7.1.13 Lucy AMPS 127!!! Shoot????

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LucyCat

Member Since 2013
Lucy's preshot was 127...this is her 4th day on Lantus (see spreadsheet in signature). She is on 2 units...stopped dry food yesterday.

Should I still give her AM shot?
 
Ok...well, I waited 30 minutes and no response...thought this group was more responsive than that...

I'm going to give her her 2 unit shot and continue to monitor. I don't have much data to tell me what to do yet so fingers crossed.

I also read that between 80-100 it should be fine to shoot.

Will update later on...

Becky
 
Hi, Becky and welcome to the board. Since you've already given her shot, please get a +2 test. This will determine how quickly she may be dropping if at all. +2 and +3 are usually good tests to get. The 127 # could be the result of being off the dry kibble and going to a LC wet food. It is best to monitor, and if she decides to drop (keeping fingers crossed that she doesn't), please have some medium carb (MC) or high carb (HC) food at the ready, and/or syrup (Karo is best, but if you don't have it, then an alternative is also good... You may need to rub some on her gums in case of a unusually low #). You may want to adjust her feeding times to be a bit closer together to help offset the dives. Since this is the 2nd full day of being on Lantus, you're correct in saying that you don't have enough data at this point. You'll get there, though.

I'll try and be here throughout the day. I don't have any dosing advice to give you though, as I leave that up the more knowledgeable folks on here. I'll do what I can to help you if you need it.

Welcome! :-D
 
Sorry, Becky. I have the week off and went back to bed. I'm usually the person here after Dyana is here for the really early morning people. Just in case you feel stuck in the future, remember there's information on shooting low in this Shooting & Handling Low Numbers sticky. There are always going to be (usually brief) times when no one is around or the folks that are around aren't comfortable giving advice about whether to shoot or dose.

Since you shot, which is great, please get a +1 and a +2 test. Whenever you are shooting lower than you have in the past, always plan to get early tests. If either your +1 or +2 is considerably lower than your pre-shot number, it can indicate that it's going to be an active cycle. For example, I would have probably gotten an additional test last night given what your +2 looked like.

Just to be sure, do you have plenty of strips and high carb food on hand should you need it?
 
I'm sorry...I must have just missed you, too....like Sienne, I'm on vacation and crashed right after Trix's shot this morning. Great job shooting this morning...please let us know how Lucy is doing when you have a chance!
 
Didn't know I was supposed to get a +1 or +2 after a low PS...I just did a +3 and it was 161 so it's gone up.

I need to know how/when other people feed. Since I'm used to leaving out dry food and only giving wet food before her shots, I'm not sure if I'm doing it right.

Basically, I give her half a can in the AM after I test her BG. So that's basically a fasting BG test. Is that why it was so low? Are fasting ones lower? Then I feed her then I give the Lantus. Then I've been giving her about a quarter can every 3 hours. Her last meal last night was around 10 pm. So she went from 10pm to 7am with no food. Is that okay?

Can someone please tell me what the protocol for giving food, testing BG and administering Lantus is? In what order does everything happen? And is 2- 5.5oz cans enough food for her? She is 10 lbs.

Thanks,
Becky
 
On the ProZinc it was important for her to eat and then get the insulin...is that the same for Lantus? Thanks to the videos on how to get a BG test, I learned not to roll the Lantus. I had been told to do that with ProZinc so I had assumed it was the same but that video stated you do not roll Lantus so I didn't! Phew!
 
It is definitely a good idea to get earlier-than-usual tests when you shoot a low number (or shoot a low number for the first time), just to be sure you catch it in case there is a drop. Like Sienne mentioned, the +1 or +2 will help indicate if an active cycle is in store...although, of course, every cat is different (ECID), and some don't get active until a little later in the cycle. You want to know as early as possible if things are going to be active, so you can be prepared to jump in and steer the cycle with higher carb food if necessary.

The rise with her +3 could possibly be a food spike; I'd be curious to see where else she heads today.

Feeding schedules are another one of those things that we try to tailor to the individual cat, depending on how they respond to insulin, food, and the two together. For Trixie, I feed most of her main meal right before her shot (and right after testing her), but I also give her small snacks a couple times during the evening (mainly because she's so pitiful and I'm a big softee). I usually don't feed her after +6 since there is less insulin available in her system after the nadir, so she often does go as long as Lucy did without food. At the very least, you definitely don't want to feed after +10, because you want to be sure the preshot number is NOT food-influenced. If she eats close to the preshot reading, you won't know if the number you received is "artificially inflated" by the food...you want a true, fasting preshot number, so you can accurately assess whether or not it is safe to shoot.

