1/22/20 new member io

[Jazmin]

Hi everyone! So I just got back from the vet today with my boy io (named after one of Jupiter’s moons) he is confirmed diabetic. I have no idea where to start, what I should or should not do, etc. He’s on Lantus, the vet prescribed 2 units once daily. We have a follow up appointment Monday to see how he’s doing and if we need to up the dose.

I included what I all picked up (glucose meter pic) let me know if there’s anything else I need.

I also included some info from the vet and also my chicken scratch notes that probably have a lot of misspellings because I was in a hurry. Oops.

They said to start his Lantus tomorrow, give him food and then inject. When should I test his glucose and what should the numbers be? I’m so lost.

 

[Deb & Wink]

You sure your vet didn't say 1U lantus twice a day?

 

[Jazmin]

You sure your vet didn't say 1U lantus twice a day?

100% sure

 

[Juls and Billy]

Agree with Deb. 2 units once a day is highly unusual, but 1 unit twice a day (every 12 hours) is a very normal starting dose. Might be worth checking with the vet. I know with our kitty, that first diagnosis was a lot to take in.

As far as testing goes, it's safest to always test before you give insulin. If the BGL is to low, better to skip a dose than risk a dangerous hypo event. On day 5, this information saved my Billy's life.

Then, it's good to get some mid-cycle readings, for example, at 5 hours after the dose, and 7 after, to make sure he doesn't go too low. This can be hard to do when one is working, etc, but great to do it when you can.

There's all kinds of great information here on the board that will help. Take a look around and read all the sticky posts. That helped me so much when Billy was diagnosed. This is also a great place to start- New? How to Help Us Help You!

You are in a great place to help Io!

 

[Deb & Wink]

Neither Royal Canin Glycobalance dry (29%) or wet (14%) are low carb. Neither Hill's W/d dry (37%) or canned (26%) are low carb. Purina DM dry (18%) canned (10-12%) Both are recommended in the "prescription diet sections" of your take home instructions.

(2018) AAHA Diabetes Management Guidelines for Dogs and Cats recommends 12% or less carbs. Here on the message board, we recommend 10% or less carbs. That is anecdotal evidence, but that is what we have found works better for diabetic cats.

Lantus insulin does not last in a diabetic cat for 24 hours. Humans, yes. Cats no.

Still trying to read the tiny print on those photos. Bear with me as I read more. Stayed tuned for more information.

 

[Deb & Wink]

More problems with the discharge instructions.

1. Lantus is not a suspension type insulin. There is nothing to mix. NO reason to roll lantus insulin to mix. Has your vet ever prescribed Lantus for a cat before?
2. You will find 3/10 cc (volume) syringes with half unit markings easier to use than those 5/10cc (1/2 cc) syringes your vet says to use. Tiny doses are hard to see in higher volume syringes.
3. 2U twice a day is a large starting dose. We feel it is better to 'Start low and go slow' with the insulin. We don't want your cat to have a hypo on his first dose. There are special circumstances where a larger starting dose may be appropriate. Presence of ketones, DKA, other conditions.
4. Looks like the discharge instructions you got were for Vetsulin. Lantus works much differently than Vetsulin.
5. Home testing takes time to learn and become better at it. Would you like some home testing tips?

I'm not a vet, or vet tech. Only a volunteer here that is making suggestions based on my own experience.

p.s. Welcome to kitty Io and his caregiver Jazmin. Sorry for the long post, but there can be a lot to learn in treating feline diabetes. We are here to supplement the information your vet gives you. But I have to say I already see some/ many 'errors/misinformation/mistakes' in the info your vet gave you.

Be cautious. We want to keep your kitty safe. I'll provide links to the lantus package insert instructions that also say you do not mix lantus if you want to see that. Your vial of insulin should have come with those instructions.

p.p.s How did you find us?

 

[Deb & Wink]

Looks like you have been a member since 2015. Not your first experience with Io and a diabetes diagnosis. Found your old post when you first joined.

