10/28 Maverick - lower number at +12 preshot?

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Karrie and Maverick

Karrie and Maverick

Member Since 2010
This is our first post. Maverick is on Lantus and was diagnosed a week ago (fructosamine was 571).

I have a spreadsheet started and will link to my signature today. His preshot reading 1/2 hour after wet food breakfast was 311.

The vet started him on 2 units of lantus. I am wondering because of the 300 reading if this will be too high. I'd like some advice on the starting protocol. The vet wants me to monitor his blood glucose every four hours. (I know the curve is every two hours).

Thank you.

Karrie and Maverick
13.5 yr old main coon mix. 15.5 lbs (down from 20 earlier this year when diagnosed prediabetic)
Asthmatic, rear end arthritis.
Eating Presidents Choice turkey and giblet.
 
Re: Maverick AMPS 311 - first shot ever

welcome carrie and maverick!

i'm not an advisor...others will be along to help you with that. just wanted to say you have found a wonderful place with folks who have great knowledge and much support to offer...and they offer it willingly!

glad to have you here with us...

celi & binks
 
Re: Maverick AMPS 311 - first shot ever

Welcome to Lantus Land!!

Great work knowing how to home test and getting a spreadsheet started. When you have a chance, you'll also want to set up a Profile. The Profile contains information about Maverick's health status, other medications, date of diagnosis, what you're feeding, etc. That way, we won't keep pestering you for that information.

If you've not done so, you'll want to read the starred, sticky notes at the top of the Board. You may want to start with the New to Lantus/Lev and the Dosing Protocol stickies.

With regard to starting dose, one way to calibrate the initial dose is based on ideal weight (initial dose = 0.25 x ideal weight in kilograms). Most cats' starting dose, based on this formula is in the vicinity of 1.0u or a little more. Any numbers of factors, though, can influence starting dose. You noted that Maverick's weight is 15.5 lbs. I don't know if this is his ideal weight, but based on this weight, Maverick's starting dose would be 1.75u.

Many people will do a "mini" curve -- testing every 3 hours. That may be an option for you, as well. Do not expect to see a huge response to Lantus initially. It takes about 5 - 7 days to create a depot, or "shed" (see the sticky). A small amount of each shot forms a pool under the skin. This allows for overlap between shots and causes Lantus to be more gentle than many of the shorter acting types of insulin.

Please let us know how we can lend a hand. You may want to read our condos (our daily threads -- one condo per cat per day) and look at our spreadsheets. It's a great way to learn. Please ask questions. The people here are very generous with their support and their knowledge.


Thread from Health
 
Re: Maverick AMPS 311 - first shot ever

Hi Karrie & Maverick and welcome! You sound like you are already getting comfortable with the test/shot routines and you are doing great! Never hesitate to ask questions. Someone will always be along to help. The support and advice you will get on this board is truly awesome. Welcome to Lantus Land!!

Ella
 
Re: Maverick AMPS 311 - first shot ever

welcome guys! There are tons of people here who will help you figure out the best dose for maverick and its awesome that you guys already have a SS ready to go ... Have a great day!
 
Re: Maverick AMPS 311 - first shot ever

Welcome to LL, Karrie and Maverick! You've come to the right place.

Sienne has given you great info for getting started, I won't repeat any of it. However, I did want to let you know that your preshot readings should be taken before you feed Maverick. Otherwise, the food causes a spike in the numbers and makes it higher than it would be. You always want a "clean" PS number, so test before food, ok?

Please ask any questions you might have, we're a big family here and people will be glad to help you!
 
Re: Maverick AMPS 311 - first shot ever

Welcome to lantus land--You are starting out great--home testing already!.
Always be calm, as cats pick up on our stress & anxiety.
Just remember, a treat (like dried chicken treats, real chicken, or turkey-no carbs) will help with testing as they are distracted while eating.
If you have any questions, ask--someone is always here to help you.
Read the Stickys at the top of the lantus page--chocked full of info..Welcome again :mrgreen:
 
Re: Maverick AMPS 311 - first shot ever

Welcome to Lantus Land! I'm so glad you came over here and posted. Your SS looks great. Please keep us updated (you can add more numbers as the day progresses). You will get a lot of good support and feedback here. I hope to see you post daily. You and Maverick are are going to do really well.
 
Re: Maverick AMPS 311 - first shot ever

Thank you guys. I've been reading non stop for a week. Some of the info is muddled together in my brain. I have to reread the stickies now that the pressure is off a bit and I know what to expect. This forum/website has been an absolutely amazing resource.

