8/17 • Bowie • 92 AMPS

Mon & Bo

Mon & Bo

Member Since 2026
Hi everyone! Bowie and I are new to feline diabetes and this forum. I'm trying to follow all of the posting guidelines, but please let me know if I did anything incorrectly!

History: Bowie was diagnosed on 8/6 at the ER with BG of 376, DKA, and severe pancreatitis after visits to 2 other vets. The ER vet believes this is a case of steroid-induced diabetes, as Bowie was on a brief prednisone regimen in July for allergies. Her DKA was treated in the hospital with fluids and electrolytes and her ketone levels have been negative since coming home. Previous blood tests did not show signs of diabetes. Bowie is 11 and aside from her allergies, she has been very healthy.

Insulin and BG: She is supposed to be on 1 unit of Lantus every 12 hours (11AM/11PM). We are so new to this that I haven't officially started on a specific dosing method, although I'm hoping to move to TR.
  • Over the past few days, her pre-shot blood glucose numbers have been quite low (<100), so I've skipped some of her shots.
    • This morning, her BG ranged from 92-98. About 12 hours ago, it was 82-93. She has not received a shot since AM 8/16.
    • Her BG after her PM shot on 8/15 did jump up to 209 and was at 208 for her AMPS on 8/16.
  • Before the BG monitor arrived, I was relying on ketodiasticks to test her glucose.
    • They repeatedly showed high glucose in the first few days, but have since been lower.
    • Last night her pee was positive/high for glucose, although her BG was around 90.
    • This morning, her pee was negative for glucose. She peed outside of her litterbox (probably because I had to remove the litter and she doesn't like the smell) so I don't know if that messes up the readings.
Food: She is eating Fancy Feast Classic Pate (chicken) or Fancy Feast Gourmet Naturals (chicken) throughout the day and freeze dried chicken treats on occasion.

Other Meds: She had inflammation throughout her abdomen and is on clopidogrel to prevent blood clots from any leaky vessels. She is also on cerenia/mirataz/gabapentin as needed.

Questions: Should I continue targeting 1 unit of Lantus every 12 hours, and skipping doses when her PS levels are too low? Or should I start to cut back on her dosage and maintain the 12 hour frequency?
I feel weird about skipping so many shots. I also recognize that it's probably to soon to make any changes, and more data collection is required. I have an appointment with her normal vet on Wednesday, although I'm not sure how knowledgable he is about feline diabetes. I am going to monitor her BG more frequently throughout the day today and will be updating her spreadsheet.
 
Welcome to you and Bowie! Great job getting everything set up and on the post format... it is a little overwhelming at first (on top of the dx too).

Her numbers are looking great, especially so early on. Let's see what @Wendy&Neko, @Marje and Gracie, @Bandit's Mom or the others think on the dose. To me it feels like 1 unit might be a little too much for right now, seeing that many greens even with skips in there.
 
Thank you, Tim! The first few days out of the hospital were definitely a whirlwind. I'm so happy she has perked up since then and is acting more like her old self.

Just tested her BG again and she is at 98. Would have been +2 if I had given her an AM shot. It has been +26 since her last insulin shot.
 
Mon & Bo said:
Thank you, Tim! The first few days out of the hospital were definitely a whirlwind. I'm so happy she has perked up since then and is acting more like her old self.

Just tested her BG again and she is at 98. Would have been +2 if I had given her an AM shot. It has been +26 since her last insulin shot.
Click to expand...
Welcome and thanks for doing such a great job setting everything up and giving us a brief history.

She is getting some nice, normal numbers. But these are also numbers we would have other members give insulin as it can take up to six cycles to deplete the Lantus depot. Of course, with a 1u dose, it shouldn’t take as long.

Because she’s also had DKA recently, we are very cautious about stopping insulin until we know they are in remission. I don’t think she is showing that yet. Did they ever determine the infection that set the DKA in motion as it is usually due to infection (not inflammation) + not enough insulin + not enough calories/water.

The sugar in urine is always a bit delayed so it won’t necessarily equate with current BG. It if she’s spilling sugar into her urine, she is going over about 200-250 at some point. If she spilled last night, it was likely due to higher numbers yesterday morning. It looks like she bounced up from lower numbers and likely gradually came down all day yesterday.

