New Member (July 1, 2024) - Muffin & Kit

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FauxPaw

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Hi, I'm Kit, mom to Autumn (8) and Vegeta (9) and auntie to Muffin (9), our diabetic patient.

Muffin belongs to a friend of ours and was previously staying with his ex, but her landlord was threatening eviction if the animals weren't removed, so we agreed to take care of him for awhile. The whole thing happened much sooner than expected and we ended up taking Mufffin before his parents got him in to see a vet (not the original plan) and then there was some initial resistance from dad when we pointed out his symptoms (overweight, drinking lots, peeing lots, low energy) and insisted he make an appointment ASAP, but he seems to be on board with helping get Muffy's needs met now that he's been diagnosed.

He is a sweet boy, super snuggly and eager to meet my cats (if only I could say the same for them...) and he's been so brave with all the poking and prodding and vet visits. Right now we have him on 1 unit Semglee twice daily after his meal of 1/4 cup dry, 1/3 can wet (Hill's Presciption Diet GlucoSupport). We're testing his blood sugar with an iPet glucometer before every meal and halfway between meals. So far his sugar is still pretty high (18's to 20's mostly) and we're bringing him back in for a dose adjustment later this week.

Needless to say, this had ended up being a lot more work and stress than we initially expected. We want to do everything we can to help the little guy and our friend, but my partner works 12 hour shifts and I am disabled/chronically ill, so we're not sure how long we can realistically do this. Finances are also a concern. Muffin's dad is covering all the costs right now, but we're not sure how long he can afford it, since he's not working full-time and we can't afford to take on the full cost either. We have tentatively agreed to four months, but we don't have a plan for what happens after that, and of course re-homing a diabetic cat is going to be a lot more challenging than with a healthy cat.

I am planning to read though the medical information on this forum over the next week, but in the meantime, any tips from other disabled folks for managing the additional time and energy demands of caring for another chronically ill body without totally burning out would be so helpful. Plus any general "newbie" advice. One specific thing I'm wondering about (and I'll ask the vet as well) is how much wiggle room there generally is with "same time every day" meals and insulin doses? Right now my partner is working all days, but when he goes back to night shifts, he won't be able to give the morning dose at the same time every day. He leaves at 7AM when he works days, returns at around 8AM after nights, and Muffin takes about 30 minutes to finish his meals, so we'd likely be looking at 6:30 AM doses on some days and 8:30 doses on others. My sleep and wake times can vary when I'm flaring and I sometimes need to sleep more than twelve hours, so me doing both morning and evening checks every day isn't really feasible either. Any tips for saving money without compromising his help would be a big help too.
 
Hi and welcome to the forum. thank you for taking care of Muffin.
As you are using Semglee, do you live in Australia?
you can save money right away by swapping to a food that is not prescription food. It is not necessary. You just need to look for food that is 10% carbs or less.
I will give you a link to low carb food at the end.
If you can tell me which country you live in that would be helpful.
I am going to ask @Bandit's Mom to help you set up a spreadsheet and signature so that you can add the blood glucose data. Then we can help you with dosing. That will also save money from vet visits.

Two hours late or early is too much wiggle room really for giving doses. But in saying that, you have to work with what you have.
Let’s get you set up with the spreadsheet and signature so we can have a look at the data and go from there.
 
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Hi and welcome to the forum. thank you for taking care of Muffin.
As you are using Semglee, do you live in Australia?
you can save money right away by swapping to a food that is not prescription food. It is not necessary. You just need to look for food that is 10% carbs or less.
I will give you a link to low carb food at the end.
If you can tell me which country you live in that would be helpful.
I am going to ask @Bandit's Mom to help you set up a spreadsheet and signature so that you can add the blood glucose data. Then we can help you with dosing. That will also save money from vet visits.

Two hours late or early is too much wiggle room really for giving doses. But in saying that, you have to work with what you have.
Let’s get you set up with the spreadsheet and signature so we can have a look at the data and go from there.

We're in Ontario, Canada. Very close to the border, so semi-regular trips to the US wouldn't be a huge inconvenience. I'm already thinking of popping down this weekend to get a Relion glucometer after seeing how much a 25-pack of iPet test strips costs. Also looking at the Freestyle lite because it takes smaller samples and we sometimes have trouble getting big enough samples to get accurate readings.