A vet told me that Maverick's ideal weight is 16lbs. He has dropped from 20 pounds in January. He was diagnosed pre-diabetic and managed to stay below diabetic levels with diet alone. We switched him from Hills ID to wet food and it wasn't an easy transition and included assist feeding but he still dropped more weight faster than I was comfortable with. His spine is very pronounced but he has belly fat still. He has hind end arthritis and is slow to get up the stairs and can't jump. We have baby stairs around the house for him and raised food/water bowls. So I am not sure if he is at ideal weight. The past month his appetite has increased but his weight has dropped (weigh him on a baby scale). Not sure what will happen in the days/weeks after starting insulin.

I will do a mini curve today. Oops I didn't realize the first reading should be before food.

Can you guys point me to the template to do a profile? I can get one started on him.

Thanks again for the welcome and advice :)
 
Re: Maverick AMPS 311 - first shot ever

Welcome Karrie and Maverick!!! :mrgreen:
I am so happy that you are here!!

We start a new "condo" (thread) each day for our kitties. The header is just as you wrote it with
Date, Kitty's Name,AMPS=_________
Good job!! And your SS is linked to your signature! congratulations! :thumbup

You are welcome to visit other condos and say hello. We are all learning here and much information can be picked up by reading what is going on with other kitties. We do have many who past each day and we link the previous day's condo to the first post of the day. That way, we can just click on the link to see what happened the previous day. It keeps all our posts linked together.

As Sienne said, there are starred stickies at the top of the page that you should read and print out certain things. In particular, print out the information on Hypos and have on hand the items shown in the Hypo Tool kit. You will find it in this sticky "New to the Group" viewtopic.php?f=9&t=18139
We ask that you select a high carb (.18%)canned food with gravy and also have karo syrup at home.

what food are you feeding maverick and what is your feeding schedule?
You will find a list of different brands of food in the Binky's Food chart: http://binkyspage.tripod.com/canfood.html
We choose a low carb food for meals and snacks (<10% the lower the better for now) but have the HC canned gravy food always on hand. We use only the HC gravy from the can to bring the numbers up if need be. More about that later, but do try to have those things at home from the beginning.

Congratulations on home testing! What we do is test, feed and shoot. So, our AMPS/PMPS is a number before our shot. We have our kitties fast for at least 2 hours before our preshot test. Food too close to the testing time can be elevated from the food, so try to not feed at least 2 hours both morning and evening, okay?
After reading the starred stickies above, you are welcome to come back here and post any questions you may have right here in your first condo! :mrgreen: There is one condo per day per cat. When you get new BG numbers during the day, you may come back here and post that new number in the header...and also add a new post with your updates to the condo. I am so haply that you are here...and look forward to watching Maverick's progress! :mrgreen:

ETA: here is the link for setting up a profile: viewtopic.php?f=6&t=17766
 
Re: Maverick AMPS 311 - first shot ever

Patience grasshopper! The Lantus may be slow to act, but once it has built to a stable level, there will be less variability in Maverick's BG throughout the day.

If you read the package insert for the Lantus, you will see that when you inject it under the skin, it forms a micro-precipitate of crystals which slowly dissolve over time. This is why you won't see an immediate drop after using it - it isn't designed to work that way.

Welcome.
 
Re: Maverick AMPS 311 - first shot ever

Welcome aboard! not an adviser here - I just wanted to say welcome aboard. you've fund an amazing place with many caring. compassionate giving people. Congrats on getting everything up and running, and being on top of home testing. WELCOME!
 
10/28 Maverick AMPS 311(food), +3.5 266 (day 1)

I am beyond impressed with the support here.

I missed the three hour mark and tested at 3.5 hours - it came down to 266 (14.8). I've downloaded an iphone alarm app for managing his insulin, adding in testing alarms and my dogs heart meds too.

I did the profile thing right I hope. Since we are so new the answers will change (like doing a curve regularly).

Maverick doesn't eat regularly on a schedule. Prior to switching him to wet food earlier this year he was a 100% kibble grazer. The switch to wet food was very difficult and involved assist feeding him. Any advice on this? I leave his food out overnight and he eats about 2 ounces overnight. He only eats about 3 oz in the day. (Until recently when his appetite spiked). The food he is currently eating is 60% fat. We will use Binky's list to try again at finding a food he will eat lower in fat content. He is extremely picky and has to maintain 15lbs minimum. Currently 15.5lbs down from 20lbs in December 2009.
 
Re: Maverick AMPS 311 - first shot ever

Good Morning Kerrie and Welcome to Lantus Land! (Welcome to Maverick as well!)

Great job on the profile! I'm not an advisor, but I can certainly sympathize with you on the picky eater. My Muffin is the Queen of Picky! Switching her to canned food was very difficult also, and I had to assist feed her as well. Then one day she just started eating it on her own. She's only been eating canned for 3 weeks exactly, and she's already giving me trouble with it again.

Anyway, I just wanted to say hello, and glad you found us!
 
