10/16 - Need Advice for my Henry

Hello and welcome to FDMB!

I see that you have an excel spreadsheet where you have started collecting BG data. That's good. Unfortunately, it's not in our format. Could you please set-up a spreadsheet as per our format. If you have any difficulty with that, please let me know and I will be happy to help you with it! :-)
FDMB SS Instructions

I have a bunch of questions for you that would help us get to know Henry's situation better in order to advise you:
(a) How old is?
(b) Does he have any other health issues besides diabetes? Any history of ketones?
(c) What are you feeding him?
(d) I see he was diagnosed in Feb - has he been on insulin since then?
(e) How are you adjusting his insulin dose? I see that he was at as high as 4.5 units two weeks ago!

Welcome again! :-)
 
That looks like one of our Alphatrack spreadsheets but the colours haven’t filled in for some reason o_O

Another question for you - what type of insulin is Henry getting?
And can you confirm that it is the Alphatrack rather than a human meter that you’re using.
 
Thanks Patty, I still can’t see that. Maybe because I’m on the iPad.

So with lantus you want to find a dose you can safely dose twice a day. Based on the data you have 2u is too much for Henry. What does he weigh? And if he is over or under weight was would his ideal weight be?

Try not to stress you have found the right place to help Henry. People will be able to help once we have the answers to our questions :cat:
 
Bandit Mom - Yes I'll need help with the spreadsheet, Henry is nine years old, He weighed 25 pounds when diagnosed in Feb 2020, Toady he's 21 pounds six ounces target is 16 pounds. Henry is a large cat measures 22 inches long. We have him on High protein diet both wet (Earthborn Holistics) & dry(Dr. Elseys) both have carbs @ 5%. Ketones???. I can attached the results lab which I will do so. He has been on Insulin (Lantus) since Feb 2020.
I also have my personal Spreadsheet of his entire history of insulin injections with about four Blood Glucose curves. The device Glucose meter is ALPHATRAK2. Thank You for your response I'm ready to get this back to normal
 

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Hi Kay

I will set up a spreadsheet for you. Will send you a PM with the details I need to do so.

I don't see a urinalysis in the lab results. Did your vet every check for ketones?
Like @Vyktors Mum pointed out, Lantus is dose twice a day with the same number of units.

Here's the sticky on the dosing protocols followed here. Since you are feeding both wet and dry, you could start with the SLGS protocol which is a less aggressive dosing protocol.
https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/

I would also test Henry for ketones. You can do it yourself at home with Ketone test strips.

Finally, our dosing protocols are written for human glucometers. A lot of people here have switched to human meters because the strips are much cheaper than those of pet meters. That's something you could think about at some point.

Bhooma
 
Hi and welcome
I can’t see the Lantus on the top of the SS either Serryn
I agree that 2 units is too much.
Lantus needs consistent dosing, otherwise the depot can’t fill and stabilise and you will get wonky numbers.
Looking at the SS I’d like to make a couple of comments.
It is really important that you test the BG before every shot and again during the cycles...Both the AM and the PM cycles.
At the moment you are not doing that and it is hard to see what is going on.
Unless you test during the cycles we can’t see how well the insulin is working and how low it is taking Henry.
I am really glad you are no longer giving 4.5 units!!

I would do a few things.
I would reduce the dose to 0.5 unit twice a day and make sure you test before every dose.
I would test around +4 and +6 every cycle until we can see what is happening. Keep to the 0.5 unit dose for a week unless the BG drops under 90 in which case you would reduce the dose by 0.25 units, or ketones show in the urine.
I would post every day to tell us how Henry is going and to ask for advice.
If the preshot number is under around 180 on the Alphatrak meter I would stall, don’t feed and test again in20 mins to see if the BG is rising. Post and ask for help as well.
I would also go out and buy a bottle of Ketostix from Walmart or a pharmacy and test the urine for ketones every day and put the result in the results column of the SS.
I can see in the labs that there were no ketones but it is a good idea to check them especially if we are reducing the dose of insulin.

I will assume you are following SLGS method as you are feeding dry food so if he drops under 90 you take a reduction in dose down to 0.25 units.

Here is a link to useful information
https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

also would you mind taking down the 911 please as it is only for emergencies such as a very ill cat or a cat with a hypo...thanks:)
 
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Guys I really scared to reduce to .5 units did you check out my personal spreadsheet all the way back to FEB it you can see it went from .5units in Feb to 4.0 units in May He currently has readings in the 400's Why would I revert back to FEB dosage?
 