For the different dosage times, would it be best to try and push the times back and forward gradually? He will always have 1-4 mornings off between day and night shifts, so we could do it by about 15-20 minutes most of the time. The only time it would be longer would be when he switched from night to day with only one full day off in between, we would have to do something like M-8:30AM/8:00PM, T-7:30AM/7:00PM, W-6:30AM/6:30PM. Would that be too much of a jump? Would it be better to just skip a dose and then give the next one at 6:30?

That food chart looks like a great resource. Thank you so much for your help. This whole situation has been so overwhelming.
 
We're in Ontario, Canada. Very close to the border, so semi-regular trips to the US wouldn't be a huge inconvenience. I'm already thinking of popping down this weekend to get a Relion glucometer after seeing how much a 25-pack of iPet test strips costs. Also looking at the Freestyle lite because it takes smaller samples and we sometimes have trouble getting big enough samples to get accurate readings.

For the different dosage times, would it be best to try and push the times back and forward gradually? He will always have 1-4 mornings off between day and night shifts, so we could do it by about 15-20 minutes most of the time. The only time it would be longer would be when he switched from night to day with only one full day off in between, we would have to do something like M-8:30AM/8:00PM, T-7:30AM/7:00PM, W-6:30AM/6:30PM. Would that be too much of a jump? Would it be better to just skip a dose and then give the next one at 6:30?

That food chart looks like a great resource. Thank you so much for your help. This whole situation has been so overwhelming.
Very good idea to get a ReliOn meter and strips. Much more economical.
For the dosage times…15 or 20 minutes variation is fine.
Re your suggestion to do M-8:30AM/8:00PM, T-7:30AM/7:00PM, W-6:30AM/6:30PM…we recommend only changing the times 30 minutes a day (24 hours). However you have to find something that is going to work for you. How often would this happen?
What about M-8.30am/8pm, T-7.45am/ 7.15 pm, W- 7am-6.45pm. That is still a bit over but
The main thing you would have to be aware of is if the BGs are on the lower side, an early shot can act a bit like an increasing dose.
The other option is to miss a dose and go straight to the new time as you suggest.
Do you know if Muffin had any ketones in his urine when he was diagnosed? They should have tested his urine at diagnosis. If you could find that out, it would be helpful, because if he did have ketones, skipping a dose would not be a good idea.

Keep posting so we can help you along the way. It is overwhelming in the beginning but you are actually very well organised and seem to have a good grip of it all. Lucky Muffin.
 
Very good idea to get a ReliOn meter and strips. Much more economical.
For the dosage times…15 or 20 minutes variation is fine.
Re your suggestion to do M-8:30AM/8:00PM, T-7:30AM/7:00PM, W-6:30AM/6:30PM…we recommend only changing the times 30 minutes a day (24 hours). However you have to find something that is going to work for you. How often would this happen?
What about M-8.30am/8pm, T-7.45am/ 7.15 pm, W- 7am-6.45pm. That is still a bit over but
The main thing you would have to be aware of is if the BGs are on the lower side, an early shot can act a bit like an increasing dose.
The other option is to miss a dose and go straight to the new time as you suggest.
Do you know if Muffin had any ketones in his urine when he was diagnosed? They should have tested his urine at diagnosis. If you could find that out, it would be helpful, because if he did have ketones, skipping a dose would not be a good idea.

Keep posting so we can help you along the way. It is overwhelming in the beginning but you are actually very well organised and seem to have a good grip of it all. Lucky Muffin.

No ketones. Vet said everything in his urinalysis was normal except for the glucose. He suspected UTI based on the blood work, so he gave him an antibiotic shot on diagnosis day and it seems to have cleared up by the time we brought his urine in (there was a few days delay trying to get him to pee in the nosorb and between his belly fat and bladder size, the vet said he wasn't comfortable attempting cystocentesis.)

