  • DKA or other recent health issue (if applicable)
  • Acro, IAA, or Cushings (if applicable)
To add this tap in your name up top, tap signature add this and tap Save
I am no expert but by looking at your spreadsheet we do not increase by whole units ,we increase and decrease by 0.25 units .
Some members might say 4 units was a lot to start with
You need to be testing more often during each 12 hour cycle , especially at night.
What we're food are you exactly feeding and dry food?

I see on your SS Alice didn't receive insulin due to no one being at home
Click to expand...
I will add the additional information right away.
My vet has increased her dose twice now by one whole unit each time. So I’m not sure why he wouldn’t be increasing it by 0.25 units? I just follow his instructions. I’ve currently only been testing her prior to injections other than on glucose curve days. I can start testing more frequently though and especially at night if that’s what you would advise. :)
I’m feeding her purina cat chow. 3/4 of a cup in the morning prior to first injection and then she free feeds on that throughout the day. She then receives 39.7g fancy feast pate prior to second dose. Some freeze dried treats throughout the day as well. I’ll usually give her a tiny scoop more of the purina before we go to bed. I’d say it’s about 2 tablespoons.
There were a few days where Alice missed her dose due to no one being home. April is a busy month for us with birthdays/anniversaries and we have no one who can administer her insulin for us when we’re away.

*Edit
I’m currently using Lantus 100 in an AllStar Pro pen injector. It goes up by single units. I have extra food on hand and a bottle of corn syrup in case of hypoglycaemia.
 
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MissSarahJean said:
I will add the additional information right away.
My vet has increased her dose twice now by one whole unit each time. So I’m not sure why he wouldn’t be increasing it by 0.25 units? I just follow his instructions. I’ve currently only been testing her prior to injections other than on glucose curve days. I can start testing more frequently though and especially at night if that’s what you would advise. :)
I’m feeding her purina cat chow. 3/4 of a cup in the morning prior to first injection and then she free feeds on that throughout the day. She then receives 39.7g fancy feast pate prior to second dose. Some freeze dried treats throughout the day as well. I’ll usually give her a tiny scoop more of the purina before we go to bed. I’d say it’s about 2 tablespoons.
There were a few days where Alice missed her dose due to no one being home. April is a busy month for us with birthdays/anniversaries and we have no one who can administer her insulin for us when we’re away.
Click to expand...
Sorry to say but most vets know nothing about diabetes, if it wasn't for the experienced members here advising me Tyler would not be in remission today.
Dry food is very high in carbs , but you don't want to take that away right now ,,the Fancy Feast Pate is fine it's low in carbs. Taking away the dry food can drop her BG by 100 points , the dry food is probably keeping her save with the 6 units you are giving.
If you work can you get a few tests in before you leave and when you get home
After you add to your signature would you like me to tag a few experienced members when it comes to dosing?


I found this on the Chewy site about the Purina Cat Chow
what is the percentage of carbohydrate now that the formula has been changed? Thanks!
This recipe contains 27.20% Carbohydrates on an as fed basis

We like to feed around 6% carbs and under ,but DONT CHANGE ANYTHING NOW
 
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Thank you very much Diane. Tagging some experienced members would be helpful yes!
I’ve been reading up a lot here on this site before making my account today. 6 units does sound extreme from what I’ve read and I’m aware of her dry food being very high in carbs. I’ve been planning on changing Alice’s diet to wet only but I know there is risk involved with her blood sugar going too low too quickly. Especially with such a high dose of insulin! I’ve been gradually trying to introduce her to more protein. I’ve taken her completely off of temptations treats and switched to high protein freeze dried ones. She loves them thank goodness! I’ve also decreased the amount of dry food given as compared to before diagnosis.
I’ve changed my signature. Not sure if it’s enough? I wasn’t sure which date needs to be added.
Thanks again!!
 
MissSarahJean said:
Thank you very much Diane. Tagging some experienced members would be helpful yes!
I’ve been reading up a lot here on this site before making my account today. 6 units does sound extreme from what I’ve read and I’m aware of her dry food being very high in carbs. I’ve been planning on changing Alice’s diet to wet only but I know there is risk involved with her blood sugar going too low too quickly. Especially with such a high dose of insulin! I’ve been gradually trying to introduce her to more protein. I’ve taken her completely off of temptations treats and switched to high protein freeze dried ones. She loves them thank goodness! I’ve also decreased the amount of dry food given as compared to before diagnosis.
I’ve changed my signature. Not sure if it’s enough? I wasn’t sure which date needs to be added.
Thanks again!!
Click to expand...
Just add the DX Date I will tag some members now :bighug:
Also great job in setting up the SS and signature
 
I feel terrible for missing doses as I know how important consistency is. I hadn’t actually counted how many doses were missed until you pointed it out. The more recent skipped doses were due to me being afraid of administering 6 units when her numbers are lower than I’ve seen before. I live in a remote area where my vet is a 20 minute drive away and only hubby has a licence and works throughout the week.
 
