31/5 Elysia 2u x2daily NO AMPS +4 5.0(90) +7 4.6(83) +9 5.2 (94) +11 6.4 (115) PMPS 7 (126)

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Elysiabliss

Elysiabliss

Member Since 2015
Hello everyone, this is my first time posting in this forum, so I hope I'm giving enough information.

My girl has been good today, shes in the green, but as its edging closer towards dinner and needle time, I'm a bit nervous as to what to give her in terms of insulin.

Last time she looked good during the day, I didn't give PM insulin but the next morning AMPS was 20(362) so looking back I should have given her 1 unit.

I don't want the same to happen tonight, so I've updated my spreadsheet, any advice would be much appreciated! I'm still new to all this but I'm so so glad her numbers are getting in the green, she was a sick kitty when she was diagnosed

Tahns + Elysia
 
Hi Tahns and Elysia

Welcome to the forum. I see you live in Australia. So do I! It looks from your SS that Elysia has been on insulin since 7 May. She is doing well. I am not experienced enough to give you dosing advise and there are not a lot of experienced people on the board at the moment........most live in the US, Canada and the UK and are asleep at the moment. However I will tag someone I know who can help you. What time is the insulin due? If you can say you are at +10 or whatever that is easier for everyone because of the different time zones.
Three units of insulin is a lot to start on and I see you are giving 2 units. Can you tell us what Elysia weighs please?
You may need to reduce the insulin further, but wait until an experienced person comes along. It is great you are home testing and giving low carb foods. I will tag @Vyktors Mum for you and hopefully she is on the board. Serryn are you able to help with dosing please
Do you have plenty of test strips and can stay up and test if you do give insulin?
ETA. It looks like you do not always test before you give the insulin...I would strongly advise you to always test before giving the insulin. It is not a safe practice to do otherwise for your kitty. Don't worry though, we are all on a big learning curve when we first start out. You are doing a great job.
 
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Hello Tahns,


Can you check your SS link, please? It's not allowing me to view it. Edit ***my apologies, it's my sheets app that isn't allowing me to view the SS. I can view it from Google docs.***

I'm not comfortable giving dosing advice but some one with more knowledge and experience will, hopefully, be along soon. They will need to view Elysia's SS, though.
 
I've been trying very hard to get AMPS from her, but when I go out to the garage (they get locked up at night) and she sees me, she just has food on her mind. So I'm going to try a few different things while I have time off work in the next few days.
I sat with Elysia for about an hour this morning to get a reading but she cracked it and got all narky, again, food on her mind and nothing else.

It's coming into +10 now, so I will test her again in an hour.
She weighs 5kg (11lb) as of last week.

She was initially on 2 units when she was first diagnosed and then she had a 2 night stay at the vet a week later for a glucose curve, her numbers were still high so the vet decided to up the dose to 3units.
The following week I did a curve of my own and showed the vet and he said she could be rebounding to told me to reduce back to 2 units morning and 3 at night.
In the last week I have reduced the night dose to 2 units as I thought 3 was too much.

I now realise the importance of AMPS and PMPS especially when numbers are getting lower.

Thank you again for all your help, this forum has been a lifesaver for me. I was so overwhelmed when she was first diagnosed, but I feel much better and armed with a bit more knowledge now
 
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Looks like Bron has already requested a more experienced member drop by to help you.

For future reference, though, you can add a prefix to your subject/title. Use the thread tools and click edit subject. Any time you have a question, especially with dosing, add the ? Prefix to your post. It let's others know you're looking for help.
 
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Hi Tahns.

Welcome to L&L Land. As Bron mentioned, at this hour there are not a lot of dosing experts online yet, but some should be coming shortly. Until then, I'll do my best, but I do not typically give dosing advice, so if someone else comes along before you have to shoot, and they disagree with me, you can certainly follow their advice. Thank you for answering Bron's questions, and for getting your spreadsheet set up.

