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Heather & Hwy 99

Heather & Hwy 99

Member Since 2020
Hello, thank you for taking the time to help me and Hwy 99 out! I'm not sure if this is where I should post this but I have chronic health issues and take medications that severely impact my ability to process and retain information, and I feel like I am a first grader trying to enter high school algebra trying to figure all the various aspects out! I am hopeful to make a “cheat sheet” to print out and put on fridge, much like the hypo tool kit, I am hoping you all can help bottom line the relevant information for me to reduce chances of me making mistakes! Please feel free to add, or make suggestions on other relevant info but some of the questions I have:
1) What numbers should I NOT give scheduled dose of insulin? If I have to skip, do I just resume the normal dose 12 hours later?
2) What does an ideal day look like on spreadsheet? Do colors represent “good” or “bad” or are they arbitrary?
3) Which/How much bg data is helpful/essential? (I am on SSDI and currently spending aprox 8$ day on AT2 strips-many unsuccessfully-isn’t sustainable, so I need to prioritize!
4) Does food factor into his BG reading? (I realize this sounds like a stupid question but I have been so focused on actually getting samples and data that I realized I don’t understand how they affect each other!)
5) 2 days ago switched from 3 units of vetsulin once per day, to 2 units Lantus every 12 hours based on latest fructosamine levels-but from what I am reading in others messages this seems too high?
6) Given all the changes in insulin and diet, when I should I get another curve and/or fructosamine?

I am not sure what information is relevant to give you to help answer these questions so I will probably share too much but:
*We are both struggling with the frequent testing so I am concerned that stress/user error might be a factor in some BG readings…
*Due to other cat in household and his continued weight loss, I do free feed kibble
* He has lost aprox 6.5 pounds in 8 months (formerly overweight, currently bordering ideal/thin
*Added in fancy feast pate 1 month ago and is his primary now, reducing w/d kibble slowly but it’s not realistic given health circumstances to stop completely.
How I HAVE been doing the whole routine:

6am feed kibble (not ideal but due to my health limitations, I basically roll over and pour their breakfast until I can get up)
9am test (using small amount of squeeze cheese to keep him still)
Feed pate, give insulin
1-2 pm attempt test
feed combo wet/dry
9pm test
Feed pate, give insulin
I have attempted many tests thru out day to try to get data/patterns which are reflected in my spreadsheet but its been a challenge
 
Urghhhh there’s a lot of gray in the answers to your questions but since we both use Lantus have you read through the Lantus forum sticky notes? This is the gist of what i go by:

http://www.felinediabetes.com/FDMB/...-low-go-slow-slgs-tight-regulation-tr.210110/

The highlights from the above link:

“Until you collect enough data to know how your cat will react, we suggest following the guidelines in the FDMB's FAQ Q4.4:
Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?
A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.
  • Below 150 mg/dl (8.3 mmol/L), don't give insulin.
  • Between 150 and 200 (8.3-11.1 mmol/L), you have three options:
    • a.) give nothing
    • b.) give a token dose (10-25% of the usual dose)
    • c.) feed as usual, test in a couple of hours, and make a decision based on that value
  • Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
  • In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.
  • Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.”
If money is an issue, I strongly suggest you switch to a human meter. Mind you the numbers above are based on human meters. I use Walmart’s ReliOn and the test strips are the cheapest out there. 100 for about $17.99

also you need to test before feeding especially with kibbles. The food does bring the BG level up and you may be looking at number that you think it’s safe to shoot but in reality it’s not because it was raised by the food. Makes sense?
 
Adding that it’s important not to feed 2 hours prior to the preshot tests in the morning and evening. After that it doesn’t matter if they ate before you test. And yes, if you have to skip a dose, resume at the next 12 hour mark but you should test before again. Sometimes we also advise if you get a lower number to stall giving food for 30 minutes and retest to see if the BG number has gone up on its own and if it has, you may be still able to shoot either a token dose or the regular dose. If the number was too low and you skipped a shot, we also recommend testing throughout the day so you can see if the numbers are headed back up to a safe zone.
 