Re: Maverick AMPS 311 - first shot ever

Should I call the vet and ask about reducing it to 1.5 based on his lower blood glucose levels than the fructosamine showed? Fructosamine came in at 571 but yesterday at the vets office he was 16.8 (288 - afternoon, no shot) and today he was at 311 a half hour after breakfast. Tomorrows amps will be before breakfast now that I know better.
 
Re: Maverick AMPS 311 - first shot ever

With a 16 lb ideal weight, starting dose calculates out to 1.8u. You could start at 1.75 or 2.0 and monitor carefully.

Fructosamine numbers aren't the same as BG numbers. A fructosamine in the 500s would translate to a BG level in the low 300s. So what you're seeing at AMPS seems like it's consistent with the fructosamine test.

Generally, you want to pick up any food 2 hours prior to shot time. That way, your pre-shot test isn't influenced by a food spike.
 
Re: 10/28 Maverick 311(food), +3.5 266, +6 266 (day 1)

Your profile and avatar look great. Maverick is a handsome kitty. I wonder if his appetite would perk up if you sprinkled some Fortiflora on his food. Some kitties go wild for it (while others aren't that interested). You can buy it at the vet in a box of 30 pouches. If you like, I can mail you a few pouches to try, before you purchase an entire box. If you are interested, send me a PM (private message) with your address. I am in Ontario, west of Toronto.

http://www.purinaveterinarydiets.com/Fe ... x?prod=240
 
Re: 10/28 Maverick +3 +6 +9 (first day) Question

Tested at the 9 hour mark its 272. He hasn't eaten much since breakfast - purebites chicken treats. He had about an ounce for supper. He seems to eat more at night than in the daytime. I wonder if we'll have to adjust his insulin to reflect this.

AMPS (did it wrong - 1/2 hour after 1.5oz breakfast) 311
+3.5 266
+6 266
+9 272
An hour later he's eaten once ounce of wet food.

Thanks for the offer to send some forta flora. I wonder if I sprinkled some pure bites on top if that would tempt him. I'm going to give it a try and see if that sparks an appetite. The last few days his appetite has reduced a bit so I don't think his not eating all day was insulin related. But this past month his appetite has been double normal - eating like I wish he would after he is regulated.

My work day is done so I'm going to read the stickies again. How does a cat's BG normally react on day one to Lantus? I know its going to be over a few days that I see the results. Just curious if what we've experienced today is the norm.

Thanks!
 
Re: 10/28 Maverick +3 +6 +9 (first day) Question

Hi Karrie..and Maverick. Welcome to Lantus Land. You will never lack for help here. I, however am not an advisor.
Lots of them will be along soon. We're in different time zones.
About sprinkling Pure Bites on Maverick's food.. I do that for Checkers. Got the idea from Pat. I put a lot in the shredder, put the chicken 'dust' in a jar, and all ready to sprinkle on food.
Checkers goes nuts over it. :-D He also loves Forti Flora on his food.
 
Re: 10/28 Maverick +3 +6 +9 (first day) Question

I hope the chicken sprinkles/chicken dust worked! My civvie (non-diabetic cat) loves it!

Today's numbers were flat. Lantus is known for a flat "curve." Honestly, though, it's really too early to tell. Gabby tends to be a drama queen and can have big drops. Not every cat does that. There's a huge variation in the way any cat responds and they way even your cat may respond to Lantus may vary over time.
 
Re: 10/28 Maverick +3 +6 +9 (first day) Question

As a test test, try putting down a teaspoon or so of some raw ground chicken, nothing added to it (check label carefully as some brands have seasoning or broth of some sort added, which could have onion, a poison to cats).

If he goes for it, it may help get his diet somewhat improved.
 
Re: 10/28 Maverick +3 +6 +9 (first day) Question

Welcome to Lantus Land. Maverick seems to be getting results from the start, that's really great. As he becomes regulated he might put some weight back on.

Is he taking anything for his arthritis? My KB has arthritis, particularly near his hindquarters. He takes supplements and they seem to help.
 
Welcome

Welcome Karrie and Maverick.

This is a great place for help, and support, guidance, and advise. So much better than just trying to do what your vet says, and no one to ask a million questions to. We are here to help, and together there is a wealth of information to be shared, here. Welcome to the family :-D

As far as food; I feed the low carb varieties of Fancy Feast, Friskies, and sometimes Sophisticat (from PetsMart). My cats LOVE LOVE LOVE FortiFlora, and if (which rarely happens) they don't like what I serve, I sprinkle a little FortiFlora on top of their food, and they eat the whole meal ..gobble gobble..num num. They come running and try to jump up just to smell the packet before I even begin to pour it on their food. :-D I also will sometimes use a sprinkling of crushed freeze dried (100% meat) treats on top of their food it I want to encourage eating. I use Wildside Salmon, Foster and Smith Liver Bites, or sometimes bonitos flakes bought from an asian market.
Sometimes, I even sprinkle the food in the time feeder with the toppings to make sure they are encouraged to eat, while I'm away at work.

