Melinda and Kitkat NEW MEMBER This was just private messaged to me just now

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Diane Tyler's Mom GA

Diane Tyler's Mom GA

Member Since 2018
New Member: Hello All. I am so grateful to have found you.
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  1. Melinda and Kitkat
    Joined:
    Today
    Hello, I am a newly diagnosed 'mama' of my old boy, Kitkat. He is a 17 yr old DL /Maine Coon cross. He is a big boy (and also overweight) and has been around 20 lbs (+-) for the last 10 years. He was showing all the signs of poor health; lethargy, reduced appetite, excessive PU and PD. There are long wait times for a Vet appointment at my clinic. Due to a cancellation we managed to get him in and on Oct 30 of this year the vet visit confirmed Diabetes.
    They ran a 'full geriatric workup' , weight 17 lbs, BG was 576.
    Prescribed Lantus, 4 units twice daily (3/10cc) with followup in 15 days.
    Followup was +4 PI and BG was 342. Dosage was increased to 5 units twice daily (followup 13 days).
    Nov 28- followup at +4 PI, BG was 70. Dosage was decreased back to 4 units twice daily.

    At this point I had already started researching everything, and your site is just amazing and a wealth of information. I bought a BG monitor and started home testing. He was going downhill again and I withheld a dose. +24 and BG was 145. At +36 it was 273. I gave him 4 units.
    It has been 7 days since his visit and I have called and left several messages for my vet, they are very busy and I have not had a return phone call. I know I not supposed to be changing his dose, and may very well be doing the wrong thing. It worries me greatly. Kitkat is looking much better and I am testing 3xday. Dosing 4 units when it hits 270 or greater.
    I know it well past due for me to actually sign up, register and introduce myself. I do look forward to reading further, setting up my spreadsheet, and talking to you wonderful folks. So grateful I found you.

    Melinda and Kitkat, 15 minutes ago
 
Hi and welcome @Melinda and Kitkat
4 units a very large dose to start off with, but I do see he is 20 lbs.
The Lantus insulin is an excellent insulin for cats.

Can you tell me what you are feeding him please?

I am very glad to hear you have bought a glucose monitor. Can you tell me what type of meter it is please? Is it a Pet or a human meter?

What I would suggest you do is set up a spreadsheet and enter all the data you already have and then start testing before every dose of insulin and again during the cycle around the +4 to +7 mark so we can see how the dose is working for him.
If you need any help with the spreadsheet @Bandit's Mom will be happy to help you. I will put the link to the spreadsheet and other useful information below. Once we can see the data, we will be able to help you with the dose. Don’t worry about changing the dose without the vets permission. If they are not getting back to you and you can’t get an appointment, keeping Kitkat safe is the main priority.

I would also set up a hypo kit so you have something there if you need it. Link to that in link below.

link to SS, signature, hypo kit and more
HELP US HELP YOU

HOME TESTING HINTS AND LINKS

Keep asking lots of questions, we are happy to help.
Bron
 
Hi Melinda if you can tell us about KitKat that would be help just tap in this link it will tell you how to set up what's called your signature, it's information about KitKat you will see it in gray at the end of everyone's posts.
It will also tell you how to set up what we call our spreadsheet. We enter our cats BG numbers here to see how the insulin is working and how low they are dropping, that's how we determine how many units to give
We do not base how much insulin we give by the Pre Shots.


If you need help with setting up the spreadsheet just ask, we have a member who will be glad to do it for you
https://felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

Here is the link so you can read all about Lantus , read all the yellow stickys :cat:
https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/
 
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Bron and Sheba (GA) said:
Hi and welcome @Melinda and Kitkat
4 units a very large dose to start off with, but I do see he is 20 lbs.
The Lantus insulin is an excellent insulin for cats.

Can you tell me what you are feeding him please?

I am very glad to hear you have bought a glucose monitor. Can you tell me what type of meter it is please? Is it a Pet or a human meter?

