? 10-03-2020 New Member- Patty and Smoochie

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Patty and Smoochie

Member Since 2020
Hi I've read quiet a bit now but still don't know/can't find how to upload my spreadsheet into my post here...or does it just happen automatically?

If you are able to see my spreadsheet could you please inform me and give me some much needed advice if I'm giving my boy Smoochie the correct dosage amount currently?

Vet told me to do 2 units twice a day and I'd already switched him to wet low carbohydrate food and got a lot of concerned messages that it was too much so have put him on 1 unit twice a day for the past few days and yesterday he was getting lower numbers and asked somewhere on a post for advice on Facebook whether to keep him on 1 unit or decrease his insulin (Lantus) I was advised to drop him to half unit which I have done but have also had people ask me/advice me to stay on the 1 unit. So could I please get some informed help on what dosage I should stick to for now please?

Thank you...am a little confused now :(
 
If you are able to see my spreadsheet could you please inform me and give me some much needed advice if I'm giving my boy Smoochie the correct dosage amount currently?

We can see your spreadsheet fine, but it looks like you deleted the tab for the US numbers. Our "World" spreadsheet lets you enter the numbers you get on your meter and then it will automatically convert them to US numbers on another tab. Most of us are from the US so we're more familiar with our numbers. Since you're spreadsheet is still pretty new, it wouldn't be hard to transfer what you've gotten so far onto the version that converts for us silly Americans that refuse to learn the metric system :oops:

All that being said, I agree with the people who suggested you stick with the 1U dose. On the SLGS dosing method, you wouldn't decrease the dose by .25 units until you drop below 90 (5.0 on your meter)

If you get a Pre-shot number you're not sure about shooting, stall, don't feed and test again in 20-30 minutes. Use that time to post here with an obvious subject line like "STALLING! NEED HELP!" to get some eyes quickly. Once you have somebody to help you, you can go back and edit it.

We have a tradition here...if someone advises you to shoot a lower Pre-shot than you're used to or comfortable with, they agree to stay online to watch for updates as long as necessary to make sure both you and Smoochie are safe and comfortable. If they can't, they'll either tell you up front they can't stay online, or they'll stay until they find someone else with experience to take over.

One more little piece of housekeeping for you! (especially if you're on your PC now!) Can we get you to go ahead and fill out your Signature? If you look below our comments, you'll see some basic information that always shows up every time we post. It keeps us from having to ask the same questions over and over again...especially if it's an emergency! Just go to the top right of the page and there's a drop down menu where your sign on name is. Choose "Signature" and add info like:

Your name, cat's name, age, sex, date of diagnosis, type of insulin, type of meter, type of food, any other health problems or medications? and maybe a general location. It's the same place you have your spreadsheet link so you've already been there!
 
Thank you so much for all of this information!

Yay my spreadsheet works and oh noooo will have to figure out how to make the other spreadsheet now, I wouldn't have a clue how I deleted the US numbers? I'm sure I did the world spreadsheet but will have a look at it again :)

Ok I have gone back to 1x unit and see how he goes with that again and will do another curve test day in a week see how he's going.

I'm not even 100% sure the difference of TR or SLGS but I think Smoochie goes in the SLGS category.

I just updated/filled out my signature details so hope that shows up now also thank you for that.

Wow so great to hear and comforting that so many of you are willing to offer advice and continue to help out no matter what! I love that I found such a friendly and great group who can help each other out and especially us newbies!

Thank you again :bighug:
 
Hi Patty and a big welcome to you and Smoochie.

Please, only enter data on the World version of the spreadsheet (SS). It will be transferred automatically to the US version. Just a tiny tidbit of information for you to keep the SS in order and working well.

@Bron and Sheba (GA) live in Australia, so will be able to give you country specific advice.
She's not on right now, but here is a wonderful document she put together for Aussie diabetic cat caregivers.
http://www.felinediabetes.com/FDMB/threads/information-for-aussie-feline-diabetic-caregivers.217781/

I bookmarked it in my web browser, so I could find it again.
 
Ok have managed to do new spreadsheet now have both world and US on them- thank you! Will make it a lot easier to read for everyone

Great job! Both the spreadsheet and the signature!

That'll make it a lot easier for those of us in the US to help you!

Here's some information on the Start Low, Go Slow dosing method and the Tight Regulation protocol.

You don't need to make a firm decision right now.

TR is the more aggressive way to go, but also gives the best chance at remission. You're already testing enough to do TR if you decide to go that way.

SLGS doesn't have the remission rate that TR does, but we've had cats do SLGS and go into remission too!

