12/13 PMPS 358 could someone please help us

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Cheryl & Whiskers (GA)

Cheryl & Whiskers (GA)

Member Since 2010
My cat is on Lantus. we have a spread sheet and a post earlier this evening. I am overwhelmed. I don't know how to do this. We have a SS for Whiskers. I have read the Lantus sticky's. Am I supposed to feed her and wait an hour, to give insuline or do I give it with food since she is already over 300.

Also Whiskers will not sit still for BG, she shakes her head, and I usually have to prick her ear approx 8 times to get any blood. It is traumatic and stressful for both of us.

thanks
 
Give the shot with food. A lot of people here test, give food, and then shoot while the cat is eating. There is no need to wait an hour after feeding to give the shot.

What you don't want to do is feed before testing (many withhold food for at least 2 hours prior to AM and PMPS tests to be sure the preshot number isn't affected by food).
 
Hi,

Thank you. I usually do give it with food, but I thought I read somewhere on FDMD that you should wait 1 hour than test again and give insulin dose base on that BG test result.

I just gave her the shot now.
 
Ideally you want to test, feed, and shoot within about a 10 minute timeframe if you can. If you are feeding on a schedule like many of us are, you want to be sure that you test BEFORE you feed or you may get a food-influenced BG number. We dose based primarily on nadir with some consideration of PSs. If you read that on FDMB, it *could* have been on PZI which is a totally different insulin and managed in a totally different way...they base their dose primarily on PSs with less consideration to nadir. If you've read the stickys, you know we have a protocol of staying with a dose for a particular time unless there are circumstances that warrant changing it. With PZI, they may shoot two different doses in a day. One thing I notice from your SS is you are taking Whiskey up and down way too fast. We recommend reductions and increases in no more than .25u ....you could put "DOSE QUESTION" in your subject line and get a dosing expert to help you.

How long have you been doing this and what are your specific questions that we can all help you with? It does take some time to get used to doing the ear sticks...for you and the kitty but you need to be patient with her and with yourself. Are you warming her ears? You can either do it by rubbing them gently between your fingers, using a rice bag slightly warmed in the microwave, or putting a warm cloth in a ziploc bag. Are you poking along the edge of the ear? If you are poking the main vein, it might be more uncomfortable for her. Here's a diagram of the sweet spot:
 

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I'm not able to view the SS because my computer is busy working on a virus scan and keeps closing it, so I'm not sure how long you've been at this. I'm also not sure what you read, but it may have been regarding another insulin or regarding what to do if you get a low number.
 
Hi Marjorie and Complick8d,

Thanks for your replies. I will stay at 1unit for 7 days if We are going up and down to fast. How often should I test. I do work full time, which limits test to before and after work and weekends.

I do warm the ear, and have not had much luck with the sweet spot.

I have read the sticky's on Lantus

I have been testing Whiskers blood glucose for a few months, but joined FDMD just a few days ago, since she did not seem to be getting better
 
i'll let others answer your questions, but this will bump your post up to the top of the forum.

and Welcome! you've found the right place to get help.

celi & binks
 
A small low carb treat like freeze dried chicken or real chicken put in front of the cat at test time, will distract her long enough for you to poke for the BG test--
When the eat they are distracted, and most are too busy eating to care about the small poke--Just keep on trying with the bg tests, they are vital..
Get neosporin with pain relief to put on the ear after the bg test so it wont hurt--Moonie waits for ear meds before she will leave the test spot--
Just keep at it--Took me months to perfect it, now it's second nature--She hops right up to her test spot & waits for her treat & test...

Please come on here every day & post the bg number & what time you have tested==amps is the am preshot number--pmps is the pm preshot number, and you should try to get at least a +3 and +6--Read the Stickys at the top pf the page, very helpful-And someone is almost always here to help you--
You are doing well by asking questions & testing--It does get easier & cat will improve--Good luck & Welcome to lantus land...
 
OK I'll give it a try here to answer you.

