Heidi & Petey

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Hey Heidi,

Why is the first [ on the line above the text. It should all be on the same line.

I will cut and paste the line I created for you twice here. The first is what I sent. The second one, I took out the ?marks.

[?url=https://docs.google.com/spreadsheet/ccc?key=0AojNpnN0rEeHdFF3bWdFYUxpRE1qb1BQX2k3elM5cWc&usp]Petey's numbers[/?url]
Petey's numbers

Notice how the second one becomes a clickable link?

Try and get the whole line on 1 line as it does work.

Kevin
 
Heidi, you've done a great job at getting some extra tests in to help fill out the picture! What I can tell you is that this dose is pretty close for him. When a cat has pancreatitis it can cause an increased need for insulin. Hyperthyroid can do the same thing.

You said you didn't think he could go into remission, but I can assure you that we can't rule that out at this point. Most everyone comes in new with their blood sugar all over the place - his spreadsheet looks very normal for a cat new to diabetes.

If you DO want to work towards remission, you would want to get his blood sugar into a lower range than he's in now. When a cat's blood sugar is kept between 50-120 on a human glucometer, the cat's pancreas can heal. That's what the Tight Regulation support group is about - trying to keep cat's blood sugar tightly regulated in that 50-120 range so that if possible, the cat can go off of insulin and become diet controlled. If there is too much damage to the pancreas, keeping the blood sugar controlled at least protects the rest of the cat's body from the damages of high blood sugar.

Is there any possibility that Petey is getting into any dry food at all - any dry dog food? any dry cat food? what are you feeding him?
 
Heidi,

You are so close to getting the spreadsheet clickable in your signature.

You are missing the first bracket [
 
I feed petey one can of fancy feast, classic or flaked, in the morning, and 1 can fancy feast in the pm. Sometimes he does get into the other cats dry food, but I quickly catch him and of course pick it up. I was getting excited to see that his numbers were starting to be on the lower side, until last night. Thanks for your help!
 
hi heidi!

we've had people do experiments to see how their cats blood sugar responds to dry food. As few as 3 crunchies can send a cat's blood sugar soaring and it will stay high for the next day until the carbs work out of their system. Often people find the only way to prevent their cat from getting dry food is to transition all of the pets in the household to low carb canned food. It's better for them anyway. Dry food can easily have 50% carbs and a mouse, a cat's perfect food in nature, has about 3-7% carbs that come from whatever the grains in the mouse's stomach are. High carbs place a huge burden on a cat's pancreas, which is one reason why so many cats become diabetic now.

There is a great site, http://www.catinfo.org that is run by a vet who posts here on FDMB sometimes. Take a look at it and see what you think.

The reason i asked you about the dry food is because his dose suggests it. If you want to work towards remission, i would transition all of your cats to canned or raw food asap. The cost of feeding them canned food is nothing compared to the cost of keeping Petey on insulin for the rest of his life.

We have a member, Linda, whose kitty Scooter, went from 5.5u to off of insulin in a very long day and a half when the whole 13 cat household went off of dry food. Linda was pretty sure that Scooter wasn't getting any - he didn't seem interested in it. But the "proof is in the pudding" and when his blood sugar dropped after the dry food disappeared, it was obvious he'd been eating it every day.

Here's his spreadsheet. Look for February 19th - the day the dry food disappeared. Notice his colorful spreadsheet before Feb 19th, and what happened afterwards.

Kathy's Trey snuck into the dog food here - look at his spreadsheet for July 30th here when that happened.
 
One of my cats, sticks his nose up at wet food, I have tried all kinds ! I give him the indigo moon in a different room, but yes, I will admit, sometimes petey does get a mouthful. He even bit off the top of a hot dog roll after it popped up from the toaster, while my husband was on the computer. I call him the tazmanian devil. I am certainly going to try to totally limit the dry food, since i would be so happy if he went into remission. Thanks for your advice and help , as always!
 
hahahaha on the hot dog bun! high blood sugar makes them starving and willing to eat people food.

good luck - on that catinfo.org site there is an entire section on transitioning dry food addicts to canned food. one trick is to pulverize the dry food and sprinkle it on the wet. that works for a lot of cats.

you're welcome. when you're new you don't even know the questions to ask, or what things might be having a negative impact on your cat. i like to encourage hope for remission in people - the stats are 90%+ if you get with TR right away. We never know which cats will be the lucky ones, but i've seen many, many cats go off.
 
Thanks Julie, I will def. try this with the dry food ! His blood sugar is low this morning, 200! Very happy with that. Lets hope it stays this time.
 
When you get a chance, perhaps you might add a few more details to your signature.

Go to the top left of the screen.
Click on User Control Panel.
Click on Profile
Click on Edit Signature
A test box displays.
This is where you paste the link for your spreadsheet, once it is set up.
Add any other text, such as
your name, cat's name,
city and state,
date of Dx (diagnosis)
insulin
meter
any other pertinent issues like food issues, allergies, IBD, etc.
 
this morning, peteys' blood sugar was low, so I skipped his shot...It was 85. I hope this is the right thing to do ! :?:
 
Just tested blood sugar again, 7 AM, about 1 hr later = 174, not sure about giving shot, since I did not give after breakfast at 5:45 AM, since his bg was so low ? confused_cat
 
Since Lantus likes to be consistent in dose and time, if you give a shot now, you've going to have to shift back to your regular time by 15 min per shot or 30 min total per day.