I'm guessing Lucy's AMPS this morning means she is responding well to Lantus! Please keep asking questions...everyone here is very generous with their time, knowledge, and support!
 
10 pm to 7 am is a long time without food.
Most of the kitties bg numbers go lower at night already.

Many here make catcicles out of canned food. I have silicone muffin holders, others use ice cube trays to add water and make the food more like soup and then you can
pop one out at bedtime and it will thaw.
Lucy can lick it while frozen or eat it when it's thawed. That way she can have access to some food at night.

Or you could just get up and give her some... since you will want to get some random tests in the night any way to see how she's doing.
 
Sometimes you might need to do night time tests. If Lucy is running low, you may need to set an alarm to test her during the night, to make sure she is in safe numbers.

For example, last night, Trixie was at 48 at +4 (9:45 EST). I was ready to call it a night, but that 48 by itself isn't too dangerous (although it IS low), but I didn't want her going any lower than that. I gave her a little bit of high carb food to bring her up in to safer numbers, then tested her again an hour later. She was in a safer number at that point (62), but there was a good chance that, once the food that I fed her at 9:45 wore off, she could drop back down into lower, unsafe numbers again. So, I set an alarm and got up to test her again at 12:15.

This is not a nightly occurrence, though, but this is where our testing comes into play. Since we've been at this for quite awhile, I am very familiar with Trixie's patterns, I know what I can consider a "safe" number for her at +4, and most of the time, that is her last test of the day. But, once in awhile, she does drop lower, and I do have to get up and check on her.

As a newly diagnosed kitty, it's a good idea to get random spot checks when you can, so you can start to see some trends.

I know it all sounds very overwhelming right now, but it does get easier and less stressful. Please keep asking questions...we'll do our best to make this easier and less daunting for you!
 
Welcome,Yes we do have to get up and test. Lucky has had me going for a week I think now and his cycles haven't slowed down.I was able to go to bed at +4 the set alarm for +6 yeah he stayed up, but that was help with honey and HC food and LC food there are those nights i'm finding out, I hate nights LOL Your doing good hang inn there, let your gut feelings guide you some nights guys and gals do there very best here but can be a wait sometimes ad you stall shots too.they were here with me the last few nights good luck.
Linda and Lucky
 
+6 215

Interesting that yesterday her levels slowly decreased and today they are slowly increasing...
 
Becky --

I agree with the info that Amy provided. What I'd suggest is you take a look at spreadsheets. It will give you a sense of how different people test. (And don't get freaked out. People like Marje and I are testaholics.) For example, Gabby is prone to dives early in the cycle and she has an early nadir. As a result, I test more frequently early in the cycle. I also break her food up into 4 portions and I feed at pre-shot (test, feed, then shoot when her head is in her bowl), +1, +2, and +3. This strategy helps to prop up her numbers early in the cycle.

I do not get up in the middle of the night to test. However, I will stay up if numbers warrant. It's easier for me to stay up. I also don't feed over night for the reasons that Amy noted For a newly diagnosed cat, it's best to not feed past nadir since it will often result in higher numbers late in the cycle. There are times when you may need to feed -- like if then numbers have dropped and you need to use food to bring them up.
 
Ok, I noticed you said that you will administer the insulin while she is eating...that is okay to do? With ProZinc (which she was on previously...we recently switched to Lantus) it was recommended to me by someone to shoot like 20 minutes after she has eaten.
 
Hi and welcome to Lantus Land!

I'm still fairly new to all this too, but from what I've learned over the past several weeks, as long as they don't get food for the 2-3 hours prior to testing, it's test, feed, shoot...and yes, I shoot while she's eating just because she's already busy eating and doesn't even notice me!

It takes a few hours before the Lantus kicks in, so feeding while shooting is fine..or shooting while feeding :smile:
 
One of the several differences between Lantus and Prozinc is that Lantus onset (when it kicks in) is longer than with Prozinc. For shorter acting insulin, you want to be sure your kitty has eaten before giving insulin. Lantus, which is a long-acting insulin, is more forgiving because the onset is later.
 
Everything I have read and been told on here has pointed to the fact that dry food is bad for diabetics and should be taken away immediately. In an e-mail from today with my vet, he told me that there is no harm in giving diabetics dry food. This is exactly what he wrote:

Hi,
That's fine. Your nadir for her was 229 (lowest), which is close to our target range of 80-180 most of the day. So 2.5 units is fine, if not enough to end up the target range of 80-180, then go to 3 units. Looks like you will not need R insulin. Be careful on what you read /take from the internet. There is no great advantage of using wet verses dry foods in a diabetic. Wet food is about 70% water and thus is more expensive on a dry matter basis. It does help keep the urine more dilute and the cat a little more hydrated, but if you feed a good quality dry food like Iams or Science Diet, it really doesn't matter if it is dry or wet, unless Lucy eats the wet better ...
Dr"...

