6/11/20 NEW MEMBER looking for beginner advice

[Abby and Cassie]

Hello, I'm looking for beginner advice although I've been giving insulin for about a year now. Unfortunately my previous veterinarian wasn't very good and told me to give two units/twice daily, and sent me home and never contacted me again. I didn't do much research and pretty much just thought my cat Cassie will have that many units for the rest of her life. I've been delving into it today and I found I am so woefully ignorant on how to care for my baby. Here's what my routine is:

Half a can of friskies pate (ocean whitefish and tuna flavor, I don't know what else friskies flavor to give)
I sprinkle some powdered freeze-dried chicken bits on top to entice Cassie to eat
2 units of lantus solostar insulin (pen) and I was using the pen needles. I've just bought syringes as I've read that's the better option even with the pen.

I do this routine twice daily (so she gets one can of friskies pate a day with chicken sprinkled on top twice) I don't test her blood sugar often, maybe once every few months. I just purchased the relion glucometer from walmart to pre-test before each shot. I guess one of my biggest questions is related to pre-testing:

Hypothetically, if I pretested Cassie before insulin and food and it was in a normal range, would I still give the normal amount of insulin so long as she ate her normal serving of food? I read the lantus solostar insulin doesn't kick in for 3-4 hours. I want to avoid making her blood sugar too low, but if I feed her then obviously the blood sugar would go up, so I'd still need to give insulin, right? I hope that makes sense. I obviously have to feed her still, just don't know if I skip insulin in the morning then, which seems like the wrong thing to do.

Thanks so much!

 

[jayla-n-Drevon]

Hi!
So glad to hear your are going to home test as it is crucial in order to keep Cassie safe and not go hypo.

I am not qualified to answer your questions but many are on this forum and Im sure they will give you all the info you need and there is lots of info you can read about the go slow method or tight regulation.
@Wendy&Neko
@Chris & China (GA)

 

[Chris & China (GA)]

if I pretested Cassie before insulin and food and it was in a normal range, would I still give the normal amount of insulin so long as she ate her normal serving of food?

At first, we recommend that if you get a Pre-Shot test that's under 200, that you stall, don't feed and test again in 20-30 minutes. Use that time to post and make your subject line really clear (like "STALLING! NEED HELP!"....LOL)

If the number goes up without food, it's usually OK to go ahead and give the scheduled dose because you ARE going to feed which will bring it up some too.

As you gain experience, that "stall point" comes down and you learn to shoot lower and lower numbers.

We have a tradition here....if someone advises you to shoot a lower number than you're used to, they will stay online to watch out for you as long as necessary. If they can't, they will tell you up front so you can weigh that into your decision.

Many of us have stayed up all night with someone new because we advised them to shoot and we don't leave them until they're totally comfortable with what's going on.

Here's some information on what you can do to help us be able to help you

 

[Wendy&Neko]

The Lantus onset (when the insulin starts to work, is more like 2-3 hours after the shot and for some cats it's sooner.

I don't know if you've found Dr. Lisa Pierson's website yet, she's a specialist in feline nutrition. She also has a food list of a number of the commercially available foods, including Friskies. You want to feed something under 10% carbs ideally. The ocean and whitefish you've been feeding is 4%, but there are a number of other flavours that would also work.

Did you buy the U-100 syringes with half unit markings?

 

[jt and trouble (GA)]

WELCOME TO FDMB! It looks like you are seeking tweeks to your already routine. Thats GOOD! I think maybe you might want to start with your signature and a spread sheet. Thats so member can look at a glance at your cats history. you can find how to do that here"
Suggestions, Tech Support & Testing Area

Again welcome to the best site on the planet to help you help your diabetic kitty .
jeanne

 

[Ale & Bobo & Minnie (GA)]

You already got some amazing advice and info so I just want to say Welcome!!!

it took me months to find this place and realize all the things I wasn’t doing right. But you’re here now and that’s a great thing!

 

[Abby and Cassie]

At first, we recommend that if you get a Pre-Shot test that's under 200, that you stall, don't feed and test again in 20-30 minutes. Use that time to post and make your subject line really clear (like "STALLING! NEED HELP!"....LOL)

"If the number goes up without food, it's usually OK to go ahead and give the scheduled dose because you ARE going to feed which will bring it up some too."

Hope I'm replying right lol! I think I edited my signature with all the right info.

