11/7 Mugsy 466/248/106 Updated

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8:30 am - 1.5u
9:05 am - bg 466
12:30 - 248
2:30 - 106 :-D :-D :-D

If I can't hold him, can't restrain him, can't catch him...just how do you suppose I could get a reading? Tuesday - larger lancets.

Queensland Research Study Report
 
Re: 11/7 Mugsy 466

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Previous thread: viewtopic.php?f=9&t=29187&p=299877#p299877

good work on the test this morning.
I hope you can continue to get some more today.
It does take some time, but it can be done.
Try to remain calm when you are testing him, that goes a long way.
offer a treat if you have any.

An excellent option as suggested to you previously, is to speak with your vet.

Very concerned about the raised dose without enough data to support that.

and just to repeat Libby's post to you from yesterday:


Please talk to your vet about Mugsy's dose. Be sure they know and support what you are doing.

I don't mean to beat up on you because I know you are trying, but we cannot help you in Lantus Land. We are lay people, not vets. We suggest dosing here based on a published protocol. Without data, we cannot make dosing recommendations.

You DO need to find help somewhere. If you cannot blood test, then you need to go to your vet for curves and dosing advice. In the meantime, also post on Health and see if anyone can help you learn urine testing. Vets are used to giving dosing advice without data, so talk to them.
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Re: 11/7 Mugsy 466

YAY! a reading! I am so glad to see you on the board this morning. :-D :-D whatever you did worked! I know how it is to hold a cat that doesn't want to be messed with. I think that in time he will get used to the routine. Good luck. So nice to see you this morning. :-D
 
Re: 11/7 Mugsy 466

IMHO, you are putting a great deal of faith in a larger gauge lancet. I'm not sure it will be any easier since you will still need to have your cat cooperate with testing. Mugsy may bleed more easily but the poke will hurt more. I don't know if you saw Libby's post from yesterday since you didn't link the condo.

Libby & Lucy said:
Please talk to your vet about Mugsy's dose. Be sure they know and support what you are doing.

I don't mean to beat up on you because I know you are trying, but we cannot help you in Lantus Land. We are lay people, not vets. We suggest dosing here based on a published protocol. Without data, we cannot make dosing recommendations.

You DO need to find help somewhere. If you cannot blood test, then you need to go to your vet for curves and dosing advice. In the meantime, also post on Health and see if anyone can help you learn urine testing. Vets are used to giving dosing advice without data, so talk to them.
Click to expand...
 
Re: 11/7 Mugsy 466

I'm also glad to see an AMPS test this morning! Good job on that, I hope your testing continues to be successful, especially in light of the large dose increase. I hope you realize that the protocol does NOT support that increase. I'm also quite concerned about it and agree with Libby's recommendation.
 
Re: 11/7 Mugsy 466

as mentioned, we're not vets and because we're not vets, all we can do is make suggestions based on data and experience. the reason for that is simple. our first priority is to keep kitty safe... same as yours, right?

there's very little information available on the Internet about using water intake and urine testing as a means of adjusting the dose.
here's some links to information which may help until you're able to test mugsy frequently. it's all i could find.

Dosing protocol for cats on glargine or detemir and glucose monitoring every 1-2 weeks

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Understanding feline diabetes mellitus: pathogenesis and management - scroll down to "Monitoring therapeutic efficacy" and continue reading about "Water intake" and "Urine measurements when using glargine" and "Treating and evaluating fractious cats using glargine".

i have to agree with the others. i'm very, very concerned about the amount of insulin mugsy is receiving. one of the few things we do know at this point is that 1u bid is capable of dropping him to 53. increasing the dose to 1.5u is scary and could be dangerous.

Please be prepared:
HYPO TOOLBOX
LIST OF HYPO SYMPTOMS
TREATING HYPOGLYCEMIA


measuring water intake and urine glucose is not the best method for determining dose adjustments. however, if push comes to shove and it's all you have to work with it's better than nothing.

please discuss this information with your vet.
 
Re: 11/7 Mugsy 466

just want to offer my support with testing it took me quite a while to get Do Lou to cooperate but now he is so good just sits there waiting and then expecting his treat JMO I think a larger gauge lancet is not the answer since it will hurt more and it might turn him away from this even more I would stick with 30 gauge and freehand and just try to make it enjoyable to him you could start by just giving him treats in the testing area but not doing any tests and get him used to that so he thinks its a treat area I understand the frustration since I gave up on home testing for 4 months but later realized I was going to have to try again and my success was not overnight it all just took time on patience
 
Re: 11/7 Mugsy 466

I learned decades ago to trust my instincts over logic - I'm trusting my instincts now.

The following is an excerpt from the Queensland Research Study Report:

*Dose changes should be made based on pre-insulin glucose concentration, nadir (lowest) glucose concentration, daily water drunk, and urine glucose concentration.

Refer to original updated post for entire report.

I looked over his prior Vetsulin charting and his current Lantus charting plus his behavior and made my decision. I will be trying for more successful tests today.

i am in contact with his vet to keep him updated and for advice but, as I said, he is learning from me!

See edited first post :-D
 
I see on your spreadsheet that Mugsy is in the 50's. Since we don't know if his dose is safe, please feed high carb food and test again in 30 minutes.
 