You have done a good job so far.

Good luck, and I hope to see you posting everyday, or often.
 
Re: 10/28 Maverick +3 +6 +9 (first day) Question

Hi Kelly and Maverick welcome to this site. You came to the right place for help. Everyone here is there for you when you need them. I'm new about 2 months and I've received a lot of support and help here. The advisers are incredible and are very knowledgeable. It's amazing you already have your spreadsheet and profile done. It took me a long time to get mine up which I couldn't have done without the help of others. :oops: They were really kind and patient.

My Powder never ate dry food until diabetes he hated it too. Now he begs for it and treats too but he's Mr Picky Pants. He likes Fancy Feast but really loves Whiskas in the plastic tray. I hope you find a food he really enjoys. :smile:
 
I'm really confused. Just did the pmps reading. I put away his food so he didn't have it for two hours. He ate about an ounce of wet food. Not much. So only about 3 ounces for the day so far.

His reading was first was 225 and I redid the test 235. Using the accucheck nano. Do I risk giving him a 2 unit shot or should I do 1 for the night? He normally eats more at night but he hasn't been eating nearly as much as normal the past few days. I couldn't feed him enough the past few weeks he was begging for food but that has stopped.

I'm off to the ER with my heart dog also - something is poking through her repaired (as a puppy) umbilical hernia spot. If I don't hear back before we leave, I won't give him an injection.
 
Since he normally eats more at night I'm going to give him just one unit. I don't feel comfortable yet with 2 units if I'm not home tonight to monitor him.
 
I'm not a dose advisor, but I think it is fine if you want to be cautious tonight. You aren't going to be home to monitor, so it's a safe option. I hope your dog is OK.
 
You have to do what you're comfortable with. The difference between the two tests is nothing to be concerned about -- it's meter variance. There can be a 10 - 20% variance between one test and another done immediately after. You can even get different readings off of the same drop of blood.

A number in the 200s should be fine to shoot. We generally suggest that if you get a pre-shot below 150 when you don't have a great deal of data, that you skip the shot. The following is from the 'data ready' sticky:

A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines. Below 150 mg/dl (8.3 mmol/L), don't give insulin. Between 150 and 200 (8.3-11.1 mmol/L), you have three options: a.) give nothing; b.) give a token dose (10-25% of the usual dose); c.) feed as usual, test in a couple of hours, and make a decision based on that value. Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
Click to expand...


There is an additional set of guidelines on shooting low numbers but I think the information in the above noted sticky will be helpful for now.

I hope your dog is OK.
 
Thanks guys. We have to go back with my dog for an ultrasound tomorrow. No answers tonight.

I think I'm just worried that 2units is too high from reading here and I'm scared of a low. We'll see what tomorrow brings.

His ear looks like its going to do some damage pricking him this often. You can't see it unless the light is up against it. Is there any tips besides pressing with gauze to minimize bruising? The vet hit right on the vein. Others post about lancing off to the side of the vein closer to the edge of the ear.

I'm glad we got through today without a surprise with Maverick anyways :) Thank you to everyone who replied. It is comforting you guys being here thats for sure.
 
Have a look at Little Boy's spread sheet (sorry it doesn't work well on US - but if you click on WORLD you can see his colours which show how well he's doing) He's part maine coon too. He started this journey at about 20lbs or more (9.3kilo's at one point). He is 11. Dry food was 25% of his diet pre diabetes but possibly 95% the best part from his perspective. I think we have his weight down to about 8 kilo's now but won't know until vet visit this week. He's certainly eating a lot less than he was and he eats raw chicken and fancy feast which he seems to like. LB had some ketone action so we had to start on 3 units and that wasn't enough so kept moving it up to 4.25. Careful monitoring has got him down to 2 units and he's doing really well currently.

We have followed more advice from this site than from the vet. We've followed the Qld protocol as well as we are could. We feed raw, free range chicken which has produced the best results for his numbers and some fancy feast (1 tin daily - usually at 5am). His appetite has flagged in recent months - he will let me push meat into the side of his mouth if I need to get his numbers up. I've not had time to read this thread but just wanted to say hello from one part maine coon kitty to another part maine coon kitty - I hope that you can find some food that your kitty likes. Little Boy is very big cat - doesn't look fat anywhere except he has floppy fat tummy. He is also having trouble jumping.

They are magnificent creatures aren't they? My boy seems very intelligent (from my side!) Oh and since dx for diabetes I've introduced lots of new foods to his diet and found he is open to trying new foods. Unfortunately he's allergic to a lot of them - so he's just on chicken mostly cos he doesn't itch as much from eating that.

welcome here
Marilyn
 
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