Adventures in Home Testing (newbie)

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Lori & Lulu

Lori & Lulu

Member Since 2015
Today I was able to get a bead of blood from Lulu, yay! and she tested high at 17.4. Yesterday I tried and tried, but ended up with a very unhappy kitty -- growling and yowling to the point where I gave up in tears. (I have inadvertently gotten a blood from my own fingers several times) I know it'll take time to get proficient at this, and am really happy that this forum is here for pointers and encouragement. The vet recommended Lulu's a.m. dosage be increased to 2 units Lantus in the a.m. and remain at 1 unit in the p.m., so she got 2 units yesterday morning and this morning. I have also ordered a baby scale so that I can monitor her weight. I'm slowly moving her to a 100% canned diet. Thanks everyone.
 
Hi and welcome. I promise testing will get easier. Try massaging the ear before poking, a warm compress and massaging her ear when just sitting around with her.

I don't know why vets suggest different doses for the cycles. Lantus doesn't work well like that. In your case I suspect it is because you don't have syringes with 1/2 unit markings? You can get Terumo ones from ADW on line. They are a sponsor here and currently are giving a 10% discount.
 
I can't open Lulu's spreadsheet. Please remember to set the "share" permissions to "anyone with the link."


Welcome to Lantus and Lev land – the best place you probably never wanted to be! If you are like most of us, if this is your first few weeks of trying to wrap your head around the fact that your kitty has diabetes, you’ve no doubt been terrified, in tears, in a state of shock, and completely overwhelmed. Don’t worry. It gets easier. It really does.

None of us here are veterinary professionals but many of us have been working with our cat’s diabetes for a long time. Even those of us who have been here for a short time are here to help. This is a wonderfully supportive community.

There are a few first steps. We firmly believe that home testing is the best way to keep your cat safe. We keep a record of our cat’s blood glucose (BG) data on a spreadsheet (SS) which you can create using the linked instructions. If you’ve not mastered home testing, we’re happy to offer suggestions or you may want to spend some time on the Health board mastering the basics of testing, low carb diet, and getting your SS set up. We’re happy to help you with those things, but you should be aware that this is a busy board and if there’s an emergency, everyone’s attention goes to helping the caregiver and his/her kitty.

Once you’ve got a handle on the basics, you will have the option of following the Tight Regulation Protocol or the Start Low Go Slow (SLGS) method for managing your cat’s diabetes. You don’t have to stick with whichever approach you initially choose but it is helpful to give your choice a chance so you can evaluate the results fairly.

The Tight Regulation protocol was developed based upon the premise that a cat's pancreas may be able to heal and return to producing insulin if the cat's BG is kept in a normal range (i.e., 50-120}. Caregivers following this protocol adjust insulin doses following the protocol guidelines to aim for that range. This is the link to the basic information on the TR Protocol. The advantage of this approach is that it is based on research published in a leading veterinary journal and has an admirable track record of getting cats who are within the first year since diagnosis into remission.

The Start Low Go Slow (SLGS) approach has caregivers start with an initial dose based upon the BG at diagnosis and whether kitty has been transitioned to a wet low carb diet, hold that dose for a week or two while testing for ketones regularly, being consistent with food and testing before shooting every 12 hours. Once a week a curve is done (test every 2 hours for one cycle) to check for the lowest point. the low number in that curve determines any dose change for the following week. This approach was the original method used in the FDMB prior to the TR protocol. It is an alternate approach if TR is not the right fit for you or your kitty. Basic information on the SLGS approach is here.

Both approaches require that you test at pre-shot times and do your best to test at least once each 12-hour cycle. Lantus and Lev dosing is based on the lowest number in the cycle (i.e., the nadir) so getting at least one spot check is important to guide your dosing decisions.

Amy&Trixie, Dyana&(GA)J.D., Julie&(GA) Punkin, Marje&Gracie, Sandy&Black Kitty, Sienne&Gabby, Wendy&Neko

The only thing that I would add is that Lantus does best if you are giving the same dose in the AM and PM. Because it is a depot-type of insulin, every time you change a dose, it has an effect on the depot. If you are shooting different amounts at every shot, the depot won't stabilize and typically, you end up with wonky numbers. You may want to discuss this with your vet.

If you've not transitioned your kitty to a fully canned diet, you will need to focus on the SLGS approach. Tight Regulation stipulates a low carb, canned food diet.

 
Hi Sienne - I just changed the permissions on Lulu's SS. The syringes I have do show 1/2 ml, do you think I should up her p.m. dosage?
 
Your SS took an incredibly long time to load!

When did Lulu start Lantus? Your SS starts on 3/25 but I didn't know if that's when you actually started shooting. I'm hesitant to suggest doing anything if you just started shooting other than giving the same amount twice a day. The reason that I'm hesitant is that we don't know what's happening during the PM cycle. Are you able to get at least one test during the evening? We encourage everyone to get a "before bed" test. Many cats experience lower numbers at night. The benefit of testing is that you can keep your kitty safe.

