8/22 Jax AMPS 479 - New to Group

Discussion in 'Lantus / Levemir / Biosimilars' started by JaxBenji, Aug 22, 2020.

  1. JaxBenji

    JaxBenji Well-Known Member

    Joined:
    Jul 10, 2020
    Hi! New member here and was guided over to this board from the main board. I'm just looking for some insight/guidance. Jax was diagnosed in June, about 2.5 weeks after his annual visit (sedated, annual exam, and rabies). He was lethargic and not eating and ER vet diagnosed him at high 500s (560 I think...at his annual exam his was below 200). I...like it seems many others...don't have the best patience :) and little support from my vet (he's alright but is not super knowledgeable on diabetes). I am working to move Jax off the Blue Wilderness Mature Cat...he does like it better than the BFF I'm feeding him so I may pick up some Beyond Pate to mix with the BFF. Thanks again for having us :)
     
  2. Butters & Lyla

    Butters & Lyla Well-Known Member

    Joined:
    May 30, 2020
    Welcome :)!

    Here is your previous thread for reference.

    Your vet sounds like many of ours. You will get good help here. Bit quiet in the forum as of late but hang tight. I assume you want to get some opinions on your spreadsheet and dosing for Jax?

    In the meantime.....
    Have you reviewed the sticky on Lantus dosing methods? Your signature says you are dosing ‘slow’. Maybe have a look at the ‘start low go slow’ dosing method if you don’t want to make any fast moves with Jax. Tight Regulation is more aggressive and requires more testing.

    Read through all of the stickys at the very top of the LB&L board when you have time. I still re-read them regularly. Lots of good info.
     
  3. JaxBenji

    JaxBenji Well-Known Member

    Joined:
    Jul 10, 2020
    Thank you @Butters & Lyla! I had read those dosing methods previously but did read the again. Yes, I tend to go slow to give time to adjust but I'm open to switching to the TR one. I'll work through some of stickys today too :) I'm honestly wanting to just get his food on even lower carb and start over...my gut is saying his insulin is too high. Even since I started mixing in 1/2 BFF in to the BW this week, his urine output is higher...which doesn't make sense to me...shouldn't he be improving as he has more insulin essentially to combat less carbs?
     
    Last edited: Aug 22, 2020
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  4. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Welcome to the group!

    I hope you won't mind if I offer a suggestion regarding. your spreadsheet. Most of us leave the comments/remarks section to the far right column. That way you can have as much room as you want for your comments. It also allows us to see more of the numbers on the spreadsheet. (I work on a laptop. With the way. your SS is organized, I can see as far as your PMPS. It's helpful to see as much of the numbers as possible since it's the easiest way to see trends.)

    I'd also encourage you to start getting a before bed test every night. This is especially important if you are going to transition Jax to a lower carb food. Many cats experience lower numbers at night. You don't want to miss a dose reduction or worse, low numbers when you need to intervene. Not having PM tests on many evenings also means you're missing half of your data.

    I am glad you're getting more spot checks during the AM cycle. Lantus dosing is based on the lowest number in the cycle so those spot checks are important.

    The Blue Wilderness isn't horrible (11% carb). I'm just very hesitant to use their products. There have been a few recalls. The recalls have been mostly for dog food but I'm leery. I'm assuming you're using Dr. Lisa's food chart so there are lots of choices that are lower in carbs.

    For now, it really looks like your kitty could use more insulin. What would you think about raising the dose by at least 0.25u?
     
    Last edited: Aug 22, 2020
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  5. Erin and Moe (GA)

    Erin and Moe (GA) Well-Known Member

    Joined:
    Sep 8, 2019
    Hi, and welcome! We started with the SLGS protocol until we got comfortable with frequent testing. Like you, our vet is great, but not super experienced with feline diabetes (and never treated a cat with acromegaly). We are learning a ton from the wonderful folks on this board.

    I second what @Sienne and Gabby (GA) said above regarding pm testing. Our PM shot is at 5 pm, and I test at +2 and again at +5 or +6. That lets me see which direction Moe is heading and whether I need to set an alarm for a later test and continued monitoring overnight.
     
  6. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    Welcome. I also want to emphasize the need for a before bed test. For Max, who dropped often at night, a+2-3 let me know if more tests would be needed as that’s when Lantus typically kicks in. It would also be a good idea to do a 12 hour curve testing every 2 hours for a cycle to see how low this dose takes him.
     
    Last edited: Aug 22, 2020
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  7. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
  8. KittenTheCat

    KittenTheCat Member

    Joined:
    Apr 10, 2020
    Welcome! :cat: You’ll find great support here! It’s a busy forum so you’ll want to be sure to follow the helpful tips on “new to group” sticky so you can get the help you need by providing the info for the members. It’s a lot of info at first (And can be overwhelming) when you add on the sticky’s on dosing methods, but over time it becomes common knowledge and you can always ask questions in your daily posts :D
    my vet didn’t even mention doing daily tests or checking BG before injecting so everything I’m doing now is thanks to this forum! If I had followed my vet advice Kitten would still be in the 200+ as my vet was happy with those numbers :nailbiting:
     
  9. JaxBenji

    JaxBenji Well-Known Member

    Joined:
    Jul 10, 2020
    Thank you all so much! It really just means a lot to connect with others who have been through this or are going through this!

    I will start to do evening tests - our PM is at 6PM so I should be able to get a +2 and +4 and can do later tests with an alarm (this not-so-old lady goes to bed around 10 :D).