Please Check out my personal spreadsheet Titled - Copy of Henry Insulin Injection is (8) months of data with a few BG Curves on it
 
Golf2015 said:
Guys I really scared to reduce to .5 units did you check out my personal spreadsheet all the way back to FEB it you can see it went from .5units in Feb to 4.0 units in May He currently has readings in the 400's Why would I revert back to FEB dosage?
Click to expand...

At the top of the page, where it says "Thread Tools" - click on it and select "Edit Title"
In the pop-up box that opens, change the prefix to '?' from '911'


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Henry has had injections consistently from Feb 2020 to just last week. The only lapse in injections is listed on the FDMB spreadsheet. Prior to those lapses he had injections (with no miss dosages) BID for the last eight months as you can see I my personal spreadsheet
 
Hi Kay, I did take a look at the log and I see that he has indeed been getting injections from Feb 2020. However, there is very little BG data to see how he is doing on the insulin except for a curve every month or so which does not give us a good enough picture. Lantus dosing is based on the nadir - how low the kitty goes on the dose and to ascertain that we need daily tests like @Bron and Sheba (GA) said.

Henry was 71 and 85 today with almost no insulin in the last 7 days. That shows that he should be on a much lower dose than 4 units or even 2 units.

The higher numbers you see are, what we call a bounce, the liver's reaction to seeing lower numbers than the body is used to.
 
Bron & Sheba did you check out my spreadsheet attached to my original post you can see how the Insulin injections were administered over the last eight months. The only lapse (No Injections) occurred just last week
 
Golf2015 said:
Please Check out my personal spreadsheet Titled - Copy of Henry Insulin Injection is (8) months of data with a few BG Curves on it
Click to expand...

I see that you have set-up the spreadsheet. Good show!

Could you also update your signature to add Henry's name, age, date of diagnosis, what you are feeding him, the insulin he is on and the meter you are using?
See my Signature at the bottom of my posts to get an idea of what I mean.
 
Golf2015 said:
Bron & Sheba did you check out my spreadsheet attached to my original post you can see how the Insulin injections were administered over the last eight months. The only lapse (No Injections) occurred just last week
Click to expand...

you can tag a person by adding an @ before their name. As you start typing out @ and their names, you will get a drop down list from which you can select from.
@Bron and Sheba (GA)
 
So let me get this right after viewing my personal spreadsheet your still recommending .5 units. Guys I'm really scared that you missed the data of the last eight months
 
Golf2015 said:
So let me get this right after viewing my personal spreadsheet your still recommending .5 units. Guys I'm really scared that you missed the data of the last eight months
Click to expand...

Yup! A cat's insulin needs change with time. That's why we have a dosing protocol that stipulates when to increase and when to increase doses.
The last 2 weeks of data are usually most relevant.

ETA: you want to shoot a dose that you can consistently shoot twice a day for several days. Lantus is a depot insulin and you don't dose based on either pre-shot numbers or the highs in the cycle.
 
Hi (sorry don’t know your name)
Yes I have looked at the data from the last 8 months.
I’m assuming you did the BG curves at home...is that correct.?
I can see you went up in 1/2 unit increments when you increased. Just a FYI ....It is better to go up in 1/4 unit increments so as not to go past the best dose and it is safer for the cat.
In Feb through to May you look as if you took curves every 2 weeks but did not do any other testing such as before shots or during the cycles.
In June there were just 2 BGs taken and one curve in July, then in August no testing. At this post Henry was on 4 units Then after 2 BG tests on the 18sept you increased the dose to 4.5 units having not testing at all since the 12 July...then still no testing until 5 October when you got a reading of 56@+6. Then you did several skips, reduced the dose to 2 units and 0.5 units over the next 10days which brings us up to today.

Insulin needs change in cats. That’s why it is so important that you test before every shot to see if is safe to give the dose and then test again during the cycle to see how low the dose takes the cat.
With an alphatrak meter the BG number you have to reduce the dose is 68. This is when to get out the high carb food and the honey to bring the number up higher.
If you would like us to help you I would suggest you look at the Start Low Go Slow method. It is structured to keep Henry safe. You would need to to reduce the dose when he drops to 90.

