Hello. New member/newly diagnosed cat

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Just heard from Kim and she was able to get a little blood this time - still not enough for the test though. I told her if she can to try tonight or tomorrow again.

Kim, you are doing great! Just keep trying and I know you will soon be able to test!
 
Hi Kim,
I live up in Novi area and work in Plymouth. Last fall, my hubby and I also helped another gal in Westland with testing her kitty, O'Malley.

I will send you a PM with my cell phone (text messages are fine). If it works out, I would love to connect you with Sarah, who lives in Westland and has been doing very well with O'Malley for the last 6+ months. (i will need to text Sarah, as she doesn't post here every day).

gotta get to work now --
phoebe

edited to add - I see that you're near 275 and MI Ave - I might be able to come during my lunch break today or tomorrow -- check your Private Messages (PM) for my message with cell phone number.
Another possibility is my husband might be able to come on Friday. I just checked with Sarah / O'Malley - she is working double shifts, so she can't come over this week.
 
Oh, wow. Thank you Phoebe! That would be awesome. I got the OK to switch to Lantus, so were going to start that this evening too. If I can get enough blood out to test this evening, I'll post later. I will be lurking on and off this afternoon as usual! THANK YOU to everyone for your help!
 
ed4blue50 said:
Also the meter I have is the Relion Prime, which uses more blood.. I think .05 and the confirm was .03. Next week when I get paid, I am considering taking the Prime back to get the confirm, but I can't afford to buy the strips for the confirm until then.
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Sometimes that tiny difference between a drop of blood and a drop of blood is the difference between success and failure when first starting out. The Micro/Confirm does require half the amount of blood, but you're right; the strips are much more expensive. My suggestion would be to still keep the Prime for future use once Smokey's ears learn to bleed better and you guys have both gotten more used to testing. It's also great to have a backup meter anyway. Mikey once managed to knock his glucometer into his water bowl (they were nowhere near each other and I think it might have been purposeful...) and I had to wait a couple of days for it to dry out before I could use it again. It wasn't a big deal because I had a backup meter, but imagine if I didn't have a backup meter and he'd done it one of the numerous times he was running low numbers at 2 am! :?

Also, you can't return diabetic ("blood") supplies to the store, but have to contact the manufacturer directly for a refund, so it might be more trouble than it's worth.
 
ed4blue50 said:
Do you know of a link that I could go to so that I can get used to checking his numbers and the termonology used. I don't know what numbers are considered normal for a cat on a human glucometer.. or what furshots are..etc..

If you have a link I could go to to learn up on this, it would be greatly appreciated!
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I simply use Wikipedia's link to Blood Sugar Guidelines in cats for help in determining what numbers are "good."

ETA: The numbers on the Wikipedia table are what you see with human meters. (A 70 on an AlphaTrak, a pet meter, is hypo territory vs. a 40 on human meters.)

Another handy "numbers" list, since you're going to be using Lantus, is the "typical" curve:
Example of a typical Lantus curve:
+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.
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When I was first starting out, I printed both of those off and made little laminated (well, scotch-taped :lol: ) reference cards that I kept in Michelangelo's glucometer bag. They're also useful for surrogate testers (like family members who don't test as frequently).

As for keeping track of numbers, here are the instructions to our amazing spreadsheets and also how to create a profile and update your signature. :-D
 
A quick run-down of common terms:
  • Fur shot: when the syringe needle pokes through almost like a sewing needle through fabric and it is unknown how much, if any, insulin actually made it inside the cat. Usually detected by wet fur or the smell of insulin (it smells like band-aids or scotch or antiseptic). IT IS ALWAYS ASSUMED THAT THE CAT GOT THE INSULIN AND YOU NEVER GIVE ANOTHER SHOT. It is always better to miss a shot than to give too much insulin.
  • AMS/PMS: morning (AM)/evening (PM) shot
  • AMPS/PMPS: morning pre-shot test/evening pre-shot test (it's assumed the shot is given within 15 minutes or less of this test).
  • +1, +2, +3...: How many hours after a shot, i.e. +1 would be one hour after their last PS (pre-shot) test
  • BG/BS: Blood Glucose or Blood Sugar (numbers). Usually used in relation to testing and dosing and what "level" or "point" the cat is at. Used in a sentence: "Michelangelo's BGs have been high so I've been increasing his dose."
  • AMBG/PMBG: morning/evening Blood Glucose. Used when no shot has been given at the regular shot time.
  • Condo: In Lantus Land, this is your daily post about your cat. My suggestion is to browse through a few condos to see how people post on a daily basis there and start posting yourself. You do not have to be following Tight Regulation to post here; you simply need to be home testing with some frequency (at minimum 3 to 4 times a day) and have your spreadsheet set up for others to view.