What I would suggest you do is set up a spreadsheet and enter all the data you already have and then start testing before every dose of insulin and again during the cycle around the +4 to +7 mark so we can see how the dose is working for him.
If you need any help with the spreadsheet @Bandit's Mom will be happy to help you. I will put the link to the spreadsheet and other useful information below. Once we can see the data, we will be able to help you with the dose. Don’t worry about changing the dose without the vets permission. If they are not getting back to you and you can’t get an appointment, keeping Kitkat safe is the main priority.

I would also set up a hypo kit so you have something there if you need it. Link to that in link below.

link to SS, signature, hypo kit and more
HELP US HELP YOU

HOME TESTING HINTS AND LINKS

Keep asking lots of questions, we are happy to help.
Bron
Click to expand...
Hi Bron, many thanks for your welcome and quick reply. I will add this info as I learn the site.
Kitkat is now on FF classic, 2 meals daily and is supplimented with Purina DM dry (as he has been life long kibble grazer with small wet treats). I have been adjusting his diet to low carb over the last month.
I have set up a hypo kit, have honey at hand and a can of gravy lovers wet. So far he has not had a hypo incident, lucky.
BG meter is Accu-chek Guide ( Vet has Accu-chek Aviva - this model no longer available in Canada).
Thankyou!!!!
 
Melinda and Kitkat said:
Hi Bron, many thanks for your welcome and quick reply. I will add this info as I learn the site.
Kitkat is now on FF classic, 2 meals daily and is supplimented with Purina DM dry (as he has been life long kibble grazer with small wet treats). I have been adjusting his diet to low carb over the last month.
I have set up a hypo kit, have honey at hand and a can of gravy lovers wet. So far he has not had a hypo incident, lucky.
BG meter is Accu-chek Guide ( Vet has Accu-chek Aviva - this model no longer available in Canada).
Thankyou!!!!
Click to expand...
Thanks for the information….very useful.
Do you think you would be able to swap him to an all wet low carb diet? The Purina dry is high carb …18%… and that would be one of the main reasons you are needing more insulin. We only give high carb food when the BG has dropped really low to bring it up again.
Maybe you could try giving him some low carb wet snacks during the first half of the cycles to see if you can wean him off the dry. He will do much better if you can.
 
Diane Tyler's Mom said:
Hi Melinda if you can tell us about KitKat that would be help just tap in this link it will tell you how to set up what's called your signature, it's information about KitKat you will see it in gray at the end of everyone's posts.
It will also tell you how to set up what we call our spreadsheet. We enter our cats BG numbers here to see how the insulin is working and how low they are dropping, that's how we determine how many units to give
We do not base how much insulin we give by the Pre Shots.


If you need help with setting up the spreadsheet just ask, we have a member who will be glad to do it for you
https://felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

Here is the link so you can read all about Lantus , read all the yellow stickys :cat:
https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/
Click to expand...

Hi Diane Tyler's Mom, thankyou for these links!! I am going through them now and will update what I can this evening. I will work on the spreadsheet tomorrow.
 
Welcome to the best place. Waving from Ontario. The folks here have done the research and have the experience of living with a diabetic cat 24/7.

There are very few options in Canada for low carb dry food (it's best to try and get him off dry food altogether but sometimes it is what it is).
Dr. Elsey's Clean Protein (chicken or salmon flavours). Grain-free does not mean carb-free.

For treats, freeze dried snacks (only ingredient is meat) can be used. PureBites is one brand. Orijen is another. It is more economical to buy the dog treats and crumble them up if too big. Same product.
 
Hi Red and Rover ! A wave back from Calgary! Thanks! I truly am bound and determined to undo the mistakes I have made all this time. I got an old boy who has been on Whiskas Dry forever (my bad). He has been so good to take to the wet food, Ive read the link and tips about transitioning my dry food addict, it is beyond helpful!. Kitkat has been a trooper, having always been a grazer he is slowly getting used to a big wet breakfast, wet snack, wet dinner and snack. And that empty food dish in between? The complaints are rolling in!!! lol. so 1/8 to 1/4 cup when I just can't take it anymore, about 1/4 cup overnight till we figure his proper dosage. And Yes! I recently heard about the Purebites (Temptations be gone!) and he loves them. Those treats have helped tremendously with his shots and BG tests.I'm very lucky and thankful to have all of you here on this site.
 
