2/9 Eleanor AMPS 251 First Lantus Shot!

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Julie and Eleanor (GA)

Julie and Eleanor (GA)

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I'm finally getting Eleanor started on insulin in a couple hours. I'll be giving her Lantus.
Her bg was 389 at the vets, I've tested her a few times and she is around 265 without food, after food (Fancy Feast Classic) she goes up to around 320. I wanted to get an idea ahead of time what her numbers are.
I'm very nervous with these lower numbers and I'm wondering if anyone else here has started insulin with numbers this low. All the references I can find starting bg's were much higher.
I called the vet but was told my meter is probably not accurate and she is really around the 389 she was at diagnosis so to go ahead and start her on 1 unit. I was already planning on starting her on .5 unit, she was terrified at the vets plus had eaten a couple hours before we went so I was figuring the number they got was higher than what she "really" is.
I'm really, really scared she will hypo. Any words of advise, hand holding etc appreciated!
 
Re: Lower Numbers Than DX, Starting Insulin Now

Julie,
You're fine to shoot that number. The less stress at home contributes to naturally lower numbers but she's still high. She's not going to hypo so put that one away on your worry shelf and forget that fear right now.

YOU CAN DO THIS! I'm so proud of you for already testing!!! That's the BEST way to keep Eleanor safe! You've already got your arsenal ready - do you have your 'hypo' kit put together yet? That consists of a couple of cans of medium and high carb food, honey/Karo/Syrup and a few extra test strips (don't let them expire tho'). This will be a backup just in case - you will not need it today. I keep 3 cans of Fancy Feast grilled Chicken in gravy in mine - if needed, I know KT will lick the gravy where most of the carbs are without having to be coaxed.

WAY TO GO GIRL!!! You got it goin' for Miss Eleanor!
 
Re: Lower Numbers Than DX, Starting Insulin Now

Thank you!! Now, just come over and hold my hand!
Eleanor does not like the ear pokes. Hopefully that will get easier, soon.
I do have my Hypo Kit. Karo Syrup, needleless syringes, 4 cans of FF Gravy Lovers, test strips, vaseline in case I have to give syrup rectally, address/phone number of emergency clinic, all in a basket on the dresser!
 
Re: Lower Numbers Than DX, Starting Insulin Now

Eleanor and Julie said:
I'm finally getting Eleanor started on insulin in a couple hours. I'll be giving her Lantus.
Her bg was 389 at the vets, I've tested her a few times and she is around 265 without food, after food (Fancy Feast Classic) she goes up to around 320. I wanted to get an idea ahead of time what her numbers are.
I'm very nervous with these lower numbers and I'm wondering if anyone else here has started insulin with numbers this low. All the references I can find starting bg's were much higher.
I called the vet but was told my meter is probably not accurate and she is really around the 389 she was at diagnosis so to go ahead and start her on 1 unit. I was already planning on starting her on .5 unit, she was terrified at the vets plus had eaten a couple hours before we went so I was figuring the number they got was higher than what she "really" is.
I'm really, really scared she will hypo. Any words of advise, hand holding etc appreciated!
Click to expand...

Eleanor,
Those numbers you are getting at home are not low; you want to try and get Julie's numbers under 240, OK?
As for the vet saying your meter is not accurate, of course many vets say that because if you are testing at home, they can't have you bring Julie in for a curve.

What you say about Julie's numbers at the vet being false is correct. Poor kitty scared at the vet would be enough to give higher than normal numbers. One of my cats always tests higher at the vet and the other actually tests lower at the vet. Vet numbers are not comfy home numbers. What meter are you using at home?

Remember that with Lantus, you have a few days for the shed to build up before you are going to see much of a reaction.... just like when you get meds from the dr and they say you won't feel much of an effect for a few days.... same thing here.

Don't worry; you have lots of support from very knowledgeable people here, so when you are just about ready to shoot, why not post and have someone with you online to help you and answer any questions you have right then?

With the numbers like 320, I am sure the dose of 1u Lantus will be just fine for Julie.
 
Re: Lower Numbers Than DX, Starting Insulin Now

Hi Gayle, thank you.
Actually my cat is Eleanor, I'm Julie, I think I may have put our names in the wrong order when I signed up!
I'm using a Bayer Contour meter.
I will do that, be online while I give the insulin!!
 
Re: Lower Numbers Than DX, Starting Insulin Now

You are using a meter designed for humans and assuming your vet is using a lab test or a cat calibrated meter, than you can expect your meter to read lower than the vets, somewhere in the 30 point range is typical. This is something you and your vet need to be aware of when interpreting your home test numbers. An important benchmark to keep in mind is that with a human meter, the 'normal' range for a cat is considered to be 50-120. Your 265-320 readings are still quite high.

Every cat will respond differently and has different circumstances, but for what it's worth my cat was in a similar blood glucose range when I started Lantus at 2u bid on the vets advice. My spreadsheet is linked below and there's a 'us units' tab if you want some reassurance. Knowing what I know now, I should have done some mid-cycle tests the first week, and I probably would have started at 1u instead of 2u, but in retrospect the 2u was just fine for me. 1u is typically considered a safe starting point, unless your cat is particularly tiny or sickly underweight.

It gets less frightening as time goes on.
 
Re: Lower Numbers Than DX, Starting Insulin Now

Thank you Brian!
Maybe I should go ahead and start at 1u. I don't know what to do, I would feel better at .5, but I don't have a clue what I'm doing.
 