And, as always, when in doubt, ask! Around here, the only bad question is the one that goes unasked. ;-)
 
I can't say thank you enough to everyone! I've learned so much from this board over the last week, can't imagine not having the access to the information I've gotten here. I give Smokey his insulin as close to 8 AM/PM as possible. With him being so used to free feeding, it's been a little trying to get him to eat enough food to give him insulin, so I usually give him about a 30-45 minutes to eat, and will give him insulin about 20-30 minutes after he started eating. I'm hoping that over time, he will get used to having meal times, and he will eat a bit more. During the times where I have to coax him, I will try talking him into eating more, (which actually has been working, most of the time!) if that doesn't work, I try putting on his paw/nose/side of face. As a last resort, I will use the syringe. Don't want to do that unless I have to, the last thing we need is him to develop food aversion!
 
ed4blue50 said:
I'm hoping that over time, he will get used to having meal times, and he will eat a bit more.
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Actually, once you switch to Lantus, you don't have to make sure they eat at shot time. As long as they're eating throughout the day (most specifically around peak/nadir/+5 to +7), you should be fine. You can go back to free-feeding if that is what Smokey prefers (yes, you can free-feed with wet by adding water to it, freezing it, and/or using timed compartments). The only thing recommended is for the food to be picked up ~2 hours prior to shot time so as to not affect the PS BG number with an artificial spike from food.

Another secret to getting them to eat is sprinkling their food with Parmesan. This works like a charm EVERY time I use it on my cats (usually to get them to eat cold food I took straight out of the fridge).
 
I will try the parm tonight if he's being his usual picky self! :lol: My dad was a sucker, and spoiled him with treats (too often for my taste) so, he's getting used to eating food more often now. I am going to get to petsmart this weekend and grab some freezedried treats for him. I hope he likes them!
 
Having them eat before the shot is most important for NPH insulin because it hits pretty fast.

Lantus and Levemir are gentle and free feeding during all day / all night is ok.
 
Yet another upside to the Lantus! lol I'm so happy I convinced my vet to switch. She told me the NPH"is what they use" at her office. It makes me sad to think about the kitty's whos owners don't have a computer or don't take time to do the research.. If my printer was working correctly, I'd print out some of the information I found online about FD and NPH insulin, and take it to her next time we go in..

Oh, and I was finally able to make an avatar! Everyone.. please allow me to introduce you to Smokey on left, (aka Mokey Monster or Mokey Moo), and his son, Anton (aka TT or Mr.T) on the right. ;-) Smokey says thank you as well!
 
Well,.. good news is, I got enough blood to test...
Bad news is, his BG was 497... I fed him, and as he was eating gave 2.5 U of Lantus.

I will be checking it again in a few hours, and will post results if still extremely high.
I really hope the Lantus works, the NPH obviously wasn't working well at all.
 
Smokey & Kim said:
Oh, and I was finally able to make an avatar! Everyone.. please allow me to introduce you to Smokey on left, (aka Mokey Monster or Mokey Moo), and his son, Anton (aka TT or Mr.T) on the right. ;-) Smokey says thank you as well!
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What cutie pies! cat_pet_icon

Smokey & Kim said:
Well,.. good news is, I got enough blood to test...
Bad news is, his BG was 497... I fed him, and as he was eating gave 2.5 U of Lantus.

I will be checking it again in a few hours, and will post results if still extremely high.
I really hope the Lantus works, the NPH obviously wasn't working well at all.
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Congratulations on getting blood! :thumbup Remember, Lantus should be given as close to every 12 hours as possible, so if you gave him a shot now, the next shot will have to be 12 hours later from now. Also, be patient. You might see higher numbers the first few days as the Lantus depot fills and this is normal. Don't change the dose over the next few days unless at any time he drops below 50, then immediately drop the dose at the next shot time.
 
Kim

I am going to ask some of the Lantus users to look in on you. I think you might have dosed him a little to high. But they have been doing this a long time and can help you with the dosing.

Terri
 
Thank you. I was giving 3u of nph after giving him 2u at the beginning. Both at the direction of my vet. Just for a little backstory. I will test again, at +2, +4, etc... I switched ears this evening. Should i keep switching ears? I just don't want them getting sore.
 
