Disco Update and a few questions

[Teri & Disco NoFurNo (GA)]

Hope this is where I post a new message (says create thread but it seems like a new conversation, so please let me know if I'm doing this correctly). I'm still learning how to navigate the group and feel like I need to print out all the great info and documents and files to put in a binder so I don't have to search around in a panic (haven't panicked yet, but I'm only 6 days into the sugar journey). I did start a spreadsheet and was glad to have others sheets to help guide me and added Disco's labs into it this morning.

I recently moved from Virginia to Oregon and he was seen for his 6 month senior exam/labs on 10/22 at a mixed animal practice where I used to work decades ago. I am so used to working at all-feline practices (the past 17 years) that I just can't get past thinking that the vet is 'thinking with their dog brains' and have contacted another practice that is both AAHA and AAFP Gold Cat Friendly, so may try a visit with them soon. Most of our patients there where on Lantus and a few on Pro-Zinc as that's what they started on with previous vets and didn't want to change. I would like to get Disco on Lantus eventually, too.

Disco is currently on Vetsulin, 1 unit BID and I'm AlphaTrak testing him at 7:30am and 7:30pm but his poor ears look like a pincushion as I am not adept at one prick being enough to get blood. I'm using the lancets provided in the starter kit, but read in a thread that there are alternate site lancets 26g and will go to Walmart and get those and may get one of their Relion meters, should have joined the group before I bought the AlphaTrak as now realize that the supplies are cost prohibitive and I'd rather spend that money on Lantus, LOL. I wondered if I put something like one of those firm foam makeup sponges behind his ear if I would find that easier but will try the folded up toliet paper next inj as I found the cotton pad too bulky to keep on the ear flap, but that's mostly because of my fumbling. I had to roll my eyes when the vet said I could try his inner upper lip--maybe on a large dog but I can't imagine doing that on a cat. Has anyone used a paw pad? To me, that seems like it would be sensitive afterwards but might be a good place to rotate to. The vet also said I could just go to once a day testing at the 6 hour post inj time, would appreciate any input on that.

His readings have been coming down gradually, started at 335 and this morning 283. His appetite is good, eats the main part of his post-inj meal immediately and grazes on the rest over a few hours (gets approx 3 oz raw/wet mixed in the AM and PM). Is that an OK feeding regimen? I just read over the Vetsulin Beginner's Guide and will adjust my test/inj/feeding schedule to that timing.

 

[Red & Rover (GA)]

His appetite is good, eats the main part of his post-inj meal immediately and grazes on the rest over a few hours (gets approx 3 oz raw/wet mixed in the AM and PM). Is that an OK feeding regimen?

It is best to feed throughout the cycle, taking food up two hours (+10) before the next shot so that the preshot test is not food influenced.
Vetsulin is a harsh insulin and can drop a cat fast. Feeding a snack or two throughout the first half of the cycle will help with that.
The order is:
1. Test to see if the number is high enough to shoot.
2. Feed, to make sure the cat will eat.
3. Wait 30 minutes after feeding to shoot.

It is very important to get some mid-cycle tests to find the nadir, especially since the preshot numbers are coming down. Dosing is based on the nadir of the cycle, and not the preshot. Also, it is important to get a test in before you go to bed. Cats tend to go lower in the PM cycle.

Neosporin with pain relief will help heal the pincushion ears. The ears are not as sensitive as one might think.
Yes, a larger gauge lancet will help. Some people have better luck freehanding rather than using the lancet device.
Yes, some people here paw test and I have not read about any problems associated with that method.
Testing does get easier.

You can save money on Lantus by buying from Canada (it is much cheaper up here). Many people do. Buying insulin from Canada. You will need a paper Rx from your vet to send to the company. Marks is a reputable pharmacy.

 

[Red & Rover (GA)]

Since Vetsulin is harsh. A +2, then depending on that test, a +3 or +4 test is useful.

I'm tagging @MrWorfMen's Mom who has knowledge of vetsulin.