Aleluia Grugru & Minnie said:
Urghhhh there’s a lot of gray in the answers to your questions but since we both use Lantus have you read through the Lantus forum sticky notes? This is the gist of what i go by:

http://www.felinediabetes.com/FDMB/...-low-go-slow-slgs-tight-regulation-tr.210110/

The highlights from the above link:

“Until you collect enough data to know how your cat will react, we suggest following the guidelines in the FDMB's FAQ Q4.4:
Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?
A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.
  • Below 150 mg/dl (8.3 mmol/L), don't give insulin.
  • Between 150 and 200 (8.3-11.1 mmol/L), you have three options:
    • a.) give nothing
    • b.) give a token dose (10-25% of the usual dose)
    • c.) feed as usual, test in a couple of hours, and make a decision based on that value
  • Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
  • In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.
  • Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.”
If money is an issue, I strongly suggest you switch to a human meter. Mind you the numbers above are based on human meters. I use Walmart’s ReliOn and the test strips are the cheapest out there. 100 for about $17.99

also you need to test before feeding especially with kibbles. The food does bring the BG level up and you may be looking at number that you think it’s safe to shoot but in reality it’s not because it was raised by the food. Makes sense?
Click to expand...
thank you! and yes that makes sense, although I just dont know what to do about the fact that he still needs the w/d kibble until his body hopefully adapts enough and he doesnt have diarrhea from only getting the fancy feast...i dont know if this means my bg numbers will always be skewed as a result...?
 
Heather Bentley said:
thank you! and yes that makes sense, although I just dont know what to do about the fact that he still needs the w/d kibble until his body hopefully adapts enough and he doesnt have diarrhea from only getting the fancy feast...i dont know if this means my bg numbers will always be skewed as a result...?
Click to expand...

Its smart to transition slowly and know that the numbers will go down as you feed less kibbles so keep an eye out for that. Have you considered probiotics? Minnie is on S Boulardii which folks here recommended and it helps keep her stool regulated. I can look the the amazon link of the one I give her if you’d like @Nan & Amber (GA) what are you thoughts on all of this, but especially the kibbles?
 
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Hmm, kibble addicts are tough! If it were me, though, I'd stick with the slow transition you are doing, for two reasons. One, it will be easier on Hwy 99's digestion (and if he's sensitive, you may even have to try a couple different wet foods before you find one that agrees with him. It may be that Fancy Feast just isn't "the one" for him). Two, I do agree that the current dose seems too high, and the carbs in the kibble may be helping to keep him safe. Eventually you want to go all low-carb food, but let's do it slowly and safely!

I second the recommendation to switch to a human meter-- much cheaper strips, and in fact easier for people here to interpret (most of us use human meters, and all of the dosing methods were developed with human meter numbers in mind).

If you are home testing, there's no need to spend money on fructosamine tests or curves at the vet, either. You'll be able to monitor Hwy 99's progress much better at home.

As for colors on the spreadsheet, ideal numbers health-wise will be the cool colors of dark green and blue. "Too low" is light green; the other warm colors (yellow, pink, red) and black are "too high". Eventually you'll want to get Hwy 99 spending most of his time in blues and greens, but don't worry too much about that yet. It takes some time to get to the point where you can get him to that zone safely, without dipping down farther into the light green (too low) zone.

In numbers: normal BG on an AlphaTrak is roughly 68-mid/high 100's (maybe 150-180 at the high end). On a human meter, if you do switch, normal is 50-120.

On this board, we recommend that newbies skip a shot if BG is under 200 (the document excerpted above is from the Lantus forum, which tends to be a little more adventurous). I might even move that no-shoot number up in this case, due to the use of the AlphaTrak (which will run at higher numbers in general), and due to our suspicion that Hwy 99 is on too high a dose. In addition to that, if it's not feasible to keep kibble and other food away in the 2-hr window before shot time, we want to be extra-cautious in case the BG number is inflated from that.

So, if you get a number below 250 at pre-shot, stall, don't feed a meal, and post here for advice. Sometimes it might be fine to shoot depending on the number and how brave you are feeling, sometimes it just isn't the day (or night :coffee:) for it :confused:.

Last, let me just say this: I totally get the problem of dealing with your own health challenges while trying to manage FD. If you look at my cat's spreadsheet, you'll note an almost-complete absence of late-night tests. My cat got a lot of bedtime carbs (soooooo many carbs!!!) that she technically shouldn't have on nights when I knew I ought to stay up and monitor but just couldn't. Was that the "correct" way to deal with the diabetes? Nope. Did I have a choice while dealing with my own health? Also nope!

