greetings :D

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charioteer

charioteer

Member Since 2012
Hey Feline Diabetes MB community!

My name is Julian and I am the owner of a recently diagnosed diabetic cat named Norman!

He is around 15 lbs and is probably around 15-16 years old. I adopted him two years ago from a woman on Craigslist. He was diagnosed this fall while he was being fostered by a friend of mine, and she was wonderful enough to spear point his early treatment. I have now got him home with me, after a long trip(!), and am looking to get him regulated. He is currently still drinking a lot of water and peeing a lot, but I just got a home glucometer (Bayer Contour USB) and just got my first reading! So exciting. He is on Lantus. His first vet started him at a dose of 3ius twice a day (!) so I slowly reduced him to 1iu twice a day and will work up from there as necessary. He's eating Fancy Feast Classic.

My main concerns right now are getting him to a vet here in Washington before the bottle of Lantus I have expires, but I'm pretty concerned about costs. I'm working for a national org that pays a stipend (and it's like only 1000$ a month) so I'm really struggling with paying for all his vet bills left over from when he was first diagnosed. Any tips?
 
Hello and welcome to the board! I can see you have done some research and you have made some good first steps. I do have a couple of ideas around costs but first... Wow his first reading is low, and you shot anyway ? I hope have a hypo kit ready (extra strips, karo corn or regular syrup and high carb food)... When did you shoot? Can you get a +1?

Cost thoughts..

1. Unless you have a good source, tHe bayer contour strips can be expensive, the Walmart relion is cheaper at $9 for 50.
2. How old is your lantus? It can last up to six months if you keep it in the fridge, and don't shake or roll it, and there is no cloudiness or flakes. I can personally attest to over four months.



I am going to get some other eyes here.
Wendy
 
hi and welcome. I am with Wendy, that is a low level to shoot at without prior data to go by. please do test some more tonight to make sure kitty does not go too low.

good job getting started too. both with testing and lowering the dose. I am west coast too so will check back in in a bit
 
Julian

Welcome to the FDMB. Norman is lucky to have you.

For new members with no data, it is recommended in this Health forum that you not shoot if you get a BG under 200 so we want to make sure he is safe tonight.

Do you have any data on his BGs before you got him and do you know what amount of insulin he was given this morning?

Do you lots of test strips there and also some High carb food with gravy and perhaps some karo or honey?

It's great you are testing....could you please get a test one hour after you shot and post it for us? Thank you!
 
Yeah, I can definitely do a one hour afterwards. He wasn't given insulin this morning, and I definitely have high carb food and some karo syrup. Will keep you updated; I think I was confused about when to shoot, and have done some more reading after getting your responses. Good to know, and hopefully we'll avoid a hypo.

My lantus expires in February I believe, but it can't be more than two months old. I'll probably just have to shell out for a new bottle when this one expires, but good to know it can't last that long for future reference.

edit: Yeah, I don't have any other background BG data. I was told by the previous vet to shoot pretty much no matter what (? I know, in retrospect I'm confused) and I didn't shoot this morning because he didn't eat. But he ate really well this evening so I figured I'd do the shot anyway? Well, now I know more and hopefully can avoid doing that again...

another edit: And yeah, I'll probably stay up with him tonight and try and test every two hours or so just to make sure he's good-- at least until the nadir of the insulin.
 
Do you know if he got insulin yesterday and if so, how much?

Good that you didn't shoot this morning...that might help his numbers come up tonight.

Lantus is a depot insulin so if you miss a shot or shoot a reduced dose from what he has been getting, the depot drains. Of course, we have no idea what he was doing on the 3u.

I'll be watching for your +1 test. Did you feed him immediately after you shot tonight?
 
you may be able to save money on the insulin when you need it by contacting Diabetic Cats In Need. I am on my kindle right now so cannot get the link for them right now but maybe one of the other girls can

do you know what numbers are too low? and do you know what symptoms to watch for for hypo?
 
Thanks to all who have responded, I truly appreciate it.

He did get his shots yesterday, just 1u after breakfast and 1u after dinner.

And yeah, I fed him immediately before I did the shot. Is it better to feed after or before, in your opinion?

Yep, I re-reviewed all the signs of hypo, and for numbers we're looking for something in the sixty to forty range. Please correct me if I'm wrong?
 
Most of us shooting lantus or levemir test, feed, and shoot within about 15 mins. Because lantus and levemir onset at roughly 2 and 4 hours (depending on the cat), respectively after the shot, there is time to feed..... But again, most of us do it all at the same time.

Alot of us give the shot while the kitty has his/her face in the plate and is distracted.

Normal numbers are 50-120. I would really prefer to see Norman go up until you have some data.
 
I've got twenty minutes on it :/ I wish I'd checked the board before shooting, but we'll see. He's seemed fine so far.
 
He might seem fine now but they can go rapidly from fine.. to an ER trip. Lets not have that happen. We are being better safe than sorry here.

His +1 might be ok but he can drop rapidly anywhere from now to +6 or beyond .. without prior data we dont know what his plans are. However I am sure based on +1 and +2 the others will recommend when to test and what to do! Please keep us updated.

Good news though if he does drop below 50 you would do a dose reduction.

We are all waiting with baited breath!
 
No worries, I definitely trust your expertise and experience, and I totally prefer better safe than sorry! the +1 is coming up in less than ten minutes, so I'll be back soon!
 
Okay, so I got a reading of 33. Advice/next steps?

Again, thank you so much for sticking around and offering your advice.
 
Yikes!! Seconded. Insulin reaches its maximum action at around six hours from the shot.. He will only drop from here. They will put him on a sugar iv and watch him all night.

Let us know how it goes and we will be here tomorrow for next steps, dose decrease being one of them for sure.
 
