179 right before Lantus and after diet change. To give or not to give?

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MamasPrettySugarKitty

MamasPrettySugarKitty

Member Since 2018
Hello all, this is a cross post from the main forum based on a users suggestion:

First time poster with a newly diagnosed diabetic kitty on Lantus every 12hrs since 1/11/18 PM. First I must say THANK YOU to everyone on this message board. You helped me gain invaluable knowledge and courage from reading this forum over the past few weeks. I hope someone can help me with a few questions? I’m wondering how much Fancy Feast Classics I should be feeding per day for my slightly chubby (12-13lb) cat in general per day? I worry about weight gain with wet but also don’t want to starve her! I’m sure this answer is out there everywhere on this forum but I simply can’t track it down!

My next question: it’s time to give her insulin now. I switched her to Fancy Feast Classic over the past few days and have been home monitoring. The vet had her on Hills Prescription W/D dry food which I learned here was not a good idea!!! And I also knew because of this site that I should be VERY careful w her insulin when switching from high carb to low carb diet, so hence my question...yesterday was her first full day on wet, and her BG 1hr pre-shot was 240. Prior to the switch she had readings around 300BG pre-shot - although I only ever managed to do it at home 2x - and so I was too scared to give her the full 2u and only gave about 1.5.

Today I just took her BG again and she’s at 179. I’m so glad to see her numbers in a better range...but now I’m concerned about how much Lantus I should give her right now. Can anyone help reassure me?! Hypo scares the daylights out of me!

Thank you so much for any guidance,
-Erin and Kitty (and her brother Elliott too)
 
Needs asap dosing advice!
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Do you have a spreadsheet with the blood sugar reading you have taken so far? Here are the instructions if you haven't got one set up yet. Without that data, I can't suggest you shoot. We suggest that brand new people do not give insulin if the number is under 200, though eventually you'll gather the data that will allow you to do so.

As for amount of food, do you have a baby or pet scale? If your vet has given you an idea weight for you kitty, you can use the scale to determine if you are going in the right directions with feeding. The amount of food will depend on size of cat, and exercise level. I never fed Fancy Feast, but when eating canned, my girl got about a 5.5 oz can a day.
 
Unfortunately I don’t have a spread sheet set up yet, but have taken her level at the same time ever time I’ve gotten it. First time at the vet was 389 home on dry food was on 1/16 and it was 267 pre evening dose. Next time I took it was Thursday still on dry food pre evening dose 314BG. Started switching to 1/2 wet 1/2 dry Friday and then full wet food as of yesterday. BG was 240 Friday night and I went down to 1.5u Lantus. 1.5u again this morning and now pre evening dose and pre feeding she’s at 179.

Thank you again, I think I should feed and skip insulin unless these figures help make a better decision?? And I really appreciate your pointers re: feeding. FF cans are small 3oz so 2 cans is about on par. The vet didn’t give me an ideal weight but said she was a bit overweight. She is a very loooong kitty though.

If any new thoughts from those #s I would love to hear them. ☺️
 
It takes a couple of days for the effects of dry food to get out of the system, so you are probably seeing that now. Sorry I can't help on dose. I'm a visual person and need that spreadsheet to comment.
 
Hi Erin and Kitty,
Just a few questions. How was Kitty's 2 Unit dose arrived at? 2 units seems like a high starting dose for a newly diagnosed cat. Do you have any records of her 2 weeks on insulin? If so, please set up our Google spreadsheet for Kitty. First join Google if you are not already a member. If you need help with the spreadsheet I'm sure that @Marje and Gracie will offer to set it up for you.
I agree with Wendy that you do not have enough data to safely shoot tonight. The switch to wet food will make a huge difference in Kitty's blood glucose. It is good that you are home testing. What meter are you using? Are you testing somewhere in the middle of the 12-hour cycle in addition to the pre shot? Lantus dosing is based on the lowest blood glucose number (nadir) of the cycle--not on the pre shot.
My suggestion would be to skip the shot tonight. Test somewhere in the middle of the cycle, not just at pre shot. Set up a spreadsheet so that the people here can help you. And read the "Stickies" (information posts at the top of the forum; start with "New to the Group").
WELCOME!
P.s. Maybe 3 cans of Fancy Feast classic? Spread them out over the course of the day, but don't feed 2 hours before pre shot.
 
Ella & Rusty & Stu(GA) said:
Hi Erin and Kitty,
Just a few questions. How was Kitty's 2 Unit dose arrived at? 2 units seems like a high starting dose for a newly diagnosed cat. Do you have any records of her 2 weeks on insulin? If so, please set up our Google spreadsheet for Kitty. First join Google if you are not already a member. If you need help with the spreadsheet I'm sure that @Marje and Gracie will offer to set it up for you.
I agree with Wendy that you do not have enough data to safely shoot tonight. The switch to wet food will make a huge difference in Kitty's blood glucose. It is good that you are home testing. What meter are you using? Are you testing somewhere in the middle of the 12-hour cycle in addition to the pre shot? Lantus dosing is based on the lowest blood glucose number (nadir) of the cycle--not on the pre shot.
My suggestion would be to skip the shot tonight. Test somewhere in the middle of the cycle. Set up a spreadsheet so that the people here can help you. And read the "Stickies" (information posts at the top of the forum; start with "New to the Group").
WELCOME!
P.s. Maybe 3 cans of Fancy Feast classic? Spread them out over the course of the day, but don't feed 2 hours before pre shot.
Click to expand...

