First curve

[Lindsayg]

I’m hoping I did my curve okay. I will try to get a bunch of readings tomorrow since I’ll be home. Any thoughts on his numbers? Also, have any of you had luck with using methyl b12 and improvement with back leg neuropathy? I started the b12 two days ago as his back legs are getting worse. I know regulation would help the most but unfortunately we aren’t there yet.

Thanks everyone!

 

[Bron and Sheba (GA)]

Hi Lindsay,
Yes ,methyl B 12 can treat neuropathy but as you say, getting the BGs down will help the most. My cat Sheba had neuropathy badly and I gave her Zobaline and she improved and returned to normal but it took about 6 or 8 months.

Just confirming you are using a freestyle libre at the moment.
Looking at the SS, I would like to see more days at this dose, because Riley dropped to 118 this evening and he could drop further. Have you tested again since the 118 at +5?
It is possible he has been bouncing from lower numbers and that is why you are seeing some black and red numbers and then the blue BGs.. You may have missed other blue BGs as well. Bouncing can happen when the BGdrops too fast, too low or lower than the kitty has been used to lately. The body panics and dumps stored glucose and counter regulatory hormones into the system which sends the BG up high. Bounces can last from 1 to 6 cycles and there is nothing you can do about them but wait.

Has Riley been a diabetic since March this year?

Would you be able to set up your signature so that we can see the information about Riley and we won’t have to keep asking you about him.
You will find the link to the signature within this link, which has other useful information and links as well.
HELP US HELP YOU

You might like to look at the 2 dosing methods we have for Lantus HERE

Do you have a hypo kit set up? You will find information about a hypo kit in the link above called Help us help you.

Can you tell me what food you are feeding Riley and how often you feed him please?
Bron

 

[Lindsayg]

Thanks for your reply! Currently Riley is using the Freestyle Libre. He’s been diagnosed since March and been in 2 units of Lantus. He’s probably had diabetic a bit longer but I didn’t realize it right away. I realized it once he was peeing so much the litter couldn’t absorb it. I took him in the next appointment they had and confirmed it.

Due to my work schedule I can’t always do the shots 12 hours apart so sometimes it’s 11 or13 hours apart.

I believe when I got the HI readings I was feeding a high carb wet food that I didn’t realize was high carb (I thought it was low but misread the info) so I stopped feeding him that and haven’t had a “HI” since( I only fed him that food twice). He eats friskies, 9 lives, fancy feast, etc pates which I confirm have low carbs in the food spreadsheet from the Feline Diabetes fb page.

I do have a hypo kit ready.

I had been feeding him twice a day but when I had a vet tech come to my house to help me install the Libre she looked at his back legs (it’s obvious he is having issues with them). She said it seemed like atrophy because he had very little muscle mass compared to his front legs. Someone told me in the feline diabetes fb group he might need more protein so I started (like 2 days ago) to give an extra partial can of wet food. I also wasn’t sure if I was feeding him enough. He has a sister , so they split 5.5 oz in the morning and 5.5oz at night.

I will try to do another curve today since I think I’ll be home most of the day. I don’t know if I did the spreadsheet exactly correctly, so I think I’ll message the person who helps with that just to verify. I will also post my Libre log since that is more accurate on the times I took his levels ( I wasn’t sure how to do the time increments since my readings weren’t exactly to the hour apart). Never mind, it says I can’t upload a file with my response. How can I show you my Libre logs and chart?

thank you!!!

 

[Bron and Sheba (GA)]

Never mind, it says I can’t upload a file with my response. How can I show you my Libre logs and chart?

You need to put the data into the spreadsheet.

Are you giving snacks during the day and evening as well as the preshot meals? diabetic cats who are unregulated can’t absorb all the nutrients in the food and often need extra food. You could also give him some plain cooked chicken breast to supplement the other food and that is protein. Also cooked egg is good protein.

 

[Lindsayg]

I messaged the spreadsheet guru for help as I don’t know if I did it quite right. No he doesn’t get snacks during the day as I’m at work. However, now that I know he can’t absorb all the nutrients are needs more food I’ll look into ways I can get him some throughout the day. I have heard about those auto feeders that open at certain times, maybe I’ll look into that. I didn’t know he could have egg. That’s an easy thing to do . This is what his number did last night after the 118. I will try to take his levels later in the night more often.

 

[Sienne and Gabby (GA)]

It's great that you have the Libre. However, looking at one day of data isn't all that helpful when we're looking to see patterns in your kitty's blood glucose (BG) numbers. It's why we rely on the spreadsheet.

Just a word of caution. Lantus likes dosing consistency. Because it's a depot insulin, you do not have a great deal of flexibility with shot time. If you shoot more than an hour early, the early shot acts like a dose increase whereas a late shot acts like a dose reduction. It disrupts the depot. So, if you end up shooting at +13 in the evening because you're late coming back from work you've essentially reduced Riley's dose. If you end up shooting at your regular time in the AM, you're then an hour early. If there's any way you can try to keep the margin within 30 min, you should be OK. Otherwise. you need to shift the time in small enough increments that it doesn't disrupt the depot and I'm not sure how easy that will be given your schedule.