Kim

I have asked for help, NPH is a totally different kind of insulin and you need to test many times with it, its old school and no one uses it anymore.
Lantus dosing is usually based on cats body weight and just dosed twice a day at twelve hour intervals. I am trying to get someone over here for dosing help. You are doing a great job. You got him a great insulin, I just don`t want you to give him to much to start.

Terri
 
Oh boy - Did you give him the same amount of Lantus as you were of N? That may be too much.

The initial recommended dose for Lantus = (the lower of ideal weight or current weight in pounds) / 2.2 * 0.25

Lets figure out if that might be too much:

What are his ideal and current weights?

OK - someone told me he currently weights 15 lbs
divided by 2.2 = 6.8 kg
times 0.25 = 1.7 units

He might be OK, but!
just in case - do you have Karo syrup, some high carb gravied foods, an oral syringe and lots of test strips (like 50)? You've got a couple of hours before it starts really kicking in if you need to get any of that.
 
Kim

His ideal starting dose of Lantus should be NO higher that really 1.5 units based on body weight every twelve hours.

Terri
 
Oh god.... Karo.. No... Syringe and wet food yes. Now im freaking out. His ideal weight? Im not sure. Right now hes 15.5
 
terri1962 said:
Kim

I am going to ask some of the Lantus users to look in on you. I think you might have dosed him a little to high. But they have been doing this a long time and can help you with the dosing.

Terri
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Thanks for checking, Terri! I was also a little worried about Kim starting him at 2.5u (depending on size, most cats don't need more than around 1 to 2u if they're being feed wet, low carb food). I just don't know enough about starting dose recommendations to help with this so the best advice I can give at the moment is test frequently to make sure he doesn't drop too low and have your hypo kit ready in case he does. Again, because Lantus utilizes a depot, you might not even know it's too high a dose until 3 days later! :o

Smokey & Kim said:
I switched ears this evening. Should i keep switching ears? I just don't want them getting sore.
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Do whatever you feel comfortable. I mainly test Mikey on his right ear because it bleeds better than his left and is easier for me to get to in the position he prefers to sit in when I test him. Smokey's ears may be a little sore the first few days/weeks (and will probably look terrible, too), but it will all clear up with a little bit of time, so don't worry.

ETA: Thanks, BJM! I knew there was a formula for initial Lantus dose somewhere and couldn't find it fast enough. :lol:
 
OK

Don't panic - this is manageable.

You need gravied foods, Karo syrup/honey, lots of test strips, and an oral syringe.
Have you got them? If not, go get them NOW or send someone.

Do NOT feed dry food - it expands and the cat vomits.

The basic hypo protocol is:
test for low levels/large drop
Feed 1 -2 teaspoons of gravy if he's going low
wait 15 minutes
test again
repeat until he is safe
 
Test now.

Is it OK if I round up a few troops - I've got something scheduled shortly.
 
I'd test every hour until you either see a sharp drop (i.e. from 497 to 230) or he tests under ~150 (or maybe 200?). Then switch to half-hour testing till he starts to rise again for at least 2 tests in a row that are not food-induced rises. If he goes under 100, I'd be testing probably every 15 minutes and have the high carb food and karo syrup close at hand in case it's needed.
 
Its actually Kroger light corn syrup.. If it matters.

Being 15 lbs, and eating diabetic dry at this point. He's a dry food addict, trying to slowly switch atm. Im hoping he will be okay. Esp with numbers this high. He was over 500 at the vet monday. I know not the best, but the only # i have to compare to right now.
 
A question worth asking is what syringes were you using to give the NPH (I think this is dosed with u40 syringes??? :?: ) And what syringe did you use to give the Lantus (they should be u100).
 
OK. The diabetic dry isn't great as it will swell if as it gets wet in the stomach.

If he starts getting down under 100, you may need to syringe feed a mix of the corn syrup and some wet food - about a teaspoon worth at a time, or put a blob on your finger to give it to him and maybe rub corn syrup on his gums.



I'm a "be prepared" kind of person, so just in case, (and we are nowhere near that) have you a carrier, transportation or friend who can transport, and know the nearest 24 hour vet services? If you stay on top of this, you likely won't need it.
 
hi Kim

did you manage to get a test?
The dose may be a little too high but he'll probably be fine - his depot is empty so that won't be affecting anything.

Obviously the blood tests will show exactly how he's doing so as soon as you get a number, post it and we can take it from there.

Don't worry - there are lots of very experienced people around!

Denise
 
Kim

which syringe did you use to give him his shot the U40 that you used for the NPH or the a U100 that should be used for Lantus?