He usually aims to leave for work by 6:50AM when he's on days, so the 7AM shot would be cutting it pretty close. We were brainstorming last night and if 15-20 minutes is fine, it looks like the best plan might be for me to take over the morning dose on the day his last night shift ends (the Monday in this example) so we can start shifting the times the evening before (something like S-8:30AM/8:10PM, M-7:50AM/7:30PM, T-7:10AM/6:50PM, W-6:30AM/6:30PM.) With the way his schedule works, this scenario would only happen once or twice a month and I can manage getting up at 7 occasionally.
 
No ketones.
Great.
He usually aims to leave for work by 6:50AM when he's on days, so the 7AM shot would be cutting it pretty close. We were brainstorming last night and if 15-20 minutes is fine, it looks like the best plan might be for me to take over the morning dose on the day his last night shift ends (the Monday in this example) so we can start shifting the times the evening before (something like S-8:30AM/8:10PM, M-7:50AM/7:30PM, T-7:10AM/6:50PM, W-6:30AM/6:30PM.) With the way his schedule works, this scenario would only happen once or twice a month and I can manage getting up at 7 occasionally.
That looks like a good plan. And it’s always good to have two people who can do the testing and shooting.
Just make sure you both know the plan so you never double up on it and give the dose twice….it can happen!

Can you get a before bed test in each night? It looks as if the depot has filled with the Semglee and you are seeing lower numbers.
I would say that he dropped lower last night and that is why you have seen a lower than normal AMPS today.
Information on a depot

I am going to give you a link to our 2 dosing methods for Lantus (Semglee). Have a look at them and see what you think. You might be more comfortable with SLGS until you get more into the swing of things. It’s up to you and your lifestyle. Following a dosing method is the best way forward… it is safe and takes any guesswork out of it. When you decide, can you put the method into your signature please so we can see…thx:)
DOSING METHODS.
 
Great.

That looks like a good plan. And it’s always good to have two people who can do the testing and shooting.
Just make sure you both know the plan so you never double up on it and give the dose twice….it can happen!

Can you get a before bed test in each night? It looks as if the depot has filled with the Semglee and you are seeing lower numbers.
I would say that he dropped lower last night and that is why you have seen a lower than normal AMPS today.
Information on a depot

I am going to give you a link to our 2 dosing methods for Lantus (Semglee). Have a look at them and see what you think. You might be more comfortable with SLGS until you get more into the swing of things. It’s up to you and your lifestyle. Following a dosing method is the best way forward… it is safe and takes any guesswork out of it. When you decide, can you put the method into your signature please so we can see…thx:)
DOSING METHODS.

Thank you, I'll try to read through both those pages later today.

Our current system is for him to text me a summary of Muffin's morning routine after he's completed it (Glucose--time, reading, which ear he poked so we can alternate; Food--time, if he left any uneaten and how much; Insulin--time) so I know it's been done and can fill out the log I'm keeping (and now the spreadsheet as well). Probably a good idea to get in the habit of sending him a text as well when I do his routine, to minimize risk of double doses.

We're rationing our strips as much as possible right now, so I'm not sure I can add an extra test at the moment (especially since I'm not the one paying for them), but if we get the Relion, it shouldn't be a problem. Is there a certain number of hours after the PMPS test that's ideal? Or just as late as possible?

I was worried he might be dropping a little lower today because he didn't finish his dinner last night. The vet said it's important for him to eat the same amount at each meal and we shouldn't give his shot if he doesn't eat, but it's been a struggle since he's used to grazing and he doesn't seem to have much of an appetite. I wasn't sure if I should give it or not when he eats a portion of his meal, so I went ahead and gave him the insulin last night, but maybe that was the wrong thing to do...
 
Semglee doesn’t onset for 2 hours after the dose if given. So he doesn’t have to eat it all at once. Make sure he has snacks during the cycles as well.
Test sometime between 4 and 7 hours after the dose and vary it. This will give you an idea how low the dose is taking him
I would have a sheet of paper or book where you write all the information into so it’s easy for you both to see at a glance. Just have dates and columns such as time insulin given, dose given, food eaten, which ear tested, other comments.
Also a good habit to get into is to have a glass or container next to the book (with the information in it) and each morning put 2 insulin syringes in it. And use those two syringes that day. You will both be able to see at a glance if the dose has been given, if the syringe has gone.
 
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