MissSarahJean said:
I feel terrible for missing doses as I know how important consistency is. I hadn’t actually counted how many doses were missed until you pointed it out. The more recent skipped doses were due to me being afraid of administering 6 units when her numbers are lower than I’ve seen before. I live in a remote area where my vet is a 20 minute drive away and only hubby has a licence and works throughout the week.
Click to expand...
Don't feel terrible I only pointed it out to let you know that it's important not to skip doses, yes I can see why you skipped when her BG was too low , can you put NS (No Shot) for this morning ?
Do you work ?
 
@Wendy&Neko

@Sienne and Gabby (GA)

@tiffmaxee

@Bron and Sheba (GA)
Hi Ladies I have been trying to help out a new member here , quick summary
Canada
Insulin. Lantus
DX 5-5-2022

Pet Meter
Food. Fancy Feast Pate and Purina Cat Chow Dry
Vet started Alice on 4 units. Now up to 6 units Vet increased by Whole units
At this point what would a no shoot number be
Can you give her some dosing advice

Sarah works
work Weds-Fri 10am-5:30pm.
I asked her to start testing on her off days ,testing times also to see if she can get one more test in before she leaves for work
 
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Diane Tyler's Mom said:
You put it in the U cell for units
What are your shot times Sarah?
On the days you don't work you need to start testing more often
Can you get a test in before you leave for work
Click to expand...

Spreadsheet has been updated with NS in the correct spots. :)
My shot times are 8:00am and 8:00pm.
On days I work I have only been testing before injection but I can definitely test before I head out at 9:45am. So that would be roughly in the 2hr after dose range.
These iPet pro test strips are getting expensive for us. My first refill of 50 cost us $113 and last week when we bought them they’ve increased to $140!! It sure adds up when you’re going through test strips like crazy. I’ve been thinking about changing her glucose meter to something more affordable.
 
MissSarahJean said:
Spreadsheet has been updated with NS in the correct spots. :)
My shot times are 8:00am and 8:00pm.

These iPet pro test strips are getting expensive for us. My first refill of 50 cost us $113 and last week when we bought them they’ve increased to $140!! It sure adds up when you’re going through test strips like crazy. I’ve been thinking about changing her glucose meter to something more affordable.
Click to expand...
That would be great if you can test her again before you leave
Yes the test strips are expensive most of us use a human meter that's what our numbers are based on. I see you are in Canada I can do a search here and see what other Canadian members use
 
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Hello from the west coast of Canada.

There is no easy answer to the question about not giving a shot. It's a bit more complicated than that, and depends on what blood glucose data you so far and whether you are following a particular dosing method. With dry food in the picture, we are more conservative at first about no shoot numbers. For brand new folks on this forum, the answer is 200 (11.1). As you get data about what happens with your cat when you shoot lower numbers, and you are around to monitor, you can gradually lower that number. I see you have shot as low as 146.

As for glucose meter, yes, change them! No need to use the pet specific meters. A lot of people in Canada use the Freestyle, as they need a similar blood drop. Back in my day, I cross border shopped in the US for cheaper meter/strips. You can usually find good prices on eBay for strips too. Bravo tests strips are another option, though only available on line. I'd also like to see some night time tests, maybe just before you go to bed. Many cats go lower at night, and we change doses based on how low the dose takes the cat.

Good to see you are working on ditching the dry food, that alone is probably why she needs such a high dose of insulin. And since you are cutting back the dry, that may be why you are seeing lower preshots. And I suspect she's going even lower mid cycle.

You might want to think about reducing the dose to 5.5 units. You'd need U-100 syringes to do that.
 
Diane Tyler's Mom said:
That would be great if you can test her again at say 10:30 which would be @+2.5 you would put it like this the BG # the skip a space and put @+2.5 that would be 2-1/2 hours
You would need to color code it manually when testing by half hours
Yes the test strips are expensive most of us use a human meter that's what our numbers are based on. I see you are in Canada I can do a search here and see what other Canadian members use
Click to expand...

My bad, I went back in and corrected my work start time. It’s actually 9:45 not 10:45 my goodness! I’m using my phone and I’m terrible with its tiny keyboard!! So 9:30 would have to be the time that I test before heading out. An hour and a half after injection.
Thanks so much again for your help!
I am definitely interested in finding a different glucose meter with cheaper test strips. Any suggestions are greatly appreciated.
 
