5/14/22 NEW MEMBER Tommy starting insulin soon

Hello. My cat Tommy is between 16 and 18 and is supposed to start on Lantis 2 units every 12 hours this week when mobile vet comes? I tried changing his diet to low carb but he got even skinnier and now can barely get up and falls over due to weakness. He's lost a lot of muscle, his meow, and has damaged nerves. A friend told me that he gave his cat insulin only once a day and tested the sugar with urine instead of trying to get blood, as advised by his vet. The vet I have coming is not very nice and I am not comfortable with him but the only that does house calls. He already displayed anger in my house and told me I could wait to start insulin and my cat got much worse. He said to get Alpha Track meter to test blood at home, only after I mentioned home testing. Another issue is that my cat needs an antibiotic due to a bad tooth. Is it safe for him to get the antibiotic and start insulin at the same time in his condition? Then in the future I have to find out what to do about the bad tooth since he is a senior and diabetic. I am new to all of this so any advice please. Also, will he regain his body after starting insulin and get better?

 

Hi Tommy and human caregiver welcome to the club. Yes it is quite likely that after getting on insulin, two shots a day 12 hours apart, he could gain some weight back and not be so wobbly. The bad tooth can also drive up the blood glucose so that should be taken care of asap I would think.

I am pretty new here so I won't try to give you much advice but I can tell you the people here can help you and help Tommy if you follow their advice! They helped my boy Hendrick he is doing great now, he was super skinny and wobbly too.

 

Hi and welcome to you both.
First up I want to say, can you go out and buy some Ketostix from Walmart or a pharmacy and test the urine for ketones NOW. There should be no ketones in the urine.
I am concerned you kitty is weak and falling over and has a possible infection in his tooth.
If there are more ketones than a trace in the urine please take your kitty to a vet immediately……..ketones in the urine can lead rapidly to DKA …diabetic ketoacidosis which is extremely serous.
I’ll post this then write now.

 

Insulin needs to be given twice a day. Lantus is a good insulin for cats, but 2 units to start with is too much. 1 unit each 12 hours is the normal starting dose, or 1/2 unit if only low carb wet food is being given.
I would not buy an alphatrak meter, I would buy a human meter such as the ReliOn premier meter from Walmart.
It is far superior to home test the blood glucose over testing the urine for glucose.
You definitely need to get that tooth treated…either an antibiotic or have it taken out. If the vet won’t take it out now, make sure you get antibiotics.
I don’t like the sound of your vet at all. He has no right to display anger in your house at all. It is not good to wait to start insulin in a diabetic cat. There is a risk of ketones developing and that is why I want you to test the urine for ketones immediately. It is very important we establish that there are no ketones.
Yes it is safe to get an antibiotic at the same time as the insulin. It is very important to get that tooth treated.

So the most important things you need to do today are get those Ketostix and test the urine, then make sure Tommy is eating plenty of food.
Then buy the human meter and learn to test the BG.

I am going to give you some links to information for you to read but please first get those ketones checked and make sure Tommy eats plenty of food.

Help us help you. links to the spreadsheet, signature and hypo kit

Hometesting hints and links..https://felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

 

The presence of an infection puts a diabetic cat at risk for ketones, especially if your cat's not eating. The low carb food is likely to be lower in calories that what you were previously feeding and it's fine to give your cat as much as he wants to eat.

Like Bron suggested, it would be helpful if you could get Ketostix at a pharmacy. You also don't need to use an AlphaTrack meter. The cost of the strips is prohibitive (e.g., they cost about $1.00 each). Many people here use the Walmart Relion brand meter -- the strips cost about $0.17 each. If your vet gives you a hard time, ask what he thinks about a Freestyle Libre. (This is a continuous glucose monitor that attaches to the skin so you don't have to poke your cat's ear.) If he says he's familiar with the use of this monitor, smile and ask, "Isn't that a human monitor?" There are pros and cons to using the Libre -- the biggest con being that the sensor has to be replaced every 2 weeks and the sensor can fail. Whichever method of testing you opt for, it's important to test. It's the only way to make sure your kitty is safe.

 

Thank you. I just got the Ketostix.