I know you're doing your best to get the tests. Are you giving Lulu a treat every time you test? Regardless of whether the test is a success, treats are a positive reward and will help your kitty acclimate to the process. My guys LOVE freeze dried chicken treats.
 
Hmmm...I wonder if it`s because I added a tab and manually input all her lab results on the SS...

Lulu has been on Lantus since March 14. 1 unit per day for 7 days, then I took her back to the vet. Vet changed the dosage to 1 unit BID for a week, then I took her back to the vet this past Friday. That`s when the vet changed her to 2 units a.m., 1 unit p.m. I will get a test tonight and record the results. Hoping that once we`re comfortable with the tests, I will do one of those curves...

Yes, Lulu gets Pure Bites freeze dried chicken treats while we`re doing the testing. I have to lock Otis and Coco (my other two furbabies) in a room because when I bring out the treats, they come running and stress Lulu out more -- she doesn`t get along with them very well. I also think she is fussing because she knows Mama feels bad about having to poke her ear. However, I am getting better at calming down.

Thanks for your help!
 
The calmer you are, the more Lulu will relax. If you look at Gabby's SS, you'll know I'm a testaholic. Gabby puts up with it (at least if it's me who's testing) because she knows food or a treat will follow. She's very food motivated!

Not to throw a brick at your vet, but he doesn't sound all that knowledgeable about feline diabetes. Lots of vets don't. A cat's metabolism is fast. They need insulin twice a day. Once a day dosing means that easily, 12 hours of the day their numbers can be in the stratosphere. With a depot insulin, you never have enough insulin on board for the depot to form. At this point, Lulu has been dosed appropriately (i.e., x2/day) for approx. a week. That's enough time for the depot to form. In addition, with Lantus, doses are raised in small increments -- 0.25u -- so you don't bypass what can be an effective dose. Raising a dose by 1.0u can drop numbers precariously.

With SLGS, you hold the dose for a week unless numbers drop below 90. If they are above 90, you then increase the dose by 0.25u. With Lantus, you want to hold the dose for at least 3 days/6 cycles in order for the depot to stabilize.

The Royal Canin that you're feeding, which one is it? In the calorie control line, pate is 14% carb, morsels are 25% carb, and high fiber is 29% carb. We consider low carb to be less than 10% carb and most of us feed less than 5%. Has anyone given you the link to Dr. Lisa Pierson, DVM's website on feline nutrition? She has a food chart with the carb and other values of many of the available cat foods. It will help you to find lower carb foods. I feed my guys Wellness chicken or turkey pate. Others use Fancy Feast or Friskies, Weruva or other brands. If you switch to lower carb food, you don't want to be raising the dose simultaneously.
 
Welcome Lori and extra sweet Lulu!

It can be really helpful to establish a routine with testing. Pick one spot that you want your "testing spot" to be (I like the kitchen counter because it's got good light and it's at a good height....it also already blocked 2 escape routes due to the wall and the backsplash) It can be anywhere though...a rug on the floor, a table, a particular spot on the couch...wherever is good for you. Take Lulu there as many times a day as you can and just give her ears a quick rub and then she gets her treat. Most cats aren't objecting so much with the poking..it's the fooling with their ears they don't like, but once they're desensitized to it and learn to associate a certain place with the treats, they usually start to come when they're called! Or even when they hear us opening the test kit!

You also have to remember...you're not poking her to hurt her...you're testing her to keep her safe and understand what's going on inside her body. There's just nothing better than truly understanding what's going on inside your kitty's body and with this disease, the more knowledge you have, the more power you have against it. The edges of the ears have very few pain receptors, so it really doesn't hurt them. Also, if you're nervous and tense, it's going to make Lulu nervous and tense too. As silly as it might seem, try singing! It forces you to use a different part of your brain!

I agree with what Julie has said...without having more tests, it's hard for us to really advise you, but it IS important to get at least a test in on the PM cycle before bed. You don't have to stay up all night! Most cats go lower at night, so getting that test before bed can tell you if you might want to set an alarm to wake you up later to get another test in. We want Lulu to be safe!

Lantus works best when given at a consistent dose every 12 hours, not one dose in the AM and a different dose in the PM. We also don't ever increase by whole units. All our increases are done in .25 unit increments. You don't want to skip over a "best dose" and in most cats, it can make a huge difference with just a tiny bit more or less insulin.

If she were my cat, I might go back to 1 unit and give it every 12 hours...and get at least 1 test in during the PM cycle and as many as you can during the AM cycle ...and ALWAYS get pre-shot tests too. Let's see what others have to say

Again, welcome to the best place you never wanted to be!!
 
I am so disappointed -- my vet is a Board Certified Feline Specialist, her practice is cats only, and I`ve trusted her implicitly for years. I don`t blame the vet, but am finding much more helpful info regarding diabetes on this website.

Okay, so this is what I`m going to do. I will test Lulu pre-shot tonight and see what the results show. I will give her 1 u and then will test her before I go to bed. I will
try to get lots more tests during the day tomorrow.

