Getting Control

[Danette & Esmeralda]

Hey Guys,
Newbie here, Esmeralda (Siamese Female 11years), has Type 2 Diabetes, she is all over the board w/her glycose. She has gone into the vet 2xs for a glycose curve
When she was diagosed (aprox 1month ago), Dr put her on 1.5 Lantis 2xs a day; saw a big improvement, but the dr wanted to do a glycose curve.
1st Glycose Curve, she plummeted to 70 w/ 1.5
The Dr said, lets decrease her to 1.0 once a day in the AM only.
Aweek later, Esmeralda couldnt jump off the bed w/o falling over, her back legs were giving out. Called the Dr., she said to bring her in immediately, so I did, and in doing so, Esmeralda lost all bladder control. Needless to say it broke my heart, and was just beside myself. The vet kept her over night, and did a 24hr glycose curve.
2nd Glycose Curve, she is now on 1.0 2xs a day
Ive taken control of the siutuation, and Iam now testing her (one touch ultra) before I give her insulin (1.0).
Today (9/7) she was at 376 (b4 insulin), I gave her insulin, and tested her 2hours later, and now she is at 340. It didnt drop like I thought it would.

I guess my question is, what shoudl it be? Iam reading 150ish?
Any help would be great... Its been very emotional for me, to watch her go through this.

 

[mybuddybinks]

no advice, but welcome...you've come to the place with great guidance and support...

and what a beautiful girl esmerelda is!

celi & binks

 

[Sienne and Gabby (GA)]

Welcome to Lantus Land!

Esmeralda is a beauty!

First stop is to read over the starred, sticky notes at the top of the Board. There is an overwhelming amount of information there. I would suggest concentrating first on the notes about the Tight Regulation Protocol and the New to Lantus/Lev stickies. The protocol will give you information how Lantus is dosed - when to decrease or increase dose. There are also links in that note to the formal versions of the protocols. The New to Lantus/Lev sticky will introduce you to the basics of how this Board is organized -- the format for posting, links to our slang dictionary, how to do a curve (so you don't keep having to pay your vet to do this), etc.

It's great that you're home testing. That's a huge hurdle. If you look at our signatures, you'll see we all use the same spreadsheet (SS) template. You can find the instructions in the Tech Center. We are very numbers driven so having a record of Esmeralda's BG test data will allow you to make good decisions about dose and will allow us to lend you a hand. If you have any test data, it would be very helpful if you could even list it out for us to take a look at until you get your SS linked. You'll see from the SS, we use a particular way of delineating time since we're all in different time zones.

Please visit our condos (each of our cats' threads) and look at our SSs. And please ask questions -- we're here to help.

 

[Jana+BK+Chester(GA)+Wilbur]

Welcome!

Lantus is an insulin that works a bit differently than others - it forms a "shed" in your kitty. There are sticky posts at the top of this forum and they contain a great deal of information you will find helpful.

As for the doseage, because of the way Lantus works, you should plan on sticking with the 1 unit BID for at least the next several days. Keep testing, and you should start to see some improvement in Esmeralda's BG levels. That doesn't mean you ultimately won't have to adjust her dose some (or not), but until several days have past with the same dose, that is something you can't know.

Also, are you feeding Esmeralda low carb wet food? Unfortunately, the food sometimes recommended by vet's (i.e., D/M, etc.) is very high in carbs, and that keeps a cat's BG levels high. If you look at Janet & Binky's food chart here http://www.felinediabetes.com/diabetic-cat-diets.htm, you can see many different brands and varieties of low carb canned food that will benefit Esmeralda.

I'm glad to see you are home testing. Not only is that critical to knowing when to shoot/not shoot insulin, being able to home test will give you a clearer picture of Esmeralda's BG levels, as testing at the vet's is impacted by "vet stress," and will provide test results that are higher than would be experienced if tested at home.

I'm sure you will have many questions...please do post, and we'll do our best to help and support you and Esmeralda.

 

[Libby and Lucy]

awww, I love dark seal point girls. :smile:

I'm glad you're here. Keep testing and posting and you should start to see trends. One thing you really can't do is worry about one or two numbers. Lantus builds a lot of overlap, so each cycle affects the next couple of cycles. You'll learn that it works best to step back and look at trends over several days instead of looking at each cycle one at a time (unless that cycle is a low one, then you focus on where you are!). The spreadsheet, and the colors on it, is really helpful in seeing those trends.

 

[Pat+Raja+Shadow (GA)]

Hi and welcome to you and Esmeralda! (she is a darling! what a beauty!!)
First off, what can we call you? I am Pat and I would like to tell you a few things about this board and hope to persuade you to join us and post daily....
When was Esmeralda diagnosed?
Does she have any other medical issue or on any other meds?