A followup BIG Thankyou to all of you that have responded and for the incredible resources compiled in these precious links and pages. I am still reading and learning, and have made great progress. A little over 1 month in to this, I sure would not be at this point without you. Spreadsheet is up, fixed up my signature info. KitKat is getting so much better about BG testing and he calmly accepts his shots. Getting a large enough drop to test IS getting easier, just as you have said ;-) He's taking well to the new wet diet. He still has his ups and downs (as do I) but I am certain we will figure out his perfect dosage and such.
My husband and I found the lancet pen finally worked ok on the 5 setting (3 burned through many unsucessful test strips and lancets and KitKat's patience). 5 was most successful. That was up until we noticed that the gauze pad or cottonball became the new thing Kitkat would freak out about. We switched to just using the lancet freehand and now apply 1 or 2 heavy fabric bandaids around our finger for protection. Works like a dream and it's one less thing to fumble with if he squirms a bit. Follow up treats also magic!
 
Hi from another Calgarian. 4u is too high, regardless of Kitkat’s weight. Even with TR if you weren’t feeding dry food, which you are, the most under TR would be to start at 0.25u per kg of ideal weight. That’s around 2u. With dry food on the mix, we’d have suggested starting at 1u following SLGS. I see you’ve been getting lower pre shots and a lot of no shots reinforces that the dose is too high.

Ideally with Lantus you want to find a dose that you can give consistently both am and pm. The other consideration is that mid cycle tests would help fill in the picture as to how low the dose is taking Kitkat. I appreciate you are just getting the hang of testing, good job! With the data you have, my immediate concern is that it appears to me that Kitkat is likely going a lot lower than what your current tests indicate. With the SLGS dosing guideline, that recent 88 would already have meant a dose reduction by 0.25u per our dosing methods. There too were a few 70s where reductions weren’t taken. That said, without midcycle tests and tests during the pm cycle where cats are notorious for dropping lower, it is hard to know how low he is actually going. For safety’s sake and if it were my cat, I wouldn’t be giving 4u anymore, and would suggest reducing down to 2u and try and get some midcycle tests in. I see that you commented Kitkat was doing poorly on those days when you caught 70s which makes me wonder if there were some lows not seen. Going down to 2u may be overly conservative, but I do feel 4u is most definitely too high.
 
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Thanks for getting the SS up and running. Now that we can see some data, I agree with Christie that the dose is too high. Having to skip doses because of low Preshots and with no mid cycle tests, we have no idea of how low the BGs could be going.
I totally disagree with the vets recommendation of stopping testing and continue with 4 units and doing a curve in 10 days at home:eek:. Yikes, that is head in the sand approach and hoping for the best as well as a very risky idea!
You could try 2 units twice a day and see if you can shoot both cycles (that is the aim) and try and get some mid cycle tests in. They are important because they tell us how well the dose is working for KitKat and Lantus dosing is based on how low the dose takes the cat. So you can see how important those mid cycle tests are.
Lantus likes consistent dosing so chopping and changing the dose from 4 units to nil is messing with the depot and you will get wonky numbers.
What I would do though is get a bottle of Ketostix or Keto-diastix from a pharmacy and test the urine for ketones while we try and find the best dose. It’s just a matter of collecting a urine sample and dipping the test strip into the urine and reading exactly 15 seconds later. It’s important we know there are no ketones forming when we drop the dose as we are recommending. I would post daily so we can see how things are going. It may be that he will need a bit more than the 2 units but we will be able to see and help you.
 
Hi Christie and Mav, a neighbour !!!! thanks for this info, Vet info and followup has been more than troublesome. I truly have been relying on looking at KitKat and seeing his demeanor..... using that as a guide. I am a self employed contractor and have not taken any work since diagnosis so I can watch him all day. (lucky for me I can do this). I really like your advice that it is too high a dose, i watch him daily, and he can really crash(?) after a few hrs and be lethargic. I really do want to be more conservative (like you say) than my vet. I really think his dose is too high too, not that I understand it all. Since testing is going so much better each day I can definitely do more as needed. I likely have complicated all these readings by changing from 95% kibble and a canned tuna treat to 80% LC wet/ 20% dry Purina DM over the last month and 1/2.
 