So, with that I'm tempted to continue with dry food since my VET, the one with a medical degree, is telling me it's fine.

Thoughts??

Thank you,
Becky
 
So we have conflicting information from vets....what to do...does anyone on here still feed dry food and have a regulated cat?

Becky
 
There are many here who get conflicting info from their vets. Over time, I think you will see the wisdom here from many people who live feline diabetes 24/7.
I have 4 vets here in one practice and none of them agree about the best course for FD. They expected I would put my cat down.
The newest one was the most open minded and let me lead the way from the advice I was given here.
And she was amazed when I aggressively sought and was lucky enough to make it to remission.
She showed all of her partners my cat's spreadsheet and they were flabbergasted. They had never seen any one willing to work so hard for their cat.
Apparently the people in my town give up with most major ailments.

If you want, you will soon know more than your vet if you are willing and learn from other peoples questions. Just read condos. That's what I did. ( I couldn't sleep anyway)
And I couldn't have made it without the people here.
We are a very special community.
I hope you will stick around and join in.
I will chat endlessly with you about any of it.... feel free to pm me.
 
Hi Becky-

I don't think anyone here feeds dry food and has a regulated cat. In fact, check out "Checkers" condo for today. Barb purposely fed him dry food today to drive his numbers up, because she had a long appointment and didn't want to worry about his BG numbers dropping too low. (One of our mantras here is "Better to be high for a day than low for a minute.") Dr Lisa's site is awesome and very accurate and scientifically sound.

If Lucy is willing to eat 100% low carb wet food diet, that is exactly what I would go with. With that said, I know removing dry can be difficult. Fortunately for me, Trix loves her wet food, but I do also have a few dry food junkies, and admittedly, if they (God forbid) became diabetic, I would probably have to work around that, because I just cannot convince them that wet food is the way to go...and I have tried a LOT of tricks. But, dry food is far from being ideal with regards to treating and managing diabetes.

Sadly, vets are just not very well-versed in the treatment of diabetes. Being a vet is a hard job - they have to know a lot of info about a lot of animals (plus they have to deal with the humans involved), and unfortunately diabetes, insulin dosages, and nutrition seem to suffer. My own vet is fabulous - but she has also said that she will leave Trixie's dosage decisions to me, because I obviously have a great handle on it. As much as I love my vet, I don't feel comfortable with her knowledge with treating diabetes...not like I feel here at FDMB, that's for sure. I have seen many people follow the advice from their vets with regards to treating diabetes, with very, very bad outcomes (ie, fatal and near-fatal hypo events).

We have had many cats here go into diabetic remission by following the TR protocol we follow here. Many who haven't gone into remission, like Trixie, are well-regulated, thanks to the guidance of the fine folks here. By being well-regulated (ie, being in the true normal range most of the time), the diabetes takes far less of a toll on the body.

But, Lucy is your cat...you have to do whatever you are comfortable with. Not everyone is comfortable with taking the approach to treating diabetes that we do here, and that is perfectly fine.
 
Also...I just notice that your vet recommended an increase of .5U. Please don't do that...that is far too much of an increase, especially with a newly diagnosed cat who is obviously responding well to insulin like Lucy is. We generally increase by .25U at the most (although there are SOME circumstances that require a greater increase.) Remember what I just mentioned about hypos? Increasing by too much in one shot can definitely lead to them. It is not something you want to experience.
 
I'm going to be somewhat more moderate. The issue is largely one of the carbohydrate content of day food. If I recall, you were feeding a dry food that was exceptionally high in carbs (i.e., Indoor Weight and Hairball Control = 40% carb). If you were to feed a canned food that was 40% carb, numbers would be off the charts, as well. In addition, the ingredients include: Chicken By-Product Meal, Corn Meal, Corn Grits, Ground Whole Grain Sorghum, Dried Beet Pulp, Powdered Cellulose, Chicken, Chicken Fat (preserved with mixed Tocopherols, a source of Vitamin E), Dried Egg Product, Natural Flavor, Brewers Dried Yeast, etc.