First, there are two tests that you need to get: before the am shot and before the pm shot. These two shots are needed to know if it's even safe to give the shots. If you test and the number is low, you may have to delay the shot or even skip the shot, so those two tests are most important. A third test that is quite important is the before-bed test. Many cats go lower overnite, so testing just before you go to sleep will let you know the number has not gone too low. Many people have been surprised by a low number and stay up to feed the number and bring it up.
Testing stress on your part is contagious, so if you are upset, kitty is going to feel it and also get upset. Make the testing a more calm and rewarding event. By just sitting for a bit and patting to calm both of you, and by offering a small treat will go a long way to associate test with treat and makes for positive results.
Feeding before the test is not a good idea because you want a true number that is not reflected by food. Many take up food for the 2hrs prior to shots because food may bring up numbers higher but for a short time only. You may give a shot to a number that is higher from the food and then find the numbers drop after to a low number. If you test and find a low number, you may be told to HOLD food, and test again in 15min to see if you have a rising number and it's safe to give the shot. If you have fed at ps test time, you will not know if the test in 15min is higher because you fed or higher because the BG is rising on its own.
So, test first, then if OK to shoot, give food and prepare shot.

Now, from looking at the ss, your dosing is all over the place, so there's no way that the insulin has been able to settle - the shed needs to fill and only then can you see if the dose is good.
If you can stay at this dose of 1u BID for 5 days as in the protocol, you will allow the shed to be properly filled and settled, and you will see how well the dose is working. Be sure to stick closely to the 12/12 shot times, and get your ps tests every time. Others will want to see more data around mid cycle to see where nadir is, and see how well the insulin is working. Your dose changes are going to be based on the BG numbers around nadir and not on your ps numbers, so when you are able, maybe weekends or something, do curves as you have been doing. Most people who work are in the same position as you... we test on evenings and on weekends. Depending on you, curves can have tests as often as you like. Every 3hrs or 2hrs is good. Eventually, you are going to see a picture emerge, you will see where she has her nadir.
After the week of letting the dose settle, you and others will be better able to tell you how to adjust the dose, and by how much.
Post daily in one thread a day so you can keep all numbers and questions together. The others can give you the specifics on that aspect, as well as linking the previous day's thread into the next day's thread. It's important to be able to look back through the days threads to see how things have been going.
I am sure you will quickly find that she does not mind the testing, especially when she is getting some nice pats and a little treat out of the deal.
 
Welcome to Lantus Land.

Feeling overwhelmed goes with the territory! Everyone who arrives here seems to feel pretty much the same way. The sticky notes are a great resource but it's like having an entire library fall on your head. The good news is that the people here do understand the feeling and are very generous with their time and information. A few deep breaths helps.

It looks like Whiskers was started on Humulin N and switched to Lantus on 10/18. Whiskers has been on Lantus long enough to have a shed.

Also, having been on N, you would have needed to feed well before you gave insulin. Lantus is far more gentle than N and it's onset is not immediate whereas N kicks in very quickly. I'm sorry if your vet didn't explain that to you.

Do you work nights? It looks like that's when you're either not testing or not home. If your schedule permits, is there a way to get a test in before you leave or when you get home (in or out the door tests)? It's very helpful to get at least one test per cycle. There are many people here who just can't be home to get those tests due to work and commute time but if you can squeeze another test in, it may help.

I really want to encourage you to test every day, before every shot. I don't know if you just omitted days from your SS or if you didn't test. Either way, keep good records. It's the best way to spot trends and to have the data to make good dosing decisions.

At this point, I agree with what the other have said -- pick a dose and stick with it for a minimum of 3 days. Since you have been using Lantus for a while, there's already a shed. You just need to stabilize the dose and begin to make decisions about dose based on a consistent set of data. You can stick with 1.0u.

Also, do you have syringes that are in 1/2u increments. If not, you will need them. You can get Relion syringes at Walmart that are marked this way. Dose changes are made in 0.25u amounts and the 1/2u syringes are the closest you can get.
 
Hello,

I do give the food and shot while she is eating. All Dose changes were made on the vet's recommendation, Except for the last one going from 1.5u to 1.u after a week. That was because the best numbers she had were when she was first switched from Humilin N to lantus on Oct 18, 2010. I do work nights 2:00pm until 10:30pm central time. We feed her at 11:00am and 11:00pm and we give the shots at the same time 12/12. We can not leave food out because we have 3 other cats and a dog (pomeranian) and food left out will not go the the intended animal. With that in mind she would not have had food 2 hours prior to AMPS and PMPS. I do not think I have ever changed the dose in less than 1 week time, and again that was based on the vets request.
As for how long we have had Whiskers, it has been about 18 months. She was originally on Humilin N for the first year, and did well. The last six month have not been good. She drinks a lot of water, urinates outside the box, especially when she is under stress (ie vet visits BG testing). Two months ago the vet diagnosed a urinary tract infection and asked us to switch to lantus, which we did. Two weeks ago we were back at the vet and she had another urinary tract infection and was also diagnosed with pancreatitis.
I recently got a newbie kit which included a rice bag which I have started using this week after warming slightly. I have offered a treat at testing time, which she gobbles so fast. I will get some neosporin for pain after relief to put on the ear after testing so it wont hurt so much.
It appears I should test all week AMPS and PMPS to be sure it is even safe to give shot. Test again before bed and do a BG curve on the weekend. I'm not sure what it means to "Post daily in one thread a day so you can keep all numbers and questions together. The others can give you the specifics on that aspect, as well as linking the previous day's thread into the next day's thread. It's important to be able to look back through the days threads to see how things have been going." Maybe someone can tell me how to do this?