Here is the link to your thread from back in 2015.
http://www.felinediabetes.com/FDMB/threads/adopted-io-two-days-ago-and-found-out-at-his-vet-this-morning-he-is-malnourished-and-had-diabetes.138974/
There may have been a lot of changes since then.

Would you please read this first?
New? How You Can Help Us Help You!

It's a lot to get your head around, but we can help you with that.

 

[Deb & Wink]

They said to start his Lantus tomorrow, give him food and then inject. When should I test his glucose and what should the numbers be? I’m so lost.

At least the vet got the test, feed, shoot sequence right.

Now to answer your original question.

Test before every pre-shot. You do this to make sure the BG is high enough before you give insulin. Once you inject, there is no way to get the insulin back out. You would not want to give your cat insulin if his BG (blood glucose) is already low.

Suggest a 'shoot/no shoot' reading at PS (pre-shot) of 200 in the beginning. As you become proficient at testing and know where your cat nadirs, then you can re-adjust that to 150 'shoot/no shoot' with lantus.

Each cycle is 12 hours. So test at AMPS and again at PMPS. Then you need to see how the lantus insulin is affecting YOUR cat, so you need to find onset,nadir, duration, overlap. We suggest testing in the +4 to +7 timeframe.

Cats can drop lower at night, so a test at the +3 and before bed can be very helpful, especially in the beginning.

Lantus is best dosed in 12 hour cycles.

Lantus has a 'depot' effect. Think of it like a storage area from which the insulin gets released slowly over time. It can take 6 12 hour cycles of insulin to fill that 'depot' area.

I suggest you go to the Lantus forum and read the first "Sticky" pinned to the top of the forum there.

 

[Christie & Maverick]

Hello and welcome! I hope you don't mind if I ask a few questions? How old is Io and what weight? What food are you currently feeding? Canned or dry? Did the vet happen to say they were going to do a fructosamine test? It can happen that kitties get very stressed at the vet office, which can bump up the blood glucose. Did they do a urinalysis? I didn't see those results in your post. Were there symptoms that you saw at home to make you get a vet check? Losing weight....drinking, peeing a lot?

A couple of thoughts based on what info you have shared at the moment.

There is no need to roll Lantus, it doesn't need to be mixed. With vials you do draw up some air and insert the syringe and push the air into the vial, but not with cartridges. Also, you want to draw up a bit more insulin than required, then take the syringe out, then tap for bubbles to rise to the top, then squeeze it out to get to your dose. I can't see any value in tapping the bubbles while the syringe is still in the vial, since at some point you need those air bubbles out! You don't want to inject them back into the vial. The syringes have lubrication in them, so you don't want to contaminate the insulin, it will end up not lasting as long. Many of us can continue to use a vial of Lantus up to 6 months, some people more, as long as you store it in the fridge. Just take it out to draw up the insulin, then put it right back.

With Lantus, you want to test before the shot, feed and shoot, all with around 15minutes or so. Testing before each shot is important so you know it is safe to give insulin.

Some vets aren't up to speed with Lantus, it definitely works better with kitties and their metabolisms to give insulin twice a day.

We also find that feeding multiple meals over the course of the day works better than just feeding twice a day.

There is a lot of great information here, so go at whatever speed works for you. I could offer more, but let's have you digest a little first

It helps if you can set up a signature with some basic info to get you started ... see here for info on creating a profile

We love to answer questions, so let us know how we can help

 

[Jazmin]

Agree with Deb. 2 units once a day is highly unusual, but 1 unit twice a day (every 12 hours) is a very normal starting dose. Might be worth checking with the vet. I know with our kitty, that first diagnosis was a lot to take in.

As far as testing goes, it's safest to always test before you give insulin. If the BGL is to low, better to skip a dose than risk a dangerous hypo event. On day 5, this information saved my Billy's life.

Then, it's good to get some mid-cycle readings, for example, at 5 hours after the dose, and 7 after, to make sure he doesn't go too low. This can be hard to do when one is working, etc, but great to do it when you can.

There's all kinds of great information here on the board that will help. Take a look around and read all the sticky posts. That helped me so much when Billy was diagnosed. This is also a great place to start- New? How to Help Us Help You!