MissSarahJean said:
My bad, I went back in and corrected my work start time. It’s actually 9:45 not 10:45 my goodness! I’m using my phone and I’m terrible with its tiny keyboard!! So 9:30 would have to be the time that I test before heading out. An hour and a half after injection.
Thanks so much again for your help!
I am definitely interested in finding a different glucose meter with cheaper test strips. Any suggestions are greatly appreciated.
Click to expand...
That's fine , Wendy gave you some suggestions above about the human meters and other info , when you read a reply back from someone can you tap the like word to the right just so we know you read it :cat:
Also I found this post about meters in Canada so take a look and go through it
BTW Alice is a cutie
Sarah do you use the U-100 syringes with half unit markings to shoot?
https://felinediabetes.com/FDMB/thr...lucose-monitor-in-canada.253097/#post-2865241
 
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Wendy&Neko said:
Hello from the west coast of Canada.

There is no easy answer to the question about not giving a shot. It's a bit more complicated than that, and depends on what blood glucose data you so far and whether you are following a particular dosing method. With dry food in the picture, we are more conservative at first about no shoot numbers. For brand new folks on this forum, the answer is 200 (11.1). As you get data about what happens with your cat when you shoot lower numbers, and you are around to monitor, you can gradually lower that number. I see you have shot as low as 146.

As for glucose meter, yes, change them! No need to use the pet specific meters. A lot of people in Canada use the Freestyle, as they need a similar blood drop. Back in my day, I cross border shopped in the US for cheaper meter/strips. You can usually find good prices on eBay for strips too. Bravo tests strips are another option, though only available on line. I'd also like to see some night time tests, maybe just before you go to bed. Many cats go lower at night, and we change doses based on how low the dose takes the cat.

Good to see you are working on ditching the dry food, that alone is probably why she needs such a high dose of insulin. And since you are cutting back the dry, that may be why you are seeing lower preshots. And I suspect she's going even lower mid cycle.

You might want to think about reducing the dose to 5.5 units. You'd need U-100 syringes to do that.
Click to expand...

I will absolutely start testing Alice more often to get a better picture! :) Thank you for the info!
Yes I feel the meter the vets supplied me with is quite expensive in the long run and they want you to have to keep going back for those test strips through them but there has to be a better way of saving some money with all of Alice’s diabetes supplies.
I’m learning! :)
 
Diane Tyler's Mom said:
That's fine , Wendy gave you some suggestions above about the human meters and other info , when you read a reply back from someone can you tap the like word to the right just so we know you read it :cat:
Also I found this post about meters in Canada so take a look and go through it
BTW Alice is a cutie
Sarah do you use the U-100 syringes with half unit markings to shoot?
https://felinediabetes.com/FDMB/thr...lucose-monitor-in-canada.253097/#post-2865241
Click to expand...

She sure is! She’s my whole word :bighug:
I feel like she’s pretty lucky to have me lol
I can imagine there are lots of poor kitties out there that go undiagnosed :(
I’m glad to be her caregiver!
My pen is the AllStar pro pen it goes up by whole units.
I will definitely check out that post on meters thanks!!
 
MissSarahJean said:
She sure is! She’s my whole word :bighug:
I feel like she’s pretty lucky to have me lol
I can imagine there are lots of poor kitties out there that go undiagnosed :(
I’m glad to be her caregiver!
My pen is the AllStar pro pen it goes up by whole units.
I will definitely check out that post on meters thanks!!
Click to expand...
You are lucky to have each other :cat: You need to get U-100 syringes with half unit markings to draw out the insulin so you can shoot half doses or lower
 
Just take the cap off the pen and use a U100 syringes and pull the insulin out of the pen!
syringe-in-pen-pic-jpg.45006
 
Diane Tyler's Mom said:
You are lucky to have each other :cat: You need to get U-100 syringes with half unit markings to draw out the insulin so you can shoot half doses or lower
Click to expand...

Oh dear. The thought of drawing up the insulin with syringes method gives me anxiety! I’ve been quite comfortable using the pen injector. But I am assuming pens only go up in full units?
The pen is so easy to use.
 
MissSarahJean said:
Oh dear. The thought of drawing up the insulin with syringes method gives me anxiety! I’ve been quite comfortable using the pen injector. But I am assuming pens only go up in full units?
The pen is so easy to use.
Click to expand...
Yes the pens can only be adjusted by full units , you wouldn't be able to shoot for example 5.5 units , 4.5 units , 4.75 units etc all the way down to 0.5 units, 0.25 units
By shooting or whole units at a time you could be skipping over a good dose for Alice . You wouldn't even be able to decrease the units
You might not be able to get her BG under control
It's really not that hard at all using a syringe
 
Diane Tyler's Mom said:
Yes the pens can only be adjusted by full units , you wouldn't be able to shoot for example 5.5 units , 4.5 units , 4.75 units etc all the way down to 0.5 units, 0.25 units
By shooting or whole units at a time you could be skipping over a good dose for Alice . You wouldn't even be able to decrease the units
You might not be able to get her BG under control
It's really not that hard at all using a syringe
Click to expand...