All you can do is to do what you can, and adjust and adapt the advice and recommendations to fit your own circumstances. You'll find workarounds and solutions too. It's all very overwhelming at first, but you have already mastered a lot of it by coming here and learning to home test. It does get easier, and it will all be worth it to get Hwy 99 feeling better and gaining some of that weight back!
 
Welcome Heather!

There is a mountain of information to try to absorb and it's a bit harder when you're transitioning from a shorter acting insulin like Vetsulin to Lantus. They are very different!

First a safety question. Did you switch from U40 syringes to U100 syringes? Lantus is a U100 insulin and the syringes need to match the insulin concentration.

Second, a finance issue. There is absolutely no need to use a AlphaTrack meter. The strips are prohibitively expensive and it is the one major issue that causes people to abandon the meter. (Well the cost and the fact you can only get them by ordering online which is a problem if you're low on strips.) The Walmart brand, Relion, meter is inexpensive as are the strips for that meter. Lots of people here use a human meter. All of our dosing methods are based on using a human meter. The human meters are calibrated to run a little lower than a pet meter but it's like comparing Centigrade and Fahrenheit -- the scales are just different but the underlying meaning is the same.

I would also suggest you consider moving over to the Lantus forum. The folks there only use Lantus and there is a great deal of information in the sticky notes at the top of the board. In the mean time, I'll try to respond to your questions.

1) What numbers should I NOT give scheduled dose of insulin? If I have to skip, do I just resume the normal dose 12 hours later?
We suggest that if you are new to using Lantus, you post and ask for help if you have a pre-shot number that is lower than 150. Do NOT feed your cat if you get a low pre-shot number. A lot depends on what you do next -- stall or shoot a reduced dose. If you are skipping, then it's fine to feed your kitty but if you're stalling, you don't want the numbers influenced by food. If you are seeing a pre-shot number that is below 50, never shoot. There is no margin for safety if your pre-shot number is that low. Again, depending on what the numbers looked like initially, you would either shoot your regular dose at the next shot time. If your cat earned a dose reduction, you would shoot the reduced dose.

2) What does an ideal day look like on spreadsheet? Do colors represent “good” or “bad” or are they arbitrary?
Green and blue numbers are "good." (Well, providing they are above 50.) Normal BG range is 50 - 120. That's what you're aiming for to get your cat regulated.

3) Which/How much bg data is helpful/essential? (I am on SSDI and currently spending aprox 8$ day on AT2 strips-many unsuccessfully-isn’t sustainable, so I need to prioritize!
Ditch the AT2. This is a hard question to answer. I'm a testaholic. I like data. I also had a kitty that was prone to drama and could drop into very low numbers early in the cycle. My testing took my cat's behavior into account. With the Lantus dosing methods you need to get a pre-shot test before giving a shot. Lantus dosing is based on the nadir so it's important to get at least one test around the middle of the cycle. So, 4 test per day is the minimum. Looking at Hwy 99's spreadsheet, you need to get tests during the PM cycle. You're seeing some reduction worthy numbers in the AM cycle. Many cats have lower numbers at night so getting a "before bed" test every night can be very important.

4) Does food factor into his BG reading? (I realize this sounds like a stupid question but I have been so focused on actually getting samples and data that I realized I don’t understand how they affect each other!)
Yes, food is a big factor. Your kitty should be eating low carbohydrate, canned food. Many people here feed their cats either Fancy Feast or Friskies pate style food. You want to be feeding under 10% carb -- many people feed their cat about 5% or so. See Dr. Lisa's food chart for your options. Think in terms of a human diabetic. If you eat cookies and ice cream you'll need more insulin to keep your blood glucose (BG) in a less than awful range. Kibble is the equivalent of feeding your cat cookies.

5) 2 days ago switched from 3 units of vetsulin once per day, to 2 units Lantus every 12 hours based on latest fructosamine levels-but from what I am reading in others messages this seems too high?
Generally, with switching from Vetsulin to Lantus it's a unit-to-unit switch. Looking at Hwy 99's spreadsheet (SS), I think you're starting out on a bit too high of a dose. I would suggest no more than 1.5u twice a day (i.e., dividing the 3u in half so you can shoot twice a day). It may be easier on your nerves to drop it back to 1.0u per day. Do you have any of your test data from when your cat was on Vetsulin? It would be helpful to see what his numbers looked like.

