First time post...am I on the right track?

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stanleythecat

Member Since 2012
I've been lurking for a week or so now, I think I am on the right track with Stanley, hoping for a little feedback with my numbers.

Stanley was diagnost end of April, I took him in for a check up because he had been sneezing alot. He has a herpes virus. With his low weight and rough looking coat we did a round of bloodwork and found out was diabetic with his bg at 444. Changed his diet to purina DM and 1 unit of Lantus twice a day. Week later vet tested his bg at 178. We were very pleased, vet asked us to return 2 weeks later to do a curve. The curve didn't look so good, he tested high to begin with and it just went higher (sorry I don't have the exact numbers - I believe it was in the high 300's.) Anyways, vet wanted to switch his insulin. I was in shock because Stanley was a whole new cat - very social again, coat was beautiful again, gaining weight, very playful - playing alot with our youngest cat which he never did before. His litter box use was so much better (we had alot of accidents outside the box) We were leaving for the weekend and I didn't want to change his insulin at that point. (My sister thankfully was willing to give him his shots!) I haven't been back to the vet since.

This is where I began to research things more. I am 1000% convinced that his curve was so high because of the all day vet visit. Stanley is an indoor cat and usually hides when others are in the house. I bought a monitor to do testing at home. Sadly, it sat for a few weeks before we used it - my bad. Anyhows, last Tuesday we noticed Stanley was twitching a bit. So my husband and I decided we better tackle the testing. After alot of pokes and frustration, we got a reading of 37! It was close to midday feeding so we gave him his food ( I have now switched him to Whiskas pate) did another test and it was rising. Needless to say, we spend all last week perfecting our technique of home testing and although I am very nervous about it, skipping some insulin shots.

Any feedback on what I am doing would be greatly appreciated! And I have successfully done 2 tests today without the help of my hubby! yay!
(I am hoping my spreadsheet will attach to this post lol)

PS we have 3 cats - all were Friskies dry food junkies - all have been on wet food since we found out how bad the dry is!

Tina
 
Well to start, it is VITAL to home test. Yes, it's scary to do at first, but once you learn how, it really is a simple task and one that can save your cat's life.

If I understand you correctly, your cat is receiving 1 unit of Lantus twice a day. Lantus is an excellent insulin and there is no need to change it.

However, you did receive a 37 and that is considered a hypo number. What this means, is based on that number a dose reduction is typically recommended.

Have you been to the Lantus forum and read the stickies (starred information there)? It will tell you everything you need to know about handling, storing and using lantus.

Changing to all wet diet is a great and this is a great diet for all your cats.

What we find is that blood tests (curves) at the vet really is pretty useless as vet stress can cause overinflated bg's and if you base dosing on this, could potentially be dangerous as you would be giving too much insulin.


But yes, you are on the right track, keep up the testing.

How else can we help you.
 
Congrats on figuring out how to home test your Stanley. It will give you peace of mind and help you perhaps get Stanley to be diet controlled (or perhaps not -- depends on Stanley and Mr. P (his pancreas))

You're on the right track and good job getting the spreadsheet up already.

Looks like you've skipped a lot of shots this past week - it appears that 1U is too much for Stanley.

Do you have syringes that have half-unit marks? They are available at many places - Walmart is usually cheapest, but I order online from ADW (american diabetes wholesale).

My Tiggy (adopted through DCIN in 2009) has been diabetic for about 8 years -- he is on the recommended diet of low carbohydrate canned food (wellness and fancy feast classic) and still needs a tiny dose of 0.5u twice per day.

You can get a magnifier to help measure small doses or I find that a flashlight helps (I have a headlamp so my hands are free)

I would suggest trying a dose of 0.5u twice per day and see if Stanley is at a "shootable" blood sugar at the next shot time.

For "newbies", the safe to shoot BG number is 200 -- this is until you know more about your cat and how he uses the insulin.