I totally understand what you’re saying. Every kitty is different and finding that right dose is important. I see there is much more flexibility when using syringes. I mean I was nervous at the beginning just using the pen so I’m sure I could get used to the syringe method too! I’m wondering what my vet is going to suggest after her next glucose curve…
 
If you change your mind about the using the U-100 syringes half unit markings rather than the pen here is what I found that was posted by a member from Canada and where to buy syringes

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

Or
Shoppers drug mart or Walmart.
 
You know those replacement cartridges you put in the pen? You can actually draw insulin directly out of them into a syringe. Here's a picture:
49823503981_e7c9b23f0e_o.jpg

Don't bother buying the Solostar pens Diane references. They aren't the reusable kind like the pens you are using. Get the Lantus 5 pack of cartridges and the BD Ultrafine II syringes (purple and yellow box). They have half unit markings. Shop around for prices, there is quite a range. The online store Diane referenced are quite expensive. I found syringes cheapest at my local Safeway pharmacy. Costco and Superstore/Loblaws a close second. But that's here in BC.

As a bonus, syringes are supposed to be easier on the cat.
 
Wendy&Neko said:
You know those replacement cartridges you put in the pen? You can actually draw insulin directly out of them into a syringe. Here's a picture:
49823503981_e7c9b23f0e_o.jpg

Don't bother buying the Solostar pens Diane references. They aren't the reusable kind like the pens you are using. Get the Lantus 5 pack of cartridges and the BD Ultrafine II syringes (purple and yellow box). They have half unit markings. Shop around for prices, there is quite a range. The online store Diane referenced are quite expensive. I found syringes cheapest at my local Safeway pharmacy. Costco and Superstore/Loblaws a close second. But that's here in BC.

As a bonus, syringes are supposed to be easier on the cat.
Click to expand...

Thank you very much Wendy!!
I am in BC as well :) so that’s perfect! I’ll start checking around and comparing. I did check out the diabetes express.ca website and saw the needles you’re talking about for $37 for 100 and they also sell a pack of 5 Lantus for $112.99. I paid $51.49 for one cartridge from my vet. I wonder what peoples experiences are with purchasing from that site.
I’m not sure where else I could find Lantus in stores? Or if it’s strictly sold from vets or online.

Good to know that syringes are easier on them!!
 
Wendy&Neko said:
You know those replacement cartridges you put in the pen? You can actually draw insulin directly out of them into a syringe. Here's a picture:
49823503981_e7c9b23f0e_o.jpg

Don't bother buying the Solostar pens Diane references. They aren't the reusable kind like the pens you are using. Get the Lantus 5 pack of cartridges and the BD Ultrafine II syringes (purple and yellow box). They have half unit markings. Shop around for prices, there is quite a range. The online store Diane referenced are quite expensive. I found syringes cheapest at my local Safeway pharmacy. Costco and Superstore/Loblaws a close second. But that's here in BC.

As a bonus, syringes are supposed to be easier on the cat.
Click to expand...
Hi Wendy I didn't suggest buying the Solostar pen ,I just wanted to show Sarah how to draw the insulin from a pen, sorry for the confusion,
What do you mean when you said
They aren't the reusable kind like the pens you are using. ?
 
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MissSarahJean said:
Thank you very much Wendy!!
I am in BC as well :) so that’s perfect! I’ll start checking around and comparing. I did check out the diabetes express.ca website and saw the needles you’re talking about for $37 for 100 and they also sell a pack of 5 Lantus for $112.99. I paid $51.49 for one cartridge from my vet. I wonder what peoples experiences are with purchasing from that site.
I’m not sure where else I could find Lantus in stores? Or if it’s strictly sold from vets or online.

Good to know that syringes are easier on them!!
Click to expand...
Wow that's a good price for the 5 cartridges of lantus and the syringes
I see many members order from them
 
MissSarahJean said:
I paid $51.49 for one cartridge from my vet. I wonder what peoples experiences are with purchasing from that site.
Click to expand...
Don't buy insulin from your vet, way too expensive! Online you have to pay shipping and worry about temperatures. Try Safeway or Superstore or Costco. You can just walk up to any pharmacy, say it's for your cat and get it over the counter. My local Save On Foods pharmacist who I first went to, knew more than my vet about Lantus vials vs cartridges, cause she has lots of kitty clients.

Diane Tyler's Mom said:
What do you mean when you said
They aren't the reusable kind like the pens you are using. ?
Click to expand...
She is using the Allstar pro pen injector as per post #6.
 
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