? Hello from Newbies: Holly and Zena

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Zena-Jaxtobias

Zena-Jaxtobias

Member Since 2020
Hi All,

So grateful to find these forums! My 6-year-old Zena was diagnosed July 24th (with a 552 BG at vet from bloodwork/urinalysis, for a ”she has been very lethargic lately” check appointment). What a shock that was!

I will TRY to summarize her history.....She had been on the plump side but now was thinner (11.4 lbs.), about a 2 lb. weight loss from a year earlier. Since this was in the middle of Covid, I had to drop her off and speak with the vet after. He explained insulin options and I decided to go with Lantus and at 1 unit, 2x/day; but I got NO instruction on administration, ongoing care, monitoring and certainly not any BG home testing help (I am searching for a new vet who is an expert in FD or at least very familiar!). So I had to research everything on my own from YouTube and thankfully found this site! I have completed the SS but as you can see, she is all over the board, but I do see improvement.

Water/Litter box: I have been monitoring her water intake and litter box, and she has greatly improved....in the beginning she was urinating constantly and always hungry (typical FD), but now skinnier/boney. She had been on IAMs dry her whole life, and initially vet recommended Purina DM, which I got, and weaned her off IAMs fairly quickly. After DM ran out, I put her on FF pate Sept 27 and that is where I am finally seeing improvement in water/litter box and her BG's coming down (her water is now a normal ~4 oz a day, down from 6-10 oz on dry). Litter box appears to be normal again; never any diarrhea or puking (only once or twice, very small), and normal pee clumping.

Home Testing: Zena tolerated the ear pricks, as well as the shot (in scruff), surprisingly well initially. I didn’t want to overdo them in fear of her agitation (and anger), so I have not done regular testing, other than different times on different days to get the pattern. I did manage to do one curve on 8/31 every 2 hrs. (AM only) to get a baseline. However, I have noticed lately that she is increasingly testy when I prick her ears, as if they are becoming more and more sensitive (although I rotate locations), so that has made me nervous to test at all, and now less often. Same with the shot…usually OK, but she also acts like that is more sensitive as well. Perhaps it is because she is thin and hardly has any meat (or fat) on her? Too afraid to try foot pads as she is very anti-foot anything.

Dosing: I fully admit I am a novice and have tried to adjust according to what I have minimally learned, but I can definitely use more guidance. I started out at 1.0 twice a day per vet; when her numbers were still high, I increased to 1.5 and kept it there for about a month. Soon after she went on wet food, her numbers dropped suddenly to under 100 (and I freaked a bit), lowering her dose to 1.0 again (and skipped the shot on the couple super low days). She has never exhibited any dangerous hypo symptoms, and throughout this journey has still been fairly energetic, playful and generally happy, once the super high numbers started to lower. I had hopes of a miracle remission with the low numbers just from wet food, but they are still up and down, tho overall lower.

Weight: I’ve monitored weight too and it has fluctuated from 11.8 to 11.0 and back up to 11.4. I am concerned she is too thin; I feared she was starving to death, so I increased her food to 1.5 can’s FF twice/day and even a half can midday to try to get some weight on her. She was always a grazer on dry and now I leave her portion out and let her eat at will during the day (she is not ravenous any more). She seems happy with this, but now sometimes seems to be eating less!! UGH! The ups and downs for no reason are exhausting!

Sorry for the long-winded explanation! Any advice/guidance would be greatly appreciated! MANY THANKS!

PS. I am located about 35 miles SW of Chicago… if there are any FD vet recommendations, please let me know!
 
Zena-Jaxtobias said:
h Lantus and at 1 unit,
Click to expand...
Lantus is a great choice and 1 unit is the recommended starting dose. So far so good. And awesome that you are testing right from the start!!!! Changing to wet pate was the right choice as well.