Whenever you get a really different number from what you've been seeing, retest. Sometimes, it is meter error

If it is still a low number and it is the pre-shot test, stall 30 minutes without feeding to see if it is going up. If rising, and over 150 mg/dL, it is probably safe to shoot. You're still starting out on Lantus, so we want you to have data to support shooting any lower before you try it. There are some folks who have that kind of data and "shoot low to stay low".

That really low number suggests to me that he may need a dose reduction of 0.25 units, which you'll need to eyeball as no syringe marks those.

That, or perhaps he vomited over night or had some other GI upset which dropped his glucose. Check around for any evidence of that.
 
i did retest right after and it was still low, i have no choice but to feed him, since he is crazy hungry. I realize I will have to give him a shot a little later. than normal. I did cut his dose in half, 2.5 after feeding him. He has not vomited at all during the night. I was not comfortable leaving for work without a shot. I knew it would be really high when i get home.
 
That is a reasonable compromise.

Lantus forms small crystals under the skin when injected. This is called the depot.These gradually dissolve and release the insulin to work. Some are left at the end of 12 hours in most cats, so the next shot has some overlapping effect on the glucose levels. It takes 5-7 days for the initial dose to stabilize the depot and 3-5 days to stabilize it for later dose adjustments.

You started off at a pretty high dose of 5 units on the spreadsheet. If this was his first insulin, that dose could be too high for him. It is usually calculated as follows:
Get his current weight in kilograms (pounds / 2.2)
Compare to his ideal weight in kilos.
Take the lower number.
Multiply by 0.25.
Round down to the nearest quarter unit. Compare that with where you started. How big a discrepancy is there between those numbers?

I'm thinking that 4 units tonight might be a good idea; 5 seems to be too much. You end up needing to skip after several days when the Lantus depot has built up. Lantus really likes consistent dosing as close to every 12 hours as possible.

Typically, you increase Lantus based on the nadir, the lowest glucose level after a shot. You evaluate this after 3-5 days of the same dose.
Whenever the glucose drops below 50 mg/dL, you earn a 0.25 unit dose reduction.
 
I did not always give 5 units. Have been using lantus since May when he got really sick with high ketones! In and out of the vet and over notes in the er! I will lower to 4 units does 7:30 sound good ? His shot this morning was at8 am thanks for all of your info!:)
 
Yes, 7:30 sounds good.

Since he's had DKA, I suspect you test regularly for urine ketones, right? If you can swing it, you might want to get a NovaMax meter which can test for blood ketones and use it any time the urine ketones are positive, to get a more accurate level.
 
just tested petey= 322..2.5 units this morning @ 8 AM getting ready to feed him, should I keep the dose on the low side rather than 5 units ???
 
...I'm thinking that 4 units tonight might be a good idea; 5 seems to be too much. You end up needing to skip after several days when the Lantus depot has built up. Lantus really likes consistent dosing as close to every 12 hours as possible...
Click to expand...
 
I received your reply a little late, of course the tazmanian devil can not wait to eat.! I ended up giving him 2.5 units @ about 7:30. This morning his fasting bg = 302- not terrible. I gave him something to eat, a small can of fancy feast, and will feed him a little at 7 :30, and try another 2.5 units. What do you think?
 
Please stick with the 2.5 unit dose for at least 3 full days before changing again, unless the glucose goes below 50 mg/dL on a human glucometer.

Please don't shoot below 150 mg/dL on a human glucometeruntil, with stable dosing for a full 3 days or more, you know it will be safe.

Please read over the Lantus Tight Regulation Protocol and ask any questions you may have.
 
I M P O R T A N T

You need to keep the dose the same for 3 full days, no matter how high.
(Do test for ketones.)

Lantus is adjusted by the nadir - the lowest glucose after a shot.

Never increase the Lantus dose because of the pre-shot being higher.
Lantus doesn't work well that way because of the depot, the overlapping characteristic of the insulin.
Bouncing the dose around gives you erratic numbers.
 
ok, so this evening i gave him 4 units, and yes I do bounce around. should i keep it there or go lower for at least 3 days.? I get nervous when i see numbers that are 359 , like tonight. ????
 
If you look at his chart, I have had it at 5 units for a while and his #'s are still all over the place. Should I just give him less units. ? what do you think.?
 
Stick 4 units for a minimum of 3 full days unless he earns a reduction by going below 50 mg/dL.

High numbers aren't going to be the concern. LOW numbers are the concern. Cats can often tolerate high numbers for a while, though not forever.

Did you read the Lantus Tight Regulation Protocol?
 
I did read the lantus tight regulation , is 50 mg his bg levels? I assume it is. This morning his fasting bg is 195, still give him 4 units??
 
Yes, I meant 50 mg/dL. Divide by 18 if you need mmol/L.

See my signature link Glucometer Notes for some info on what various glucose numbers may mean.

Yes, stick with 4 units.

If his mid-cycle numbers go below 50 mg/dL, and intervene with 2 teaspoons of high carb gravy, wait 20 min, re-test. If still low, repeat. Do this until past nadir and rising and above 100 mg/dL. Note that high carb gravy/Karo syrup wears off fast.
Also, the next shot would get reduced by 0.25 units if he goes below 50 mg/dL.
 
It is normal for the glucose to rise a bit in the 2 hours after eating.

The mid-cycle, between +5 to +7 hour post shot, is where you want to watch for it getting too low.

What did you think about the Tight Regulation Protocol? Is that something you want to follow?
 
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