How much do the numbers have to go up for me to know that it's okay to give insulin? I'm guessing above 200 right? Someone told me (can't remember who) that lantus works best with the same dose, every time. So how do I account for that? Like if her blood sugar is lower and I need to give her less insulin than usual, what do I do since I should give her the same dose? Once I receive my relion in the mail (should be here tomorrow) I'll start testing her throughout the day and create a curve, but I was wondering if I should wait a few weeks since she's still recovering from a brutal dental surgery? I don't want to stress her out during this time. Thanks so much, hope I'm not too confusing!

 

[Abby and Cassie]

The Lantus onset (when the insulin starts to work, is more like 2-3 hours after the shot and for some cats it's sooner.

I don't know if you've found Dr. Lisa Pierson's website yet, she's a specialist in feline nutrition. She also has a food list of a number of the commercially available foods, including Friskies. You want to feed something under 10% carbs ideally. The ocean and whitefish you've been feeding is 4%, but there are a number of other flavours that would also work.

Did you buy the U-100 syringes with half unit markings?

So all the food on this list is okay for Cassie to eat? I was hoping to continue feeding her these flavors: Salmon dinner, Mariner's catch, ocean whitefish and tuna, chicken and tuna dinner, mixed grill, and turkey and giblets dinner. Are these in the clear since it looks like they're all under 10% carbs? My vet gave me a list with originally only 2 flavors of friskies that Cassie could have, which is why poor Cassie has had nothing but ocean whitefish and tuna for the last week. So it'd be great if she could continue eating all the flavors still!!

And yes, I got the half unit markings on my syringes.

 

[Ale & Bobo & Minnie (GA)]

Signature looks great!

Yes, Lantus needs consistency with the same dose am and pm but that’s when numbers are over 200. If kitty goes lower and you have to either skip or give a token dose, go back to the “regular” dose at the next cycle unless of course kitty is still under. You would only decrease the dose if your cat goes under 90 at any point in time. That’s for the SLGL protocol. We adjust the regular dose by the lowest or nadir not by the pre shot numbers.

look for the foods with less than 10% carbs in the list. Not all of them are

 

[jt and trouble (GA)]

Did Cassie have a lot of extractions? Poor kitty kitty. I think if a cat needs insulin she needs insulin. If shes in pain her number could be a bit higher than usual.
I cannot give dosing advice as I havent has a diabetic in too many years. But I wanted to congratulate you getting your spread sheet ready and your signature up! Good job!
There will be experts answering your questions. Yes Ive always used FF pates. Even now (no diabetic kitties) I am trying to wean my Zoe off the fish varieties they have higher phosphates and shes stage 2 kidney failure. Were I you, I would feed more meat like, Beef Feast, Chicken and Liver , Turkey and Giblets, Beef and Chicken, Beef and Liver, and every once in a while throw in some fish maybe twice a week?. Also some friskies pates.
good luck you're doing great!
j

 

[Abby and Cassie]

Signature looks great!

Yes, Lantus needs consistency with the same dose am and pm but that’s when numbers are over 200. If kitty goes lower and you have to either skip or give a token dose, go back to the “regular” dose at the next cycle unless of course kitty is still under. You would only decrease the dose if your cat goes under 90 at any point in time. That’s for the SLGL protocol. We adjust the regular dose by the lowest or nadir not by the pre shot numbers.

look for the foods with less than 10% carbs in the list. Not all of them are

What does token dose mean? I hope that's not a silly question. I still feed her even if I don't give insulin, right? I don't want to wait to feed her for too long. If I feed her without insulin, do I check her blood sugar later and then give some insulin if it's too high, or I wait til night time dose? I feed/insulin her at 10AM/10PM every day ideally.

 

[Abby and Cassie]

Did Cassie have a lot of extractions? Poor kitty kitty. I think if a cat needs insulin she needs insulin. If shes in pain her number could be a bit higher than usual.
I cannot give dosing advice as I havent has a diabetic in too many years. But I wanted to congratulate you getting your spread sheet ready and your signature up! Good job!
There will be experts answering your questions. Yes Ive always used FF pates. Even now (no diabetic kitties) I am trying to wean my Zoe off the fish varieties they have higher phosphates and shes stage 2 kidney failure. Were I you, I would feed more meat like, Beef Feast, Chicken and Liver , Turkey and Giblets, Beef and Chicken, Beef and Liver, and every once in a while throw in some fish maybe twice a week?. Also some friskies pates.
good luck you're doing great!
j

Thank you so much! I stick with the pates because I blend it in the food-processor with added water so it's more like a smoothie. I never tried blending the shreds before. She had 4 extractions, maybe 5 because I'm not sure if the vet included the one that fell out when he just TOUCHED IT. She also had one tooth absorption. She is not a happy kitty currently. but she has a checkup in a week to make sure everything is healing good. So would these friskies pate flavors be good for her then?: turkey and giblets, mixed grill, poultry platter

 

[jt and trouble (GA)]

No such thing as a silly question. Except for the one not asked. A "token" dose is a lesser amount (just in case) I'm probably not relaying that correctly I'm sure there will be a correction on that

An unregulated diabetic is ravenous. Until their numbers are more in the controlled range they need to eat.