You are in a great place to help Io!

Is BGL blood glucose level? Do you know where I can find the info on whats too low and whats good? Thank you for your response btw

 

[Jazmin]

Looks like you have been a member since 2015. Not your first experience with Io and a diabetes diagnosis. Found your old post when you first joined.

Here is the link to your thread from back in 2015.
http://www.felinediabetes.com/FDMB/threads/adopted-io-two-days-ago-and-found-out-at-his-vet-this-morning-he-is-malnourished-and-had-diabetes.138974/
There may have been a lot of changes since then.

Would you please read this first?
New? How You Can Help Us Help You!

It's a lot to get your head around, but we can help you with that.

When I had first gotten Io the vet said he was diabetic but I put him on fancy feast classic and he was 100% fine for YEARS and now this is a totally different wheel house because he was not this bad before and was ketoacidosis and we never needed insulin either so everything feels brand new. Thank you for all your responses

 

[Jazmin]

Hello and welcome! I hope you don't mind if I ask a few questions? How old is Io and what weight? What food are you currently feeding? Canned or dry? Did the vet happen to say they were going to do a fructosamine test? It can happen that kitties get very stressed at the vet office, which can bump up the blood glucose. Did they do a urinalysis? I didn't see those results in your post. Were there symptoms that you saw at home to make you get a vet check? Losing weight....drinking, peeing a lot?

A couple of thoughts based on what info you have shared at the moment.

There is no need to roll Lantus, it doesn't need to be mixed. With vials you do draw up some air and insert the syringe and push the air into the vial, but not with cartridges. Also, you want to draw up a bit more insulin than required, then take the syringe out, then tap for bubbles to rise to the top, then squeeze it out to get to your dose. I can't see any value in tapping the bubbles while the syringe is still in the vial, since at some point you need those air bubbles out! You don't want to inject them back into the vial. The syringes have lubrication in them, so you don't want to contaminate the insulin, it will end up not lasting as long. Many of us can continue to use a vial of Lantus up to 6 months, some people more, as long as you store it in the fridge. Just take it out to draw up the insulin, then put it right back.

With Lantus, you want to test before the shot, feed and shoot, all with around 15minutes or so. Testing before each shot is important so you know it is safe to give insulin.

Some vets aren't up to speed with Lantus, it definitely works better with kitties and their metabolisms to give insulin twice a day.

We also find that feeding multiple meals over the course of the day works better than just feeding twice a day.

There is a lot of great information here, so go at whatever speed works for you. I could offer more, but let's have you digest a little first

It helps if you can set up a signature with some basic info to get you started ... see here for info on creating a profile

We love to answer questions, so let us know how we can help

Io is "11" not really sure if that's accurate but thats going off how old the shelter said he was when I adopted him and then celebrating his gotcha date as his bday every year. He weighed around 11lbs at the vet today. Currently am feeding him friskies Pate only, and am probably going to get some classic fancy feast as well for variety. We did a blood and urine test at the vet and there were ketones in his urine and his glucose levels were high. The symptoms I first noticed were this monday he was throwing up food, lethargic, extreme weight loss, drinking a lot, not interested in eating. I was gone over the weekend and came home monday morning to all this and took him in asap.

Do you think I could do one unit twice a day once every 12hrs? I dont want to be like screw you to the vet, but I also want my cat to be okay haha. Do you know what the test should say for his levels before feeding and giving him the shot? How do I know if I should give him the shot or not?

Thank you so much for all your help! I really appreciate detailed and easy and clear instructions and information!

 

[Juls and Billy]

Is BGL blood glucose level? Do you know where I can find the info on whats too low and whats good? Thank you for your response btw

Yes, BGL is Blood Glucose Level. I should have said.

I'm not familiar with your meter. Is it a pet meter or a human meter? Either works fine, and the human meters can be much cheaper, but they have different scales.

Okay, I Googled it and I think it's a human meter. In that case, if you click on the link in my signature that says Billy's Spreadsheet, not only can you see an example of the message board's awesome spreadsheet, but the BGL key for human meters is at the top. You're aiming for blue and green numbers eventually. Lime green (under 50) is concerning, and under 30 is an emergency hypo event, which is very dangerous.