Having taken care of Tiggy for over 3 years, we know that we can safely give him his full 0.5u shot at BG 90 and from 70-90, we will give a half dose of 0.25u. Below 70, we skip his shot. Tiggy is on Levemir insulin which is very similar to Lantus - a long-lasting, gentle insulin.

So - with so many tests in the 145-190 range, Stanley is still diabetic but it is obvious that 1u is too much. And since he is already in these pretty decent numbers, there is a good chance that he will go "Off The Juice" and become diet controlled.

you want to find the ideal dose to keep Stanley in normal range without going too low.

@Hillary - she already has a spreadsheet linked in her signature

Also - too much insulin can CAUSE high blood sugar because the Liver will dump extra sugar into the bloodstream to absorb the overdose. Those 300's after the 1u shot could be this phenomenon- called REBOUND.

Continue testing and reduce dose to 0.5u. If you are going to be home to observe, you can give the shot when Stanley's BG is around 160 and test 3-4 hours later then +2 more hours after that (mini curve = 2 to 3 tests between shots)

Keep records of how he does and you build up your knowledge base for the future.
 
My syringes do have half unit markings - I was also thinking that perhaps 0.5 unit twice a day would be best at this point.

So as long as he is around 160 - 200, start giving him 0.5 unit twice daily unless it drops below a certain number? If 200 is shootable, what would be my non shootable range at this point?

Just when I think I have it all figured out...haha

Many thanks for the help!!
 
Well, blood sugar normally goes up and down all day long. -- we recommend testing before every shot (every 12 hours) plus at the peak insulin action time - until you know this time for Stanley, you can test between +4 and +8 hours after the injection -- with my work schedule, it is hard to get a +8 hrs test except on weekends.

Things that make blood sugar go up:
stress / fear
illness/infection (including bad teeth)
food (all food)
too much insulin (liver dumping - rebound)

Things that make blood sugar go down:
insulin (both naturally created and injected)
exercise (burns up the fuel in the blood)
anesthesia (vets must be extra careful during operations in future)
fluids (injected to counteract dehydration) (probably not applicable to Stanley)

Cats metabolize insulin faster than humans - so the once per day human insulins (Lantus / Levemir) are needed twice per day for cats.

Since these insulins build up a "storage shed" in the body, it is most effective to give a consistent dose twice per day every day.

Some people that have tiny-dose cats will practice tiny doses by pulling up 1U of Koolaid or colored water in a syringe and carefully twisting out drops to achieve a consistent tiny dose.
(how do you measure 0.1u? by figuring out how many drops are in 0.5u and expelling some into the sink before injecting)

There are laboratory syringes available for tiny doses (lab rats) but they are very expensive.
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Regarding non-shootable numbers -- you and Stanley need to learn this together over time.

The way to find out -- is to give the shot and monitor him to see what happens. Have some High Carb gravy canned food available in case Stanley goes too low.

Or give a half shot and see what happens. ---

A blood sugar curve is done by testing every two hours for a 12 hour span. In the early days while testing is a struggle, you can build up data over several days -- extra mid-cycle tests at +4 +8 one day, +2 +6 +10 another day or even one extra test per day.

So to find out Stanley's NO SHOOT number, give him his shot when he is at 180 and see how low he goes +6 to +8 hours after the injection.

The first few days at a new dose may be "Wonky" as Stanley's body gets used to it. In the Lantus Forum, this is called NDW or New Dose Wonkiness. This is because the insulin level builds up in the body and takes a few days to stabilize. So if blood sugars go high and strange, don't worry too much -- if you see numbers below 50 -- time to decrease the dose!

There are lots on tips and "sticky" posts at the top of the LANTUS forum with a lot more info on these topics.
 
Thank you so much for the info - I am going to go over and the read the Lantus forum....

Stanley and I seem to comfortable now with the testing so I will start with the lower dose of insulin and start doing a few more tests during the day. I am a stay at home mom so I am able to keep a close eye on Stanley.

It makes alot of sense to me that the Lantus builds up a bit of a storage shed as you said and skipping shots here and there proabably isn't the best thing to do at this point!

Tina
 
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