6) Given all the changes in insulin and diet, when I should I get another curve and/or fructosamine?
Since costs are an issue and since you're testing, you do not need to spend money on a fructosamine test. A fructosamine test is meant to tell you the average of your cat's BG over a few weeks. If you continue to test, you'll have the same data on your SS so a fructosamine test isn't really necessary. Getting a curve can alway be helpful especially if you are testing only 4 times a day. Also, it takes a week for the Lantus depot to form. You'll want to get a curve once a week so you can have a feel for when insulin onset and nadir (lowest point in the cycle) occur as well as how much duration you're getting.
 
Sienne and Gabby (GA) said:
Welcome Heather!

There is a mountain of information to try to absorb and it's a bit harder when you're transitioning from a shorter acting insulin like Vetsulin to Lantus. They are very different!

First a safety question. Did you switch from U40 syringes to U100 syringes? Lantus is a U100 insulin and the syringes need to match the insulin concentration.

Second, a finance issue. There is absolutely no need to use a AlphaTrack meter. The strips are prohibitively expensive and it is the one major issue that causes people to abandon the meter. (Well the cost and the fact you can only get them by ordering online which is a problem if you're low on strips.) The Walmart brand, Relion, meter is inexpensive as are the strips for that meter. Lots of people here use a human meter. All of our dosing methods are based on using a human meter. The human meters are calibrated to run a little lower than a pet meter but it's like comparing Centigrade and Fahrenheit -- the scales are just different but the underlying meaning is the same.

I would also suggest you consider moving over to the Lantus forum. The folks there only use Lantus and there is a great deal of information in the sticky notes at the top of the board. In the mean time, I'll try to respond to your questions.

1) What numbers should I NOT give scheduled dose of insulin? If I have to skip, do I just resume the normal dose 12 hours later?
We suggest that if you are new to using Lantus, you post and ask for help if you have a pre-shot number that is lower than 150. Do NOT feed your cat if you get a low pre-shot number. A lot depends on what you do next -- stall or shoot a reduced dose. If you are skipping, then it's fine to feed your kitty but if you're stalling, you don't want the numbers influenced by food. If you are seeing a pre-shot number that is below 50, never shoot. There is no margin for safety if your pre-shot number is that low. Again, depending on what the numbers looked like initially, you would either shoot your regular dose at the next shot time. If your cat earned a dose reduction, you would shoot the reduced dose.

2) What does an ideal day look like on spreadsheet? Do colors represent “good” or “bad” or are they arbitrary?
Green and blue numbers are "good." (Well, providing they are above 50.) Normal BG range is 50 - 120. That's what you're aiming for to get your cat regulated.

3) Which/How much bg data is helpful/essential? (I am on SSDI and currently spending aprox 8$ day on AT2 strips-many unsuccessfully-isn’t sustainable, so I need to prioritize!
Ditch the AT2. This is a hard question to answer. I'm a testaholic. I like data. I also had a kitty that was prone to drama and could drop into very low numbers early in the cycle. My testing took my cat's behavior into account. With the Lantus dosing methods you need to get a pre-shot test before giving a shot. Lantus dosing is based on the nadir so it's important to get at least one test around the middle of the cycle. So, 4 test per day is the minimum. Looking at Hwy 99's spreadsheet, you need to get tests during the PM cycle. You're seeing some reduction worthy numbers in the AM cycle. Many cats have lower numbers at night so getting a "before bed" test every night can be very important.

4) Does food factor into his BG reading? (I realize this sounds like a stupid question but I have been so focused on actually getting samples and data that I realized I don’t understand how they affect each other!)
Yes, food is a big factor. Your kitty should be eating low carbohydrate, canned food. Many people here feed their cats either Fancy Feast or Friskies pate style food. You want to be feeding under 10% carb -- many people feed their cat about 5% or so. See Dr. Lisa's food chart for your options. Think in terms of a human diabetic. If you eat cookies and ice cream you'll need more insulin to keep your blood glucose (BG) in a less than awful range. Kibble is the equivalent of feeding your cat cookies.