Glad you were able to catch Mugsy and test. That's quite a feat....Congrats. I too had difficulty w/testing my kitty. Someone here said the "ear learns to bleed".....I asked my Vet about that...Basically, the more you poke, the more you make the ear inflammed (not in a bad way..sounds horrible though), the more inflammed, the easier it is to test. The vet sd you can't really hurt the ear.....he's never seen one that was damaged....That made me feel better....And he didn't say don't test as much.....Just the above information. It does sound like you have a workout each time you have to test....Hang in there...Pat's kitty, Raja, would also hide.....Now she just stays in one place.....


It took a week of poking Curry's ear until it finally started to bleed....I was wondering where she was hiding all the blood.....She thinks I'ma vampire now. :mrgreen:

Hang in there
 
Sally:

The information and the links that Jill posted above are directly from the Queensland protocol. It is what everything we do here is based on. If you are measuring ins and outs (i.e., fluid in and fluid out), how are you measuring? I hope it's not by instinct. A research protocol, such as the version of the Queensland protocol that's been cited, is from a veterinary journal. There are precise methods of measuring fluid intake and output. I have a sneaky suspicion you are not measuring precisely. While PU/PD are symptoms of diabetes, they are not the most effective or precise ways of ascertaining blood glucose values. In fact, I doubt there's even a loose correlation. They are symptoms, not BG equivalents.

I'm honestly not sure what you want us to tell you. Personally, I think it would help if you took several giant steps backwards and made an attempt to hear what we're saying. The bottom line is that we want Mugsy to be safe. How you are approaching diabetes management is not safe. Let me put this in a different perspective, if this were a child, would you not test? Of course, the big difference is a child might tell you if he or she didn't feel good (i.e. was hypoglycemic). A cat can go to sleep and what's really happening is a hypoglycemia induced coma. At that point, if you don't know what you're seeing, the likely result is your cat is dying. No one wants that to happen. Mugsy's numbers dropped over 400 points today and for all we know are still dropping. If you are lucky enough to catch the drop and have fed HC, I expect that Mugsy will be in the 500s tonight or tomorrow. (Of course, you won't know where his numbers are because you aren't testing at night.) To not sugar coat this, your approach to treating Mugsy's diabetes is putting your cat's life at risk.

Please post on Health to see if there is someone who lives in your area who will help you learn to test. Ask if someone can provide you with urine glucose testing information in the interim. Urine glucose testing is not an effective means of garnering real time information but it's better than what your getting.
 
sally, i'm not sure if you know this or not. forgive me if you're already aware.
the action of lantus is cumulative. one dose can effect up to the next three days.

mugsy dropped into the 50s today on the very first shot of the increased dose of 1.5 units. i'm worried.

you won't see the full effect of this dose for another couple of days. that means this dose could take him even lower... dangerously low.

mugsy *could* continue to drop for several more hours. please do NOT administer any more insulin tonight before testing him.


please, for safety's sake... drop the dose!
 
Final update - 9 am - 466
12:30 - 248
2:30 - 106
5 pm - 58
8 pm - 142 Very sore footed cat! cat(2)_steam


That's it for tonight - goodnight.
 
Whoa big drops there!
I am not sure about that big dose increase ... you basically tripled Mugsy`s dose.
As has been said, with the shed involved, you can expect to see even lower numbers, so be prepared for any hypo situations.
My Oliver shows no outward signs of low numbers, so you can`t rely on seeing Mugsy act a certain way.

For the pm part of the ss, there are no numbers, and I think many cats go low at nitetime, so it is a good idea to get a before-bed test done. There have been times that I tested before bed and got a low number so I had to stay up and feed. Low numbers overnite may be contributing to your high am numbers too.

As in the protocol, you want to be holding a dose for 4 to 6 shots before you will see what you are going to get from a dose. Some cats take a longer time to fill their shed and react to a dose - Oliver sometimes takes more than 6 cycles before I see how he likes a dose.
Once you have held the dose, you can decide on a proper dose increase or decrease, maybe a .25u or .5u, but a 1u increase would be if your current dose was something like 10u BID and then, the 1u increase would be like a 10% increase, whereas yours was a 200% increase ... wicked high, so watch very closely and get tests in around nadir, with karo or syrup or honey handy to give or mix with some food. Even if you have only LC, you can mix in the honey to bring it up and it`s faster acting than any treats.

Good luck with the dose and testing.
 
Sally and Mugsy said:
Final update - 9 am - 466
12:30 - 248
2:30 - 106
5 pm - 58
8 pm - 142 Very sore footed cat! cat(2)_steam


That's it for tonight - goodnight.
Click to expand...

chances are, mugsy will bounce from dropping into double digits. however, there is not enough data to predict what he will do. he could drop again tonight. please continue testing...
 
Sally and Mugsy said:
That's it for tonight - goodnight.
Click to expand...

Not so fast...

a little math for you. Today Mugsy dropped at least 408 points. Tonight you are starting at 142. He doesn't have room to drop 408 points again.

He'll probably start to bounce at some point tonight, but don't go to bed until you know the bounce has started. We don't know how long it takes Mugsy to start his bounces. Some cats wait until the NEXT cycle to start theirs.
 
Sally, I have to tell you that I have a very sick feeling in my gut about Mugsy. If you believe in intuition, mine is telling me that he is in serious danger. I hope you will be able to keep him safe.
 
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