Welcome to FDMB.

You've gotten some great information about getting things started and it's obvious you're doing a lot of reading. I agree with Christie and Bron -- the dose needs to be lowered. There is a formula for the initial dose of Lantus (if you're using the Tight Regulation Protocol) and even with an aggressive dosing strategy, the starting dose would have been in the neighborhood of 2.25u. Lowering the dose to 2.0u sounds like a safe place to start. (And frankly, I haven't a clue where your vet came up with that starting dose especially since it doesn't sound like your vet is accessible if you have an emergency.)

I'd also strongly encourage you to get at least one test every single night during the PM cycle. We recommend at least one test before you head off to bed. Many cats experience lower numbers at night. You don't want to miss a dose reduction and you want to be certain that your cat is in safe numbers over the PM cycle. In addition, if you don't test at night, you're missing half of your data.

With the diet change, there's a good chance the lower carb food is having the effect on lowering Kitkat's numbers. Again, reducing the dose will give you a greater margin for safety. I would be negligent though if I simply agreed that your cat's demeanor will be enough of a clue about where his numbers are. My kitty rarely gave me anything more than a subtle facial expression (she would glare at me with a "feed me now" look) that her numbers were low.

Given that you noted that Kitkat has "poor dental", is there any reason that he hasn't had his teeth cleaned? Gingivitis can also add to higher numbers -- any infection or inflammation tends to raise blood glucose numbers.
 
Hi Bron, thank you too..!!! ;-) It is very comforting to recieve more knowlegable opinions. My vet does not seem to be a fan of home testing at all,,,, you guys have taught me otherwise..... I will test as much as needed.
Kitkat is having dinner now and I will test him in 3 hrs for his pm and post before any dose. Is this right?
 
Melinda and Kitkat said:
Kitkat is having dinner now and I will test him in 3 hrs for his pm and post before any dose. Is this right?
Click to expand...
You don’t feed for the 2 hours before the preshot BG so the BG is not food influenced. Then when the insulin is due, you test, feed and then shoot in that order. If the preshot BG too low, you stall, don’t feed and test again in 20 minutes to see if the BG is rising. You can also post and ask for help. Make sure you chat the subject line to reflect that you need help.
You don’t need to worry about when you feed during the cycle as far as when you test. Just feed and test as needed.
Does that answer your question?
 
Hi Sienne and Gabby, many thanks ;-) I too truly want that 'margin of safety" as you mention. I am hearing you. If it's the best thing to reduce to 2 units then it will be done. Now that KitKat and I have a new understanding, he gets cuddles, treats and a little poke we are over the hurdle of cooperation, now to find the dosage.... so many thanks for this step.
As for his dental, it is now a mess. I have never had him in for a cleaning (my bad) since I rescued him or had him put under for a procedure . I didnt know better but should have. He has been wheezy since I got him, lung xrays found spider webbing, possibly asthma developing 8 years ago, unchanged xrays over last 6 years, slight improvement last 2 years on shadowing, sent to specialist, diagnosis uncertain, no panting, no coughing. Lost one of his canines last year (snapped at root) and caused infection 8 months later, antibiotics (Clavaseptin) cleared it. Occasionally sneezy since then. Recommended cleaning and put under for it, sign waiver as he is high risk. I just can't
 
Yes Bron
Bron and Sheba (GA) said:
You don’t feed for the 2 hours before the preshot BG so the BG is not food influenced. Then when the insulin is due, you test, feed and then shoot in that order. If the preshot BG too low, you stall, don’t feed and test again in 20 minutes to see if the BG is rising. You can also post and ask for help. Make sure you chat the subject line to reflect that you need help.
Click to expand...
Yes it does, thankyou. I will do this
 
Melinda and Kitkat said:
yes.... no dose given at +12 , he ate some food, just did test, 14 hrs + last dose, its 5.2 (93)
Click to expand...
That tells us that the 4 units is definitely too high. You need a dose that you can give consistently each 12 hours.
Now that you have skipped the dose, you can move your dosing schedule to a more convenient time if you like. If the current schedule suits you that fine too.
If you get a chance to test sometime during this pm cycle that would be helpful just so we can see how he goes without the insulin.