5) 2 days ago switched from 3 units of vetsulin once per day, to 2 units Lantus every 12 hours based on latest fructosamine levels-but from what I am reading in others messages this seems too high?
Generally, with switching from Vetsulin to Lantus it's a unit-to-unit switch. Looking at Hwy 99's spreadsheet (SS), I think you're starting out on a bit too high of a dose. I would suggest no more than 1.5u twice a day (i.e., dividing the 3u in half so you can shoot twice a day). It may be easier on your nerves to drop it back to 1.0u per day. Do you have any of your test data from when your cat was on Vetsulin? It would be helpful to see what his numbers looked like.

6) Given all the changes in insulin and diet, when I should I get another curve and/or fructosamine?
Since costs are an issue and since you're testing, you do not need to spend money on a fructosamine test. A fructosamine test is meant to tell you the average of your cat's BG over a few weeks. If you continue to test, you'll have the same data on your SS so a fructosamine test isn't really necessary. Getting a curve can alway be helpful especially if you are testing only 4 times a day. Also, it takes a week for the Lantus depot to form. You'll want to get a curve once a week so you can have a feel for when insulin onset and nadir (lowest point in the cycle) occur as well as how much duration you're getting.
Click to expand...
thank you! Yes, I do have the accurate syringes and great idea I will pick up that more affordable unit at walmart! The SS is categorized-the primary one is a combo of both insulin's (which I hopefully made clear enough on the SS) but for just the vetsulin info from last week is the next tab at the bottom-I only have one week of testing and it seems with so many changes its hard to tell if that data is helpful even...? I'm going to work on getting some PM numbers, I usually go to bed shortly after his 9pm dose and I i didnt realize it would be important to have this data which now seems silly. I have an all inclusive insurance type plan I pay for monthly which is great for annual/preventative/emergency vet care as it covers all needed tests and makes sure I am not put in a situation where I cant afford to go to vet BUT it is basically a fast food version of veterinary medicine and they dont retain knowledgeable or caring staff it seems and they have consistently given me incorrect or zero information as to how to properly manage his conditions...thank God for you all! I do have the benefit of having fructosamine or curves being covered for no charge in house if you guys think its beneficial? I do have to pay for all the supplies myself and am prioritizing getting as much bg data as I can-and I think that other meter will help!
 
Nan & Amber (GA) said:
Hmm, kibble addicts are tough! If it were me, though, I'd stick with the slow transition you are doing, for two reasons. One, it will be easier on Hwy 99's digestion (and if he's sensitive, you may even have to try a couple different wet foods before you find one that agrees with him. It may be that Fancy Feast just isn't "the one" for him). Two, I do agree that the current dose seems too high, and the carbs in the kibble may be helping to keep him safe. Eventually you want to go all low-carb food, but let's do it slowly and safely!

I second the recommendation to switch to a human meter-- much cheaper strips, and in fact easier for people here to interpret (most of us use human meters, and all of the dosing methods were developed with human meter numbers in mind).

If you are home testing, there's no need to spend money on fructosamine tests or curves at the vet, either. You'll be able to monitor Hwy 99's progress much better at home.

As for colors on the spreadsheet, ideal numbers health-wise will be the cool colors of dark green and blue. "Too low" is light green; the other warm colors (yellow, pink, red) and black are "too high". Eventually you'll want to get Hwy 99 spending most of his time in blues and greens, but don't worry too much about that yet. It takes some time to get to the point where you can get him to that zone safely, without dipping down farther into the light green (too low) zone.

In numbers: normal BG on an AlphaTrak is roughly 68-mid/high 100's (maybe 150-180 at the high end). On a human meter, if you do switch, normal is 50-120.

On this board, we recommend that newbies skip a shot if BG is under 200 (the document excerpted above is from the Lantus forum, which tends to be a little more adventurous). I might even move that no-shoot number up in this case, due to the use of the AlphaTrak (which will run at higher numbers in general), and due to our suspicion that Hwy 99 is on too high a dose. In addition to that, if it's not feasible to keep kibble and other food away in the 2-hr window before shot time, we want to be extra-cautious in case the BG number is inflated from that.

So, if you get a number below 250 at pre-shot, stall, don't feed a meal, and post here for advice. Sometimes it might be fine to shoot depending on the number and how brave you are feeling, sometimes it just isn't the day (or night :coffee:) for it :confused:.