It's basically just what you're most comfortable with....you can always change if you try one and it doesn't feel comfortable to you.
 
Hi Patty and a big welcome to you and Smoochie.

Please, only enter data on the World version of the spreadsheet (SS). It will be transferred automatically to the US version. Just a tiny tidbit of information for you to keep the SS in order and working well.

@Bron and Sheba (GA) live in Australia, so will be able to give you country specific advice.
She's not on right now, but here is a wonderful document she put together for Aussie diabetic cat caregivers.
http://www.felinediabetes.com/FDMB/threads/information-for-aussie-feline-diabetic-caregivers.217781/

I bookmarked it in my web browser, so I could find it again.

Thank you!

Yes have been entering in the World version and saw what you mean that it automatically converts, how handy is that?! So good!

Thank you yes I've printed out I think it was about 18 pages from that link very VERY handy for us here in Australia :cat: and that's a good idea to bookmark it thank you :bighug:
 
Hi Patty and Smoochie.. what a handsome boy!
I live in Sydney.
I’m so glad you found us. This is a very knowledgeable and supportive community.
I see Deb gave you the Aussie Caregivers Info.
Here is a list of Australian foods.
http://www.felinediabetes.com/FDMB/...an-cat-food-list-suitable-for-fd-cats.216897/

Ask lots of questions, we are happy to answer them.
Bron:)

Awww hi and thank you yes he is my handsome gentle giant :cat:

We are on the Gold Coast.

Yes I printed out the caregivers one from Facebook that I'm sure it was you that send me the link when I joined the group last week so thankful! and have thoroughly looked through all the foods list (even send my mum the list even though she doesn't have diabetic cats...knowledge is power and prevention is key!)

Extremely happy I found this group and feel so much more confident than not knowing what to do over a week or so ago :bighug:
 
Great job! Both the spreadsheet and the signature!

That'll make it a lot easier for those of us in the US to help you!

Here's some information on the Start Low, Go Slow dosing method and the Tight Regulation protocol.

You don't need to make a firm decision right now.

TR is the more aggressive way to go, but also gives the best chance at remission. You're already testing enough to do TR if you decide to go that way.

SLGS doesn't have the remission rate that TR does, but we've had cats do SLGS and go into remission too!

It's basically just what you're most comfortable with....you can always change if you try one and it doesn't feel comfortable to you.

Thank you! Appreciate it :bighug:

I've only just started to wrap my head around how and where to find things on here so now I can print off more info so I can keep re -reading it to really understand it fully.

Yes by the sounds of it I'm definitely more TR so will probably adapt to go that route and hopefully get my boy into remission! Ultimate goal fingers crossed :cat:
 
Please let us know what else you would like to learn about.

There is a lot of information here. We can help you find lots of good info for lantus and other aspects of treating feline diabetes. Such as the "Sticky" or pinned posts in the
Lantus / Basaglar (glargine) and Levemir (detemir) Forum.
A good beginning is this particular thread from that forum.
Sticky The Basics: New to the Group? Start here!
(Sticky or pinned posts are always at the top of the different forums.)

You want to hold that current 1U dose for 1 week, since you are using the SLGS (Start Low Go Slow) dosing protocol/method - for now. Then reevaluate the dose. Hold the dose, UNLESS he drops really low, < 2.7 mmol/L (<50 mg/dL). Then Smoochie would be due for a reduction in dose, no matter which protocol you use.

That 1U does not look like quite enough insulin, but the "depot" or storage area is rebuilding, so you need to give that "depot" time to refill. That can take 6 cycles or more. So we really can't say for sure right now on the 1U dose.

Keep us posted please.

p.s. Something like 3 am your time, so don't expect you to be awake to read this for a while.
 
Patty I don't know if you are happy with your vet or not but there is a great vet practice at Mt Gravatt. It is a cat only clinic. They have 2 very experienced vets there who know a lot about feline diabetes....Rhett Marshall and Marcus Gunew. I haven't been there but I have spoken with Rhett and he has written international papers on FD. I have also had feedback from people who have used the clinic and they were very happy.
Not sure if it is far from you.
Here is a link to the clinic
http://www.thecatclinic.com.au/meet-our-staff
 
Please let us know what else you would like to learn about.

There is a lot of information here. We can help you find lots of good info for lantus and other aspects of treating feline diabetes. Such as the "Sticky" or pinned posts in the
Lantus / Basaglar (glargine) and Levemir (detemir) Forum.
A good beginning is this particular thread from that forum.
Sticky The Basics: New to the Group? Start here!
(Sticky or pinned posts are always at the top of the different forums.)

