Betty and Bear are scared in Ohio

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The liver is involved in blood sugar regulation by detecting and compensating for levels that are too low. The liver stores a carbohydrate called glycogen. When the glucose level drops suddenly and/or gets too low, the liver release the glycogen from storage and it is broken down for glucose.

As Humulin lasts about 8 hours, I'm a bit concerned by the low levels that have resulted in no shot. Why? Because we don't know how low he went overnight.He may be risking hypoglycemia. When you need to skip a dose half the time and the other dose isn't tiny, this suggests a reduction is advisable, so the glucose levels are on less of a roller coaster. I'd encourage you to back off some.

Also, water consumption will decrease as the glucose lowers.

Edited to add: verified that it is, in fact, glycogen which is the stored sugar.
Per Wikipedia:
"Glycogen is a multibranched polysaccharide that serves as a form of energy storage in animals[2] and fungi. In humans, glycogen is made and stored primarily in the cells of the liver and the muscles, and functions as the secondary long-term energy storage (with the primary energy stores being fats held in adipose tissue)."

Glucagon:
"Glucagon causes the liver to convert stored glycogen into glucose, which is released into the bloodstream. "
 
Actually, that info is not correct. Glycogen is not released in response to low numbers or drops. The liver releases counterregulatory hormones and glucagon...which is also a hormone...in response to drops or numbers lower than the liver is used to. The numbers do not have to be really low...just lower than what the liver has come to recognize as normal.

Betty...Carl asked me to pop in. Many of us really like our vets but realize their knowledge about treating feline diabetes is very limited. I use a clinic of five female vets although we typically see the same one but I actually had them all come over for lunch one day and gave them a presentation on FD and they were amazed to find out that their knowledge was so lacking. And they are constantly in continuing education.

I think it's a bit of a viscious circle...clients tell vets they don't want to treat a diabetic cat because the vets lack the knowledge to assure them that it is a very treatable condition. I haven't really figured out why so many vets are against home testing...mine are not. But many believe you can keep a cat well enough using urine testing. I think we've dispelled that myth for you.

Lantus and levemir are the gold standard for treating cats with diabetes and are much more gentle than Novolin. They have very high rates of remission when started within the first few months of dx and when a tight regulation(TR) protocol is followed. It's imperative to combine the use of lantus with a low carb canned or raw diet for the best results. Lantus and lev are dosed vey differently from Novolin or Prozinc. For the latter two, you base the dose on the preshot. For the "L" insulins, we base dose on the nadir...or the time of peak action of the insulin..with some consideration to the PS. We hold doses for minimum times and increase/decrease by small amounts.

It would be helpful to see a spreadsheet with Wendy Bears numbers on Novolin so we could help with a starting dose of lantus.

Let us know how we can help. But I would try to get a script for lantus for either your old vet or the new one as soon as possible. Wendy Bear might start on a low dose and have great luck with without the dry food in the picture.
 
Hi Betty,
She mentioned the liver -I thought the pancreas was involved?
Click to expand...

Actually you are right. It starts in the pancreas, which releases glycogen, which then triggers the liver to release glucogon, converted to glucose with other hormones like Marje said. WAY too many "G" words!

But the pancreas starts the process. I've got a great bookmark on my PC I can link you to later when I can get to it.

Carl
 
Hi everyone -I have Bear on FF Clasic pates. Thanks Marje for popping in. Here is my attempt at a spread sheet. I'm sure there are a lot of holes since I was following my vets instructions.

1/26 am Bear diagnosed 1/26 pm 3 units
1/27 am 3 units 1/27 pm BG 209 no shot given
1/28 am BG 250 1 unit 1/28 pm BG 229 1 unit
1/29 am BG 182 no shot 1/29 pm BG 283 no shot
1/30 am BG 200 no shot 1/30 pm no shot
1/31 am no shot 1/31 no shot
2/1 am BG 172 no shot urine 500 2/1 pm 3 units
2/2 am BG 98 1 unit urine negative 2/2 pm BG 269 1 unit
2/3 am no shot given urine negative 2/3pm BG 247 no shot
2 /4 am BG 194 1 unit urine 500-1000 2/4 pm BG 153 1 unit
I hope this isn't too confusing. Thanks for all the help.
Betty & Bear
P.S. When I submitted this it scrunched the table all together so I lost the spacing. Sorry it is so hard to read.
 