Thank you guys! I will set up the spread sheet as soon as I can sit down at the computer.

I’m not sure how the vet came to the 2u decision to be honest, and I’m rapidly losing faith in his experience w diabetic cats since he also put her on that dry food. Maybe the high carb diet was part of his decision.

I am using a CVS brand “advanced glucose meter” which I brought w me to my first vet visit after getting the insulin Rx. That day we measured my monitor against his and it was negligibly different (only 25 points difference I think it was). I hope to get a better quality one if this one is notoriously not good, but the cost of care for the new diagnosis set me back a bit. So far I’m fairly happy with the meter and was glad to see it was very close to the vet’s reading.

I haven’t tested any other time than preshot (again per the recommendation of my vet). I will have to read up more and check out all the stickies—I’m not sure what you mean by nadir, but I assume it’s some time later in the curve when she dips her lowest. I still have a lot of learning to do!

Tomorrow morning will be safe to feed and give insulin? I have to go to work so can’t stay home to monitor and end up worrying all day it’ll get better I’m sure once we all get the hang of this thing!

Thank you again for your advice. Will report back w better info!
 
Wendy&Neko said:
It takes a couple of days for the effects of dry food to get out of the system, so you are probably seeing that now. Sorry I can't help on dose. I'm a visual person and need that spreadsheet to comment.
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I understand! Better safe than sorry! I will heed your advice and skip tonight and set up that spreadsheet!
 
The nadir is the lowest number of the cycle. It usually appears near the middle of the cycle, but some cats have later nadirs and others early.
If you shoot tomorrow don' t shoot 2 units. 1 unit or even less until you can see what is happening with the food change. The important thing is to keep Kitty safe.
 
Thank you! It is such a relief to be able to get this advice. I can’t believe you guys are so quick and I very much appreciate the guidance. I hope to someday return the favor to another newbie like me ☺️

I will take your advice and go down to 1u tomorrow. She was actually at 1.5u last night and this morning—I thought that was erring on the side of caution after the diet change. I feel comfortable w 1u tomorrow. Wish there was a way I could stay home with her to try check her BG during the cycle!

Going to see about that spread sheet now!

Thank you <3
 
Thanks Kris! You were right on!
And thank you Ella, Wendy, and Heidi for all your help too!
I just finished with the spread sheet--and it felt good to make. I feel much more in control now just by writing it all down in that format. I hope to start getting better with the BG and being able to get a better grip on what her curve looks like.
 
Just some housekeeping notes on your spreadsheet.

The AMPS and PMPS cells are where you put the actual test numbers. (If you really want an extra column to note the times, you have to add it) Some of us put shot times into the "Remarks" section, but most of us don't bother since we know to keep shots as close to every 12 hours as possible. The actual times you shoot don't matter to us. We look at how she's responding over the entire cycle.

You should Test/Feed/Shoot.....all within about 5-10 minutes....and for the AMPS and PMPS you want to make sure they don't eat for the two hours immediately before those tests so it's not influenced by food.

It's not necessary to put n/a into the cells when you don't test....just leave them empty.

In your signature, it's a good idea to go ahead and add the type of insulin you use as well as the type of meter. We're just used to checking the signature for the basic information like you see in my signature below this comment.

Hang in there! It looks like she's doing really well with the diet change!! Hopefully she'll be one of the lucky ones that can reach remission quickly with just the correct diet and a little support from the insulin!!
 
Chris & China said:
Just some housekeeping notes on your spreadsheet.
Click to expand...

Thank you for the words of wisdom @Chris & China I’ll be updating as soon as I can with today’s info and will clean up the mess! And oh boy do I hope she can be one of the lucky ones, but dont want to get my hopes up tooooo much!!

Today’s update (sorry haven’t updated the spread sheet yet, will soon). She was given 1U insulin this morning with her breakfast (a dose reduction since she was at 179 last night). I unfortunately wasn’t able to get her BG until this evening when I got home from work, so at +11 again. 117!! Not bad, Kitty!! I’m leaning towards no insulin again tonight. How do you guys feel about that decision? Would love to hear some thoughts!

Thank you all you kind and gentle people for holding my hand! Makes a world of difference!!
 
Are you testing in the mornings before the morning shot? There's nothing in the AMPS column on your spreadsheet (but I know you're working on it)

You Test/Feed/Shoot....all within about 5-10 minutes. One of the nice things about Lantus is they don't need to eat a "full meal" before it's safe to shoot. Just that they're willing to eat.

Lantus doesn't usually start to "kick in" for 2-3 hours after the shot so you have that much time for them to eat more.

You may need to try a lower dose so you can get two shots a day in! It's nice to see how well she's doing so soon!
 
Unfortunately morning testing has thus far failed me...and makes me super nervous to leave after injecting! I will try again tomorrow though. I think it's probably my stress due to the morning time crunch which makes it so much more difficulty to get her. I'll be at it again in the morning though. I do try to Test/Feed/Shoot...although obviously keep failing at the test portion! I like the sounds of decreasing the dose to be able to shoot twice, any decrease seems like a trend in the right direction :)

Assuming I'm able to get a reading in the morning, I'll have more info to make a judgement call...but suppose I don't get the BG. Think it would be safe to 1U again, or maybe step it down again to .5 and see if she's ready for another .5U in the PM?
 
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