This board's rule of thumb for how low is too low to give a dose is under 200 for us newbies. Once you've done it longer and have a good idea how your particular cat handles insulin, that number can be lowered a bit. But until you have the data to know how Io handles the insulin, it's better to have a day with high levels than an emergency low. If Io's level is just under 200, the other thing you can do is stall. Wait an additional 20 minutes without feeding and see if the BGL comes up enough.

Normally that would change the time of your second dose. Honestly, I've never seen a cat on a single dose per day, so I don't know how a stall effects that.

 

[Bron and Sheba (GA)]

Hi Jasmin and Io and welcome.
You have been given some good advice by others.
I agree that 1 unit twice a day is much better than 2 units once a day. Two reasons.......cats have a faster metabolism than humans and Lantus lasts approximately 12 hours in a cat. So if you only give it once a day you will find that the other 12 hours Io will be in higher numbers. Secondly 1 unit is a good starting dose for a cat. 2 units is double that and is not as safe a dose. You do not want him dropping too low.

Well done on home testing! That is the only way to keep Io safe.
Test before EVERY shot and again somewhere between +4 and +7 (4 to 7 hours aft the insulin dose). And as mentioned cats often drop lower at night, so get a before bed test in every night, if that test is lower than the preshot number than it will probably be an active cycle and you will need to test again later.

I would ditch all the dry and highcarb food that the vet mentioned. The food you were feeding before, Fancy Feast pates, is a much bette choice.

You mentioned ketoacidosis ....when did this happen?

 

[Jazmin]

Hi Jasmin and Io and welcome.
You have been given some good advice by others.
I agree that 1 unit twice a day is much better than 2 units once a day. Two reasons.......cats have a faster metabolism than humans and Lantus lasts approximately 12 hours in a cat. So if you only give it once a day you will find that the other 12 hours Io will be in higher numbers. Secondly 1 unit is a good starting dose for a cat. 2 units is double that and is not as safe a dose. You do not want him dropping too low.

Well done on home testing! That is the only way to keep Io safe.
Test before EVERY shot and again somewhere between +4 and +7 (4 to 7 hours aft the insulin dose). And as mentioned cats often drop lower at night, so get a before bed test in every night, if that test is lower than the preshot number than it will probably be an active cycle and you will need to test again later.

I would ditch all the dry and highcarb food that the vet mentioned. The food you were feeding before, Fancy Feast pates, is a much bette choice.

You mentioned ketoacidosis ....when did this happen?

Just recently, his urine came back today with ketones in it. I got the ketone test strips to continue checking at home as well. I just want to clarify again- I test, feed, then shoot?

 

[Juls and Billy]

Do you think I could do one unit twice a day once every 12hrs? I dont want to be like screw you to the vet, but I also want my cat to be okay haha

No one is going to want to say "screw the vet!" But I have no shame, so here goes. While my vet is perfectly awesome about many things, and has helped us through tough time with other issues, I found out quickly his knowledge of Feline diabetes was lacking. It is not unusual. A lot of people doctors have little real knowledge of diabetes and they aren't nutritionists at all. Now, you should listen to what other Lantus users say, they know better than me. I do know that Lantus is a great insulin for cats, it's a depot insulin (some stays in a little pocket under the skin and is used slowly.) and it's important not to vary dose times, because it can be less forgiving than the non-depot insulins.

Now, that said, for any diabetic, human or feline, having a steady dose of insulin is important. You might get that steadier dose by doing 1 unit twice a day.

Personally, though I trust my vet in many things, if I had followed my vets diabetic advice to the letter, I would have lost Billy on day five.

 

[Jazmin]

Yes, BGL is Blood Glucose Level. I should have said.

I'm not familiar with your meter. Is it a pet meter or a human meter? Either works fine, and the human meters can be much cheaper, but they have different scales.