 

Thank you. Can I use the Ketostix alone to test or do I also need the blood testing monitor?

 

Ok thank you so much.

 

I am feeding low carb wet food that has only tapioca starch and no carb wet Tiki Cat and Core duck pate. So confusing!

 

Can you tell me how much to expect to pay for the Lantis? I have to get it at pharmacy for now until he is better. Than can order online for less I was told.

 

Hello. The Ketostix test showed "trace". I did another stick test too and it showed glucose highest, leukocytes highest, "blood" high, protein high, specific gravity mid.
I really appreciate any advice at this time.

 

Trace ketones is not bad but it could change quickly. Don’t be concerned about the other values. There is glucose because he’s diabetic and not yet on insulin. I diagnosed my cat with diabetes with a urine strip and started insulin the next day. Max never went into remission but once on insulin and regulated he never had glucose in his urine but still needed insulin. I don’t live close to a Walmart but ordered my meter and test strips online and had them delivered. I often bought strips on eBay through auction and saved a lot of money that way.

It is not dangerous to start insulin and have him on an antibiotic. In fact treating the infection will help his bg and hopefully prevent dka as the others have mentioned.

We can help you manage his diabetes. You just need the antibiotic, insulin, and syringes. As others mentioned do not buy the vet meter. Way too expensive to monitor with it.

@Chris & China (GA) might be able to help you get supplies. She works for DCIN (diabetic cats in need).
Is your cat eating enough? Feed him as much as he wants.

 

There are 3 separate threads I've seen so far.

@TommyS .....I put the information you need in THIS ONE

 

Tommy started Lantus generic insulin yesterday at 1 unit every 12 hours. I gave a shot today 12 hours ago and am ready to give the next since he just ate a little. Today he is not eating much and seemed even weaker. I wanted to start him at 1/2 but vet said no. He is on a low carb diet as far as I know. The only carb is tapioca starch in the wet food. I do not have the meter yet because I had to order online the one the vet said to get. Will hopefully have it tomorrow. The reading yesterday was 303 when vet was here. Should I skip the dose tonight? Vet had me skip last night and start today at 8 am. First dose was yesterday 11 am and he was fine.

 

What is his bg? Did you give insulin? If your vet said to get a pet meter that is not necessary and the test strips are expensive. Did you see the other thread where Chris gave you information? With money an issue the pet meter is crazy expensive and human meters work just fine.
https://www.felinediabetes.com/FDMB/threads/ear-testing.262969/#post-2949909

 

I hope you didn't skip, Lantus works best with consistent dosing every 12 hours same dose. Being as consistent as possible will help Tommy the most and you should start to see some improvement within a week or two

 

Yes I did because I don't have a meter and if he was too low giving the dose would have been bad right? He wouldnt eat anything so I couldn't give it anyway.

 

Yes thank you. I did get the Relion but vet said it can be off by 40 points? So now I ordered AlphaTRAK2. I am not happy with this vet but they are the only who do house calls. He wanted to start Tommy at 2 units of Lantus generic. I said 1 and now I will have to argue about lowering it. Yesterday he was weak and wouldn't eat so I am assuming his sugar was low.

 

I am so confused about my threads and nobody is replying to my questions at this point. My cat needs a lower dose most likely. Where can I get advice about what to do now? He started Tues 1 unit 11am and vet said do not give PM dose first day, yesterday Weds was 1 unit 8 am, then he was weak and not eating so I did not give the second dose at 8 pm last night. Today I need the needles for giving lower dose and to have to tell this vet I want it lowered. I have the Relion and am so confused. Where are the links to use the Relion readings instead of Alpha Trak2 that vet made me order? I hope I am typing in the right thread here?

 

@Bron and Sheba (GA)

@tiffmaxee

@Chris & China (GA)

 

In order for members to help you can you please set up what's called your signature, it's information about Tommy, it's at the end of everyone's post in gray
Tap on this blue link
Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help.
Click on your name up top TommyS a drop down will appear click on signature

• Add info we need to help you:
  • Caregiver & kitty's name
  • DX: Date
  • Name of Insulin (do not include dose or frequency)
  • Name of your meter
  • Diet: "LC wet" or "dry food" or "combo"
  • Dosing: TR or SLGS or Custom (if applicable)
  • DKA or other recent health issue (if applicable)
  • Acro, IAA, or Cushings (if applicable)
  • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
  • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.

Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.


We also have a spreadsheet where we enter out cats BG number on to see how the insulin is working and how low it's dropping
Here is the link to set it up and it will also explain how to use it , if you have trouble setting it up I will tah Bhooma
@Bandit's Mom to set it up for you

 

Are you testing yet with the Relion or any meter yet (Alpha Trak)
Our numbers are based on human meters, most of us use them
You said you can't afford the insulin, the Alpha Trak strips are very expensive like 54.00 for 50 strips
@Bron and Sheba (GA)

@tiffmaxee

@Bandit's Mom

THe Relion is a human meter, so it's going to read lower then an alphatrak. the numbers are closer together at lower ranges, and far apart at higher numbers. The scale for normal on a human meter is 50-120 and on an alphatrack it's 68-150

Do you have a hypo kit in case he drops too low and you need to bring his BG up to safe numbers

For your hypo kit you want some
Med and High Carb food and some honey



Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

Good idea to mark the cans with magic marker how many carbs

Or any on the food chart.
https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/

Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up

6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand
I find it better to see where I'm aiming
You can also put a thin layer of vaseline on the ear ,to help the blood bead up
A video one of our members posted
VIDEO: How to test your cat's blood sugar

 

You have gotten responses including how to get financial help here. Click on this link about that.
https://www.felinediabetes.com/FDMB/threads/ear-testing.262969/#post-2949909

Did you test a bg test before insulin? Did you test today? Nobody can help with dosing until you set up your spreadsheet. We have no idea what the bg is now or how low it’s gone.

Read the link I gave you. Continue using this thread today. I will refer others to this thread. Then tomorrow start a new one and only use that one. Link this thread.

I’m confused. Did you start lantus this week?

 

Hello and thank you. I am here with the Relion meter about to use it for first time, but need a link to information about how to read it for cats? Vet said cat should be in the 200's according to his AlphaTrak. Cats reading on his AlphaTrak was 303 2 days ago when vet was here. I did end up ordering AlphaTrak2 which I don't have yet and may send back.. I had to borrow the cost. Vet was angry I had the Relion.

 

I will set up my spreadsheet as soon as I figure out Relion here today to test.
Searched pharmacies for the needles with the 1/2 markings today. I gave him 1/2 unit today after he ate at 11:30 am.
Yesterday morning he got 1 unit and 6 hours later he was weak and wouldn't eat, so did not give PM dose. Assumed his sugar went low but did not test. Had no meter yet.

 

Yes sorry, it is generic Lantus (Insulin Glargine).

 

Can you please tell me how to start a new thread and link this thread tomorrow? So confused about that. Thank you.

 

Hello. I am here figuring out the relion to use for first time. I don't know where to find the information for what numbers I want? Vet said in 200s if I was using AlphaTrak.

 

I mean how to read Relion for cat? I won't be using AlphaTrak due to cost.
I have Karo and higher carb foods on hand.

 

Get a test. Then post it. Being new to lantus you can shoot if over 200, if lower there are choices. I think I read you are feeding dry food. So you would follow our SLGS method. Let’s see the bg.

 

scale for normal on a human meter is 50-120 and on an alphatrack it's 68-150

 

You aren’t expecting to see normal bg at this point. Lantus takes 5-7 days for the depot to build. Once that happens we will know if the beginning dose is a good one. If ever you see a bg under 90 a reduction will be earned. But let’s take this one step at a time. I dint know where you are so not sure what time it is for you. You can’t shoot less than every 12 hours. So your shot time has to be a good one fir you to be able to do that.

Just saw you are on the east coast. So this mist likely is not a good time to shoot.