 

[Bron and Sheba (GA)]

I messaged the spreadsheet guru for help as I don’t know if I did it quite right. No he doesn’t get snacks during the day as I’m at work. However, now that I know he can’t absorb all the nutrients are needs more food I’ll look into ways I can get him some throughout the day. I have heard about those auto feeders that open at certain times, maybe I’ll look into that. I didn’t know he could have egg. That’s an easy thing to do . This is what his number did last night after the 118. I will try to take his levels later in the night more often.
View attachment 62315

Ill tag @Bandit's Mom to help with the spreadsheet. Thanks Bhooma!
Have you thought about a timed automatic feeder?
They are a great asset for caregivers of diabetic cats. They can feed your kitty while you are at work.
The petsafe5 is a very good one.

 

[Lindsayg]

I will definitely look into the auto feeder. I will try to see if when I’m going to be late and my fiancé is home, that he can feed and give the shot so the timing is more consistent. I gave him cooked egg for a snack… he ate the white part but apparently wasn’t fond of the yolk parts. He loves chicken and pork when we cook it for ourselves so I’ll make some for him too. How much do you feed your cats? I hear diff things so I am starting to think I have been feeding him too little.

Odd question regarding his back legs… I tend to overthink things way too much and just end up confusing myself more. As his back legs are getting worse I worry he won’t be able to get in and out of the litter box as easy or up on the couch. The couch seems to be getting a bit harder for him to jump on. Should I get him stairs or a little ramp? If so, which do you think would be better and easier on his legs? But then if I make things too easy for him will he lose more strength?? Are there any exercises I can do with his back legs to help him? He’s not a huge fan of his legs being messed with but if it will help I’ll give it a try! As I type this, I can see how my overthinking sounds dumb lol.

 

[Bron and Sheba (GA)]

I gave him cooked egg for a snack… he ate the white part but apparently wasn’t fond of the yolk parts

If you scramble it, he might like it better. The white of the egg is very good on its own if that is what he will eat. It is full of protein.

How much do you feed your cats? I hear diff things so I am starting to think I have been feeding him too little.

I feed my cats a raw diet. The smaller one eats more than the bigger one to maintain her weight. If I fed the larger one as much as the smaller one, he will get fat. So every cat is different(ECID).
How much does Riley weigh? While he is unregulated, he will not be able to absorb all the nutrients in the food and will require more food. As long as he isn’t putting on weight, I would feed him if he’s hungry.

Odd question regarding his back legs… I tend to overthink things way too much and just end up confusing myself more. As his back legs are getting worse I worry he won’t be able to get in and out of the litter box as easy or up on the couch. The couch seems to be getting a bit harder for him to jump on. Should I get him stairs or a little ramp? If so, which do you think would be better and easier on his legs? But then if I make things too easy for him will he lose more strength?? Are there any exercises I can do with his back legs to help him? He’s not a huge fan of his legs being messed with but if it will help I’ll give it a try! As I type this, I can see how my overthinking sounds dumb lol.

It is not a dumb question at all.
It is possible for the lack legs to get worse before they get better. But you are giving the Methyl B12 and are giving the insulin.
My Sheba had neuropathy badly and slipped and slid on the wooden floors, had trouble getting up the stairs, couldn’t jump up into the bed or chairs and had trouble squatting in the litter box. But she got completely better over time and regained all the muscle she had lost and could again jump up into the beds etc.
Apart from doing what you are doing now there isn’t much else you can do. Once the BGs come down into more normal range, that will help a lot.

 

[Bandit's Mom]

Ill tag @Bandit's Mom to help with the spreadsheet. Thanks Bhooma!

Hi @Lindsayg, Welcome to FDMB!
I can set up your spreadsheet and signature. Will send you a PM with the details I need. Look for it in the Inbox at the top right corner of this page.

 

[Lindsayg]

So, I sent Riley's blood sugar info for the last week to his vet. I am leery on her advise though. I was wanting to see what you guys thought. Right now he is on 2 units of Lantus 2 times a day. She wants me to increase it to 3 units 2 times a day. I wasn't sure if I should go up a whole unit, especially when I work during the day. What are your thoughts?

Thank you

 

[Bron and Sheba (GA)]

I would definitely not increase the dose by 1 unit. How long has Riley been on the 2 units?
The only reason I hesitate to say increase is that blue118 three days ago at +7 in the pm cycle. It is possible Riley is dropping lower overnight and you are not catching it.
If you see the BG has dropped into yellow BGs try and get another test in to see if the BG is dropping further.
I would hold the dose at 2 units for a bit longer to see if you see any more blues.
When you do increase I would only go up to 2.25 units.