Last, let me just say this: I totally get the problem of dealing with your own health challenges while trying to manage FD. If you look at my cat's spreadsheet, you'll note an almost-complete absence of late-night tests. My cat got a lot of bedtime carbs (soooooo many carbs!!!) that she technically shouldn't have on nights when I knew I ought to stay up and monitor but just couldn't. Was that the "correct" way to deal with the diabetes? Nope. Did I have a choice while dealing with my own health? Also nope!

All you can do is to do what you can, and adjust and adapt the advice and recommendations to fit your own circumstances. You'll find workarounds and solutions too. It's all very overwhelming at first, but you have already mastered a lot of it by coming here and learning to home test. It does get easier, and it will all be worth it to get Hwy 99 feeling better and gaining some of that weight back!
Click to expand...
SHOOT, I thought I remembered you say 'if below 200' but you said 250, and I just got his pm bg at 223 and fed him and came to confirm if I should give his shot...shoot, if you or anyone is still awake and checking this thread out, please advise if I should still give his shot! thanks!!
 
With Lantus vs other insulins, the "post and ask for help" number varies. On the Lantus board, we use 150. On Health, because there are people using a variety of different insulins, most of the time you're advised to post if your pre-shot number is 200. Either way, you want to begin to get comfortable with gradually shooting lower numbers. The mantra with Lantus is ultimately, "shoot low to stay low." This is not the case with the faster acting insulins.

What time do you get up in the morning? It would be helpful if you can shift your shot time so you're able to get some tests in the evening. A +2 can be helpful -- if you see a sizable drop by +2, often it means you need to get additional tests since it could be a cycle where your kitty is gearing up for a dose reduction. You can safely move shot times by 30 min. once a day or by 15 min at each shot time.
 
Yes, exactly what Sienne says. I made it more confusing by later modifying the 200 to 250, just for Hwy 99's current, specific situation (pet meter, indications of dose being too high, etc.). It wasn't meant to be a hard-and-fast rule, just adding a little extra safety buffer as we try to figure out where he is and his proper dose. Shooting the 223 was fine.
 
Nan & Amber (GA) said:
Oh, I'm sorry no one was around at shot time! And I'm also sorry I phrased that confusingly-- my fault. I think you did well to shoot 1.5U. Did you get any tests after the 210 at +2?
Click to expand...
thank you and no, totally on me-I have a significant amount of health issues and medications that completely mess me up and I could hardly stay awake to get the +2 last night...another problem this morning (again, me not retaining/remembering correctly) he got a 72 amps reading and out of habit I started feeding him (normally I would use that time to get his shot ready but came here instead) so where I should have apparently stalled and tried again, I fed him and now I dont know (again) whether to give insulin...I should probably start a new post...?
 
Please don't shoot. With that number, I'd be surprised if stalling changed that decision, so let's just call this morning another skip and regroup tonight.

I'm going to suggest starting at much lower dose, no more than 1.0U, and probably more like 0.5U. We want to find a dose you can shoot twice a day safely, and it doesn't look like you're anywhere near that.
 
Heather Bentley said:
thank you and no, totally on me-I have a significant amount of health issues and medications that completely mess me up and I could hardly stay awake to get the +2 last night...another problem this morning (again, me not retaining/remembering correctly) he got a 72 amps reading and out of habit I started feeding him (normally I would use that time to get his shot ready but came here instead) so where I should have apparently stalled and tried again, I fed him and now I dont know (again) whether to give insulin...I should probably start a new post...?
Click to expand...
Hi Heather just checking in with you to see how you are doing today ?
 
Sienne and Gabby (GA) said:
With Lantus vs other insulins, the "post and ask for help" number varies. On the Lantus board, we use 150. On Health, because there are people using a variety of different insulins, most of the time you're advised to post if your pre-shot number is 200. Either way, you want to begin to get comfortable with gradually shooting lower numbers. The mantra with Lantus is ultimately, "shoot low to stay low." This is not the case with the faster acting insulins.

What time do you get up in the morning? It would be helpful if you can shift your shot time so you're able to get some tests in the evening. A +2 can be helpful -- if you see a sizable drop by +2, often it means you need to get additional tests since it could be a cycle where your kitty is gearing up for a dose reduction. You can safely move shot times by 30 min. once a day or by 15 min at each shot time.
Click to expand...
Not to take this off track...is moving the shot time as you indicated specific to Lantus, or any insulin? Vet told me as long as I'm within an hour either way I'm good. Wondering if that might be contributing to some of my problems.
 