 

Go to the Feline Health Main Forum , to the right will say post new thread
I would put the Date then Tommy, then AMPS # and any other tests you do after that and the you can add to it PMPS # and tests after that to add additional test to your post look to the right you will see Thread Tools, tap on that then Edit Title add your tests and tap save, you need to set up your spreadsheet so you can also enter the BG numbers
Do a new post everyday
To link the previous days post to the new posts look all the way up top where you see that pic of the cat on the left hand side above it you will see the link you will copy and paste it to your new post it starts with https://felinediabetes.com/FDMB/threads/5-14-22 do you see it above , so you will link this to tomorrow's new post , then so on.
Then you can start writing what you want to

Can you set up your signature sometime today ,I posted above how to do it
Tommy is a cutie

 

Did you find them if not



If you have a Walmart near you they have them, either packages are OK, just check them
You can't order these on line, you have to go into the store, most likely with a script
We increase or decrease by 0.25 units, so the ones with half unit markings make it easier

You can also order these
https://www.adwdiabetes.com/product/16367/carepoint-vet-u-100-pet-syringe-31g-half-unit
They will contact your vet for a script ,ask for refills your vet can fax it to them,you can then go on line and place an order for a refill
Give ADW Diabetes this code
DIA10

10% off your next order!

 

OK finally have a reading! It's 305 with the AlphaTRAK that I had to use because I broke the Relion by sticking the blood side into it! They are mailing me a new one! I guess I'm keeping Alphatrak to now. Will switch to Relion as soon as I get the replacement. No, I am feeding a wet diet low carb for 2 months already prior to insulin.
305 today and it was same day he started insulin a few days ago. I lowered dose to 1/2 unit today from 1 unit yesterday and he is not weak and is eating again!
Today is day 3

 

What time did you give insulin?

 

11:30 am today. BG at 6:30 pm. When I finally got a meter delivered!
Vet said we want in the 200's according to Alphatrak meter.
But the 1 unit dose was too high. He wouldn't eat and was weaker.
He is already only 7 lbs and back legs so weak.
Today he's fine on 1/2 unit and eating.

 

Unless you are up all night that wi t be a good shot time once Tommy starts to see more normal bg. Lantus is dosed based upon how low it takes your cat. You will need some mid cycle tests. It kicks in around +2-3 for most cats. What would be an ideal shot time knowing this?

 

What is his weight supposed to be?

 

Yes thank you. The time will be adjusted as I figure it out. At least tonight he can get the PM dose because its lower and he's eating. Then 6 hours later at 530 am I can test again. Vet said 4 to 6 hours after insulin to test. Does that sound right? I plan to test more than twice a day of course now that I did it once. My cat did feel it though and moved!

 

He is a big Tom cat and has always weighed about 15 lbs.

 

7ish is better but we got all screwed up today looking for needles and meters.

 

You need to feed him as much as he wants to eat. Just dint feed two hours before amps and pmps.

Those testing times sound good to start. You can move the shot time 25 minutes early each cycle or 30 minutes every 24 hours so tonight you could shoot at 11 and tomorrow night 10:30. If you move more than that too early can act like an increase.

Since lantus kicks in about +2 for some and by +3 for almost everyone if you get a test then and it’s much higher than the preshot he likely will not drop a lot that cycle. The longer you test the easier it will be to figure out when to test.

Do you know if he had ketones when diagnosed or DKA? Do you have lab results at home?

 

Hi Elise I thought it was 15 minutes early each cycle, but I could be wrong
@tiffmaxee

 

What is amps and pmps?

 

Thats a good question. Need to ask vet.
I tested urine at home with Ketostix and ketones were "trace"
Vet said also liver enzymes. But blood work was all normal he said except sugar.
Will have to check.
He has a bad tooth too
That is another issue because he is about 17 maybe older and at risk if he gets dental surgery
He had 2 previous tooth extraction surgeries years ago

 

AMPS means AM PRE SHOT. Do not feed 2 hours prior before testing Tommy's BG first thing in the AM so the BG is not food influenced same thing when it comes to PMPS PM PRE SHOT Other than that you can feed him smalls meals during each 12 hour cycle

 

It’s 15 every cycle or 30 minutes every 24 hours.

 

The bad tooth is contributing to his high bg. Does he have an infection? Once the bg is stable you might want to take care of the tooth.

 

I do not see the link to previous posts above cat on top left. I don't know how to find links
to previous posts

 

I see you already linked your previous post to today's
Here it is
https://www.felinediabetes.com/FDMB...g-for-antibiotic-for-uti.263958/#post-2957577