Whether we hold the 1u dose or reduce to 0.75u depends on which dosing method you follow. Here is the info on them both and if you are able to read and determine which is better suited for her, it will let us know ow what to recommend going forward.

If she is not eating any dry food at all, you can do TR which helps them get regulated faster as you can change doses sooner. We dose primarily on the nadir with some consideration to preshots.

If you can read and let us know which you prefer, than if she is 150 or below at PMPS, we can walk you through whether to shoot and stay with you. Do you have a hypo kit
put together with some HC foods, karo or honey, plenty of test strips?
 
Hi Marje, Mike, and Gracie, thank you for the thoughtful reply!

Here are some responses:
Marje and Gracie said:
Did they ever determine the infection that set the DKA in motion as it is usually due to infection (not inflammation) + not enough insulin + not enough calories/water.
Click to expand...
No infection. I didn't know she was diabetic until she went into DKA. She was extremely lethargic and stopped eating/drinking when I brought her to the ER, so I assume it was the lack of insulin and food/water that triggered it. The vet said the pancreatitis could have triggered the DKA or vice versa.

Marje and Gracie said:
The sugar in urine is always a bit delayed so it won’t necessarily equate with current BG. It if she’s spilling sugar into her urine, she is going over about 200-250 at some point. If she spilled last night, it was likely due to higher numbers yesterday morning. It looks like she bounced up from lower numbers and likely gradually came down all day yesterday.
Click to expand...
Ok good to know. I'll continue monitoring her pee for glucose, especially on days I can't test as regularly.

Marje and Gracie said:
If you can read and let us know which you prefer, than if she is 150 or below at PMPS, we can walk you through whether to shoot and stay with you.
Click to expand...
I would prefer to start Bo on the TR method, but my syringes only have 1 unit markings. I think I need a prescription for syringes, so I'll ask the vet on Wednesday.
She is only eating wet food right now. I was thinking about getting some LC dry food for her to graze on throughout the day, but will hold off on that if starting the TR method.

Marje and Gracie said:
Do you have a hypo kit
put together with some HC foods, karo or honey, plenty of test strips?
Click to expand...
I have honey, test strips, and HC dry food. I'll pick up some HC wet food today and ask the vet for a feeding syringe.
 
Mon & Bo said:
Hi Marje, Mike, and Gracie, thank you for the thoughtful reply!

Here are some responses:

No infection. I didn't know she was diabetic until she went into DKA. She was extremely lethargic and stopped eating/drinking when I brought her to the ER, so I assume it was the lack of insulin and food/water that triggered it. The vet said the pancreatitis could have triggered the DKA or vice versa.


Ok good to know. I'll continue monitoring her pee for glucose, especially on days I can't test as regularly.


I would prefer to start Bo on the TR method, but my syringes only have 1 unit markings. I think I need a prescription for syringes, so I'll ask the vet on Wednesday.
She is only eating wet food right now. I was thinking about getting some LC dry food for her to graze on throughout the day, but will hold off on that if starting the TR method.


I have honey, test strips, and HC dry food. I'll pick up some HC wet food today and ask the vet for a feeding syringe.
Click to expand...
Thank you Mon.

Depending on your state, you might be able to get 0.5u marked syringes at Walmart without a prescription or online from American Diabetes Wholesale if you prefer another brand. Most Lantus users dose with calipers so it doesn’t matter if the syringe has 0.5u markings. Syringes are horribly inaccurate.

Please do not feed even LC dry especially if you want to do TR. HC dry food is not good for controlling low numbers. It takes too long to kick in and then takes too long for the carbs to leave the system. Diabetic cats never should have dry food and I would argue it’s a big no for every cat. It is sprayed with chemicals to make it addictive and there is absolutely no redeeming quality about it.

If you feel she needs snacks while you are gone, the freeze dried single protein ones are good or you could get an auto feeder.

Also monitoring the urine is not a good way to check the BG because she could be at 40 and the urine still show high glucose from many hours before. It’s not a substitute. Testing is the best way.
 
Mon & Bo said:
I would prefer to start Bo on the TR method, but my syringes only have 1 unit markings. I think I need a prescription for syringes, so I'll ask the vet on Wednesday.
She is only eating wet food right now. I was thinking about getting some LC dry food for her to graze on throughout the day, but will hold off on that if starting the TR method.
Click to expand...
We used to get our U100 syringes with 1/2 unit markings on Amazon. For folks in the US at least. The calipers is a good tip too. On the grazing, maybe you could investigate an auto feeder for wet food. They make some with refrigeration or cooling packs built in.
 