First, I'll tell you the standard things we tell all newbies, so if you've already heard these from people on the Main Board, please forgive me. It is highly recommended that you read the stickies at the top of the previous page, especially New to the Group? There is a wealth of info there. Also, since you are on the other side of the world from many of us, and Elysia seems to like to visit what we call "the lagoon" (that's green numbers), you should be familiar with Tight Regulation: Shooting and Handling Low Numbers. It's not a bad idea to print that one out and keep it handy so you can refer to it if you are ever in that situation and can't get a response on the board, or if your computer, power, or internet should go down at just the wrong moment.

I'm guessing your vet recommended your starting dose of 3 units, is that correct? Did you reduce on your own, or with advice from the vet or someone else? Typically, we recommend starting out on a much lower dose, and holding it at least 6 cycles, unless kitty drops really low. We also encourage newbies to post for dosing advice if they get a preshot lower than 200. You sound like you have a fairly good grasp of what you're doing, so please don't feel I'm insulting your intelligence with anything I say, but it's hard to know where you are on the learning curve. Please ask lots of questions anytime you don't understand something.

There is a formula somewhere around here on how to figure the appropriate starting dose based on kitty's weight. I'm going to post this so you can see what I've said so far and then go look for it. I know I should bookmark it, especially since I seem to be the late night newbie helper lately!! :joyful: I think the most common starting dose we recommend is 1 unit, but let me do some checking and get back to you.
 
All the dosages are from the vet, except the last one, where I was giving her 2units instead of 3 at night time. From the readings I was getting, I felt that changing her night to 2 would be alright.

Thankyou again, she's warming those little ears infront of the fire ready for me to prick her again, she's been such a trooper through all this!
 
I've just taken an early +11 reading of 6.4 (115) so she is on the climb naturally as the insulin is nearing +12.
 
Aha! Found it. Don't know if you've checked out the info about following either the Tight Regulation Protocol or the Start Low Go Slow method, (more reading for you) but here is the info on calculating starting doses:

The Tight Regulation Protocol uses a weight-based calculation, 0.25u per kg. At 14 lbs (6.35 kg) that would be 1.5u per shot.

The Start Low Go Slow method calls for a starting dose for all cats on low carb food to start at 0.5u per shot. If there is dry food still being fed, the start dose is 1.0 per shot.

With both methods, the dose is then held for one week unless there are unusual circumstances.
Click to expand...

Based on that, if you are interested in trying TR, the dose I believe would be 1.25 units (my math isn't the greatest, so feel free to check me). If you'd prefer to do SLGS, It'd be 1.0 units, as I see you are still feeding some dry. No doubt you've already gotten the lecture on not feeding dry food, so I won't administer it, but if you haven't already visited Dr. Lisa's site, it'd recommend you do so when you have time. Most people here select cat food based on her canned food chart.

Dosing with Lantus, as you may know, is generally based on the nadir, or lowest point of the cycle, and not the preshot numbers. It's hard to get used to that, especially if kitty is giving you some high numbers, but that's how it's done.

If you have having trouble getting Elysia to allow you to test her, here are some tips that may help. Are you warming the ear first? That helps to get the blood flowing. Also, if Elysia objects to having her ears messed with, start with just massaging the ear several times a day without poking it. Then start putting the rice sock or whatever you're using to warm the ear up to the ear and rubbing the ear without poking. Give a treat each time. Pretty soon she'll associate having her ears touched with getting treats. I usually poke Cinco's ears as he's eating, and he's so busy eating he doesn't even notice. I know Neosporin with Pain Relief isn't available in Australia. Prehaps @Vyktors Mum or @Bron and Sheba can tell you what you can use that is available there to help heal the ear.
 
She's usually pretty good, the blood really flows when her ear is very warm so I just need to make sure she's nice and toasty beforehand.

Thank you so so much for all that info, I'm using DH's solostar Lantus pens (he's type 1 diabetic) which only do full unit increments, and the syringes the vet gave me don't have .25 .5 markings. So I will have to do some investigating and get my hands on other syringes.
My three girls are biscuit crazy so I'm doing well with reducing that down. They are enjoying their wet food more.
 
I don't think there are syringes that have .25 unit markings (if there were, everyone here would definitely buy them!), but there are several that have .5. In the US we can get the Relion brand at Walmart, and they make a syringe with .5. There are also some made by BD, I believe. You might check ADW. They have good prices, but I'm not sure if they ship to Australia. No doubt some other members will chime in with suggestions.