    @Sienne and Gabby (GA) & @Erin and Moe & @tiffmaxee - thank you so much for checking out my spreadsheet - I can move the comments over! and totally heard on Blue Wilderness - I picked up Fancy Feast Classic Pate (seafood pack so they are all 0-2 carbs) - I will see if Jaxy likes them and move off the BW. Also, I'm not against increasing the insulin to 1.5 - though should I do that AND swap the Blue Wilderness food at the same time? I will definitely start the switch in food tonight and can start the increase in insulin in the AM depending on your opinion :) And...something weighing on me - even since I started mixing in 1/2 BFF in to the BW this week, his urine output is higher...which doesn't make sense to me...shouldn't he be improving as he has more insulin essentially to combat less carbs?
     
    Last edited: Aug 22, 2020
  10. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    Until his bg is low enough he will continue to have high urine output. It takes time to get this under control. As his overall numbers come down you will see a change. As I understand it insulin doesn’t combat less carbs. Less carbs helps bring down the bg.
     
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  11. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    I love the name Jax. When Max was younger I had an internet friend with a cat. I mistyped his name as Jax. It stuck and he was Jax1 and her cat Jax2. When my sister got her puppy she named him Jaxx.
     
    Kyle & Simon (GA) likes this.
  12. KittenTheCat

    KittenTheCat Member

    Joined:
    Apr 10, 2020
    Is the BW wet or dry? When I finally switched Kitten to all wet food it took a bit of time (if I remember correctly about a month) before her urine output/drinking decreased. It will happen in time :bighug:
     
  13. JaxBenji

    JaxBenji Well-Known Member

    Joined:
    Jul 10, 2020
    @tiffmaxee - okay, got it on the urine - I just see it fluctuate - some days seems more "normal" and these recent days are higher. All part of the process I guess. And love your story on the name Jax :) Our Jax was named by the child of his pet foster - he's black like a jaguar. His brother is named Benji after a bengal tiger :) When I adopted them, they were 10-12 weeks but never changed their names!

    @KittenTheCat we are feeding all wet - so at least we have that part! Before Jaxy's dx, we were on all dry...Orijen cat food. And thanks for sharing your experience on the urine output - looks like I will swap the BW wet for the Fancy Feast I picked up today.
     
  14. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    We love black cats here. Wonder why? My two girls I have now came with names that I planned to change but never did. Chai and Mocha.
     
    Last edited: Aug 22, 2020
  15. Briere Fur Mom

    Briere Fur Mom Well-Known Member

    Joined:
    Sep 19, 2019
    Welcome!!!:bighug::bighug::bighug:
    Everyone's' given you great advice. There's lots of info on this web page. Take it slow, don't get overwhelmed and ask questions. Look forward to seeing Jax and you progress through this thing we like to call the sugar dance.
    Have a great day Susanne


    ETA: One thing I forgot to mention, once your questions have been answered...remove the question mark icon from your title. If any new questions arise, add it back to your title;) :)
     
  16. JaxBenji

    JaxBenji Well-Known Member

    Joined:
    Jul 10, 2020
    Hi! Thanks for all of your support (and thanks to @Briere Fur Mom for helping me on my board etiquette :)) I was reading up on TR again and was thinking of giving it a try since we are so high (so, 3 cycles at a dose).

    My question is on testing - at least every 3 hours? I am home mostly with two human kiddos that I homeschool.

    Also, I've been using AlphaTrak2 - but it sounds like I can save that for curves for the vet and switch to my Relion Premier Classic meter (I had picked it up in case I ran out of AT2 strips). Is Relion Premier Classic alright? Should I switch to a different one?

    Thank you!
     
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  17. Briere Fur Mom

    Briere Fur Mom Well-Known Member

    Joined:
    Sep 19, 2019
    As far as I know the Relion is fine. I use a Relion Prime. Good choice due to the cost of strips(cheap). Strips seem to be the biggest cost when it comes to treating diabetes. Save money where you can, right? Hold onto the AT2 for when the Vet wants curve data. Vets love AT2:rolleyes: But seems you know this already:)

    6 cycles/ 3 days. One cycle is 12 hours;)

    I'm a very data driven person. The more tests the better if possible. But, with TR you're asked for the PS(preshot)tests and at least one mid-cycle. To me until you know how your cat reacts to the insulin, the more testing you can manage ,builds a better overall picture

    Hope that helps:)
     
  18. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    TR does have a better track record of going OTJ but SLGS has had its share. I do prefer a human meter. The strips are expensive with the AT and since human ones read lower there’s some built in help to not go low. That being said the reduction level on AT is under 68 but under 50 on a human one. I’ll let others comment on preferred meters because the Relion I used was discontinued. It was great because it only needed a small blood sample. You can give TR a try and if it’s not for you go back to SLGS at any time.
     
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  19. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    Hi Susan the Relion Premier is fine
    Most of us us the Relion Prime or the Premier
     
  20. Lisa & Oberon

    Lisa & Oberon Well-Known Member

    Joined:
    Jul 14, 2020
    I'm pretty new here, too. Welcome! I'd be cautious about changing the food and the insulin at the same time. As an example, when Oberon was first diagnosed in December, I switching him from dry food (high carb) to the FF Classic pate and within two weeks his blood glucose levels had normalized. No insulin needed. He stayed in remission until about a month and a half ago when he got pancreatitis. Not saying Jax's reaction would be that dramatic, but if you cut the carbs out the need for insulin may decrease, and you don't want to give more than he needs and risk blood glucose going too low. More experienced members may have more concrete advice about the best way to approach the timing of diet and dose changes; I just wanted to give you a heads up to be careful.
     
  21. JaxBenji

    JaxBenji Well-Known Member

    Joined:
    Jul 10, 2020
    @Lisa & Oberon - Thank you so much - this totally crossed my mind. I did increase this morning by 0.25 and switched 1/2 his meal to FF (starting last night). I'll be around today to keep an eye on him.
     
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