The BGs will fluctuate during the day and from day-to-day. Congratulations on doing the home testing! That is a most important tool. Do you have plenty of strips on hand?

Now, we do have a handy spreadsheet that we use here. There are instructions for creating a SS and attaching it to your signature line in your posts. Here are the instructions for doing that: http://felinediabetes.com/FDMB/viewtopi ... =6&t=18207 It is from the board entitled "Tech support"

In order to help you, we do need to see a SS attached to your posts so that we can see how the insulin is working on her, okay?

We post a new thread each and every day. In your condo (thread) you will post the heading: Date, Kitty's name, AMPS=________ and update with any new BG tests you get during the cycle. We also include in our first post of the day a link to the previous day's condo.

If you have any questions, you may come back and post them in this thread ok?
At the top of the page are starred stickies that you will enjoy reading. Start with the "New to the Group..." http://felinediabetes.com/FDMB/viewtopi ... =9&t=18139 and if you can, print out the section on HYPOS and also be sure to have the supplies listed in the HYPO TOOL KIT.

For now, if you could work on getting that SS up and running that would help us and we can then offer suggestions to you. I am so glad that you posted here and I look forward to watching Esmeralda's progress! :mrgreen:

 

[Danette & Esmeralda]

Thank you soooo much guys,

Yes the vet put her on Purina DM (high protien, low carb) wet and dry food. She is a grazer by nature (hard food). But 1/2 hour before her insulin shots ive been giving her the wet, today is the most ive see her eat, and less water. Its also shocking, because I have 2 other kitties, and the both WERE on Eukanuba Lamb & Rice. I was appalledd at the reviews, and the animal by products/recalls.. So needless to say, all 3 kitties, are on DM (all over the age of 9)

I am currently looking at the spredsheet, "what a template. Thank you soooo much.
And Iam sure I will have lots of questions on how to fill it out. Currently I am keeping a log, for the vet (they want to see her Monday 10/11, for a 3rd Glycose curve (UGH). Its not about the $, its the amount of time she is away from me, and the stress she is induring. Its has times, and test results.

THANK YOU SOOO MUCH GUYS FOR YOUR KIND WORDS AND WISDOM

 

[Marje and Gracie]

Welcome to Lantus Land! Your baby is very beautiful. I wanted to let you know that we have only been here 2-1/2 weeks and the help and support we have
gotten has been tremendous...we couldn't be managing FD without this board so I hope you take the time to set up the spreadsheet and read the sticksy and stay
with us. It is definitely overwhelming at first but I believe that, even as great as our vet is, she could not manage Gracie's FD as this group is helping us do and I
believe you will come to the same conclusion. Just take a deep breath, do your spreadsheet so the wise ones can helps, ask lots of questions, and...one other thing
this wonderful group has taught me...keep your sense of humor :lol: :lol: It'll be good for you and great for Esmeralda!! Welcome!

 

[PeterDevonMocha]

Just wanted to drop in and say Hi, we also have a Siamese (7 years) They sure are characters aren't they? Anyways, looks like you have already received a lot of great advice! By the way Esmeralda is just beautiful!

 

[Danette & Esmeralda]

Pat,

Danette here,

Thank you, I am looking at the spreedsheet..

Esmerlda was diagnosed 9/13, she had lost 4pounds in 1month, and was loosing muscle tone.
She has no other medical problems, or any other meds.

Thank you, I will submit a SS

You guys are great, your going to make me cry, its just been very emotional for me, I have shed ooooodles of tears over this.

Danette (Net)

 

[Anne&Muffin (GA)]

Welcome! And Esmeralda is gorgeous! I agree 110% with everything said here so far - particularly Marjorie, as I've only been here 3 months myself, but I feel the people here have definitely saved my Muffin. I love my vet too, but it simply is not possible for them to regulate or properly manage FD, they are just not with the cat enough. So I hope you read everything here and continue to post, you and Esmeralda will be happy you did. It's overwhelming at first, sooo much information to absorb and learning to do, but it DOES get easier.

 

[Pat+Raja+Shadow (GA)]

About that upcoming curve net, I brought my two in for 3 days. While at the vet office, they got various BGs and I cam home with a prescribed dose that was WAY too high. I joined the forum here shortly afterward.
IMHO the vet curve is worthless. The first thing is that the kitties are usually stressed while being there so the numbers are vet stress induced, therefore, useless. Secondly, they are not doing anything tht you yourself cannot do at home with your own meter. Granted, they are suing a meter calibrated for your cat, and yo are using a human calibrated meter. But the curves will be a tad higher perhaps than the vet's meter, but with the added stress, it makes no sense to me.