Heather Bentley said:
thank you and no, totally on me-I have a significant amount of health issues and medications that completely mess me up and I could hardly stay awake to get the +2 last night...another problem this morning (again, me not retaining/remembering correctly) he got a 72 amps reading and out of habit I started feeding him (normally I would use that time to get his shot ready but came here instead) so where I should have apparently stalled and tried again, I fed him and now I dont know (again) whether to give insulin...I should probably start a new post...?
Click to expand...
Don't be too hard on yourself! I can barely retain all the info either.

I actually made myself a flow chart (and in case anyone else has to take care of him in an emergency)... I'm still making sure it's accurate, but I attached in the event it helps you (yours will probably be a bit different due to different meter, insulin, diet).
 

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Actually, you have a good point. There's less of a problem with altering shot times with insulins other than Lantus due to the shorter duration and lack of an insulin depot. Cat's however, are creatures of habit. My civic got very used to being fed at the same time as Gabby. Gizmo still wakes me up at 5:00 AM for breakfast. According to the clock in his stomach, that's when breakfast is served. I also think it's easier for us to stick to a routine so there's less chance of forgetting to give a shot.

FWIW, given that Prozinc has a longer duration, gradually shifting the shot time would make sense for those using that insulin, as well.

Good question to raise!
 
Hi Heather, welcome to my world. I had to start over putting the square peg in the square hole so I kind of know where you're coming from.
I have not read every post here and I don't give dosing advice but I can tell you what helped me sort out the little things some people take for granted.
Some of these things may not apply to you. In no particular order:
-I already had one sugar cat before I came here so my spreadsheets were done in Excel. Do not consider that as an alternative. I'm OCD with numbers and got carried away with averages, last weeks highest numbers etc. That kind of stuff is useless. We do value long term values but picking apart days hour by hour is futile. I also wrote everything down in a notebook, nothing wrong with doing things the old way as a backup.
-Every cat is different. We want you to keep careful track of body weight, food intake etc. but what works for one cat may not work for another. Eventually you'll get a better feel for everything but it's a mistake to think you know your cat's behavior when a meter is telling you something else.
-Some people get up at 2AM every night to check their cat's blood levels, I rarely did. You'll do what you have to do but at some point diabetes will become an inconvenience and not a daily emergency. When in doubt test again.
-My last cat never achieved anything near a nice regular pattern. What I learned from him was to give him a lower dose at night because higher numbers can be worked with later. Dangerously low numbers can be deadly.
-I often don't know the date so "did I give him his shot?" wasn't a joke. Your meter has a memory function so that's how you'll know you at least tested. After a shot bend the needle backwards on the syringe and recap it, put that in your sharpies container as you're preparing the next day's shot.
-Before it gets smudged note the expiry date on your insulin. I always got a new vial long before getting to the bottom of an existing vial.
-It helped me to print everything, then curl up on the sofa with a hi-liter. Using a mouse and any version of Windows you can copy and paste almost anything into Word or better yet Notepad. I just don't retain certain things without seeing it on paper, I live in a world of PostIt notes and have lists of my lists.
-The side of the fridge and fridge magnets are your new best friends. Everything from Hypo instructions, directions and phone numbers of emergency clinics, taxi company numbers etc. There is always one more thing.
-Your Go Bag. This is what you keep by the door if you have to run out to emergency in a blizzard. Don't assume any clinic will have a meter like yours, batteries, even the same syringes. I've turned left on red lights and run out the door in my bare feet, not the time to forget where your keys are.

If it helps this is not a place where we shame people or snicker behind their backs. I've got my own problems and have gotten nothing but love here. You will too.
 