In my book one cant test too much. I would test my kitty if she looked at me weird.(but you dont have to be THAT extreme)

And yes Lantus needs consistency especially at first. Once you know how the insulin works in your cat changes can be made.(Such as lowering or raising doses)

*Someone correct me if my thinking is wrong. *
j

 

[Abby and Cassie]

No such thing as a silly question. Except for the one not asked. A "token" dose is a lesser amount (just in case) I'm probably not relaying that correctly I'm sure there will be a correction on that

An unregulated diabetic is ravenous. Until their numbers are more in the controlled range they need to eat.

In my book one cant test too much. I would test my kitty if she looked at me weird.(but you dont have to be THAT extreme)

And yes Lantus needs consistency especially at first. Once you know how the insulin works in your cat changes can be made.(Such as lowering or raising doses)

*Someone correct me if my thinking is wrong. *
j

I've been giving Cassie 2 units every morning and night for almost a year now, with practically no blood sugar testing! I'm so grateful nothing has happened. But does that mean Cassie might actually be lucky and be a "well-regulated cat?" So hopefully I can stick to 2 units since (knock on wood) nothing bad has happened. I will be testing nonstop now though just to be sure!!

 

[jt and trouble (GA)]

So would these friskies pate flavors be good for her then?: turkey and giblets, mixed grill, poultry platter

I THINK so. Its been a while since I've checked the food list. I'm SURE you will get more responses. Please give your baby some scritches from me. Poor kitty no wonder shes not happy right now...We intend to change that!

 

[jt and trouble (GA)]

I've been giving Cassie 2 units every morning and night for almost a year now, with practically no blood sugar testing! I'm so grateful nothing has happened. But does that mean Cassie might actually be lucky and be a "well-regulated cat?" So hopefully I can stick to 2 units since (knock on wood) nothing bad has happened. I will be testing nonstop now though just to be sure!!

The only way to know when you have a well regulated cat is through TESTING .

 

[jt and trouble (GA)]

I'm glad you are going that route! good for you!

 

[Wendy&Neko]

So would these friskies pate flavors be good for her then?: turkey and giblets, mixed grill, poultry platter

As long as they are under 10%, you are good to go.

But does that mean Cassie might actually be lucky and be a "well-regulated cat?"

We'll know once you start testing! When people start testing after a period of time of not testing, we've seen everything from too little, too much, or just the right amount of insulin.

 

[Abby and Cassie]

As long as they are under 10%, you are good to go.

We'll know once you start testing! When people start testing after a period of time of not testing, we've seen everything from too little, too much, or just the right amount of insulin.

So just to confirm I have everything understood, my routine should look like this:

Test before shooting, give food and shoot while she's eating. If her blood sugar is under 200, wait 20-30 minutes, retest, and then if it's higher I shoot and feed. If it's not, I skip a dose and let her eat, and don't give insulin until her next dose/feed time at 10PM. I guess I'm just still very confused about how to keep the lantus at a consistent dose and what to do if I need to change the dose in the morning to something less/or skip. I feel like I'm just not completely getting it. I feel so stupid.

 

[Wendy&Neko]

Small correction. Test first. If her numbers are under 200, do not feed, and wait 15-30 minutes and retest. If higher, feed and shoot. If lower you do have a few options, but until you have more data, I'd stick with the skip. Over time and with data, you can shoot lower numbers. If you have to change the dose or skip at this point, go back to her regular dose the following cycle, unless you see a low number and she earns a reduction in dose. Don't worry about the specifics of that just yet - post for help if you see a number below 90.

 

[Abby and Cassie]

Small correction. Test first. If her numbers are under 200, do not feed, and wait 15-30 minutes and retest. If higher, feed and shoot. If lower you do have a few options, but until you have more data, I'd stick with the skip. Over time and with data, you can shoot lower numbers. If you have to change the dose or skip at this point, go back to her regular dose the following cycle, unless you see a low number and she earns a reduction in dose. Don't worry about the specifics of that just yet - post for help if you see a number below 90.