Real quick but do you see the "issue" here? This method has you giving insulin on lower preshot numbers than at the times you are skipping shots. My guess is that she's dropping into low numbers after those shots, and that is causing higher numbers from bouncing. And no idea as to how far she might be dropping after those shots three or four hours later. The urine glucose tests are not helping things.

It has you giving 1 unit on a bg of 98 (2/2 am), which is dangerous since it is in the range of "normal" BG levels.

And skipping on a 247, then seeing her at a lower number the next morning.

This cat might not even need insulin, and even if she does, a much lower dose.

Carl
 
Carl & Bob said:
Real quick but do you see the "issue" here? This method has you giving insulin on lower preshot numbers than at the times you are skipping shots. My guess is that she's dropping into low numbers after those shots, and that is causing higher numbers from bouncing. And no idea as to how far she might be dropping after those shots three or four hours later. The urine glucose tests are not helping things.

It has you giving 1 unit on a bg of 98 (2/2 am), which is dangerous since it is in the range of "normal" BG levels.

And skipping on a 247, then seeing her at a lower number the next morning.

This cat might not even need insulin, and even if she does, a much lower dose.

Carl
Click to expand...

Hi Betty,

Please consider very carefully what Carl is saying in his post (copied above)...

There are some very smart and experienced people on this forum. And this forum has saved the lives of many cats - including mine. And many cats have gone into remission too following the advice of people here. From looking at your cat's BG numbers I'd say it's quite possible that your cat could go into remission too. But it's really important that you keep her safe along the way...

I know it's confusing at first. And hard work too. But it does get easier. And the folks here will help you. :smile:

(((Hugs))) to you,

Elizabeth
 
I have to agree with Carl. I'm not sure why, with the availability of much gentler insulins, you don't switch her. This insulin you are using is really harsh and the chances of her having a hypo on it are amplified. And I promise you, you do not want to see what a clinical hypo would be like for your kitty.

I'm not trying to scare you....we all are just trying to help you understand that there is a better, safer way to approach feline diabetes. We are here to help.
 
The other thing that has confused me is why both the urine and blood glucose testing? Since you are able to get blood tests, and they are a lot more "real time" and valuable...
I don't understand why your vet would want the urine tests, or have you basing a "shoot / no-shoot" decision on them. I apologize if you've already explained that and I missed it.

Carl

Edit - I realize that you plan on switching insulin as soon as this weekend. And until then, you can make the N work, but we could help you to be able to do that more logically and safely.
 
I believe Betty is taking Bear to a different vet on Saturday. She hopes vet #2 will be more up to date and put Bear on Lantus and support blood testing. Until then, she is trying to following vet #1's instructions on dose and urine testing, as well as blood testing because we are urging her to do it to be safe.

If Bear were my cat, I might just stop the insulin until I saw the new vet, but still test. It's only a few more days...

In the meantime, could someone explain to Betty about Lantus vials versus the pens? I know the pens save money in the long term, but I don't have the facts at my fingertips.
 
The pens come in a 5-pack of 3.5 ml pens. I think the total cost is about $225 - $250 for the 5-pack.
Somebody please "check my math", but I believe each pen contains 350 units of Lantus. IF your cat were on a dose of 2.5u per shot, that's enough for 70 days?

I believe the vials are 10 ml in volume, and the vial would contain 1000 units.

I googled "cost of Lantus" and got this:
http://www.bessed.com/lantusinsulinprice/

I know that there are coupons available so that you can get a discount on Lantus.

Whether you buy the vial or the pens, you would use a syringe to draw the insulin from them.