Nan & Amber (GA) said:
Hi @Heather Bentley , how's he doing today? I see on the spreadsheet that he hit blue again last night :cool:, but I don't see anything for today yet. Is everything OK?
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thank you for asking, I am just in tears and so frustrated with myself and this situation and I feel paralyzed with anxiety afraid to make things worse...I just updated, he was 59 again first thing, then 96 +2 so I skipped AM dose again and am continuing to try to test but it is nothing like all the you tube videos for us-its a whole stressful ordeal and he is avoiding me and I dont know at what point I am making things worse by all the stress pokes...with so many changes this week (he was on 3 units vetsulin once a day, then vet advised to go to 2 units twice a day LANTUS after I asked based on this forum, THEN 2 days on that new dose and insulin his readings have been so low I have been back to dosing once a day...its a lot of changes and I am seriously paralyzed by the fear I am making him worse that I just dont know what to do! People were suggesting to go even lower like 1.25 or 1 unit but I cant even read that on these syringes and I worry that these continued changes every day are making it hard to get any accurate data...sorry to unload Im just on the verge of a nervous breakdown-I really appreciate you checking in on us!
 
:bighug: :bighug: :bighug: :bighug: :bighug: :bighug: :bighug: :bighug: :bighug: :bighug:

I'm so sorry. I know it doesn't help much to hear that we all had "those" days ( :arghh: :arghh: :arghh: ) in the beginning, but it's true. You are not alone, and even if no one else on the planet understands, here, we get it.

Take a break. I'm going to advise you to skip tonight's shot too. He's been going low every time you shoot, he's sending you a message. Next time, you can shoot in the morning and be able to watch him during the day, so you don't get another of these surprises at shot time.

I really do think he needs less insulin. We'll figure out the dose tomorrow. Don't worry about all the rapid changes in dose-- we need to do this right now, but once we get to the right dose for him, we'll be able to settle down to give it a chance to show what it can do.

It really is tough to see those tiny doses :(, though. I think some people around here have used "reader" glasses to help magnify, or a cheap jeweller's loupe, or even a standing lighted magnifying glass (fancy!). Do you have anything like that you could try to set up?
 
Hi Heather I just wanted to tell you t's going to be ok. Hwy99 is LUCKY to have you as his care giver. Testing is the hardest part of this whole thing. Boy do I remember crying my eyes out thinking I'm going to kill my cat. Trouble hid from me. I thought he hated me.

Have you tried singing a funny song while trying to test? I use to hum "You Are My Sunshine" to Trouble it helped me calm down and in turn helped Trouble. Maybe something as simple as a silly kids song?

You are not alone. I dont know of one person that has said it was a breeze in the beginning. We got your back. You come here ANYTIME and vent. We WILL listen!
Take care and please give adorable Hwy 99 some scritches from me.;)
jeanne
 
I think some folks also use colored liquid in a sample syringe and then use that to compare every time. I feel like @Deb & Wink suggested that one time. You’re using the 1/2 marked syringes, right? Even with those it’s still hard I know. It helps me to look at it against the light and then against my hand so I start to get used to where that dose should be visually.

Everyone already said this, but you’re doing great!! You’ve got him on a better insulin and better doses too. You’ll get there. I thought I was going to lose my mind with testing, shooting and all the additional meds Minnie was on and still is for the last few weeks in addition to tube feeding. I allowed myself to have a meltdown for one evening and then I took a deep breath, put on my big girls pants and reminded myself that some of the stuff may not be enjoyable but it’s for their health and to help them heal. You got this!!! :bighug::bighug::bighug:
 
When I said "we have all been where you are now" I meant that literally. I was tearing out my hair those first two weeks, pretty sure I was about to murder my cat one way or another. We've all stared at a cat, "Crap, is he dead or just sleeping?" and I've shredded so many ears the Cat Gods may never forgive me but in the end it all worked out. Nigel wasn't drinking or peeing too much when he was diagnosed, we finally took him in because he was after people food like a bad dog. He very well could have been diabetic for a month before we found out. I have some oddball neurological stuff going on and there were many nights when I had to get medicated and run to bed with ice bags. Those were the nights Noah never even got tested never mind getting his shot. Being diabetic and missing a shot won't kill your cat but it sounds like you're about ready to keel over. Start again tomorrow, repeat as necessary. We'll all be here.
 
Thank you all so much for your kind words and help:bighug: I am battling a flare up and having to sleep like a ton so I'm a little off schedule but I have now skipped 3 consecutive doses based on his numbers and y'alls recommendations, I should probably start a new thread (probably will) but I trust you guys now being on this journey with me so I am hoping you can look at his spreadsheet and continue to help tell me what to do! thanks so much!!!
 
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