 

[Diane Tyler's Mom GA]

Welcome Teri, you are in the best place, everyone is so helpful and knowledgeable.
I don't know what I would have done without them. Suggestion you might want to add to your signature that you are giving 1 unit of Vetsulin now. Only because members might not look back on your original post if it gets to long. Like Red & Rover said it is very important to get mid cycle tests to see how the insulin and dosage is affecting his BG. Best of luck

 

[Teri & Disco NoFurNo (GA)]

It is best to feed throughout the cycle, taking food up two hours (+10) before the next shot so that the preshot test is not food influenced.
Vetsulin is a harsh insulin and can drop a cat fast. Feeding a snack or two throughout the first half of the cycle will help with that.
The order is:
1. Test to see if the number is high enough to shoot.
2. Feed, to make sure the cat will eat.
3. Wait 30 minutes after feeding to shoot.

It is very important to get some mid-cycle tests to find the nadir, especially since the preshot numbers are coming down. Dosing is based on the nadir of the cycle, and not the preshot. Also, it is important to get a test in before you go to bed. Cats tend to go lower in the PM cycle.

Neosporin with pain relief will help heal the pincushion ears. The ears are not as sensitive as one might think.
Yes, a larger gauge lancet will help. Some people have better luck freehanding rather than using the lancet device.
Yes, some people here paw test and I have not read about any problems associated with that method.
Testing does get easier.

You can save money on Lantus by buying from Canada (it is much cheaper up here). Many people do. Buying insulin from Canada. You will need a paper Rx from your vet to send to the company. Marks is a reputable pharmacy.

Thanks so much for the detailed recommendations! I just did a +3 test and it was 199 (and I got it in one poke, too). Yes, I have been freehanding the poke, gave up on the device as the lancet seemed to move down into the device. Yes, we used Marks Pharmacy at the clinic I worked at last in Virginia, too.

 

[Red & Rover (GA)]

Thanks so much for the detailed recommendations! I just did a +3 test and it was 199 (and I got it in one poke, too). Yes, I have been freehanding the poke, gave up on the device as the lancet seemed to move down into the device. Yes, we used Marks Pharmacy at the clinic I worked at last in Virginia, too.

So that's roughly a 100 point drop in 3 hours. It would be interesting to get a +4 if you can, to give you an idea of what vetsulin is doing.

Testing on a daily basis periodically throughout the cycles will help to fill in the blanks and give you a bigger picture. Also, cats are tricky beasts. You never know when they will get bored and decide to change the pattern.

 

[Teri & Disco NoFurNo (GA)]

Welcome Teri, you are in the best place, everyone is so helpful and knowledgeable.
I don't know what I would have done without them. Suggestion you might want to add to your signature that you are giving 1 unit of Vetsulin now. Only because members might not look back on your original post if it gets to long. Like Red & Rover said it is very important to get mid cycle tests to see how the insulin and dosage is affecting his BG. Best of luck

Thx! Just added his current dose to the signature.

 

[Teri & Disco NoFurNo (GA)]

Thanks so much for the detailed recommendations! I just did a +3 test and it was 199 (and I got it in one poke, too). Yes, I have been freehanding the poke, gave up on the device as the lancet seemed to move down into the device. Yes, we used Marks Pharmacy at the clinic I worked at last in Virginia, too.

4+ was 181, poor guy--multiple pokes but nice treat afterwards.

 

[Teri & Disco NoFurNo (GA)]

8+ 3:30pm reading was 277 and I tried the paw pad this time and it worked well for both of us!

 

[Red & Rover (GA)]

Tagging @MrWorfMen's Mom for dosing advice.

You are not the first to make that mistake and you will not be the last.

Focussing on feline diabetes 24/7 is a lot different from seeing it in a veterinary practice.

 

[Teri & Disco NoFurNo (GA)]

Tagging @MrWorfMen's Mom for dosing advice.

You are not the first to make that mistake and you will not be the last.

Focussing on feline diabetes 24/7 is a lot different from seeing it in a veterinary practice.

Thank you for the comforting thoughts.

I wasn't sure if I should start a new thread, so deleted the post that you left this comment to and started a new one. By the way, what is the 'proper' way to add a new days info--new post or keep adding to initial post even if it was a day or more ago?