 

[Lindsayg]

He has been on two unit since he was diagnosed. The vet didn’t really do any follow up so I ended up researching on the feline diabetes Facebook page and changing him to the low carb wet food and finally got him the freestyle libre. However I do need to get different syringes because right now I just give him insulin with the pen and I can’t do partial units. What syringes do I need to get? I’m sure the pharmacy can help me to I guess I’m just paranoid to use syringes. I’m scared I’m gonna go in too deep or something.

 

[Bron and Sheba (GA)]

For Lantus, you need the U100 3/10 ml 30 or 31 gauge 6 or 8 mm 1/2 unit syringes.
There are a variety of brands.
Walmart have the ReliOn brand which is good.

 

[Lindsayg]

In the time he has had his Libre he had only dipped into normal range once (overnight on the 21st). Since I couldn't get to the store to get syringes (today I will), I tried the 3 units my vet said, BUT I slept on the couch with him and I wake up all the time so everytime I would wake up I scanned him. Well, at 12:42 am it was 64 so I fed him as I didn't want him to get any lower than that. It was up in the normal range 1.5 hours later. I made a collage of all his graphs from the 18th to this morning...since it shows overnight what his blood sugar does. Do you think I should try 2.25 (I am not doing the vets recommendation of 3 again! He's been at 2 and I believe you guys generally say to go up by .25)?

 

[Bron and Sheba (GA)]

Do you have all the data in the spreadsheet?
We can’t really see it properly on the little graphs. We need to see it all on the SS please

 

[Lindsayg]

All the numbers I have when I scan him are on the spreadsheet ( except last night and this morning which I’ll do once I get to work) there aren’t exact numbers for the times I’m not scanning while at work or overnight but it shows what the numbers are doing. I’ll post the graphs separately and not in a collage.

 

[Bron and Sheba (GA)]

Have you managed to get the insulin syringes I mentioned in an earlier post. I think you are going to need to increase but I would only go up to 2.25 units.
If you see any more blues on the 2 units I would hold the dose longer.

 

[Lindsayg]

*A note about some of the graphs
The 25th evening shot is when I gave him the 3 units and then fed him about 6.5 hours later since is BS was dropping low. Its kind of frustrating there is no real trend on when is BS goes up and down. I got syringes, but they weren't correct...I got the smallest ones they had but they weren't small enough. I am going to call around to all the pharmacies today and hopefully get some.

 

[Chris & China (GA)]

OK, Lindsay messaged me on FB and asked me to take a look so without going back and reading everything, this is my opinion.

When your vet told you to go up to 3U, yes, that was too much of an increase but instead of going all the way back to 2U, I would have gone to 2.25 and held that dose for at least 3 days but I understand you didn't have the correct syringes. If you have a WalMart nearby, you can get a box of 100 for $12.58 and they will have half unit marks (the .25 and .75 doses we have to eyeball). They come in two different packages depending on where you live but you want 3/10ml, 30 or 31 gauge insulin syringes. They will look like one of these: (but they can be 30 gauge or 31 gauge)

OK, with that 156 at +10 yesterday, I would have really suggested you get a regular test instead of using the Libre number just to make sure it was a good test. Anytime you get a number that's that out of the ordinary, it's a good idea to get a re-test, which means using a regular blood glucose meter. The Libre is a great tool, but it makes mistakes too and even the instructions that come with it tell you to retest with a regular meter anytime you get unusual test results.

Since you DO have 2.25 and 2.5 in the last two "U" columns, I'm going to assume you did get some syringes so you'll want to hold the 2.25 unit dose for at least 3 days (6 cycles)

If you're going to continue to use the Libre, you're getting plenty of testing data, you just need to transfer some of it onto the spreadsheet. Example (since I don't know what time you shoot).....On 9/22/21, if you shot at 9am, it looks like his BG was about 470 so that would be his AMPS....about 12 noon it looked about 375, 3pm about 350, 6pm about 240. etc. etc.

I understand you can't scan when you're not home or when you're sleeping, but you can still do what I just did and do the best you can to estimate where his BG is at different points in the cycle using the information it gives you.

Last, but not least, it's totally normal for the numbers not to make much sense, especially this early in treatment. It was a good 5-6 months before China settled down enough to give me something that resembled a pattern.

 

[Lindsayg]

Oh ok, I wasn’t sure if I should guesstimate for when I’m not home but I will go back and do that tonight when my son goes to sleep. I guess I just thought ( more so hoped) after 5 months I’d understand something about his numbers‍. I did get the correct syringes (yay). Thank you!

 

[RCB & Mitsu]

The libre is a continuous monitor. If you log into the libreview website online you can download a csv of all of the sensors data and have a reading every 15 minutes. You have to scan the senaor to pickup for the full data to transfer, but you will have the complete dataset that produces those graphs.

 

[Lindsayg]

Ooooooooo thanks!!!!