You do have to have a nicer working relationship with your vet, but for myself, I found that I wanted to do it alone with the help of the forum and the Protocol that we use. But do think about the necessity of having the curve done there verses doing it yourself at home. There is information on doing a curve in the stickies at the top of the page.

If it's not too much work, you can transfer the numbers you have been recording to the new SS online. I print the blank one up and work from that as I am working around the house while testing and then transfer the numbers and upload it to my computer SS.
The + hours are the times after the shot, +1 is one hour after the shot, and the +2 is 2 hours and so on. 2 cycles, one in the AM and one in the PM. AMPS is morning Pre Shot number, and PM is evening Pre Shot.

Most of us use the canned foods from the Janet & Binky Food Chart: http://binkyspage.tripod.com/canfood.html instead of the very expensive and poor quality prescription foods. We add warm water to the canned too. My Shadow never drinks from the bowl any more while in the beginning, it was his best friend!! There is much to do and learn in the beginning...I hope you will set up the SS and join us quickly! :mrgreen:

 

[Jana+BK+Chester(GA)+Wilbur]

Thank you soooo much guys,

Yes the vet put her on Purina DM (high protien, low carb) wet and dry food. She is a grazer by nature (hard food). But 1/2 hour before her insulin shots ive been giving her the wet, today is the most ive see her eat, and less water. Its also shocking, because I have 2 other kitties, and the both WERE on Eukanuba Lamb & Rice. I was appalledd at the reviews, and the animal by products/recalls.. So needless to say, all 3 kitties, are on DM (all over the age of 9)

I am currently looking at the spredsheet, "what a template. Thank you soooo much.
And Iam sure I will have lots of questions on how to fill it out. Currently I am keeping a log, for the vet (they want to see her Monday 10/11, for a 3rd Glycose curve (UGH). Its not about the $, its the amount of time she is away from me, and the stress she is induring. Its has times, and test results.

THANK YOU SOOO MUCH GUYS FOR YOUR KIND WORDS AND WISDOM

Most of us have found that curves done at the vet's office aren't very helpful. When our cat's stress, the BG levels go up and that is what the vet sees - BG numbers that are much higher than "normal" for your cat. B.K.'s BG levels rise 300+ at the vet's office, and even my mellow Chester goes up 100+. That leads to the vet directing you give far too much insulin.

If you look at Janet & Binky's food chart (link above), you will find many brands and varieties of low carb wet food that is not only good for Esmeralda, but far less expensive than D/M.

Hang in there...I know this can get overwhelming, but we're here to help you help Esmeralda.

 

[Perry and Sooty]

I'm quite new here too but I concur with EVERYTHING everyone else has said so far, my Vet too, is terrific but she just doesn't have the experience with Lantus that the folks here do. She advised us to go from a 2.0 BID initial dose (BID = twice per 24hrs) up to 3.0 BID in one hit. Here the correct initial dose was more like 1.5units and also here, going from 2.0 to 3.0 units would have been done in FOUR steps by 0.25 unit each time! Yes - even 0.25 of a unit can make ALL the difference, as you can easily jump over your cat's needed dose and go into rebound if you increase too much at a time - even by such apparently small amounts.

Listen and follow the advice you get here and you will soon start to be so glad you found this place! Be cautioned though - it all takes TIME - and LOTS of testing, as you need to wait AT LEAST 3 days on any given one dose to know what effect it had. Also the change to wet fom dry food thing - frequent testing during that transition is absolutely essential as that change alone, can drop BG levels by a LOT (and can require a drop in insulin dose to compensate, to avoid Hypo).

Welcome - and all the best to you and Esmeralda,

 

[Sienne and Gabby (GA)]

I agree with Jana and Pat about our kitties blood glucose reflecting stress when at the vet. How about a compromise? Could you do a curve at home and send the spreadsheet to your vet? I'm getting that your vet is like many of the vets we've all run into -- they aren't used to having people who will home test and actually do a curve. The more open minded vets are very responsive -- they realize that they aren't getting numbers that reflect where the day-to-day BG numbers are and as a result, the kitties are getting more insulin than they need.

I'm actually amazed and impressed that your cats are tolerating D/M. While the carbohydrate content isn't awful, take a look at the ingredients. It's mostly animal by-products. If you take a look at the website by Lisa Pierson, DVM on feline nutrition she discusses issues with prescription foods as well as the use of dry food, especially with a diabetic cat. We're big fans of canned food here! I think you will find that there are a wide variety of canned foods on Janet & Binky's food charts that are lower in carbs and better quality. Frankly, Fancy Feast is better quality than D/M.

 

[Tena and Curry(GA)]

Welcome !!

Your kitty is so beautiful. Her eyes just melt my heart.