Okay, I Googled it and I think it's a human meter. In that case, if you click on the link in my signature that says Billy's Spreadsheet, not only can you see an example of the message board's awesome spreadsheet, but the BGL key for human meters is at the top. You're aiming for blue and green numbers eventually. Lime green (under 50) is concerning, and under 30 is an emergency hypo event, which is very dangerous.

This board's rule of thumb for how low is too low to give a dose is under 200 for us newbies. Once you've done it longer and have a good idea how your particular cat handles insulin, that number can be lowered a bit. But until you have the data to know how Io handles the insulin, it's better to have a day with high levels than an emergency low. If Io's level is just under 200, the other thing you can do is stall. Wait an additional 20 minutes without feeding and see if the BGL comes up enough.

Normally that would change the time of your second dose. Honestly, I've never seen a cat on a single dose per day, so I don't know how a stall effects that.

Where can I find the spreadsheet to get Io started/ is it easy to use/figure out. Im scared Im going to ask so many questions I kinda struggle with numbers and spreadsheets

 

[Bron and Sheba (GA)]

Just read your reply where you said there were ketones when tested at the vet. This changes things a bit

• it is REALLYimportant that you test every day for ketones in the urine (I see you have bought the Ketostix...well done!)

• It is also really important that Io gets his insulin every 12 hours. Skipping shots can lead to ketones developing again.
• And it is really important that you feed him plenty of food. Try and feed him up to 1 1/2 times as much food as he normally eats. This is because the lack of food can help ketones develop. So food is like a medicine in recovering from ketones in the urine/blood.
• Also try and add some water to his food so that he is getting extra fluids to help flush out the ketones.

 

[Juls and Billy]

I just want to clarify again- I test, feed, then shoot?

Yes, test, feed, shoot. It's good to know he's going to eat before giving insulin. For my cat, I shot him while he was eating. (that sounds horrible, but you know what I mean.) But Billy wasn't on Lantus. You may want to see if the Lantus users suggest test, feed, wait a bit, then shoot.

 

[Bron and Sheba (GA)]

Jasmin it is absolutely fine to ask as many questions as you like.

Here is a link which will tell you how to set up the SS and signature and several other things for new members.
Yes you test, feed then shoot. With Lantus as long as he will eat, there is no need to wait after he eats to give the shot. You can give the insulin straight after he eats or as he is eating the last little bit.
http://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

 

[Juls and Billy]

Where can I find the spreadsheet to get Io started/ is it easy to use/figure out. Im scared Im going to ask so many questions I kinda struggle with numbers and spreadsheets

Super easy. Even I can do it, and I'm terrible at Excel and numbers.

Everything you need is in the four sticky posts at the top of the forum section: Suggestions, Tech Support, and Testing Area.

If you have trouble, give a shout, as there's folks that can help you set it up.

 

[Chris & China (GA)]

I test, feed, then shoot?

Yes...You Test to make sure he's high enough for insulin at all, Feed to make sure he's at least willing to eat, and Shoot....all within about 5-10 minutes.

With Lantus, it usually takes 2-3 hours before the shot starts to kick in, so as long as Io is willing to eat, he can take his time to eat a full meal.

Here are the Instructions on getting the FDMB spreadsheet (if you have trouble with it, feel free to send me a private message and I'll be happy to set it up for you. Just click on my name and choose "start a conversation")

 

[Christie & Maverick]

I'm sorry to hear Io wasn't feeling well, how awful to have to go through that. With Lantus we follow two dosing methods here, although there are others out there. Again, when you are ready you can read here for the info http://www.felinediabetes.com/FDMB/...-low-go-slow-slgs-tight-regulation-tr.210110/

I agree that 1u twice a day is a good starting point. Good to see you have the Ketostix to test for ketones. With Lantus, we often find that the onset (when insulin reaches the bloodstream and starts to lower the blood glucose is around 2 hours after insulin, but we also suggest each caregiver learn how their own kitty responds to insulin. You may often see Every Cat Is Different (ECID) said here often, and it really is true. Every cat responds differently to insulin and carbs, so the key really is to start getting a feel, by testing. As you gather the data, you can start to see patterns on how the insulin is working for Io. We often suggest if you get a lower preshot than usual, stall, don't feed and retest to see if the numbers are coming up. In any case, if you are ever unsure, please post on our Lantus Levemir Basalgar support group for help. People experienced with Lantus may not always come to the main forum. Here is the link http://www.felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/

At the risk of sending too much info your way, since I actually do remember what it was like when I first joined , we have these instructions for setting up a spreadsheet. It will really help us to offer dosing advice going forward. http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

Again, just go at your own speed, we'll help you as you go through, okay?