I didn't use Lantus, so I'm not certain of the shelf life. But my understanding is that long-term, the life of the pens would be longer, so it would be more cost efficient to buy the pens even though the initial cost would be higher.


Debby,
I understood that she was switching (or planning on switching) this coming weekend. I think my question was more along the lines of "why not just ditch the urine testing and go just with blood tests, especially since she's switching vets"? Using just blood tests would be much safer.

Carl
 
Hi Everyone- Today was a very stressful day-worried about Bear all day. I even called my dog walkercome early to check on her. She was ok, but here's the scoop. Bear's urine was in the 250 range this morning. According to my vet's instructions, 250 is the number we want. If she is in the 250 range then you give her the same dose as the day before which was 1 unit. I did test Bear's BG and it was 125. This is where I probably screwed up. I gave her the 1 unit. My husband and I discussed what to do. We decided on the 1 unit because we are trying to follow my presents vets instructions with the N and according to him 1 unit of N is nothing. I had told him I was afraid of a hypo situation and he said 1 unit is minimal and as long as she is eating then she'll be fine. Also, we stupidly thought the 1 unit from the day before got her to the 125 BG. At lunch time I checked the posts to the forum and based on what I read I thought I had made a bad decision. Carl keeps mentioning the bounce affect and I wondering if that isn't exactly what is going on to some extent. Her BG tonight was 245- a 120 increase. When I made my appointment with the new vet, I asked them if I should contine with the N until my appointment and they said yes. My question is- should I do what Maggies Mom Debby suggests and just quit the insulin. It is making me a nervous wreck and Bear's numbers are up and down a lot which can't be good for her. I also have another question. I am concerned about putting her on Lantus because of my work schedule. What happens if I am gone longer than 12 hours. I was following Rockpea's dilema the other night on whether she should give a shot or not and there was discussion as to whether too much time has gone by to give it. Can I do right by Bear on Lantus if I can't follow a tight protocal? I was also wondering how stress affects the BG #s at home. Bear seems to be getting more stressed every day with the testing rather than better. Tonight I had to pull her out from under the couch. How fast does the stress affect her #'s? I really appreciate everyones advise. I don't know what Bear and I would do without the support. Thanks! Betty
 
Personally I would stop the N until she sees the new vet as regardless of what the vet says..1u of N can and does cause hypo I unfortunately learned the hard way with my very first diabetic Muse...she was started on N as well, I wasn't testing yet as I had just found this site. Gave her 1u stayed up and watched her for several hours before turning in for the night, the next morning she was gone, she had hypoed and died in the night.

Life happens when it comes to dosing with Lantus...For the most part you want to try to stay on an every 12 hour shot schedule with Lantus but there are times it just isn't a perfect world and late shots happen...we have ways to fix that when it comes up, but I wouldn't worry about it right now. I think we have all at some point had to give an early shot or a late shot or even skip one here and there. That is just life, and even if a shot has to be skipped it is much better high for a day than too low for a minute.

High blood sugar kills slowly, too low can kill quickly.

Mel, Maxwell, Autumn & The Fur Gang
 
Hi Betty
One unit of N might well be "nothing" for some cats, but for other cats it's a lot. Every cat reacts to insulin differently. There's only one way to find out what one unit of any kind of insulin will do. Brace yourself for a broken record :lol:

You need to know what her BG just before you give her a shot.
You need to know how low her BG goes at the lowest point of a cycle (the nadir).
Especially with an insulin like Novolin, or with PZI or prozinc which is what I used on Bob. Those types of insulin don't last more than 8-12 hours in a cat. Once it does its job, it's all used up. It will reach the peak of its effect, then it will wear off.
An insulin like Lantus or Levemir can work longer than 12 hours, and one dose can carryover or overlap to the next.

My cat started at one unit, twice a day. He went up as high as 4 units twice a day before I saw real improvement in his numbers. As he got better, his dose was lowered to less than one unit, and then he went into remission. Some cats NEVER get anywhere close to 4 units twice a day, and for them, it would/could be fatal.