You want to hold that current 1U dose for 1 week, since you are using the SLGS (Start Low Go Slow) dosing protocol/method - for now. Then reevaluate the dose. Hold the dose, UNLESS he drops really low, < 2.7 mmol/L (<50 mg/dL). Then Smoochie would be due for a reduction in dose, no matter which protocol you use.

That 1U does not look like quite enough insulin, but the "depot" or storage area is rebuilding, so you need to give that "depot" time to refill. That can take 6 cycles or more. So we really can't say for sure right now on the 1U dose.

Keep us posted please.

p.s. Something like 3 am your time, so don't expect you to be awake to read this for a while.

I want to learn it all! Haha but my brain isn't coping as fast! The only way I learn is to print out info and keep re-reading it (I have toddlers at home so the only chance I get to myself and properly read this is usually late at night)

Thank you yes will definitely start there and see what I have printed/read etc and keep going until I have all the info I need and rely on experience and help from you all on here in regards to dosage and when to change it etc.

I will definitely hold the 1 unit for a week and then post again to see what the results are and what my next step should be :)

That makes sense so yeah it's like a storage area that's rebuilding itself and that takes a week got it :bighug: Thank you!
 
Patty I don't know if you are happy with your vet or not but there is a great vet practice at Mt Gravatt. It is a cat only clinic. They have 2 very experienced vets there who know a lot about feline diabetes....Rhett Marshall and Marcus Gunew. I haven't been there but I have spoken with Rhett and he has written international papers on FD. I have also had feedback from people who have used the clinic and they were very happy.
Not sure if it is far from you.
Here is a link to the clinic
http://www.thecatclinic.com.au/meet-our-staff

Just looked it up, it's about 30mins away from us so that's do-able. No not very happy with the vet I went to at all after reading so much info on here.

Tomorrow I have a consult for his dental clean to see how much that is and it will be done at the animal welfare league (different vet clinic) where we initially adopted him from years ago so I will have the chance to talk to a new vet there, I'll see what they say about it all. They will either be helpful or vague but at least I have my own knowledge through here to help my boy with as much hope for recovery as possible no matter what the vet has to say or try to sway me into buying more "Prescription" foods...
 
Ok have done some more reading and just wondering if I have this set up in mind correctly...

I've switched to the TR dosing method as I'm doing quite a few tests on him anyway everyday (luckily for me he's such a gentle giant) and really want to hopefully get him into remission with as much data as I can get from him.

Daily routine I would...

Test at
AMPS (test, food then insulin if necessary)
+3
+6
+9
PMPS (test, food then insulin if necessary)

* I feed Smoochie and my other 2 cats at AMPS +4 +8 PMPS plus whenever Smoochie mainly wants some food I will give him some more throughout day and just before I go to bed I usually put out some more food. I only give them Fancy Feast Pates blended with water or Gourmet Delight and cat mince(fussy cat).

and do spot checks here and there and +1 +2 +10 +11 are also important as random checks I think from memory, please correct if I'm wrong...

Whatever dose I'm on such as currently 1 unit I do that for a full week then do another curve test, testing every 2 hours? After which I ask for advice dosage wise?

If the pre shot number is 8.3mmol/L or below I have to stall without feeding, post and ask for assistance and test again after 20mins.

And the NO SHOOT number is 2.8mmol/L.

Is that all correct? Or have I forgotten something or gotten something wrong please let me know
 
Ok have done some more reading and just wondering if I have this set up in mind correctly...
I've switched to the TR dosing method as I'm doing quite a few tests on him anyway everyday (luckily for me he's such a gentle giant) and really want to hopefully get him into remission with as much data as I can get from him.

Daily routine I would...
Test at
AMPS (test, food then insulin if necessary)
+3
+6
+9
PMPS (test, food then insulin if necessary)
Yes you test feed and shoot in that order.
I would vary the times you test during the cycles so you can get an idea of what is happening during the whole cycle over time. It's like a puzzle and we need to fill in all the pieces. For example one cycle get a +3, 6 and another cycle get a +2 +4 and +7 etc. You can get BGs in the second half of the cycles as well if you like, especially if the BG is lower than normal.
If you have a lower than normal preshot you would want to get a +1 and a +2 for example to see what Smoochie has in mind.
If he's dropping fast, you would not wait three hours to test the BG, but would test an hour later. Or even 1/2 hour later depending on how fast and low the BG was. If you are ever unsure, always post and ask for advice.
Don't neglect the pm cycle. It is always a very good idea to get a before bed test in every night. If the BG is lower than the preshot number than it is probably going to be an active cycle and you will need to set the alarm and test later in the cycle.