 

[Jazmin]

I'm sorry to hear Io wasn't feeling well, how awful to have to go through that. With Lantus we follow two dosing methods here, although there are others out there. Again, when you are ready you can read here for the info http://www.felinediabetes.com/FDMB/...-low-go-slow-slgs-tight-regulation-tr.210110/

I agree that 1u twice a day is a good starting point. Good to see you have the Ketostix to test for ketones. With Lantus, we often find that the onset (when insulin reaches the bloodstream and starts to lower the blood glucose is around 2 hours after insulin, but we also suggest each caregiver learn how their own kitty responds to insulin. You may often see Every Cat Is Different (ECID) said here often, and it really is true. Every cat responds differently to insulin and carbs, so the key really is to start getting a feel, by testing. As you gather the data, you can start to see patterns on how the insulin is working for Io. We often suggest if you get a lower preshot than usual, stall, don't feed and retest to see if the numbers are coming up. In any case, if you are ever unsure, please post on our Lantus Levemir Basalgar support group for help. People experienced with Lantus may not always come to the main forum. Here is the link http://www.felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/

At the risk of sending too much info your way, since I actually do remember what it was like when I first joined , we have these instructions for setting up a spreadsheet. It will really help us to offer dosing advice going forward. http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

Again, just go at your own speed, we'll help you as you go through, okay?

Thank you! So I got Io to eat the most he's eaten in three days tonight but he kept making weird low noises that Ive never heard him make before and is completely zonked now. Should I test him or anything? Also Im planning my first shot tomorrow and Im super nervous. Is there somewhere specific I should post to have help walk me through it?

 

[Bron and Sheba (GA)]

Thank you! So I got Io to eat the most he's eaten in three days tonight but he kept making weird low noises that Ive never heard him make before and is completely zonked now. Should I test him or anything? Also Im planning my first shot tomorrow and Im super nervous. Is there somewhere specific I should post to have help walk me through it?

I would try and get a ketone test if you haven't already to day.
Also get a BG test in if you can so we can see what it is.
For tomorrow, have you worked out the times you want to give the insulin moving forward...eg 7am and 7 pm or 6 am and 6 pm.
I would get a BG test done 1/2 hour before the insulin is due, then post and ask for advice.
Say in the subjuct line something like......'new member 1st dose Lantus BG xxx please help'

If you are staying on the main forum page for the time being, the no shoot number for Lantus is below 200 while you gather data. If you are moving over to the Lantus page the no shoot number is below 150 while you gather data. If you get a preshot number under one of these 'no shoot numbers', you need to stall...don't feed, then post and ask for help as to what to do. Then you test again 20 minutes later to see if the preshot number is rising.

 

[Jazmin]

I would try and get a ketone test if you haven't already to day.
Also get a BG test in if you can so we can see what it is.
For tomorrow, have you worked out the times you want to give the insulin moving forward...eg 7am and 7 pm or 6 am and 6 pm
I would get a BG test done 1/2 hour before the insulin is due, then post and ask for advice.
Say in the subjuct line something like......'new member 1st dose Lantus BG xxx please help'

Would I post that in the lantus group? We just did a BG test and he got 227 mg/dl how would I enter that? ALso what does that even mean haha

 

[Bron and Sheba (GA)]

Would I post that in the lantus group? We just did a BG test and he got 227 mg/dl how would I enter that? ALso what does that even mean haha

Well done getting the SS up and runnning. That was quick.
Did you see the link to setting up your signature in the link I sent you earlier about how to help us help you? If you could set that up, that would help us tremendously. Make sure you add that there were ketones in the urine at diagnosis..
I would put the BG 227 in the remarks column of the SS under the appropriate date.
BG 227 is higher than normal but not too bad.
Normal numbers for a cat using a human meter which I think you are using are 50-120 .
Have you decided what time you are going to do the insulin shots?