Thank you, Marje and Tim!
Marje and Gracie said:
Depending on your state, you might be able to get 0.5u marked syringes at Walmart without a prescription or online from American Diabetes Wholesale if you prefer another brand. Most Lantus users dose with calipers so it doesn’t matter if the syringe has 0.5u markings. Syringes are horribly inaccurate.
Click to expand...
Good to know! I'm in NY and it looks like I will need a prescription for more than 10 syringes at a time. But I will buy calipers and try that method since the syringes aren't accurate.

Marje and Gracie said:
Please do not feed even LC dry especially if you want to do TR. HC dry food is not good for controlling low numbers. It takes too long to kick in and then takes too long for the carbs to leave the system. Diabetic cats never should have dry food and I would argue it’s a big no for every cat. It is sprayed with chemicals to make it addictive and there is absolutely no redeeming quality about it.
Click to expand...
Ahhhh good to know! I will avoid any dry food and only stock canned. And I'll look into an auto feeder for wet food per your + Tim's advice. Thankfully I am working from home right now so I can feed Bo throughout the day.

Marje and Gracie said:
Also monitoring the urine is not a good way to check the BG because she could be at 40 and the urine still show high glucose from many hours before. It’s not a substitute. Testing is the best way.
Click to expand...
Got it! Since her ketones have been negative, and I am testing with the monitor, I might move away from the urine tests in the next few days. Mostly so I can put litter back in the box and Bo will hopefully stop peeing on the floor.

I just tested her BG again and got 90 (+4 from her skipped AM dosage / +28 from her last shot).
 
Mon & Bo said:
Thank you, Marje and Tim!

Good to know! I'm in NY and it looks like I will need a prescription for more than 10 syringes at a time. But I will buy calipers and try that method since the syringes aren't accurate.


Ahhhh good to know! I will avoid any dry food and only stock canned. And I'll look into an auto feeder for wet food per your + Tim's advice. Thankfully I am working from home right now so I can feed Bo throughout the day.


Got it! Since her ketones have been negative, and I am testing with the monitor, I might move away from the urine tests in the next few days. Mostly so I can put litter back in the box and Bo will hopefully stop peeing on the floor.

I just tested her BG again and got 90 (+4 from her skipped AM dosage / +28 from her last shot).
Click to expand...
But do keep resting her ketones every other day or so. It’s rare to see cat’s in normal numbers get ketones but we have seen it happen.
 
Mon & Bo said:
Good to know! I'm in NY and it looks like I will need a prescription for more than 10 syringes at a time. But I will buy calipers and try that method since the syringes aren't accurate.
Click to expand...

My vet wrote me a prescription and when I took it to the pharm, they were like... you can just come buy these. They didn't even take it. (Also in NY)

Also good luck from a fellow newbie!
 
Marje and Gracie said:
But do keep resting her ketones every other day or so. It’s rare to see cat’s in normal numbers get ketones but we have seen it happen.
Click to expand...
Ah ok good to know. I will look into some nonabsorbent litter so I can continue monitoring her ketone levels.

Tim & Pookey said:
Hmm, I’m in NY too. What’s it say when you go to these?
Click to expand...
Crowley said:
My vet wrote me a prescription and when I took it to the pharm, they were like... you can just come buy these. They didn't even take it. (Also in NY)
Click to expand...
It looks like I can buy those! Thank you for sharing! I was going off of this website, which was linked somewhere else on the FDMB. The pharmacy did ask for a prescription for needles when my vet prescribed insulin in pen form. Perhaps it varies by pharmacy or location.

Tested again and got 102 (+6 from her skipped AM dosage / +30 from her last shot).
 
Hi everyone - I am approaching PMPS time (usually 11PM ET) with a BG of 109. I was wondering if I should give Bowie 1 unit of insulin since her BG is over 100, but I've seen guidance on here that newbies shouldn't shoot with BG under 150.

I unfortunately don't have calipers yet to give her a lower dose (should arrive this week!), and I won't be able to monitor her as closely during the night as I have been during the day.

I welcome any thoughts / advice on how to proceed!
 