The reason I suggested 0.5 units is because, looking at the information you have given us it is obvious that Henry’s need for insulin has dropped and if you continued with the 4.5 units, you would be risking a hypo.
He has managed to stay in reasonable numbers even with the reductions and the skips.
I think 0.5 units would be a safe amount to give him until we see how he goes over the next several days. You can always go up in dose if needed, which is much more preferable than dealing with a cat that is having a hypo from too much insulin.
The proviso would be that you test his urine for ketones.

The reason he has higher numbers today are a bounce from the green numbers this morning.
That doesn’t mean he needs a bigger dose though. It is just his body reacting to the low numbers and dumping stored glucose and regulatory hormones into his system to “save himself”. The bounce will clear in 1 to 6 cycles.

This is just my opinion and you might like to wait for others.
Please keep asking questions, we are very happy to help.
Bron.:)
 
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You
Bron and Sheba (GA) said:
Hi (sorry don’t know your name)
Yes I have looked at the data from the last 8 months.
I’m assuming you did the BG curves at home...is that correct.?
I can see you went up in 1/2 unit increments when you increased. Just a FYI ....It is better to go up in 1/4 unit increments so as not to go past the best dose and it is safer for the cat.
In Feb through to May you look as if you took curves every 2 weeks but did not do any other testing such as before shots or during the cycles.
In June there were just 2 BGs taken and one curve in July, then in August no testing. At this post Henry was on 4 units Then after 2 BG tests on the 18sept you increased the dose to 4.5 units having not testing at all since the 12 July...then still no testing until 5 October when you got a reading of 56@+6. Then you did several skips, reduced the dose to 2 units and 0.5 units over the next 10days which brings us up to today.

Insulin needs change in cats. That’s why it is so important that you test before every shot to see if is safe to give the dose and then test again during the cycle to see how low the dose takes the cat.
With an alphatrak meter the BG number you have to reduce the dose is 68. This is when to get out the high carb food and the honey to bring the number up higher.
If you would like us to help you I would suggest you look at the Start Low Go Slow method. It is structured to keep Henry safe. You would need to to reduce the dose when he drops to 90.

The reason I suggested 0.5 units is because, looking at the information you have given us it is obvious that Henry’s need for insulin has dropped and if you continued with the 4.5 units, you would be risking a hypo.
He has managed to stay in reasonable numbers even with the reductions and the skips.
I think 0.5 units would be a safe amount to give him until we see how he goes over the next several days. You can always go up in dose if needed, which is much more preferable than dealing with a cat that is having a hypo from too much insulin.
The proviso would be that you test his urine for ketones.

The reason he has higher numbers today are a bounce from the green numbers this morning.
That doesn’t mean he needs a big dose though.

This is just my opinion and you might like to wait for others.
Please keep asking questions, we are very happy to help.
Bron.:)
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Bron I would prefer TR method. OK I will do a pretest at 6:00am and input the results on the spreadsheet and the dosage will be .5 units

I will pickup the ketone test at walmart the problem will be attaining a sample he's both indoor and outdoor cat. So I guess that means I keep him in today and watch him and catch the urine in a cup. That's going to be a challenge. TR regulates has shorter 6 cycles before a change Correct? Yes, the BG Curves were performed at home. By the way the name is Robert
 
Golf2015 said:
You

Bron I would prefer TR method. OK I will do a pretest at 6:00am and input the results on the spreadsheet and the dosage will be .5 units

I will pickup the ketone test at walmart the problem will be attaining a sample he's both indoor and outdoor cat. So I guess that means I keep him in today and watch him and catch the urine in a cup. That's going to be a challenge. TR regulates has shorter 6 cycles before a change Correct? By the way the name is Robert
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Hi Robert!! Good to meet you.
Because you are feeding dry food, you can only do the SLGS method, sorry.

Remember to stall, don’t feed and post and ask for help if the number is under 180.
Do you have high carb food and honey or Karo at home if needed ....And can you test during the cycle to give us some information and to keep Henry safe?
 
Bron and Sheba (GA) said:
Hi Robert!! Good to meet you.
Because you are feeding dry food, you can only do the SLGS method, sorry.

Remember to stall, don’t feed and post and ask for help if the number is under 180.
Do you have high carb food and honey or Karo at home if needed ....And can you test during the cycle to give us some information and to keep Henry safe?
Click to expand...
Yes I have 150 AT2 test strips good until Sept 2021, I'm retired . We do have karo visible on the kitchen counter proactive just in case. When you say test during the cycle?? at what increments of data would you like. So the dry food even though it's 5% carbs still will be the SLGS method?