Those of us that use the pens stick the syringe into the membrane and treat it like a vial, rather than using the cartridge that comes with the pen.

BTW, your girl is gorgeous. There are several people on this Board with black and white kitties that will become fans when they see her picture - especially @Wendy&Neko and @tiffmaxee and @rhiannon and shadow .
 
We don't have .25 or .5 marked syringes in Australia Tahns.
I use BD ultra-Fine 11 short needle. 0.3ml , 31 gauge x 8mm for use with U-100 insulin only
If your DH is a diabetic you may be able to get them through the diabetic assoc. I buy them through a chemist and they cost about 30 dollars for a box of 100
I use the vials that fit the pens and draw up into the syringe. You will probably need to go that way as going up and down in 1 unit increments is too much.
Ask lots of questions.
Where in Aus do you live?
 
I'm over in WA a few hours south of Perth.

I've since fed my 3 girls but haven't given any insulin to Elysia. I have to run into town quickly to pick up dinner, so I will do another test when I get back, it looks like she's on the rise and will be after having 1/2 can of wet food.

Thankyou again for all your help, I'm home tomorrow so I can monitor then, but I'm back at work from Tues through till Sunday, so the readings will have to be late afternoon/evening.
 
Usually we recommend that you don't feed after about +10, so that the preshot test will give you a number that is not influenced by food.

I'm going to bed, but there should be quite a few people online when you are ready to test, so if you still aren't sure how much to shoot, add a ? to your subject line (go to Thread Tools at the top right of the page and select Edit Title. If you put your curser over (No prefix) you'll see a list of choices. 911 is only used when you need help in a hurry. The ? lets people know you need help, but it isn't an emergency).

Just my two cents' worth: I would not shoot more than 1.5 units, but we'll see who else chimes in, and ultimately, it's up to you.

I'll be looking in when I get up in the morning to see how you're getting on. I hope we've helped you so far.
 
Ohh okay, thats good to know about the food influence, I wasn't sure how quickly the onset is. I was thinking of shooting 1unit but I will wait and do another test in an hour, and wait for others to come online.
Thankyou again Tricia for all your help, it's a tricky one when they are in the green!
 
Just did her +12 PMPS and got a reading of 7.0 (126) so I will wait still and not give any insulin.
She was given wet food just under an hour ago.
 
I am not a dosing expert either, but the one thing I will add, and pardon me if someone has already mentioned it....

Elysiabliss said:
All the dosages are from the vet, except the last one, where I was giving her 2units instead of 3 at night time. From the readings I was getting, I felt that changing her night to 2 would be alright.
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Lantus craves consistency. It is a long lasting depot drug so when you inject it, not all of it goes to work right away. Part of it goes to work right away and a chunk of it goes into the depot which is then slowly released. The goal is to find a dose that you can comfortably and safely shoot consistently at both AM and PM. I do agree with Tricia, you don't have a ton of information to know what she is going to do.

The other thing that I would say is important is to always get a reading before each shot (AMPS and PMPS). That is the best way to tell us what the insulin is doing. Knowing how each cycle starts out, will help people understand how the Lantus is working in your cat's body. Say Elysia is at 65 at +2 or +3, there isn't context to tell us if she had a big drop or if he numbers were consistent from the preshot. This can be helpful in determining if she is holding the dose steady or if there is a huge drop in the numbers, which could then lead to a bounce into high numbers.

There is so much information in the beginning it is overload and overwhelming. But those are the few things I would say helped me a lot when I first started home testing and documenting....
 
Good morning (at least here in the US) Tahns and welcome to Lantus and Lev Land!

You've gotten some great information already. I agree with what the others have been posting, especially with giving the same dose of Lantus at each shot time. It looks like Elysia is making very good progress.

One suggestion when you're seeing a pre-shot number that's lower than what you've already shot is to stall. You don't feed, though. You re-test in 20 - 30 min. If numbers are either the same or rising, you may want to consider shooting. You can continue to stall (if Elysia doesn't attempt to chew on your ankle because it's food time!). The difficulty with delaying a shot is that it then effects your next shot time since you need to shoot every 12 hours. (You can adjust shot times either by 15 min. twice a day or 30 min. once a day until you're back on schedule.)