That's why we advocate testing, at least four times a day. Twice at shot time, and once per cycle between shots, because that's the only way to know whether a dose is too low, too high, or just right.

If you were to change to Lantus, you would still need to test four times a day (at least, in my opinion). But I would recommend that amount of testing no matter which insulin you choose.

I completely understand your wanting to keep following the vet's advice, but to be honest, I don't think his way is safe. In his experience, perhaps he's never had a cat that went hypoglycemic on 1 unit of N. But it can and has happened to some cats. And with some cats, blood testing is impossible, although I would have to say that in the 18 months I've been on the board, I can't remember any that were "un-testable" forever, and eventually the caregiver was able to test that way. With cats that it not possible to get blood tests, there are alternate methods for testing. But you have been able to get the blood tests with Bear. And the more often you do so, the less stressful it will be for her, and more importantly for you. I think she might be picked up on your anxiety to some degree. Cats are very empathetic and will feed off of whatever "vibe" you're generating at shot time or test time.

I explained earlier the problem with urine glucose testing. It's "historic" data that is hours old. It doesn't tell you that it is okay to shoot insulin "now" because you have no idea what her BG is "now". That's the danger I fear from using urine glucose numbers to base the dose amount, or even if it is safe to shoot.

I will let Lantus users telly you how they deal or dealt with using Lantus when you can't be home to test, or can't shoot exactly 12 hours apart. Some people just have to deal with their reality, and their schedule, and find ways to do it, and I'm sure they can give you lots of tips on how you can make Lantus work for you and Bear.

I'm sorry if I'm coming off like a "nag".

Carl
 
Hi- Carl your not nagging, your giving very constructive advice and Momma I'm so sad to hear about Muse. I am statring to think about N as a poision and not something I'm giving to help her. Maybe I should just stop giving her the N? I can't see putting her through the stress of attempting a curve test if I'm going to switch Saturday. Carl, you mentioned making the N work until then. Would it hurt Bear to be off insulin until Saturday? When my vet had me take her off the insulin for a few days earlier her numbers ranged fron 172 to 283. I could attempt a curve test, but it would have to start with her 7:00 pm shot on Wednesday. Thanks.
Betty
 
Betty,
Have you been testing for ketones in her urine? The risk in stopping any insulin is the development of ketones, which are something you never want to have to deal with.

In your shoes, if you are wanting to make sure the N dose is safe, I would test her at shot time. If you get a number that indicates insulin is needed (we usually say above 200), then you could give her one unit. But only if you will be able to test for a few hours. I would check at 2, 4, and 6 hours after the shot. By that time, she will mostly likely be past "nadir" which usually happens 4-5 hours into the cycle with a faster acting insulin like N. You could post the numbers as you get them. If you wanted to do this Wednsday night, I (and probably others) would watch for your posts.

Which time zone do you live in?

Carl
 
Hi Carl, I haven't been testing for ketones. I read a little about them before I replied back. I read basically it causes tissue starvation when glucose can't reach the brain or body. Sounds like it can happen quickly and can be very serious. Probably not a good idea to stop the insulin. Thanks for warning me because I was really ready to quit with the N. I could do the testing Wednesday night. I'm in eastern standard time. Once I find out how low she goes, can that drop be applied to every shot. Say she goes from 240 to 120 at her lowest point-drops 120 points. Then what would be the highest BG she could have that I would be safe to give her a shot? How low do you say they can safely go? Just trying to understand how I would use the results. I could post the numbers. Would you be following in case she went too low? I hate to have anyone stay up until
1:00 am. I'm heading to bed tonight, so I'll check in tomorrow morning unless I hear back from you shortly.
Thanks,
Betty
 
Re: Betty and Bear are scared in Oh

Because so many factors go into glucose levels, while you might see some consistency from time to time, there is always a possible curve ball. A hairball, more stress, a manufacturers tweaking of their recipe from time to time, and so forth, can cause gluocse levels to change unanticipatedly. You must be ever vigilent.