No suggestions or advice from me since I'm fairly new here as well. But is sounds like you are doing a fabulous job with Esmeralda.

Ok, I lied....one suggestion...just one....Breathe....Its going to be OK.

Well, darn it...ya got me started....just two suggestions and I'll promise to stop.....

Just take one change at a time.....Trying to make a number of changes at the beginning will drive ya nuts...We don't want that for you.

So recap....Breathe......and....Baby steps....And allow yourself to slow down and take some time to absorb all this new information....

 

[Lori in Ohio]

Hi Net,
Welcome.

I am a newbie too and have been having the same issues so I know how you feel.
Stressing alot today, even took Ginger to the vet (she is still there) to get fluids because ketones were present and I was afraid she was dehydrated.

I keep being told I have to be patient, which isnt really easy when we worry about our kitties.

You can look at Gingers SS and see what I am talking about. She's been in the 300's-500's range!

Also until you get your cat to switch to canned food, I suggest you use the EVO dry- chicken and turkey.
The regular, not the weight maintanence.
Its grain free and has only 7% carbs and has good ingredients.
***The canned is much better for cats though, especially diabetic cats because it gives them more moisture into their system.

Set up a spreadsheet here.

 

[Libby & Callie]

Hi and welcome! Beautiful kitty! You are at the right place. I had and still have vet isssues and have just found a local vet (Callie had been going to a vet close to my daughter) who is familiar with feline diabetes and told me he would work with me (using the protocols here). I am going to make an appointment next week I too want to caution you about going to an all wet and keeping the same dosage of insulin. When I changed to all wet I also took the recommendations I received from here and lowered her insulin. In fact ,since it was way too high for Lantus, I lowered it from 4.25 to 2.00 and she still dropped over 100 points! I found out later the insulin had diluted someI So always be aware that diluted or strengthened insulin can play a part too. The people here make sure to ask questions so they can get an overall picture of any problems. I could have had major problems with hypo if I hadn't done the reduction! Now we are just trying to go steady. Don't get discouraged. There is a big learning curve, but it'd doable Let's see .. how many freakouts did I have .. quite a few (G) but I am still learning. It's been a week and I am over almost all of the stress I had in the beginning. If you rely on the guides advice you will see an almost immediate improvement. They have done a fabulous job for me and everyone here is very friendly and supportive! We want the best for all our furry friends Yes they told me to breathe .. many times .. and here I am breathing just dandy now .. thanks to all who have been there for me. Libby and Callie (and civies: brother Buddy and sister Missy)

 

[Blue]

Hello and welcome.
The others have given you lots of info and directions to get started, so I'll just add a few things.

The curves at the vet office are never true numbers - think how you are stressed to be at the dr office - the numbers the vet gets will not be the numbers you get at home, when your cat is relaxed and in familiar surroundings.
One of my cats measures high at the vet office and is very scared there; the other one goes very low - Ollie does not act stressed but his numbers drop at the vet and so I take food to feed him in case he goes too low!
Who wants to be alone and poked in a strange place: nobody.

I am sure the others have already mentioned it, but dumping the dry food will make for a healthier kitty with lower BG numbers. The dry will take a few days to get out of the system so you won't see much change for a few days, but some cats are more sensitive than others. If my Shadoe eats even a mouthful of dry food, her numbers will hit the 400s.

Awesome that you are home testing; you will now see how the insulin is working for your cat. I wanted to mention that you will need to gather some numbers before you know how your cat reacts, where your cat's nadir is. I have one, Shadoe, who is lowest around mid-cycle or +5-6, and another, Oliver, who is low very late in the cycle - or +10-11! I will not see Shadoe's numbers start to drop till maybe +3 and Oliver, not till maybe +4 or +5!

It's very true - ECID - each cat is different.

So you will be in data gathering mode for awhile, but as you fill in the numbers on your spreadsheet, you will start to see the pattern.
I know it's alot to learn upfront but don't worry, ask lots of questions and before you know it, you will be answering questions that others will ask.

 

[Michelle and Mannie (GA)]

I just wanted to stop by and say WELCOME! You have found a great place - very knowledgeable and carrying people. You've received a ton of information already, so I won't add any more. I am glad that you have found us.

Esmeralda is gorgeous!

 

[Ella & Rusty & Stu(GA)]

Hi Net, You will never regret giving Esmeralda (what a beautiful kitty!) the benefit of the excellent advice of the people on this board. Welcome! And don't worry about your vet's reaction to your doing curves and making decisions about dose (with the help of experts here). Many, many of us had to step away from our vets and take matters relating to diabetes into our own hands. We found this board and learned so much about feline diabetes here. The collective knowledge is awesome. It is a steep learning curve, but you will be able to do it. A new chapter in Esmeralda's life begins now!!

Ella