You can stay with the main group for a week or two while you settle in and then move over to the Lantus group or you can move over tomorrow. You will get help in both groups.

 

[Jazmin]

Well done getting the SS up and runnning. That was quick.
Did you see the link to setting up your signature in the link I sent you earlier about how to help us help you? If you could set that up, that would help us tremendously. Make sure you add that there were ketones in the urine at diagnosis..
I would put the BG 227 in the remarks column of the SS under the appropriate date.
BG 227 is higher than normal but not too bad.
Normal numbers for a cat using a human meter which I think you are using are 50-120 .
Have you decided what time you are going to do the insulin shots?


You can stay with the main group for a week or two while you settle in and then move over to the Lantus group or you can move over tomorrow. You will get help in both groups.

Im having a hard time picking times, Im a baker and usually am up mon-fri 5am, thankfully I live suuuper close to work and its no problem for me to bop home to check on Io or give him insulin. But I also (usually) go to bed by 8 or 9 so I am thinking maybe 8am and 8pm? Just so then Im not having to get up at 5am on the weekends

I think I got the signature to work.

Is there a post somewhere about all the lingo and abbreviations here as well? I'm trying to make a key for myself in my planner

 

[Juls and Billy]

There's a Glossary here.

The signature isn't working yet. Did you click the "save changes"?

 

[Crista & Ming]

But I also (usually) go to bed by 8 or 9 so I am thinking maybe 8am and 8pm? Just so then Im not having to get up at 5am on the weekends

I would choose a schedule that allows you to squeeze in an extra test before going to sleep or going to work. And that might really mean 5 am. I know it sucks but the thinking is this: lantus usually starts working (onset) at around +2 (of course, every cat is different and may onset at other times). At onset, you'll have a good idea about what the rest of the cycle may look like. If +2 is lower than PS (pre-shot), then you may need to watch Io or leave him food to keep him safe from low numbers.

What most of us do is do the whole spiel (test, feed, shoot) and then go back to sleep!! I do that. I test/feed/shoot at 6 am and go right back to sleep. Then wake up 3-4 hours later and test Ming (he's on Levemir so his onset is later than Lantus).

I was just joking with my mom recently that I haven't slept in for almost 2 years. It's just one of the things we have to deal with when we have our sugarbabies.

Is there a post somewhere about all the lingo and abbreviations here as well? I'm trying to make a key for myself in my planner

This is a good post on abbreviations: http://www.felinediabetes.com/FDMB/threads/lantus-basaglar-levemir-isg-slang-dictionary.1903/

 

[Juls and Billy]

And may I just say that you absolutely rock! You are in here, gung ho, ready to learn all the things to help your Io. That's what's going to get him feeling better, more than anything.

 

[Jazmin]

I would choose a schedule that allows you to squeeze in an extra test before going to sleep or going to work. And that might really mean 5 am. I know it sucks but the thinking is this: lantus usually starts working (onset) at around +2 (of course, every cat is different and may onset at other times). At onset, you'll have a good idea about what the rest of the cycle may look like. If +2 is lower than PS (pre-shot), then you may need to watch Io or leave him food to keep him safe from low numbers.

What most of us do is do the whole spiel (test, feed, shoot) and then go back to sleep!! I do that. I test/feed/shoot at 6 am and go right back to sleep. Then wake up 3-4 hours later and test Ming (he's on Levemir so his onset is later than Lantus).

That is really good to know actually I hadn't thought of that. I'll try for 6am and 6pm. Does +2 mean 2 hours? So I should test again at 8 am and 8 pm?

 

[Jazmin]

There's a Glossary here.

The signature isn't working yet. Did you click the "save changes"?

How about now?

 

[Juls and Billy]

How about now?