Since syringes don't come with 0.25u markings, many of us use digital calipers. Mine are approx. 4 inches long. I'd check on Amazon or at a tool company to see if you can find them. If not, there's a paper guide for use with BD syringes that will help you to measure doses consistently.
 
Hi Tahns,
I've just had a quick check to see if any of the people who could help you with the dose are online and at the moment it looks like it is still too early in the morning for them.
But good call to not give the insulin with a reading of 7 (126), especially since Elysia has been fed.

There is a saying here that it is better to be high for a day then too low for a minute.
It may be that you will need to skip this dose....I know you don't want to...but you need to find a dose that will let you shoot twice a day and safely, especially until you get the data to see how she reacts to the insulin.
It is early days and it will not hurt her if you miss this shot...far better than having to deal with a cat who has dropped too low.
I think it may be getting too late to shoot now as you would get too far out of your normal shooting times. After two hours it is easier to skip and start again the next shot time.

Do you have some high carb food and honey in the house in case you ever need it?
You are doing a good job with Elysia...it is hard in the beginning.....but keep asking questions and post when you are unsure about anything.
ETA I see Sienne has just posted as I did...great
 
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Thank you so so much for the replies, I've just tested her again an hour later than last and she's still sitting at 7.2 (130) so she's only risen 4 points in an hour. I don't think I will shoot tonight but I will check her blood again in two hours, and test first thing when I wake up tomorrow.

I'll print some more info out tonight and add it to my little folder I've got. Thank goodness for this forum! And thank you lovely ladies who replied and helped!

I've got honey and some normal biscuits the girls were eating before Elysia was diagnosed.
I really wasn't expecting these numbers only a month into her treatment, I have no idea how long she had been sick for but had started losing weight since December last year. So I would have thought a lot of damage has been done.

I'll make sure I won't feed her if her PMPS are lowish again, I'll make sure I stall it.
 
There are only a handful of people who recognize the symptoms of their cat's diabetes before the diagnosis so you're in good company!

Most of us shy away from using dry food as a quick intervention if numbers are low. Either a high carb (HC) food (Bron or Serryn will be able to tell you what's available in Australia) or syrup (corn syrup, honey, maple syrup, etc.) will get you a very quick rise in BG numbers. Dry food takes longer to metabolize and won't have as an immediate of an effect on numbers. If numbers are really, really low or your battling an inadvertent overdose, dry may be helpful. The other issue with dry is that it can be very filling and as a result, if you need to repeatedly test and feed HC, your cat may refuse food because she's full. Feeding the "gravy" from HC food or adding a few drops of syrup to a small amount of low carb (LC) food isn't as filling.

If it's not already obvious, please ask any and all questions you have. The people here are very generous with their time and knowledge and we are all here to help.

 
I've gone and tested her again, 2hrs after the last and she's actually gone down, 6.7 (121) so that's +3 without PM shot. What could this mean?

I'll grab some high carb gravy types when I'm at the shop and keep it somewhere safe in the pantry.

I've tried Wellness grain free wet and only Elysia will eat that stuff, the two other girls are a bit fussy, but they are enjoying some of the Cats in the Kitchen tins. What a wonderful list you've got there, it certainly put my mind at ease when we were first diagnosed. I was in a panic as to what to feed her!
 
Hi and welcome to LL. I think that last test confirms what others have said that she was getting too much insulin. She is gorgeous and could be my Max's sister! I think you are wise to skip the shot tonight and start fresh in the morning. If possible I would test at +11 to see if she is coming up by amps and post the results in case anyone is awake. I don't give dosing advice either but if she were mine I would start with 1.5 units if you do TR and l unit if you decide you want to go with SLGS so that you can shoot twice a day and see what happens.
 
What I suspect the drop means is that Elysia's pancreas is beginning to kick back in. A healthy pancreas responds to food by producing its own insulin and bringing numbers that rise due to food's influence on BG back down. In other words, it's a good sign. At this point, I'm hesitant to say that your cat was getting too much insulin.