Mon & Bo said:
Hi everyone - I am approaching PMPS time (usually 11PM ET) with a BG of 109. I was wondering if I should give Bowie 1 unit of insulin since her BG is over 100, but I've seen guidance on here that newbies shouldn't shoot with BG under 150.

I unfortunately don't have calipers yet to give her a lower dose (should arrive this week!), and I won't be able to monitor her as closely during the night as I have been during the day.

I welcome any thoughts / advice on how to proceed!
Click to expand...
How long will you be able to test her?
 
Oooh gotcha! I can keep testing her hourly until maybe 1AM ET (+2). I can wake up throughout the night too if needed, but don't know how frequently I would need to test.
 
Yes, I would like to do the Tight Regulation method. I ordered digital calipers but they won't arrive until Thursday. I am unsure if I should give her the full dose, no dose, or a smaller dose (that I would have to eyeball).
 
Mon & Bo said:
Yes, I would like to do the Tight Regulation method. I ordered digital calipers but they won't arrive until Thursday. I am unsure if I should give her the full dose, no dose, or a smaller dose (that I would have to eyeball).
Click to expand...
Why don’t you test her 15 mins before PMPS, don’t feed her, post here. I’ll be waiting for you.
 
Hi Marje, I just got a reading of 119.

Looking at her spreadsheet again, I noticed that the two times she's jumped up to 200+ in the last week was when she was given insulin with a pre-shot blood glucose of 138. Do you think those could have been bounces and 1 unit is definitely too much?
 
Mon & Bo said:
Hi Marje, I just got a reading of 119.

Looking at her spreadsheet again, I noticed that the two times she's jumped up to 200+ in the last week was when she was given insulin with a pre-shot blood glucose of 138. Do you think those could have been bounces and 1 unit is definitely too much?
Click to expand...
I don’t think 1u is too much. I do think she has done some bouncing from the green numbers but she clears pretty quickly. There isn’t enough data to see all she’s doing but that’s understandable.

Insofar as tonight, 119 is a shoot able number with 1u. While there is the option to stall and see if she comes up a bit, we often find the BG can start to go down making it harder to shoot and then you also have to deal with making up time from a late shot.

The other option is to shoot less insulin on a one-time basis but because of the depot, the cycle will progress like it was going to if the full dose was given.

Having said that, she doesn’t have a depot really because she hadn’t had insulin in a while so if you wanted to shoot a reduced dose tonight….say 0.5u, you could….but you’d have to just estimate half way between the 0 and 1u marks.

I’ll let you read that while I post some additional info.
 
To continue, normally when we have a new member shoot a lower number, we stay up with them. I can be up until +2 your time. We always ask members to get a +2 because if it’s similar to or less the PS, the BG is likely to come down. If she does head down at +2 and later, I can’t be up to help you work through that by advising what to feed. I don’t know if there is anyone else who will be up.

Your option is to skip tonight and start with the plan to unequivocally shoot in the morning when there are more people around to help.
 
Marje and Gracie said:
To continue, normally when we have a new member shoot a lower number, we stay up with them. I can be up until +2 your time. We always ask members to get a +2 because if it’s similar to or less the PS, the BG is likely to come down. If she does head down at +2 and later, I can’t be up to help you work through that by advising what to feed. I don’t know if there is anyone else who will be up.

Your option is to skip tonight and start with the plan to unequivocally shoot in the morning when there are more people around to help.
Click to expand...
Can you let me know what you decide please?
 
Thank you again for sharing so much knowledge with me. I was initially thinking I could do 0.5u tonight, but now I think skipping the PM dose and doing 1u in the AM makes more sense. I don't want to miss anything while I'm asleep, and I work from home so I can track her BG closely during the day.
 
Mon & Bo said:
Thank you again for sharing so much knowledge with me. I was initially thinking I could do 0.5u tonight, but now I think skipping the PM dose and doing 1u in the AM makes more sense. I don't want to miss anything while I'm asleep, and I work from home so I can track her BG closely during the day.
Click to expand...
It’s hard to say if she would react quickly to even 0.5u. I have seen cats do that and I would hate to leave you wrestling with low numbers and not knowing how to deal with them. I wish I could stay up to walk you through it but I have to up by 6 tomorrow.

I’m hoping you can shoot 1u tomorrow morning.
 
You must log in or register to reply here.
Back
Top