Yes! Well done!

 

[Crista & Ming]

That is really good to know actually I hadn't thought of that. I'll try for 6am and 6pm. Does +2 mean 2 hours? So I should test again at 8 am and 8 pm?

Yes. Since we're all different timezones, it's easier to think of +hours after insulin.

Check out this post when you have time. It has a lot of info and one part of it talks about the typical Lantus cycle: http://www.felinediabetes.com/FDMB/threads/the-basics-new-to-the-group-start-here.18139/

Example of an ACTIVE, but NOT necessarily typical Lantus/Basaglar cycle:
NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus/Basaglar cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. Onset begins around +2 for most cats. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Often lower than the PreShot number.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Basaglar/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.

 

[Chris & China (GA)]

Does +2 mean 2 hours? So I should test again at 8 am and 8 pm?

The + cells correspond to the number of hours since the shot....so yes, +2 would be 8...+6 would be noon/midnight, +9 would be 3/3....all the way up to +11 and then it's time for the next cycle.

 

[Jazmin]

Yes! Well done!

I updated Io's chart with his numbers from the morning if you wouldn't mind taking a peak. Im assuming it's good that his BG went down from 234 to I think 206? I got him to eat a bit, but he still wont eat unless prompted (ie me mashing up his food in my hand and getting him started by putting some in his mouth)

 

[Diane Tyler's Mom GA]

Hi that 206 reading is in the PM cell did you mean to put it in the AM Morning cell
and yes it's good that his BG went down

 

[Jazmin]

Hi that 206 reading is in the PM cell did you mean to put it in the AM Morning cell
and yes it's good that his BG went down

Oops I didnt notice that, thank you for pointing that out. I was trying to add it from my phone and its a bit harder to see

 

[Diane Tyler's Mom GA]

Oops I didnt notice that, thank you for pointing that out. I was trying to add it from my phone and its a bit harder to see

No problem I just wanted to make sure, you are doing a good job

 

[Crista & Ming]

Amazing job today!!!!

you may not see much action the first couple of cycles as the depot needs to build. But I would test as much as you can anyways. The more data, the more knowledge, the better

How is Io feeling? Sorry, I’m just popping in while at work and vaguely remember you saying Io had ketones? If so, I’d try to get a ketone test in daily.

 

[Chris & China (GA)]

Looking good for your first shot!! Sure happy you didn't go with the 2U your vet prescribed!

 

[Jazmin]

Amazing job today!!!!

you may not see much action the first couple of cycles as the depot needs to build. But I would test as much as you can anyways. The more data, the more knowledge, the better

How is Io feeling? Sorry, I’m just popping in while at work and vaguely remember you saying Io had ketones? If so, I’d try to get a ketone test in daily.

Ahh thank you for the support! I’ve gotten Io to eat a few times today but it’s still if I really “force” it. Yes he has ketones, I tried a test this morning and it said low. I’m hoping with him keeping eating those will go away? Also the growling/groaning while eating is peculiar.

 

[Crista & Ming]

Ahh thank you for the support! I’ve gotten Io to eat a few times today but it’s still if I really “force” it. Yes he has ketones, I tried a test this morning and it said low. I’m hoping with him keeping eating those will go away? Also the growling/groaning while eating is peculiar.

Great! Did the vet teach you how to do sub-q fluids? That’s the best way to flush out ketones. If not, adding extra water in the food will help a bit.

And yes, the growling is peculiar. Perhaps you could video it for the vet and us to see?

 

[Jazmin]

Great! Did the vet teach you how to do sub-q fluids? That’s the best way to flush out ketones. If not, adding extra water in the food will help a bit.

And yes, the growling is peculiar. Perhaps you could video it for the vet and us to see?

Here is a video of him growling. They did not teach me to do sub-q fluids. I did add some water in his pate today, and I am patiently waiting for him to use the litter box again. He's now laying under the christmas tree I still have yet to take down

 

[Deb & Wink]

Jazmin has a second thread going today also.

new member 1st dose Lantus BG 234 please help walk through!

Plus posting over on Facebook yesterday.