When you test, are you being careful to not hit the vein? That can hurt more and might make the ears sore.
Zena-Jaxtobias said:
fluctuated from 11.8 to 11.0 and back up to 11.4. I am concerned she is too thin; I feared she was starving to death, so I increased her food to 1.5 can’s FF twice/day and even a half can midday to try to get some weight on her.
Click to expand...
You said she used to be 13lbs. If that's a good weight for her then you are going to want to give her about 260 calories a day which is about 3 cans a day, but until she's regulated you can give her more. If you think she's underweight give her as much as she wants, just no food 2 hours prior to the preshot test. Most find a few smaller meals are better than two big meals. I usually feed four times a day.

We can help with dosing.
 
I'm looking at the spreadsheet. She went hypo on 1.5, so you were right to reduce. I'm not a lantus user so I'll let someone else weigh in here, but usually we lower and raise in 0.25 increments, so you would have reduced to 1.25. 1.5 I think it's too much. I know you are having trouble testing but really do try to get an evening preshot before insulin. These numbers are low for a newly diagnosed cat, so you'll want to be careful.
 
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Welcome and you already got great advice from Janet!

I agree, she went hypo with that 37. Anything under 50 on a human meter is a take action number. If that happens again, you need to feed high carb food like FF gravy lovers and retest in 30 minutes and keep feeding until numbers go up and are in a safe zone. Post here for help too!

And you do need to get the preshot tests am and pm. No food for 2 hours prior then test, feed, shoot. She needs to eat more again, Janet is on point there. The rule of thumb is 20 times ideal weight to get the daily calorie intake. Diabetic cats can’t process the nutrients in food efficiently so they eat but are always starving and lose weight. Also they burn calorie just by peeing since there’s sugar in their urine.

is this the spot you’re aiming at? Are you giving her a treat immediately after? And are you warming up the ear too? Lastly, what size lancets are you using?
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The great news is that her numbers are pretty good for a newly diagnosed diabetic cat, so we just have to find that right dose. I also agree that 1.5 seems to be too much for her right now. The food transition can bring their numbers quite low and the need for insulin decreases.

Please review the yellow sticky notes on the Lantus forum so you can read about the 2 protocol options for Lantus and select one:

https://www.felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/

With not a lot of tests, you’ll likely be going with SLGS and that means every time she goes under 90 she earns a .25 dose reduction. We dose here by the nadir, lowest point she goes in a 12-hour cycle not the preshots, but the preshots are important to determine if she’s at a safe number for the insulin. You can skip but there’s also an option to give a token dose. Have you gotten 1/2 unit marked syringes? Those are helpful in dosing the .25 increments.
 
It's very important that you test before every shot to make sure hervBG is a number that is safe enough to shoot.
The curve you said you did on 8-31 as not done every 2 hours.
You should be testing her at night, who knows how low she might have dropped

Like Ale mentioned try and get the syringes with the half unit markings, by increasing Zena's insulin by half units you could be missing the correct dose for her.
We increase and decrease by 0.25 units

Everyday you should test her different times after her pre shots
One day get a +2 , +4. +6
Next day get a +3, +5, +7
Even a +8 , +9 +10
Same thing in the evening if possible, at night at least get a +2 and a +6 in
Or a +3 and a +4

You want to see how the insulin is working and try to find her nadir
You can also put some Neosporin OINTMENT with Pain Relief, DO NOT buy the CREAM
Put a thin layer on them

It will get easier believe me
Just keep asking questions , that's what we are here for :cat:
 
JanetNJ said:
Lantus is a great choice and 1 unit is the recommended starting dose. So far so good. And awesome that you are testing right from the start!!!! Changing to wet pate was the right choice as well.

When you test, are you being careful to not hit the vein? That can hurt more and might make the ears sore.

You said she used to be 13lbs. If that's a good weight for her then you are going to want to give her about 260 calories a day which is about 3 cans a day, but until she's regulated you can give her more. If you think she's underweight give her as much as she wants, just no food 2 hours prior to the preshot test. Most find a few smaller meals are better than two big meals. I usually feed four times a day.

We can help with dosing.
Click to expand...

Thank you Janet! I always try to hit the lancet in the middle between the vein and the outside edge of her ear. I think I will up her food as you mentioned. One question... will extra food affect her readings and/or the insulin dose (up or down?).
 