Thank you all so much for your advise and for following up. We did go, and ended up not having to stay the night. Dr advised we skip the morning dose and continue to test his blood sugar and making sure he's good before giving him a much smaller dose of insulin (.25iu) in the evening. Once again, thanks! If anyone has anymore advise I'm totally open to it and appreciate all who have weighed in previously.
 
I will let the others comment on dosing but we are glad everything was ok! yay! :smile:

Please can you update the SS in the remarks field from last night with what happened and with the fact that you skipped the morning shot ( mark "skip" in the U column ) just so we remember what happened ( like we could forget.... :shock: )

have you taken any readings today?

Wendy
 
Good idea, have updated the chart accordingly! Haven't done any readings today yet (we slept all day :P Vet apparently tuckered us out completely) but will do it sometime in the next couple minutes now that we're awake and meowing. :D

edit: he's at an 81 mg/dl and hasn't had insulin since 7:50pm last night. he's eaten several times (& is eating right now)
 
Please test him and post the number here asking for advice, before giving him his shot tonight.
Is that in 4 hours?

You don't want to feed from 2 hours before his shot time, until shot time. That way we can see the BGs not influenced by food.
 
Hey, I normally do the shot around 7:30 PST. And I'll definitely be posting his numbers before doing the shot. And I can definitely make sure he doesn't eat for the two hours before his shot.
 
Julian

Depending on what his BG is...if its not way up there....it would be a good idea to skip the shot and see what he does. So be sure you don't pick up that syringe too quickly ;-) :-D :-D I'll be watching for his PM preshot number to help you.
 
Hey all, so just took his BG and it's at 79 mg/dL. Haven't given him his shot or his dinner yet. I'm assuming skipping the shot is a good idea.
 
LOL definitely not. I took Dyana's advice and he didn't eat food for over two hours before the shot so hopefully that's a good indicator of where he's at...
 
Skip. It's not worth it and its possible Mr. Norman may be toying with going into remission. :-D

Let's take it a cycle at a time but if he stays below 100, I wouldn't shoot.

The other thing I'd like to see is if his pancreas might be working on its own. So if you can feed him now and then test him in three hours and let us know where he is, that would be great. Since he does not have any insulin on board tonight, you don't have to worry about a hypo. If you check him and he gives you a low number...don't worry! It means his pancreas is working :-D

Any questions?
 
No questions, this all sounds amazing to me. Knock on wood! I'll definitely test at +3 after dinner and see where he's at :D Thanks everyone, you're seriously the best.
 
Good news! He dropped to 77 mg/dL. This is even after a little snack half an hour ago (he didn't completely finish his dinner at 7:15)! Will keep checking him before meals and doing spot checks throughout tomorrow. :D
 
Is not really a drop. Each meter can have up to a 20% variance so he's basically at the same number. BUT..that is a great number to be at!

I would suggest that you continue like this as long as his PS is below 100. If you get a number between 100 and 200, its probably best for the next few cycles that you also skip because he could still have some counterregulatory hormones circulating and we want them to clear. but you can always post for help. Over 200, shoot your .25u dose.

Great job!
 
Excellent! Thanks so much again for your help and diligence. I'll be around the boards learning as much as I can. And I'll definitely post if I need help again. :-D
 
Morning! Hope you're doing well. Norman's BG was 82 mg/DL around 7AM. I'm going to get home from work early today (huzzah for MLK day!) and will probably be able to get a +7 or +8. Have a great day!
 
It is! This looks like an OTJ trial to me? Marje can explain but I think if he stays under 130 for 10? days then you consider him in remission.
 
Yes...Julian, how about you start an OTJ (off the juice) trial with him? You can count yesterday as the first day. Here are the instructions:

  • Test at your normal AMPS and PMPS times. Feed multiple small meals throughout the day as much as possible (small meals are less likely to overwhelm a newly functioning pancreas).

  • If he is green at your normal test times, no need to test further until the next "PS" time, just feed small meals and go about your day. If he is blue, feed a small meal and test again after about 3 hours. If his number is lower 3-4 hours after a meal, then his pancreas is working!

  • If he's stayed below 120 for fourteen days, we consider him to be in remission!

Sometimes the trial doesn't work the first time and we have to give a little more support in the form of resuming insulin. It's not the end of the world if that happens, we just give him the support he needs. Our goal is a strong remission and it's better to take our time to get that than to rush into remission just to have it fail later on. If his numbers come up, I would suggest you post in the Lantus ISG so we can help you get him right back on track immediately. Don't let him stay at numbers over 120.

Also, it's important that you understand that he is and always will be a diabetic. He can come out of remission and things that typically cause it are failing to feed a canned or raw low carb diet, illness, or infection so stay on top of his dentals. We see alot of cats that come back just because of a preventable dental issue. Don't let him have any dry food no matter how low or no carb someone might tell you it is.

And lastly, once he gets through the trial, we recommend you start out by testing him once a week and eventually once a month. I see some caregivers start to slack on this and all of a sudden they are back and the cat has probably been out of remission for several months and they could have caught it early and prevented any insulin resistance from higher numbers. The sooner we get them back on insulin, if the BGs trend up, the better the chance of getting them back into remission.

Good luck and we are here if you need us.
 
Woooh! This sounds awesome, and thanks for letting me know. Yeah, the small meals should be okay because he's been more or less regulating his own food intake as small meals all day long. Made it difficult to decide if he had enough food in his belly to do insulin, but this will work well for the OTJ period. Thanks again to everyone who gave advice and was a support during the eventful last couple days, I appreciate it.
 
You're welcome! And if you want to put "OTJ Trial" and the Day (e.g. OTJ Trial Day One) on his SS, that let's us know at a quick glance.

Great job!
 
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