? Dosing Question for Charlie Cat

Sarah & Charlie-cat

Sarah & Charlie-cat

Member Since 2022
117, preshot. He's already eaten because he holds still better when he's eating/eaten. I know it's not ideal for exactly this reason! I know better, dang it.

I tried him this morning and this afternoon and he either wouldn't bleed or ran away...the last time I got a nadir, he had eaten like all of 3 kibbles and threw a 200-something. So that's not useful.

He's currently on .1 u Lantus. Should I give it or skip it. I feel like my data is so spotty!
https://docs.google.com/spreadsheet...WDunDbVvf5f-iEjgHchCTpzfkQw/edit?usp=drivesdk

I appreciate this group so much, the new all cat vet said she was impressed by my knowledge of feline diabetes. Which was due to this group, it was like having you all in the exam room.
 
I am on the struggle bus.

On the 20th, Charlie's preshot was 84. We were going to stall but he managed to get into a mix of wet food and kibbles out for another cat. Totally my fault, have already beat myself about that at length. Skipped that night and lowered his dose to .1u. He seemed to feel crappy the next day but got him eating with some other flavors of FF and Tiki cat and some Tiki Stix. He has been back to eating voraciously since then.

On the 25th, Wednesday, we saw the new vet, she gave him a good going over and said he was in fine fettle but that she needed to read the 51 pages of notes that came from the previous vet. I have not heard back yet.

Last Thursday, Charlie's pre-shot was 117 and I ended up skipping as I couldn't get a second test after I stalled for 2 hours (since he'd eaten while we were trying to get a test... he is hard to test, I am trying to more regularly enlist my husband). The following morning, he was at 283, so obviously he still needs insulin.

He has been screamier that he's hungry and is back to waking me up at 2 am for food, which I gave him, after having settled on 5 am as a way to make him less wiggly and starving at his 8:15 am test/breakfast/shot time.

I didn't manage a pre-test this morning but I did manage a +1, and it was 213. I'm going to make sure I get a +5 from him since that seems to be his nadir.

We are overdue for a curve for sure. His last one got messed up by him going into the 40s and LO on the Libre, getting kibble and karo syrup per the vet, and then removing the meter the next morning. That freaked me out.

But I am thinking .1u is not enough for him. So, we should go back up to .25u. I am anxious as the previous vet did not tell me he had ketones, but the symptoms he was displaying around the time of his diagnosis (constantly starving followed by not eating and drinking water and peeing like crazy) and what they said they did, fluids and correcting electrolytes, suggest that he was in ketoacidosis. The ketone strips I've managed have seemed peachy-grey but not bright purple. Even on myself they seem to be peachy grey, so I have bought a third package just to be sure. But catching him peeing is not always so easy and he wouldn't pee in the clean litter box with the hydrophilic sand.

Thoughts? Should we go back to .25 to see if we can get more green numbers and eliminate these yellows (some are him getting into other cats food... I'm trying, I am really trying... other cats are not getting with the program though)

https://docs.google.com/spreadsheet...DunDbVvf5f-iEjgHchCTpzfkQw/edit#gid=361360320
 
Sarah -- is there any possibility of getting a test before you turn in for the night (i.e., a "before bed" test)? Many cats experience lower numbers at night. In addition, if you're not getting any PM tests, you are missing half of your data and you may have missed a dose reduction.

I don't know if anyone ever provided you with this post on the psychology of home testing. It's a helpful read if you've not seen it.
 
PM testing is hard. I don't think we've missed a dose reduce since he's on .1 u and has had a few preshot numbers or 1+ numbers in the 200s.

Food and insulin at 8:15 am and pm work best for my schedule. Me trying to do it at 6am is not going to be great, my brain won't be booted yet ( I would foresee more furshots and worry about measuring doses at that time) and sometimes there aren't any humans home until well after 6 pm.

So a pm +4 puts us past midnight, which is hard for me to be functional the next day. Not to mention testing without a second set of hands has been challenging and my husband is often in bed by 8:30 pm.

Yes, he gets treats after tests, during tests, before tests. Yes, I have tried the rice sock but that doesn't help with him trying to shred my arm because I'm touching his ear. He's big, long cat with long legs and extra toes that come with extra claws. And he has some strong opinions about how he's touched. Most of the midday tests have been me sneaking up on him while he's napping in a warm spot. I made my husband hold him today. I had to wake them both up.

Worrying about overnight is a concern, for sure. I'm less worried about low numbers at the moment than higher ones.
 
I have read that article. I mostly test him in my room, either on the bed or on the floor where he's currently being fed. I remove other cats, usually, since they either will get in the way or hurt me for hurting Charlie. Since he's either on or near my bed, this of course leads to hiding under the bed. Treat.bag comes out, hides under the bed. I would like to get some under bed storage to make that harder but I need to get paid again first. My idiotic employer pays us once a month.

There is no room in my house where I can have him up on a table or counter that has doors. We also generally do not want cats on the dining table or kitchen counter. The upstairs bathroom door doesn't close and doesn't have enough counter space to put a long boi. My house is 110 years old and needs work and the bathrooms are very small relative to what some people might have.

I am looking into getting a desk for my room since maybe that would help, but again, I can't just drop a couple hundred bucks right now.
 
When you test depends a lot on your cat's typically cycle. My kitty had an early onset and early nadir. This made going to work much easier -- I would test at 5:00 which allowed me to get tests in before I had to leave. It also dictated if I was leaving high or low carb food out. Most cats who are prescribed Lantus see onset starting at +2. The +2 should be roughly the same as your pre-shot number. If it's substantially lower, you know to get some follow up tests.

It does sound like Charlie is literally a handful. I opted for the kitchen counter for testing Gabby since the height and lighting were good and Gabby was facing a wall. She also was in the kitchen and knew food followed her pre-shot test. (She was very food motivated.) She was, however reasonably easy to test. I wonder if having Charlie in a closed room may make him skittish/feel trapped.
 
The other options is to put five other cats behind three doors upstairs. I would also anticipate hiding under the dining table would follow much like hiding under the bed. Or running in circles around the first floor, which doesn't have any doors.

Testing at 6am and 6pm is not going to work for me. I choose 8:15 because I can reliably be awake at 8 am and reliably be home by 8pm. My work schedule is sometimes incredibly flexible and sometimes incredibly inflexible. I also need the time to work for my husband who often works late and doesn't get up early. We both have significant mental health issues and also high pressure jobs (I'm faculty at a state flagship university and he's running the mayor's reelection campaign against a truly awful person). So, there is a lot of balancing putting on our own oxygen mask first and taking care of our admittedly too many cats
 
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