* I feed Smoochie and my other 2 cats at AMPS +4 +8 PMPS plus whenever Smoochie mainly wants some food I will give him some more throughout day and just before I go to bed I usually put out some more food. I only give them Fancy Feast Pates blended with water or Gourmet Delight and cat mince(fussy cat).
I would look at feeding the cats at Preshot, + 3 and +5 OR preshot, +4 and +6. The reason I suggest these times is because the onset of insulin is around +2 and the nadir (lowest point in the cycle) is around +5 to +7 ( most of the time but not always). So it is better to give the food around these two times. And if you feed during the second half of the cycle, the strength of the insulin is mostly starting to weaken so it's better to feed during the first half of the cycle when the insulin is strongest. You may find other times during the first half of the cycle that suits you better than the ones I've suggested.

and do spot checks here and there and +1 +2 +10 +11 are also important as random checks I think from memory, please correct if I'm wrong...
Whatever dose I'm on such as currently 1 unit I do that for a full week then do another curve test, testing every 2 hours? After which I ask for advice dosage wise?
If the pre shot number is 8.3mmol/L or below I have to stall without feeding, post and ask for assistance and test again after 20mins.

And the NO SHOOT number is 2.8mmol/L.
Is that all correct? Or have I forgotten something or gotten something wrong please let me know

The +1 and +2 are good to get when the preshot number is lower than usual. If the +2 is lower or the same as the preshot, than you are probably going to have an active cycle so need to pay attention..
The +10 and 11 you might get if the BGs are lower during the cycle and you want to know what the +11 is so that when you test the preshot at +12, you will know if the number is rising or not. It will also give you a heads up if the BG is still lower than you would normally shoot and you would have time to post and ask what to do.

You need to stay on the 1 unit for a week for the depot to fill initially. Once you have done this, any change in dose will require you to stay with that dose for at least 6 cycles unless the BG drops under 2.8 (50), in which case you would reduce the dose by 0.25 units.
There is no need to do a curve if you are doing TR as you are testing enough. You can post and ask for advice if you should increase the dose or stay with the 1 unit.
While you are gathering data you would have a no shoot BG of 8.3 (150)
If that happens, stall, don't feed, post and ask for help. Change the subject line to reflect this...say something like STALLING, BG xxx, PLEASE HELP.
Then test again 20 minutes later to see if the BG is rising.
Always make sure you have enough test strips, highcarb food and honey.
You will gradually work your way down to shooting lower numbers.
Yes, never shoot under 2.8 mmol/L (50).


Sorry one more thing... Do I post/ask for advice dosage wise now only in the Lantus forum from now on? And any regular questions on the main one?
I would start posting over on the Lantus forum now. You start a new thread each day and you put the date, name of cat and BG at AMPS in the subject line. You can add something else like help, need advice, etc in the subject line as well if you need to.
You can ask questions in the Lantus forum as well as dosing questions.

If it was something quite different it is fine to ask in the main forum as well if you want.
 
Yes you test feed and shoot in that order.
I would vary the times you test during the cycles so you can get an idea of what is happening during the whole cycle over time. It's like a puzzle and we need to fill in all the pieces. For example one cycle get a +3, 6 and another cycle get a +2 +4 and +7 etc. You can get BGs in the second half of the cycles as well if you like, especially if the BG is lower than normal.
If you have a lower than normal preshot you would want to get a +1 and a +2 for example to see what Smoochie has in mind.
If he's dropping fast, you would not wait three hours to test the BG, but would test an hour later. Or even 1/2 hour later depending on how fast and low the BG was. If you are ever unsure, always post and ask for advice.
Don't neglect the pm cycle. It is always a very good idea to get a before bed test in every night. If the BG is lower than the preshot number than it is probably going to be an active cycle and you will need to set the alarm and test later in the cycle.


I would look at feeding the cats at Preshot, + 3 and +5 OR preshot, +4 and +6. The reason I suggest these times is because the onset of insulin is around +2 and the nadir (lowest point in the cycle) is around +5 to +7 ( most of the time but not always). So it is better to give the food around these two times. And if you feed during the second half of the cycle, the strength of the insulin is mostly starting to weaken so it's better to feed during the first half of the cycle when the insulin is strongest. You may find other times during the first half of the cycle that suits you better than the ones I've suggested.



The +1 and +2 are good to get when the preshot number is lower than usual. If the +2 is lower or the same as the preshot, than you are probably going to have an active cycle so need to pay attention..
The +10 and 11 you might get if the BGs are lower during the cycle and you want to know what the +11 is so that when you test the preshot at +12, you will know if the number is rising or not. It will also give you a heads up if the BG is still lower than you would normally shoot and you would have time to post and ask what to do.