And the amount of drop a particular dose achieves may not be the same at different starting points. You cannot say that if 1 unit drops him 100 points then 2 units will drop him 200 points; it isn't a 100% linear relationship. At best, you may be able to make rough estimates for non-depot insulins and develop a sliding scale for ranges.
 
Hi BMJ- What is the purpose of the curve then? How do you use it? Other than to know how safe that particular shot was. How do you apply the information?

Carl-Would it be possible to do the curve starting at 6:00 pm. I could maybe arrange to get home from work sooner than usual. Then would do readings at 8,10, and 12:00. Wouldn't be such a late night.

Thanks,
Betty
 
Betty,
Quick answer since I'm heading to bed too.
Yes, I can be on to watch tomorrow night till 1 am. And I can give you some answers to the rest of your questions in berween tests :-)
Just post your preshot number around 7pm and we can go from there. I'm on, well actually off, the east coast, so same time zone.

Carl

Just saw your last post. Sure, 6 pm works for me too. I get off work at five.
 
BettyL said:
Hi BMJ- What is the purpose of the curve then? How do you use it? Other than to know how safe that particular shot was. How do you apply the information?
...
Click to expand...

It answers the question "At that starting value, how low does the glucose go & for how long."

Dosing may start with a formula based on the cat's weight ... but is adjusted based on a specific cat's response. That's why you test and why dose adjustments are small and monitored. Some cats may start the day at 300 and go down to 50 on 1 unit; others may respond by not dropping below 200 with the exact same dose and starting point. ECID - each cat is different.
 
Hi Carl Quick question-took Bear's BG at 5:30 and it was 198. It was 284 this morning and gave her 1 unit. Should I go ahead and give her one unit at 6:00 so we can do tge curve as planned or is 198 under 200 so too low? Thanks Betty
 
Hi Betty,
Can you eyeball a half-unit? I think the 198 is close enough to 200 to shoot, but I'd rather opt for caution.

I would -
Test her one more time to see if the number is steady, or maybe rising. Maybe 6:15? Then feed her. If she eats good, then you can give the shot. If for some reason she doesn't feel like eating, I'd say "skip the shot". With a quicker acting insulin like N, it's more important that they eat well at shot time, because it tends to act sooner after the shot than an insulin like Lantus does.

Carl
 
Betty,
The reason for the 2nd test is because you want to be sure that the number is not falling when it's shot time. That might not be as critical with Lantus, but it is with N or Prozinc.

CArl
 
Carl- I tested around 5:30 and then I went ahead and fed her already so she would have eaten before 6:00 shot. I can try to retest but it may go up due to stress. We we lucky we got it real quick tonight, but now she is afraid of us. I could eyeball 1/2 unit. What about timing of food?
Betty
 
I'd go ahead and test and shoot now then. See if you can eyeball the half unit.

CArl
 
Carl not sure if you read my other post yet. Do you want me to go retest even though she ate?
 
Yes. The food would just be starting to hit her system now. It should be a little higher that the previous test.
 
I still vote for .5u. The food, and the stress could have caused an increase. Stress induced rises don't last long.

Carl
 
Carl-ok 1/2 it is. I will retest around 8:30. I going to run go give the shot. I'll check back in a few to make sure when to retest. Thanks
 
Testing at 8:30 is perfect, Betty.
Between now and then, I'll try to go back to the questions you had last night and see if I can answer them.

For now, just stick to Bear's normal feeding routine. It all depends on what numbers you see later as to whether or not she'll need "extra" food. As long as you have an idea of what she ate, and when, in relation to the shot time, that's good information to keep track of. Not just tonight, but going forward.

Carl
 
Betty,
Save this to read when you have time :smile:

Carl & Bob said:
Hi Betty,
She mentioned the liver -I thought the pancreas was involved?
Click to expand...

Actually you are right. It starts in the pancreas, which releases glycogen, which then triggers the liver to release glucogon, converted to glucose with other hormones like Marje said. WAY too many "G" words!