I am decreasing the Royal Canin OM dry food and am increasing canned...Royal Canin Weight Control, but moving off the prescription diet food and going to give her FF or Friskies....depends on what she likes. I actually gave her only FF one day, no dry, and she ended up with the runs, so am slowing down. The aim is to get her to a 100% canned food diet.

I have a baby scale on order, so will be monitoring her weight as she is still a bit of a big beautiful girl.

I appreciate the help, I have been so stressed since Lulu`s diagnoses. I will try to be patient. I`m a bit neurotic when it comes to my kitties whom I absolutely adore, but will take a big breath and slow down.
 
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There are lots of other food options available in Canada. Most of the ones on the Catinfo website can be found here. Adding Forti Flora or another probiotic may help with the tummy and the food transition.

My vet also suggested a lower dose at night, but that's because she was familiar with dosing Caninsulin, not Lantus or Levemir. She's a great vet for other things, but I don't take her advice on dosing. A friend of mine took his diabetic cat to a board certified feline practioner in a cats only clinic, and they kept pushing that high carb vet food. The senior vet at Neko's clinic is also board certified yet he prescribes Caninsulin for cats.:rolleyes: They deal with a lot of conditions in a lot of animals - people here have more experience in that one topic.

Do take some time for yourself. You've got to be well to take care of your girl.
 
Thanks Wendy. I was looking at Red Dog Blue Cat food, they sell it here in Calgary and I see that they manufacture it in North Van. I`m going to pick some up and see what my brood thinks of it.

I am trying to take care of myself, going snowshoeing next week (assuming we can find some snow in the Rockies, it has been unseasonably warm here the last several weeks).
 
Most vets don't have very many diabetic cats - many people euthanise them. Lantus and Levemir are relatively new to the veterinary world, so many vets don't have experience with how different dosing is with these depot insulins. If your vet is good otherwise, don't worry about the dosing advice - you can get that here.

As long as there is dry food in the picture, you'll need to follow the Start Low Go Slow method. The Tight Reg Protocol requires only canned food - no dry food - for the kitty. If you can transition miss Lulu off of dry food, then you can switch to the Tight Reg Protocol if you want.

Here is a post you may want to bookmark to help you find information on the site: "Where Can I Find?"

Hang in there - it takes a while to get good at hometesting. It takes the cat's ears about 2 weeks for more capillaries to grow from the poking, so it should be getting easier to get blood every time.
And welcome to Lantus/Lev Land. We're glad you're here.
 
Thanks Julie. "Where Can I Find?" is going to be really helpful. When I adopted my kitties, I made a promise to them that I would take care of them thru thick and thin. The only time I have ever made the decision to say goodbye is when I could see that there was no quality of life left, only pain and misery. As long as diabetes can be treated and Lulu can be happy, I'm in. This board is a godsend.
 
Well, I tried to get a test before her PM shot -- no dice, she was pretty upset. I will try for a pre a.m. shot -- wish me luck.
 
Spend some time trying to desensitize her to having her ears fooled with...It can really help!

You can also burrito wrap her if she refuses to let you test. Use a big towel and wrap her up tight so everything is covered but her head.

Another great thing for the real hard cases is the "Cat in a bag"
 
Instead of the 2 units suggested by the vet, this morning I gave her 1.5 u, wasn`t able to get a pre-shot test. The kitty burrito worked out well, we got two tests today: +4 was 14.6, +8 was 17.3. I`m thinking that I will give her 1.5 u tonight, thoughts?

thx
 
I had to burrito wrap punkin for the first couple of weeks - then he gave up and never gave me a hard time again. I thought the key to making it work was that it needed to be tight and pinning his front legs to his chest. Some people worry about stressing their cat, but it didn't bother him and it kept him pinned down so i could have my hands free to figure out the whole testing thing.

Yes, you want to just stay with a dose for the moment. You're doing a great job of getting tests in - it's hard until things all fall together and you get blood every time.
 
Great to hear the burrito wrap worked well!!

Just a quick request....most of us here on the board are in the US, so we're used to our numbers instead of the numbers used by the rest of the world (what can I say? They keep telling us we're going to go metric and we never actually do it!...LOL)

To convert your numbers, just multiply by 18...the spreadsheet does it automatically for us, but when you're posting in here, it can be easier if they're converted for us, especially when you start posting daily condo's and have the numbers in the title line
 
I'm dating myself, but I do remember when we went metric and how hard it was to convert. I still have to convert kg to lb when weighing myself and my kitties. Lulu's BG numbers were +4 = 263 and +8 = 311.
 
I'm just as bad...when I was in about 4th or 5th grade, they told us we'd have to learn metric since the US was changing over soon....they told my now 32 and 31 year old boys the same thing when they were in school...and the little girls next door told me they'd told them the same thing a few months ago

Seems like it's just the threat they use to get us to learn it....LOL
 
You want to hold the 1.5 dose for at least 6 cycles before making any changes (unless she drops below 50)

Try to get at least a "before bed" test in tonight, as most cats drop lower at night and we need to see if that might be happening with Lulu
 
I just took a test one hour after her shot (I go to bed early) -- results were 369 (20.5). Testing is getting easier, should be able to get an amps test in the morning.
 
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