You need to stay on the 1 unit for a week for the depot to fill initially. Once you have done this, any change in dose will require you to stay with that dose for at least 6 cycles unless the BG drops under 2.8 (50), in which case you would reduce the dose by 0.25 units.
There is no need to do a curve if you are doing TR as you are testing enough. You can post and ask for advice if you should increase the dose or stay with the 1 unit.
While you are gathering data you would have a no shoot BG of 8.3 (150)
If that happens, stall, don't feed, post and ask for help. Change the subject line to reflect this...say something like STALLING, BG xxx, PLEASE HELP.
Then test again 20 minutes later to see if the BG is rising.
Always make sure you have enough test strips, highcarb food and honey.
You will gradually work your way down to shooting lower numbers.
Yes, never shoot under 2.8 mmol/L (50).



I would start posting over on the Lantus forum now. You start a new thread each day and you put the date, name of cat and BG at AMPS in the subject line. You can add something else like help, need advice, etc in the subject line as well if you need to.
You can ask questions in the Lantus forum as well as dosing questions.

If it was something quite different it is fine to ask in the main forum as well if you want.

Thank you so much!!! Ok I’m going to have to print all that and highlight things for myself again haha awesome thanks so much again for your help! At least I can get it all done correctly from the get go and stick to this plan
 
Time for graduation! Smoochie is moving to the Lantus ISG group. Good luck Patty.

Bron did a fantastic job highlighting all the points for you.
They will either be helpful or vague but at least I have my own knowledge through here to help my boy with as much hope for recovery as possible no matter what the vet has to say or try to sway me into buying more "Prescription" foods...
Yes, vets really "love" those prescription foods. Even though they may not be the best for a diabetic cat.

I've switched to the TR dosing method as I'm doing quite a few tests on him anyway everyday (luckily for me he's such a gentle giant) and really want to hopefully get him into remission with as much data as I can get from him
TR only requires you to hold the dose for 6 cycles or 3 days before you increase the dose. SLGS had you hold the dose for 1 week. UNLESS Smoochie drops under 50 (<50 mg/dL) as Bron said.

With lantus, you will almost always have a shootable number. But gather that test data first, to see how Smoochie reacts. Those first low numbers you get, when you aren't used to them, can be scary. But there are lots of people around to help.

That +2 number can really tell you where the cycle is headed, number wise.
The +2 is like an "early warning" for most cats!
If the +2 is about the same as the PS, it's usually a pretty normal cycle...gradually down to nadir and then gradually back up again
If the +2 is higher than the PS, that usually signals a bounce, and those are the cycles when you can usually take a pokey break.
If the +2 is lower than the PS, that's your "Early warning" that kitty might be going much lower later in the cycle so it's important to plan on getting another test or two (or 6) in.

p.s. A 79 at nadir for Smoochie on 12/03/2020! Very good Smoochie! Let's see how high you bounce by PMPS.
 
Time for graduation! Smoochie is moving to the Lantus ISG group. Good luck Patty.

Bron did a fantastic job highlighting all the points for you.

Yes, vets really "love" those prescription foods. Even though they may not be the best for a diabetic cat.


TR only requires you to hold the dose for 6 cycles or 3 days before you increase the dose. SLGS had you hold the dose for 1 week. UNLESS Smoochie drops under 50 (<50 mg/dL) as Bron said.

With lantus, you will almost always have a shootable number. But gather that test data first, to see how Smoochie reacts. Those first low numbers you get, when you aren't used to them, can be scary. But there are lots of people around to help.

That +2 number can really tell you where the cycle is headed, number wise.
The +2 is like an "early warning" for most cats!
If the +2 is about the same as the PS, it's usually a pretty normal cycle...gradually down to nadir and then gradually back up again
If the +2 is higher than the PS, that usually signals a bounce, and those are the cycles when you can usually take a pokey break.
If the +2 is lower than the PS, that's your "Early warning" that kitty might be going much lower later in the cycle so it's important to plan on getting another test or two (or 6) in.

p.s. A 79 at nadir for Smoochie on 12/03/2020! Very good Smoochie! Let's see how high you bounce by PMPS.

Yes thank you for all your help and info too! I will also print your info to keep re reading it and really get this in my head because I am understanding it all right now but in a couple days I’ll half forget so if I read this kind of information again and again I’ll feel so much more confident!

Yay little graduation haha

and yes super happy with the green!!!

Thank you again
 
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