But the pancreas starts the process. I've got a great bookmark on my PC I can link you to later when I can get to it.

Carl
Click to expand...

I had it backwards, and BJM had it right.....way too many "G" words.

The pancrease does start the process. It produces glucogon. Which then triggers the liver to convert glycogen to glucose.

This is a link to a thread that I posted in PZI last year trying to explain the whole process.
And a link to where I got all the information from.
http://felinediabetes.com/FDMB/viewtopic.php?f=24&t=67645
http://bloodsugardiabetic.com/diabetestreatment/insulin/how-the-body-regulates-blood-sugar/

Here's a good explanation of what takes place in the blood, pancreas, and afterwards the liver when BG rises or falls:
http://bloodsugardiabetic.com/diabetestreatment/insulin/how-the-body-regulates-blood-sugar/
Blood Sugar Levels Rise

If blood sugar levels increase (e.g. after a meal), the beta cells of the islets of Langerhans in the pancreas produce insulin. The insulin has an effect on various organs of the body, increasing cell permeability to glucose and increasing enzyme activity in the cells allowing the glucose to be taken up and stored.
The liver and muscle tissue converts glucose to glycogen and stores it. This helps reduce the levels of sugar in the blood. In addition, the breakdown of fats in fat cells is inhibited, so that glucose will be used preferentially for energy.

Blood Sugar Levels Fall

The alpha cells in the islets of Langerhans of the pancreas product glucagon. Glucagon is “antagonistic” to insulin, basically having the opposite effect on the organs of the body. Glucagon increases the conversion of stored glycogen into glucose in the liver and muscles thereby increasing blood sugar levels.
Glucagon also increases the uptake of amino acids and glycerol into the liver so that more glucose can be synthesized.

The importance of glycogen as stored energy

Since all of the cells in your body require a continuous supply of energy, it is important that your body stores excess “energy” eaten during meals so that it can be used when food is less plentiful. Excess glucose is converted to glycogen by the mechanisms we saw above.
Glycogen is stored in the liver and the muscles. When your body is active, energy requirements increase and stored glycogen can be converted to glucose to be used as energy. If stored glycogen levels get too low however, cortisol is secreted from the adrenal cortex, and this stimulates the conversion of proteins and fats into glucose so energy levels can be maintained.
Click to expand...

So what does the glucagon do?
Glucagon and Insulin
Glucagon increases the amount of glucose in the blood by accelerating the rate at which the liver converts stored glycogen into glucose and releases it into the blood. Insulin decreases the amount of glucose in the blood by transporting glucose from the blood and into the muscle cells. It also stimulates the conversion of glucose back into glycogen so that it can be stored.
Click to expand...

It makes the liver dump glycogen, coverted into glucose, into the blood so that it can show up in your next PS reading!
And what happens when there is too much insulin? It does exactly what we don't want it to do:
Other Effects
Insulin also has a few other important roles in the body. Insulin facilitates the storing of excess glucose in the form of glycogen in the liver. Elevated levels of insulin also cause the liver to make more fatty acids. Insulin inhibits the breakdown of fat in adipose tissue for energy. Insulin also allows cells in the body to take up more amino acids, so that they can make more proteins
Click to expand...
.
In balance, that's a good thing, and in a non-diabetic, it would do so in amounts that made sense in the body. But if insulin is excessive, and it cause the liver to store more glycogen, then when the BG goes too low, and the pancreas puts out glucagon, and it makes the liver dump the glucose from the glycogen, then the pancreas (and the insulin) is sort of working against itself, isn't it?
Click to expand...
 
BettyL said:
OK- She usually gets a bed time snack around 10:00. Thanks
Click to expand...

OK, if you get the test at 8:30, it might make sense to hold off on the bedtime snack until you get the 10:30 test. But we'll know better by then.

Carl
 
Hi Carl, I haven't been testing for ketones. I read a little about them before I replied back. I read basically it causes tissue starvation when glucose can't reach the brain or body. Sounds like it can happen quickly and can be very serious. Probably not a good idea to stop the insulin. Thanks for warning me because I was really ready to quit with the N.
Click to expand...