I just checked his BG it is 342
 
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Golf2015 said:
Yes I have 150 AT2 test strips good until Sept 2021, I'm retired . We do have karo visible on the kitchen counter proactive just in case. When you say test during the cycle?? at what increments of data would you like. So the dry food even though it's 5% carbs still will be the SLGS method?
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Yes, no dry food sorry on TR.
Getting a test in around +4 to +6 is very helpful as it tells us how the insulin is working. If the BG is dropping lower getting another test in to see it hasn’t dropped too low is wise.
If you are shooting a lower than normal preshot we suggest getting a +1 and + 2 so we can keep an eye on what the cat is doing.
 
Robert, I can see AMPS was 342 and you shot 0.5 units.
Remember Henry is bouncing at the moment and he could do this for up to 6 cycles......maybe less. By testing you will be able to tell when he is coming off the bounce.
Keep giving the 0.5 units and it will fill the depot and stabilise it.
Let us know when you have manages to get a ketone test done.
Try and make sure he is eating well.
Are you feeding before the shots and again during the cycles?
We recommend feeding preshot and again a couple of snacks during the first half of all the cycles. It is ok to free feed if that is what you normally do but please pick up the food 2 hours before the preshots so that the BG isn’t food influenced.
Well done!
 
Bron and Sheba (GA) said:
Robert, I can see AMPS was 342 and you shot 0.5 units.
Remember Henry is bouncing at the moment and he could do this for up to 6 cycles......maybe less. By testing you will be able to tell when he is coming off the bounce.
Keep giving the 0.5 units and it will fill the depot and stabilise it.
Let us know when you have manages to get a ketone test done.
Try and make sure he is eating well.
Are you feeding before the shots and again during the cycles?
We recommend feeding preshot and again a couple of snacks during the first half of all the cycles. It is ok to free feed if that is what you normally do but please pick up the food 2 hours before the preshots so that the BG isn’t food influenced.
Well done!
Click to expand...
Here is his schedule of feeding (4) times a day at the following times no deviation at all 6:00am, 12:00pm, 6:00pm - (This feeding is split in half with respect to calories 1/2 at 6:00pm and the other 1/2 at 8:30pm), & 12:00am equal calories per feeding for a total of 312 calories per 24 hours. The feeding is a combination of both wet and dry(Dr. Elsey's high protein) As you can see he will have (in three feedings) six hours of no food. His demeanor is excellent Runs around and plays with the other cats something he has not done in some time but has been doing so in the last two to three months. The ketone test will be a challenge I just ordered(Amazon) NOSOOB cat litter.
 
During this BOUNCE and the reduce 0.5 units (Lantus) twice daily until the depot stabilizes is it possible for a HYPO event?
 
Hello Robert!

Golf2015 said:
During this BOUNCE and the reduce 0.5 units (Lantus) twice daily until the depot stabilizes is it possible for a HYPO event?
Click to expand...

Yes, it's always possible. But much less likely than when shooting 4U, or even 2U. Henry maintained blue numbers all on his own for quite a while with no insulin at all.

Those returns to pinks and reds the other night are a bit puzzling-- was there anything else going on (hairball, constipation, a trip the vet, getting barked at by a dog, snack on a jelly donut) around the time you got that 396?
 
Henry will be outside in the back yard during the daylight hours. I have a wood fence around the perimeter of the backyard no animals can get in and the same holds true for Henry cannot get out. No dogs in the neighborhood (actually it's very quiet all retirees in this neighborhood) , no hairball, no trip to the Vet. His feeding is strict: (4) feedings per 24 hours at 6:00am, 12:00pm, 6:00pm, and 12:00am. Total calories for 24 hours is 312 divided equally in four (78). We never deviate the times Feedings are always at those times only with maybe a plus or minus of (10) minutes. I have attached my personal spreadsheet on my original post dating back to initial diagnoses FEB 2020. Information has daily injections and the amount along with a few BG Curves performed at home under the advisement of a Vet. The others on this forum seem to think the numbers that are puzzling points to a bounce. Henry is a large cat measure 22 inches not counting tail
Thanks
 
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Golf2015 said:
The others on this forum seem to think the numbers that are puzzling points to a bounce.
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I agree that a bounce seems likely for last night's numbers, after he went down to 71 (and possibly lower earlier) at the AMPS. I'm just puzzled about the 396 at PMPS on 10/16. He hadn't had insulin for several days according to the spreadsheet, nor had he seen even any numbers above 200 (albeit with once-per-day testing frequency during that time). So what was he bouncing from on 10/16, if there was no insulin to bring him low?