Thank you for welcoming me to lantus land. I will try to post daily, so I can get this figured out with the help of the kind people on FDMB
 
Hi, Cheryl! I'm new to this too... just got the diagnosis a week and a half ago! I can tell you that the ear pricks do get easier. When I first started, I was almost in tears b/c it would take so many tries to get a good stick, willie wouldn't bleed, i'd mess up a test strip trying to use too little blood... gah! In a short time, we're doing better. The rice sock helped tremendously, as did going to a larger lancet. What gauge are you using right now? If you can go to a larger one, you can get the relion pen and lancets at walmart very cheaply. I also had good luck with the novamax lancet pen.

I'm not sure if I should be admitting this, but I've had greater success with our pokes by folding the edge of his ear and then poking on the crease. it allows me to get my finger under the spot without jabbing it with the lancet (wish I could say the same about syringes. I've GOT to learn how to get the covers back on them without bending them through the plastic and jabbing myself!). I warm with the sock first, fold and then poke. I find that 8 or 9 times out of 10, I get a good poke on the first try. I also have been using the burrito trick... wrapping willie in a soft throw blanket before beginning. thankfully, he's a mild mannered boy with no front claws or teeth, so there isn't much he can do to me! I also feed right afterwards, so he's come to associate pokes with dinner (and Willie's a SERIOUS fan of dinner!) and is tolerating them better than before.

I agree with the others. Just go in calm, give lots of pets and scritches before and after, and explain to him in a soothing voice that you understand he doesn't like it, that you don't like it either, but it is important to do it to help him feel better. I think saying it outloud calms both of us down!

This will all get easier. Whiskers will probably never jump in your lap eager for a poke, but you guys will get a routine down and it will become more clockwork-like.

Hang in there! You're in the right place!
 
hi there,

I'll give you two links to help you with housekeeping (posting in Ll)
New to the Group
and Cleaning Up LL-Revised lots of conversation about posting and condo's.

when you have some free time, read a bit here in LL, see how others post, how they add their previous day's, or last condo update links.
You'll want to find your last thread in LL, copy the link, and paste it to your new thread/condo. Helps to have two windows of LL going....It should show up as a direct link that others can click on to previous condo.
 
Hi Cheryl,

To link to your threads, just open the thread and then copy the whole address from the top of your window (browser) starting with the http:// and paste it in your new post.

I'm similar in that testing stresses me out. I've seen first-hand how it can transfer to Johnny because he's Mr. Cool when DH tests him. The best advice DH has given me is to be quick, poke at a very slight angle (not straight in) and wait a second before pulling out the lancet. There's a much better chance of drawing a spot of blood that way. Tell yourself you can do it and make each poke count. And save treats as a reward after you've successfully tested.

Good luck. Glad you're here!
Janice
 
HI! I just wanted to drop on in and say welcome aboard! I too know how overwhelming it all is at first It does get easier! You received a ton of information already, I won't add to that. It is good to see you here, and I hope you will continue to post daily. There are alot of very knowledgeable people herr to help you with your kitty.

Welcome to LL!
 
Hi all,

Thanks so much. I recently switched to a lancet that has five settings. It is definatly easier on the higher setting get blood. I will try a the tips provided to see if I can have success on the first try.

I can also try to get in a BG before leaving and when coming home from work as well as the AMPS and PMPS.

Thanks again.
 
I would recommend giving free-poking a try. Just use the lancet, not the dial-up thing. I tried it once or twice at the beginning, but felt much more control and confidence just using the lancet free-hand. I know many of us do the same. Just a thought. :)
 
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