Re: Lower Numbers Than DX, Starting Insulin Now

Eleanor and Julie said:
Hi Gayle, thank you.
Actually my cat is Eleanor, I'm Julie, I think I may have put our names in the wrong order when I signed up!
I'm using a Bayer Contour meter.
I will do that, be online while I give the insulin!!
Click to expand...

LOL I looked at your signature and saw the line and Eleanor, so took that to be you!

OK, I LOVE the Bayer meters; they are my favorite!

Julie, there is nothing wrong with hand holding in the start, and I am sure in a short time, you will be able to be around to do some hand holding of the new guys who show up here after you.

You can change your name/sign in for this board.... I changed mine a bit ago to add Oliver.
 
Re: Lower Numbers Than DX, Starting Insulin Now

Julie,
Here's the link to Janet & Binky's page with the 'as fed' canned food values. I've linked their main page below, the canned food link is under 'Diet Related Documents'.

http://binkyspage.tripod.com/index.html

If you feel most comfortable beginning with .5 then go ahead and start it there. After 5-7 days, you'll have an idea where that's going to take her. As you see her numbers at that time, then decide if an increase would be better. I also think you'd be OK starting her at 1u but YOU have to be comfortable with this.

You're already doing great! Scratch Eleanor and Mistaya for me....
 
Re: Lower Numbers Than DX, Starting Insulin Now

Thank you for the link to the food chart.
I'm worried she's going to go into DKA if I don't get her numbers down, hate to mess around with .5 for a week if it's not enough, but I'm worried about hypo if by some off chance 1 is too much....boy, I'm going to drive myself crazy! :smile:
Going to go test her then fill the syringe, she's nowhere around, guess she knows something is up.
 
Re: Lower Numbers Than DX, Starting Insulin Now

Okay. I did it.
Finally got the ear stick, 251.
Decided to go with .5, I guess any is better than none at least it is a start.
Giving the shot wasn't easy, got her to eating so I was able to inject her. Then she stopped eating. I keep encouraging her but she's looking at me like she thinks it's a trick and she won't eat. She's only eaten about 1/4 can FF, her usual is only 1/2 can FF. I thought she would want more, not less since she hasn't even nibbled since 7:30. Am worried now that she has not eaten enough!! Should I be freaking out?!
When should I test? 2 hours???
 
Re: Lower Numbers Than DX, Starting Insulin Now

Julie,
BREATHE!! Celebrate THIS victory for a minute with a BIG "I DID IT!!" grin!!!

Now...since you're using Lantus, it will take a few days for any noticeable change so don't panic! She ate enough...

Breathe again...

I wouldn't worry about testing until about +4 just to see where she is...you're gathering information now. The more info, the better you will know how she reacts to things like food, shot, stress, not feeling well, etc. I admit I'm sort of a testaholic but KT has never settled down nor gotten anywhere close to regulated and tends to jump off cliffs instead of sliding.

CELEBRATE AGAIN!!! Good goin'!!
 
Re: Lower Numbers Than DX, Starting Insulin Now

The choice of dose is a trade off between getting the numbers down while avoiding hypo and also avoiding hyperventilation of the owner, so be happy with your 0.5 as a starting point:). I only have my cat to go by, but I wouldn't be freaking out at all- the dose is low, it's your first (so no carry over effect from the past few shots), and she's eaten. It's good!

You can test at +2 if it will make you feel better, but probably not much will have happened by then and there should be no problem waiting longer. I probably don't test as much as I should, and definitely not as much as many other members here though.

Nice work!
 
Don't forget to breathe! You and Eleanor will get the hang of things just fine. Personally, I'm a fan of grabbing a +2 test to get an idea where my cat is heading each cycle; then i can use that number to decide if the next test needs to be at +3 or +4 (Mikey is a diver with an early nadir, so this where the action happens for us.) Once you have enough data to know when your cat's nadir is, you'll have a better hour of when to test; most cats nadir around +6, so a +4 or +5 can give a good idea of whether that nadir is going to be too low. Most days I test at +2 and +4 with some spot checks thrown in. Evenings are more active for many cats, so sometimes we grab a couple more then, and do a full curve every couple of weeks.

How often you test at first is personal. When I first started insulin, I followed my vet's suggestion of testing just at preshot and +6, but I had a couple of very low numbers, so I tested a LOT until I felt more comfortable with what Mikey's numbers usually do. Now I get 6-7 tests on the average day. You will find your comfort zone as you gather more data on how Eleanor (LOVE her name!) reacts to insulin, and the nerves will go away!
 
Re: Lower Numbers Than DX, Starting Insulin Now

Eleanor and Julie said:
Thank you for the link to the food chart.
I'm worried she's going to go into DKA if I don't get her numbers down, hate to mess around with .5 for a week if it's not enough, but I'm worried about hypo if by some off chance 1 is too much....boy, I'm going to drive myself crazy! :smile:
Going to go test her then fill the syringe, she's nowhere around, guess she knows something is up.
Click to expand...

Remember, high numbers or low numbers, it does not matter if prone to ketones, so if you have KETOSTIX, just test urine as often as you can for the ketone issue.

As for the .5u dose, you do not need to be holding it for a full week.... if you are getting zero reaction to the .5u after a few days in the start, it may be an idea to increase to the 1u, like the vet suggested and like many others here use as a starting dose. The .5u start is for your concerns to be calmed, and please keep telling yourself that you are NOT alone as there is always someone around here who can talk you through issues, OK?
 
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