I'm just wondering if there was something else going on then, but it sounds like there aren't any obvious candidate explanations.
 
I have another question about Henry with respect to the current situation as follows:
1) Henry is a large cat 22 inches not counting tail
2) Henry weighed about 25lbs January 2020 - Very Obese - Vet informed me the idea weight for him is 16lbs
3) Since then we have him on a RER 312 Calories a day The chart shows this is ideal for about 16.5lbs cat
4) Today he weighs 21 pounds 6 ounces.
5) Is it possible that the loss of few pounds can contribute to insulin reduction?
6) Now here's my question is this current calorie reduction making his situation worse?

Thanks in advance
@Bron and Sheba (GA)
 
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Golf2015 said:
I have another question about Henry with respect to the current situation as follows:
1) Henry is a large cat 22 inches not counting tail
2) Henry weighed about 25lbs January 2020 - Very Obese - Vet informed me the idea weight for him is 16lbs
3) Since then we have him on a RER 312 Calories a day The chart shows this is ideal for about 16.5lbs cat
4) Today he weighs 21 pounds 6 ounces.
5) Is it possible that the loss of few pounds can contribute to insulin reduction?
6) Now here's my question is this current calorie reduction making his situation worse?

Thanks in advance
@Bron and Sheba (GA)
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One of the food formulas we use is 20cals/lb healthy ideal body weight/day.
Therefore: 20 x 16.5= 330 cals per day.
You don’t want him to lose the weight too quickly otherwise you will run into other problems.
I think I would increase his intake to 330 cals per day.
How often do you weigh him?
The weight loss could have contributed to the insulin reduction but I think it is also possible he is heading towards remission.
Only time will tell..
Keep posting every day and keep asking questions. Thanks for getting the in between tests in...that’s helpful. Hopefully he’ll come off the bounce soon.
 
Bron and Sheba (GA) said:
One of the food formulas we use is 20cals/lb healthy ideal body weight/day.
Therefore: 20 x 16.5= 330 cals per day.
You don’t want him to lose the weight too quickly otherwise you will run into other problems.
I think I would increase his intake to 330 cals per day.
How often do you weigh him?
The weight loss could have contributed to the insulin reduction but I think it is also possible he is heading towards remission.
Only time will tell..
Keep posting every day and keep asking questions. Thanks for getting the in between tests in...that’s helpful. Hopefully he’ll come off the bounce soon.
Click to expand...


Bron I cannot Thank You enough for your advice

We will start 330 calories daily intake

Weigh about every 10 days or so nothing definitive if you think it should be a routine weighing - Every seven days or so

Oh by the way 12:30am our time which right now its 12:41am his BG reading jumped to 404 will enter this on the spreadsheet

Like I said earlier I cannot Than You enough you really do care Thank You
 
Robert, a request! Could you start a new thread with today's date? This one has become too long for members to go through before responding.

We encourage members to post a new thread every day. The thread title nomenclature is:
<Date> - <Kitty's Name> - <AMPS/PMPS number and any other BG numbers you may have for the day> - <Question if any>

Use the the '?' prefix in the thread title if you have a question, so people know that it's not just an update.

For e.g.
"? 10/18 - Henry - AMPS 285 - How much do I feed?"

We also ask that you link your previous post to the current post - just paste the URL of your previous post in the body of your current post saying "Previous Post"
Here's an example of a post: https://www.felinediabetes.com/FDMB...-1-95-2-90-3-101-6-119-9-196-pmps-218.237040/
 
Happy to help Robert. We all love our kitties here!
A safe rate of weight loss is 1-2%of their current weight a week. So a 20 lb cat can lose up to 6 Oz a week. As he loses more weight the amount he can lose will decrease.
This is on the catinfo.org web site. The author Lisa Pierson, a vet, is a member and contributor here on the forum.
https://catinfo.org/feline-obesity-an-epidemic-of-fat-cats/
 
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