So just checking, you will start tomorrow with 2 units for the am and pm doses and stay with that dose for 7 days to let the depot fill less the BG drops under 90, in which case you would reduce the dose by 0.25 units.
 
Hi Bron, Yes, by all means, i will start the 2 unit dose tomorrow am, thanks. Another test tonight wont be possible. We will test tomorrow AM and post, and based on advice here, will maintain a 2 unit dose x 2 daily. I think I do have some understanding of the links about the importance of Lantus being a twice daily dosage, the depot it creates, feeding times and carbs. I'm getting there.
cannot thank you all enough.... truly
 
understood Bron, i am all noob to social media, never been on ANY social platform before...but i will get it. thanks for tagging (i just learned today what that is), a big thanks for looking out for me!
 
I really overslept (a rare thing indeed) and a very bad thing now. Missed morning dose time and just did a +1 BG test. He is still 95 (5.3).
 
Sorry for the brief reply, I was on a telecon and trying to multitask ;). With our dosing method SLGS you could shoot anything above 90 but at the moment we are still gathering data to see how Kitkat responds and while there may still be some depot in effect from the higher dose, I like that he appears to have stayed green from no shot last night and into this morning. As Sienne noted, it may be that the changes in diet have really made a difference to his bg levels and insulin needs.

Can you check around +3 or +4? I presume you’ve fed so I’d like to see what he’s up to, and if numbers come down it may be the pancreas kicking in.
 
Well dang, I’d have liked to see more green, but that’s ok. So let’s see where he’s at for PMPS but seems like 2u is still the plan. Since you didn’t dose this morning, you can shoot at whatever convenient time, if you had also been wanting to adjust the shot times, now is a good time to do it.
 
Now watch him turn to greens for pre shot, just to keep us guessing :p

ETA, perhaps start a new post for tonight since this one is getting a wee bit long. We can link this current post in that for history if anyone needs to quickly look back.
 
I will finish of this thread with some nice news then! KitKat is really having a kitten day today.....it's has not been so frequent this last while.
Today he has "the Zoomies" (its what we call in now). Playing with toys, scratchies, nibbling, playing the "come chase me!" game, and he's lost his mousie under the couch at least 4 times now. Man o man.....NOTHING could make me happier than this!
Not sure if I know how to link yet, maybe I will get it figured out ;-)
 
That’s terrific! I love seeing kitties getting back to their playful old selves. Maybe those extra zoomies will burn off some extra sugar before preshot :smuggrin:. On my iPad I just go to the top where the url is, highlight and click copy and then paste that into the new post.
 
Simples !!!!! haha! Should I keep the New Member bit in the new thread or do you think it unnecessary? I'm such a noob! lol
We are having a few celebratory cocktails and taking calm deep breaths, smiling away about our furbaby! Best excuse I've had for day drinking in awhile :p In our defense it is 5:00 a few provinces over. !
And hey, I just figured out how to post emogis ;)
 
Haha the only tricky part is this post wasn’t created by you, so I don’t think you can change / edit the thread title, which is another reason to start a new one :p. I like the emojis too, just wish there was a little more variety, after almost 6 years of being here, I’d like some new ones! It’s amazing how much better you can feel when your kitty is feeling good, so glad you are seeing improvements, cheers to the trend continuing ;):coffee:. (Replace coffee with wine, since it is a cheers after all!)
 
Why don’t you start a new post with today’s date KitKat, then PMPS and whatever that test is :). That’s the style we typically use for posting on the Lantus Levemir and Biosimilars sub forum, which you’ll likely start posting to once we get some of the basics down here on main.
 
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