The items that I put in bold are plant-based. Cats are obligate carnivores. What that means is that they do not need vegetables and grains in their diet. In fact, they can't digest those products. They need protein. In fact, they need muscle meat, not "animal by-products." The dry food you were giving Lucy fundamentally did not meet her nutritional needs. Dr. Lisa's website goes into great detail about the myths regarding dry food. There are any number of cats we've seen here that once they were transitioned onto a low carb, canned food diet, their diabetes was history. It was the dry food that was causing the diabetes.

Unfortunately, neither vets nor MDs get a great deal of training in nutrition. Vets get the bulk of their information from the sales reps from the major pet food companies who sell them prescription foods to resell to us. As a result, most vets believe what they are telling us about the nutritional basis of the dry and canned foods they are selling at a profit. Unfortunately, these prescription foods are not made with quality ingredients. It's problematic that some of the diabetic dry food diets are very high in carbs.

There are a handful of dry foods that have low or no carbs. If you are determined to feed Lucy dry food, I'd encourage you to look at Young Again as an alternative. Canned food will still be better but at least this is a food that is ostensibly zero carbs. There has been one person who fed Young Again and their cat did well.
 
I'm new to this too Becky....my "regular" vet wanted to sell me 4lbs of Science Diet dry M/D ($20) and thought "insulin was too much of a hassle"...He considered getting her into the 300's a success!! I Didn't!

After calling and talking to several other vets in the area, I found they all say something different, and have their own ideas about treatment, but from reading a lot of the information on this message board, I've felt very comfortable making my own decisions regarding my cats care.

I finally found a vet who DID think she needed to be on insulin, but didn't understand how to use it. He wanted me to start with 4 units once/day...my cat weighed 8.5lbs..He DID however say I could give what I was comfortable with, but he didn't think it would do any good until we were at least up to 3 units/day

I started on .75 twice/day..(not even a whole unit) thanks to these wonderful people taking their experience and knowledge to calculate the best starting point. We did increase to 1.0u twice/day, but only after 12 cycles, and then 2 days ago, she had a low number(32) that made her "earn a reduction" and we're back at .75 now. If I'd listen to any of the vets, I would have ended up with a very sick cat...or worse.

You have to do what you feel is best for your own cat though, but I assure you, the science behind the recommendations of these great people is well researched and sound. No vet can keep up with the latest treatments, nor have thousands of patients that have been tested and documented as well as the cats here.

Good luck to you no matter what you choose.
 
for what it's worth, Hill's ( who make Science Diet) donate the most money to veterinary schools for research. Many vets sell it in their practices. They seem to have a mutually
beneficial relationship.
The problem with the dry foods is they are metabolized differently and obviously lack moisture which is hard on the kidneys. They are also high carb.
There are some that are lower in carbs but it's not science diet or Iams.
And in my opinion, those are not good quality foods.
But I really don't want to make you feel like running away. I am hoping you will stick around and let everyone help you as I said earlier.

Does your cat like the wet food or are you having difficulties? We all have many things we try to keep our furbabies happy.
 
I want to say welcome! You really have come to the best place to help Lucy. About four years ago I had another diabetic cat, Margaret. If I had listened to her vet I probably would have killed her with the insulin doses she wanted her on. Her vet even told me if I didn't listen to her I would kill her. What a nice person she was. Not! Instead, I followed advice here and Margaret was off insulin in 2 weeks! Once we changed her diet her numbers returned to normal. Thanks to this forum and wonderful people, we did it safely without harming her at all. Don't get me wrong - we still go to the vet when necessary although we go somewhere else now. I simply mean that I trust these people who do this 24-7 to guide me and us.

My best advice is to read other threads and look at spreadsheets. I've done the feline diabetes "dance" before but with a fast acting insulin so learning about Lantus is new for me, too. I find that others are asking questions and finding information that is beneficial to me and that I might not have thought to ask. Rhiannon is right - this is a pretty special place.
 
I guess I need to start thinking differently about following "doctor's orders." My own father is a human doctor and I have heard from him my whole life, how challenging it is to work with patience that think they know more about cancer than he does because they read something online.

Anyway, I am fine with giving Lucy wet food...she absolutely LOVES wet food. She loves food in general. I just feel bad because Lucy is a grazer...she would stop at the dry food bowl many many times throughout the day to have a few bites...and now I feel like I'm depriving her. Plus, when work starts back up for me, I won't be able to give her a bunch of small meals...it will have to go to an AM, after work and PM meal. I guess 3 meals isn't that bad if it means helping her body get regulated. It's very strange to me that she got diabetes at 7 years old. I don't understand why things all of a sudden changed in how her body digests food.

Bottom line is I am going to follow this message board and not my vet. I don't want Lucy to have to be dependent on insulin and if a controlled wet food diet will help her with that then that's what we'll do.