Is it common to have to skip a dose in the morning? I guess like you said it all depends once I start testing her often. Do I always have to do a mid-test every day to check her "nadir?" So a total of 3 tests a day. How often do I perform the curve test where you test every few hours? I want to wait to do the curve test until she's pretty healed up from her dental surgery, is that okay?

 

[Chris & China (GA)]

Do I always have to do a mid-test every day to check her "nadir?"

If at all possible, yes. Cat's need for insulin can change quickly and the 1 day you don't do it may be the day she drops low and shows she needs less insulin.

So a total of 3 tests a day.

No, you always want to get at least 1 test on the PM cycle too...if you can only get one, get a "before bed" test. Depending on that number, you may need to set an alarm to get more tests in. Most cats go lower at night so it's important to know they're going to be safe while you're sleeping.

How often do I perform the curve test where you test every few hours?

Depends....if you test like some of us do, you never need to do an official "curve". If you look at China's spreadsheet, you'll see that I got tests at different points of the cycle. It's kind of like you're doing a puzzle. If you have pieces (test results) sprinkled all over, it's easier to see the whole picture. If you only have pieces along the edges (like only Pre-shot tests), it's impossible to know what the puzzle is.
That being said, I admit I was a testoholic. You don't have to test as much as I did...but you can see how tests were sprinkled around at different points in the cycles.

If you don't test enough, then you will want to do a curve at least once a week (test every 2 hours for 12 hours or every 3 hours for 18 hours)

 

[Abby and Cassie]

If at all possible, yes. Cat's need for insulin can change quickly and the 1 day you don't do it may be the day she drops low and shows she needs less insulin.



No, you always want to get at least 1 test on the PM cycle too...if you can only get one, get a "before bed" test. Depending on that number, you may need to set an alarm to get more tests in. Most cats go lower at night so it's important to know they're going to be safe while you're sleeping.



Depends....if you test like some of us do, you never need to do an official "curve". If you look at China's spreadsheet, you'll see that I got tests at different points of the cycle. It's kind of like you're doing a puzzle. If you have pieces (test results) sprinkled all over, it's easier to see the whole picture. If you only have pieces along the edges (like only Pre-shot tests), it's impossible to know what the puzzle is.
That being said, I admit I was a testoholic. You don't have to test as much as I did...but you can see how tests were sprinkled around at different points in the cycles.

If you don't test enough, then you will want to do a curve at least once a week (test every 2 hours for 12 hours or every 3 hours for 18 hours)

Okay so ideally more like 4 tests a day. 1 preshot test, one "midday" test, one preshot test, and then one "before bed" test? Maybe more depending on the test results?

 

[Abby and Cassie]

If at all possible, yes. Cat's need for insulin can change quickly and the 1 day you don't do it may be the day she drops low and shows she needs less insulin.

So I'm still really confused about lantus and it's need for the same, consistent dose. Ideally I want to get her to have the same amount of units every morning and night, how important is it to stick to that? And how bad is it to skip a dose if she doesn't need her morning dose, or to give an unequal amount of insulin? If lantus works best with the same dose, wouldn't it be bad for instance to give 1.5 units for her PM dose while her AM dose was 2?

 

[Ale & Bobo & Minnie (GA)]

Yes you want the same dose am and pm. So if you’re giving her 2 units you do that in the am and in the pm. You only skip a dose if her BG level is too low, under 200 for now, and that’s to avoid her from going into a hypo so that’s the reason for the exception. It won’t happen very often if at all. Consistency with Lantus is key but if it’s a choice between consistency with Lantus and saving her from going into a hypo comma then you save her by skipping a dose. Makes sense? Otherwise, same dose am and pm always. If you increase or decrease the dose you are again giving the same new dose at am and pm

 

[Abby and Cassie]

Yes you want the same dose am and pm. So if you’re giving her 2 units you do that in the am and in the pm. You only skip a dose if her BG level is too low, under 200 for now, and that’s to avoid her from going into a hypo so that’s the reason for the exception. It won’t happen very often if at all. Consistency with Lantus is key but if it’s a choice between consistency with Lantus and saving her from going into a hypo comma then you save her by skipping a dose. Makes sense? Otherwise, same dose am and pm always. If you increase or decrease the dose you are again giving the same new dose at am and pm

THANKS!!! I feel like an idiot but now I definitely understand. I stick with the new dose for about a week and monitor it too, right? and then adjust the next week if needed?

 

[jt and trouble (GA)]

I feel like an idiot

giggling here...How many times did I say that???? Truth is you're not. You are asking all the right questions and one day you will be answering the same questions for someone else.