JanetNJ said:
I'm looking at the spreadsheet. She went hypo on 1.5, so you were right to reduce. I'm not a lantus user so I'll let someone else weigh in here, but usually we lower and raise in 0.25 increments, so you would have reduced to 1.25. 1.5 I think it's too much. I know you are having trouble testing but really do try to get an evening preshot before insulin. These numbers are low for a newly diagnosed cat, so you'll want to be careful.
Click to expand...

I think I was spooked by the high preshot two days before (391) so I thought the 1.0 may not be enough. I do have the .25 syringes so I will try that. I also fear that the variation in readings is because I may have misfired on a shot (didn't go in correctly every time).
 
Diane Tyler's Mom said:
It's very important that you test before every shot to make sure hervBG is a number that is safe enough to shoot.
The curve you said you did on 8-31 as not done every 2 hours.
You should be testing her at night, who knows how low she might have dropped

Like Ale mentioned try and get the syringes with the half unit markings, by increasing Zena's insulin by half units you could be missing the correct dose for her.
We increase and decrease by 0.25 units

Everyday you should test her different times after her pre shots
One day get a +2 , +4. +6
Next day get a +3, +5, +7
Even a +8 , +9 +10
Same thing in the evening if possible, at night at least get a +2 and a +6 in
Or a +3 and a +4

You want to see how the insulin is working and try to find her nadir
You can also put some Neosporin OINTMENT with Pain Relief, DO NOT buy the CREAM
Put a thin layer on them

It will get easier believe me

Just keep asking questions , that's what we are here for :cat:
Click to expand...

Thanks Diane for feedback; I will be try the diff hours/diff days and also night readings (I hesitate with so many bc she is starting to flinch and fight me, but I know its important!). My (weak) attempt at a curve on the 31st was AMPS 355 (7:30a, ~ an hour before food); 232 at 11am; 209 at 12:30p; 236 at 4p and then PMPS 529 (gah!) at 8p. So much to learn....!
 
Zena-Jaxtobias said:
Thank you Janet! I always try to hit the lancet in the middle between the vein and the outside edge of her ear. I think I will up her food as you mentioned. One question... will extra food affect her readings and/or the insulin dose (up or down?).
Click to expand...
Hi there the extra food will not effect her readings or the insulin dose
Only with hold food for 2 hours prior to the pre shots
 
Aleluia Grugru & Minnie said:
Welcome and you already got great advice from Janet!

I agree, she went hypo with that 37. Anything under 50 on a human meter is a take action number. If that happens again, you need to feed high carb food like FF gravy lovers and retest in 30 minutes and keep feeding until numbers go up and are in a safe zone. Post here for help too!

And you do need to get the preshot tests am and pm. No food for 2 hours prior then test, feed, shoot. She needs to eat more again, Janet is on point there. The rule of thumb is 20 times ideal weight to get the daily calorie intake. Diabetic cats can’t process the nutrients in food efficiently so they eat but are always starving and lose weight. Also they burn calorie just by peeing since there’s sugar in their urine.

is this the spot you’re aiming at? Are you giving her a treat immediately after? And are you warming up the ear too? Lastly, what size lancets are you using? View attachment 57176View attachment 57177
Click to expand...


Thank you so much! Thankfully on that hypo day she appeared fairly normal, other than a bit sleepy -- not disoriented and alert/jumping normally. (whew!) I actually gave her a bit of honey on her gums just to be safe. 6 hours later was 68 (I mismarked on sheet earlier). Scary stuff!
 