Yes Betty, ketones can happen rapidly, and they can be deadly. When Bob was diagnosed, he didn't show any ketones on his labwork. I think that was on a Friday. He had a miserable weekend with no insulin because I was waiting to get it in the mail. On Monday, if I remember correctly, I brought him back to the vet. He was diagnosed "DKA" (diabetic ketoacidosis). That fast. He spent the next three days in emergency care, and the vet told me if I'd waited any longer to admit him, he most likely wouldn't have survived. Not only very deadly, but obscenely expensive to treat. It can cost upwards of $1000 per day for round-the-clock monitoring and treatment.

Once I find out how low she goes, can that drop be applied to every shot. Say she goes from 240 to 120 at her lowest point-drops 120 points. Then what would be the highest BG she could have that I would be safe to give her a shot? How low do you say they can safely go? Just trying to understand how I would use the results.
Click to expand...

I think BJ gave you some good answers to that, but I'll add a comment or two. No, the results of just one cycle can't be applied to every shot. I think about the only thing that can be determined by a single cycle is if a dose is too high. If you were to see a drop down into the 50-ish range, and it's still early in the cycle (before typical nadir), then you can determine from that drop that the dose is too high. If you don't intervene by slowing or stopping the BGs from dropping into hypo territory, it'll just keep dropping. Yes, the liver will attempt to "stop it", but it can still fail to be able to do that. So you'd lower the dose, naturally.

But just one cycle, this one for example, won't give you conclusive data (unless Bear does drop really low). It will give you an idea of what to expect in the future, but you can't automatically assume that the same thing will happen on the same dose with the same preshot number.

What you can get from this cycle is an idea of how long the insulin is lasting, and how long it takes after the shot for the BGs to start to drop, when the nadir is, and when she starts rising as the insulin wears off. At this dose, she isn't likely to go too low, and that's the big reason for the .5u shot. We just want to see how it works, and do so safely.

Also, knowing what "N" does for her will help in determining what a logical starting dose of Lantus would be. It might be the same dose, higher, or lower. Testing her while keeping her on Novolin will let you do so safely, and it will ensure that she's at least getting "some" insulin from now until you switch.

CArl
 
Carl-Thanks for all the info-I'll have to take some time and really study it. Sounds like ketones are pretty nasty. So glad Bob was OK. I was just wondering if I can give Bear treats when I test her at 8:30. I have freeze dried chicken treats. Since you wanted me to hold off on bed time snack, wasn't sure if treats could mess up test results.The only time I ever give her treats is when I test.
Thanks,
Betty
 
A modest low carb treat or two isn't going to have much impact 2 hours later. Kibble is an entirely different stoy - some cats really spike with very few bites.
 
No the treats are fine. No matter what, we don't deny the reward for the getting the ear poked. Most freeze dried treats are close to zero carbs anyway. Definitely bribe/reward with the chicken treats. ;-)

Carl
 
OK, got some high carb gravy style food? If so, a spoonful, maybe even add a couple drops of karo. And test again in 30 minutes.

Assuming this number is "valid" which you have to do when you see a low number.... then this kitty needs a very low dose of insulin, if any at all.

Carl
 
How long since you gave shot?
Have you got a can of high carb food?

What you're going to need to do is
Test
Feed a spoonful
Wait 15-30 min
Repeat until you've 2 or more rising numbers and are sure he's going up.

If necessary, wrap her in a towel.
 
She snarffed the food down and is just sitting peacefully on the floor. No signs of distress. Heading over to retest and follow directions on getting numbers up . Thanks
 
Just tested-BG 62. Gave her another spoonful with a couple of drops of karo. At what hour do you think the insulin will reach its peak?
Betty
 
N insulins last about 6 to 8 hours, so after 4 hours it may be steadily rising.

Keep going with the half hour checks, posting, and feeding a teaspoon of food.
 
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