 
Sienne and Gabby said:
What I suspect the drop means is that Elysia's pancreas is beginning to kick back in. A healthy pancreas responds to food by producing its own insulin and bringing numbers that rise due to food's influence on BG back down. In other words, it's a good sign. At this point, I'm hesitant to say that your cat was getting too much insulin.
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Guess I am wrong again. Can you explain why? Isn't three units a lot to give a newbie? I am trying to understand. Thanks.
 
You are correct Sienne. She was started at 3 units and then told to give 2 units during the day and 3 at night. That caused her to need to skip doses I think.
 
I'm going to head off to bed and set my alarm nice and early so I can keep testing. I'm keeping her inside with me tonight so I can keep an eye on her, I'm glad I didn't give even give her 1unit.

Thank you again for your help tonight everyone, you've been absolute lifesavers!
 
Oh Rhiannon they could be twins! Same with Tiff's Maxee!

I've woke up (4am here) and quickly taken some blood, it took a little coaxing as its FREEZING! Haha! So +9 of her skipped shot she's sitting at 9.5 (171), I'm still expecting it to climb some more but it hasn't skyrocketed like last time I skipped.

I will test again in a few hours, if not it will be her AMPS, so now what should I do? If she's sitting above below 11(200) should I give her just one unit? Or keep stalling?
 
You are monitoring enough so imho, I would say continue with the 2 units.... as what Sienne said earlier.

You want to shoot the same dose.... morning and night....
Since you are monitoring, you may very well earn a dose reduction soon.
We just need to see some consistency.
If you want to do the go slow method, then you could go with a lesser dose.

It is likely that she will go up some more by your pmps test. You'll see when you get there.
 
Hello and welcome from another fan of long haired black and white girl cats. :) Since you are using the BD syringes, there is a paper scale you can print off that you can use to measure smaller doses. If you look at the Sticky Note on Tight Regulation, there is a document attached called Management of Diabetic Cats. On page 255 of that document, under the section on measuring smaller doses, there is a link to a ruler used by the Diabetes Katzen forum users (who also use BD's). I also use BD's but can get 1/2 unit marked syringes in Canada. I use digital calipers to measure the dose. Here's a post that describes how. My DH got me calipers at his favorite metal tool store.

I too agree that 2.0 units looks good, if you decide to follow the Tight Regulation Protocol. The other option people use here for determining doses is the Start Low Go Slow method. Take of read of the documents and see which you'd like to follow. Depending on your choice, the point at which you reduce doses will differ.
 
Hello there fellow WAian :)

You are definitely going to want to get those syringes so you don't have to adjust in whole units, which is too much. I use the same ones as Bron - the BD short needles but they do also come in a long needle which some people with long haired kitties prefer. I don't like them as I find it's much easier to shoot right through the tent with them.

Although we can't get the syringes with the half units marked you will find that you are able to adjust in .25 units if your eyesight is good or you use a magnifier. I make up a sample syringe of the wanted dose using coloured water. I spend a bit of time satisfying myself that the sample is just right and then just need to compare the dose I'm drawing to my sample to ensure consistency. It doesn't matter so much if your .25 is a drop or two different from my .25 you just want your .25 to be as close to the same as possible everytime.

For high carb wet in case of low numbers and needing a bump I used fancy feast filet - chicken (green colouring on tin) or turkey (purple colouring on tin). A lot of the US people will talk about feeding fancy feast as their low carb food but they get a different type than us :mad:

Welcome aboard

Serryn
 
I tried my hardest to get blood from her AMPS but she wouldn't budge, she'd had enough poking from yesterday and I couldnt get her ear warm enough even with a rice sock. I tried for over an hour but her ears just wouldn't give me drops big enough. So I gave up, fed her and gave her 1 unit.

I'm just very thankful that I managed to get a reading at +9 (9.5 // 171) so I would think that she wouldn't have climbed that much higher in those 3 hours. I'm back at work tomorrow so she won't be tightly regulated so I made the decision to give her 1 unit AM.

I'll try and grab her to do another check later on and most definitely get a PMPS for this evening.

Thank you again everyone for your help, just so glad my girl is feeling better!
 
All you can do is try your best. I have been having trouble these last couple of days getting blood too. I think it must be the cold weather.
You are doing a great job with Elysia. It will all get easier as time goes by.:)
 
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