Zena-Jaxtobias said:
Thanks Diane for feedback; I will be try the diff hours/diff days and also night readings (I hesitate with so many bc she is starting to flinch and fight me, but I know its important!). My (weak) attempt at a curve on the 31st was AMPS 355 (7:30a, ~ an hour before food); 232 at 11am; 209 at 12:30p; 236 at 4p and then PMPS 529 (gah!) at 8p. So much to learn....!
Click to expand...
We all had to learn in the beginning. a little bit at a time.
Try and sit with Zena and start to rub her ears. Then give her a little treat.
Try and bring her to the same spot so she starts to associate being tested and then gets a treat.
You can make a rice sock and put it in the microwave, put it on her ears
to warm them up, she will bleed better. Test the sock on the inner part of your
wrist to be sure it's not to warm,
Like you would test a baby's bottle
We are all here to help, so just keep asking questions :cat:
 
Zena-Jaxtobias said:
Thank you so much! Thankfully on that hypo day she appeared fairly normal, other than a bit sleepy -- not disoriented and alert/jumping normally. (whew!) I actually gave her a bit of honey on her gums just to be safe. 6 hours later was 68 (I mismarked on sheet earlier). Scary stuff!
Click to expand...
Aleluia Grugru & Minnie said:
Welcome and you already got great advice from Janet!

I agree, she went hypo with that 37. Anything under 50 on a human meter is a take action number. If that happens again, you need to feed high carb food like FF gravy lovers and retest in 30 minutes and keep feeding until numbers go up and are in a safe zone. Post here for help too!

And you do need to get the preshot tests am and pm. No food for 2 hours prior then test, feed, shoot. She needs to eat more again, Janet is on point there. The rule of thumb is 20 times ideal weight to get the daily calorie intake. Diabetic cats can’t process the nutrients in food efficiently so they eat but are always starving and lose weight. Also they burn calorie just by peeing since there’s sugar in their urine.

is this the spot you’re aiming at? Are you giving her a treat immediately after? And are you warming up the ear too? Lastly, what size lancets are you using? View attachment 57176View attachment 57177
Click to expand...

Sorry missed your additional questions; yes that is the spot I'm aiming at; Yes treat after; I try and make sure her ears are warm first; using 30g lancets (ultra thin).
 
Next time you do a curve
Don't feed herm2 hours prior to the pre shot
So then
Test , feed and give the insulin
Let's say your test times are 8 AM and 8 PM
You shoot at 8AM
10 AM test her
12 afternoon. test her
2 PM test her
4 PM test her
6 PM test her that's the curve

Then at 8 PM would be her pre shot

You can feed her during the curve as you normally would
 
Diane Tyler's Mom said:
You want to get lancets that are 26 or 28 gauge, they will make a larger hole.
As more capillaries grow every time you test she will bleed so much better.
Then if you want to you can go back to using the 30 gauge lancets

I have always stayed with the 28 gauge
Click to expand...
Yes, agreed! At the beginning the larger lancets will be your friend. 28 or even 26
 
Zena-Jaxtobias said:
Thank you so much! Thankfully on that hypo day she appeared fairly normal, other than a bit sleepy -- not disoriented and alert/jumping normally. (whew!) I actually gave her a bit of honey on her gums just to be safe. 6 hours later was 68 (I mismarked on sheet earlier). Scary stuff!
Click to expand...
Good instinct! Yes honey or Karo for sure. Now that you have us, post here if that ever happens again. Some cats don’t show a lot of behavioral signs which is why testing is so important :cat:
 
Hi Holly,

Zena's a beautiful cat! Lovely pic of her in your avatar. :)

Zena-Jaxtobias said:
And I will try the 28g, but will that agitate her ears even more?
Click to expand...
WRT lancets, in the early days of testing it's usually trickier to get a blood sample and the larger gauge lancets increase the likelihood of success compared to the finer gauge ones, so overall less poking is typically needed.

With repeated testing, new capillaries form at the test sites and it becomes progressively easier to draw a sample successfully with just a single poke.


Mogs
.
 
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Critter Mom said:
Hi Holly,

Zena's a beautiful cat! Lovely pic of her in your avatar. :)


WRT lancets, in the early days of testing it's usually trickier to get a blood sample and the larger gauge lancets increase the likelihood of success compared to the finer gauge ones, so overall less poking is typically needed.

With repeated testing, new capillaries form at the test sites and it becomes progressively easier to draw a sample successfully with just a single poke.


Mogs
.
Click to expand...
Thank you for the info, that helps! (And for kind Zena comments!)
 
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