I do want to point out that my vet promoted Iams, which he does not sell at his clinic...so he's not just saying it's okay to make money from overpriced prescription food. Also, Hills Science Diet makes wet food too...so there's that.

I will continue with the wet food...and I think tomorrow AM I am going to increase her dose to 2.25. Does that sound good??

Thanks for all the advice and nurturing feedback. No one is scaring me away from here. I am committed to helping my Lucy feel the best she can.

Becky
 
It sounds like a good plan.

There are lots of kitties here who are grazers. Grazing is a good thing -- it doesn't overwhelm a healing pancreas. If you add water to canned food it can sit out for quite some time without getting crusty. In addition, adding water is a good thing for Lucy's kidneys.

You may also want to think about a timed feeder. Many of us use either a 2-compartment or a 5-compartment feeder so there's food available when we're at work, school, overnight, etc. It's a convenient way to make sure there's food available. There's even a 2-compartment feeder that has enough room underneath the food trays for a cold-pack.

A very dear friend who I've known for many years is an MD/PhD. He's one of the smartest people I know. He was visiting shortly after Gabby was diagnosed. Much like I was skeptical of FDMB and LL when I first started here, he was likewise skeptical. After reading some posts and hearing me discuss Gabby's diabetes, he made the observation that a reasonably smart, nonmedical person can do their research and become very well versed in one disease. Many of us here have learned a great deal about feline diabetes. There are those here whose cats have other illnesses and they learn about those conditions. I don't think any of us would try to treat feline cancer on our own. We couldn't. But, you'd find resources here in terms of what to expect, tricks to help a sick kitty feel better, etc. I'm sure your father would not tell one of his patients to not utilize all of the support that's possible. I'm also certain that when he has a patient who's smart and who reads and does his or her homework and learns as much about their cancer and can be an active participant in their care, it is rewarding for them both. We are supporting your being an active participant in Lucy's care and not someone who simply says, "Yes, doctor." even when you think the advice isn't on point.
 
Hi Becky

Welcome to Lantus Land.

I'm one of the late night crew so you might not see much of me in the mornings. But, when Lucy decides to see some green at night, we might have a pj party!

Cats are obligate carnivores and, in my mind, I don't see how those little dry crunchies manifest themselves as something good for an obligate carnivore. Cats, diabetic or not, do not need all those carbs. Also, cats are typically not the best water drinkers and feeding dry food compounds the overall stress on cats' kidneys. One of the weakest organs in cats is the kidney. Wet food definitely provides more water for the kidneys than dry food does. Even at that (and my cats actually are good water drinkers), I still add a tsp or so of water to every meal my cats get.

My vet IS an animal nutritionist and she states that vets get very little info on nutrition. She would not feed prescription diets to any animal because of the poor ingredients and yet go into any vet clinic and you will see tons of these foods. Read the label some time on some of these. Iams and Science Diet are poor quality foods.

I would not raise the dose tomorrow. From the Tight Regulation protocol:

General Guidelines
Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

Not only is she in the initial dosing stage but she also has dropped below 200 so let's give her more time.

Lantus works very differently from ProZinc and so is dosed differently. We do not dose on Preshots; we primarily dose on nadirs and Lucy is under 200 on her nadir.

One other request if we could. There are some of us constantly scanning the subject lines when we are online so it helps us keep track of how everyone is doing if you can keep the subject line updated, please. You might find this post on Making the Most of your Lantus ISG Experience

We're glad you are with us. Let us know your questions.
 
Isn't +6 the nadir? Or is nadir the lowest level in a cycle? I'm confused about that...

I'll hold off on increasing the dose then...

She just tested at 344 (+4)...crazy to see her levels fluctuate so much...

Becky
 
You've probably heard every cat is different (ECID) many times. Yes, the nadir is the lowest number in the cycle but some cats nadir at +6, some cats like Siennes Gabby nadir at around +3, some nadir at +12 which makes shooting lots of fun, and many have nadirs that change even from cycle to cycle.

She is just bouncing from her lower numbers today. As hard as it is, we try to ignore the bounces and focus on the numbers when the kitty's liver is not having a field day by releasing alot of counterregulatory hormones and glucagon to bring the BG up. A bounce is a good opportunity to save a strip and sleep.
 
Her dose is a little high right now and while I'm waiting for her depot to drain, I have to test more to keep her safe. I did reduce her dose this evening but she will likely run low because of the depot.

Gracie is also somewhat unpredictable. The minute I lay off the testing, she throws me a really low number. I test to keep her safe. She doesn't care....she will sleep through them. And....my husband splits the duty with me.
 
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