 

[Red & Rover (GA)]

The Lantus/Levemir protocol is a new thread each day. The Lantus forum is very busy and people do not have the time to read through a lot of background posts. They can see from a glance at the day's thread title how a cat is progressing.
The other insulin threads seem to be continuous, starting a new thread when the thread gets to be too long or when there are questions.

To change a thread title, go up to the top right corner and click on "edit title."

 

[MrWorfMen's Mom]

Hi and welcome to FDMB. Disco looks like quite the little lover boy! Adorable!

As Kel says, Lantus forum they always start a new thread daily. While we don't want threads getting too long here, a new post every few days will work well without anything getting too long unless there are a lot of questions or comments. It takes a while to get accustomed to using the forum so just ask when questions come up. We were all new at this at one point.

Right now I'd continue with the 1u dose. That higher BG at +1 last night and higher BG this AM are likely a product of what is called bouncing. Bouncing is a phenomenon that the cat's body uses to keep status quo. Our kitties get used to being in higher numbers so when we give them insulin and BG drops, the body kind of panics and thinks BG is dropping too low. In response, hormones are released that cause stored glucose to be released into the BG to bring BG back up the levels the cat has now become accustomed to. This occurs if BG drops suddenly, drops to levels the cat perceives as low which is relative or if BG drops by a significant amount in a short period.

Disco dropped 100 points in the first 4 hours of the cycle yesterday and it looks like that increase in BG last night and higher BG this morning is likely just his body reacting. It takes a bit of time for kitty to get used to the lower BG.

Not sure when you are feeding Disco but sometimes giving a snack in the early hours of the cycle can slow down the drop a bit and extend out the insulin action. Perhaps try a small snack around +2 (just a tsp. or 2) and see if that helps slow the drop at all.

Congrats on the testing. I am always amazed when folks are able to do paw testing. That would have earned me a few good scratches I'm sure. Disco will grow more capillaries and bleed easier as time goes on but if you can test wither paws or ears, you're in great shape!

 

[Teri & Disco NoFurNo (GA)]

Hi and welcome to FDMB. Disco looks like quite the little lover boy! Adorable!

As Kel says, Lantus forum they always start a new thread daily. While we don't want threads getting too long here, a new post every few days will work well without anything getting too long unless there are a lot of questions or comments. It takes a while to get accustomed to using the forum so just ask when questions come up. We were all new at this at one point.

Right now I'd continue with the 1u dose. That higher BG at +1 last night and higher BG this AM are likely a product of what is called bouncing. Bouncing is a phenomenon that the cat's body uses to keep status quo. Our kitties get used to being in higher numbers so when we give them insulin and BG drops, the body kind of panics and thinks BG is dropping too low. In response, hormones are released that cause stored glucose to be released into the BG to bring BG back up the levels the cat has now become accustomed to. This occurs if BG drops suddenly, drops to levels the cat perceives as low which is relative or if BG drops by a significant amount in a short period.

Disco dropped 100 points in the first 4 hours of the cycle yesterday and it looks like that increase in BG last night and higher BG this morning is likely just his body reacting. It takes a bit of time for kitty to get used to the lower BG.

Not sure when you are feeding Disco but sometimes giving a snack in the early hours of the cycle can slow down the drop a bit and extend out the insulin action. Perhaps try a small snack around +2 (just a tsp. or 2) and see if that helps slow the drop at all.

Congrats on the testing. I am always amazed when folks are able to do paw testing. That would have earned me a few good scratches I'm sure. Disco will grow more capillaries and bleed easier as time goes on but if you can test wither paws or ears, you're in great shape!

I hope this doesn't sound silly, but I actually have tears in my eyes after reading your reply. I am in awe of the experience, knowledge, caring and effort experienced members go to to help! It is immensely valuable to me! Disco is on Darwin's raw with FF Classics mixed in, and is used to the AM/PM feeding schedule already and eats about 75% of his meal at first and then grazes for a few hours on the remainder, but I just changed to the recommended Test, then feed, then inj 30 min later as advised on Vetsulin users link here