Terri
 
I understand

I've contacted a few folks who've been through this to come monitor.

And as I noted - he may be OK, but being prepared is a good thing!

Take some time to read over this hypo protocol as it is possible you will need to do this.

And please keep a running list of the tests in your posts here, so switching to the spreadsheet isn't necessary to track how it is going. It'll be faster.

I've got to head out; I'll check back as soon as I'm able. Several folks will be helping you.
 
NPH is a U100 insulin just like Lantus but that is where the similarities ends....How much Lantus was given and when?

Sorry trying to play catch up here and figured it was easier to ask than scroll through the posts

Mel, Maxwell, Autumn & The Fur Gang
 
Mel

She gave 2.5 units at 6pm but trying to figure out what syringe she used if it was u40 or u100 she used. He was on NPH previously.

Terri
 
A quick Summary:

PMPS 497
2.5u Lantus given U100
+1.5 581

ETA: Had some weird board flukiness with this post. :?
 
terri1962 said:
Kim

which syringe did you use to give him his shot the U40 that you used for the NPH or the a U100 that should be used for Lantus?

Terri
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The U100. I checked the boxes, they are both U100 insulins.
 
NPH should also be a U100 like Lantus. U40 will have a red cap ....U100 an orange cap

Mel, Maxwell, Autumn & The Fur Gang
 
MommaOfMuse said:
NPH is a U100 insulin just like Lantus but that is where the similarities ends....How much Lantus was given and when?

Sorry trying to play catch up here and figured it was easier to ask than scroll through the posts

Mel, Maxwell, Autumn & The Fur Gang
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Hi, his BG was 497 at 6pm, gave 2.5u lantus. Now its 730..bg 581
 
Okay so we know it truly was 2.5u of Lantus...<gulp> Well guess you are going to learn to home test with a trial by fire, but it will be okay...done this many many times.

Mel, Maxwell, Autumn & The Fur Gang
 
On set for Lantus will be right around +3ish so its normal he would be still rising at this point, problem is Lantus lasts much longer in the system than NPH...so you could be in for a long night. Hope you have plenty of strips, coffee, corn syrup, HC food etc. BTW the coffee is for you. :-D

Mel, Maxwell, Autumn & The Fur Gang
 
For future.. I called my vet again, she says because his numbers have been running high, to go with 2u of Lantus.

We started with the NPH... were doing 2U for about 6 days, no improvements in BG according to readings at the vet. I couldn't test at home, but based on the #'s I'm getting now, I'm going to assume they were close to accurate. After there were no improvements, she upped him to 3u of the NPH.

Now, I know that according to his weight, it should be 1.5 to 1.75 of Lantus. So, for the next shot, assuming his numbers don't DROP low tonight, should I do 1.75 or 2U? I'm so confused, and stressed out. I know it will be okay, and this is going to be an ongoing battle, I just feel like I'm getting nowhere. Trying to stay positive and as stress free as I can, but it's hard. I want what is best for him.
 
MommaOfMuse said:
On set for Lantus will be right around +3ish so its normal he would be still rising at this point, problem is Lantus lasts much longer in the system than NPH...so you could be in for a long night. Hope you have plenty of strips, coffee, corn syrup, HC food etc. BTW the coffee is for you. :-D

Mel, Maxwell, Autumn & The Fur Gang
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Thank you Mel. I will test again around 9pm.
 
Kim

Dose based on weight is 15.5 lbs which is 6.8kg times .25 = 1.7 units of Lantus. That is the formula for dosing.
I would give him no higher than 1.5

Terri
 
Well there are two different protocols for Lantus ...either start low, go slow where you would start him out no higher than 1u, or the Tight Regulation where the starting dose would be based on weight...my preference with my diabetics ( I have two) is the Start Low Go Slow. I would rather them be high a little longer than go too low for a minute.

So going forward would depend on which protocol you are going to follow.

My personal recommendation would be to start at 1u, hold for a week if not enough increase based on the nadir readings...You can always add insulin you can't get it back out once it is shot.

Mel, Maxwell, Autumn & The Fur Gang
 
terri1962 said:
Kim

Dose based on weight is 15.5 lbs which is 6.8kg times .25 = 1.7 units of Lantus. That is the formula for dosing.
I would give him no higher than 1.5

Terri
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And then if his sugars don't come down after a week go up from there by .25? Am I correct (or close lol) on that?
 
Yep you will either go up by .25 or .5 depending on where his lowest point it...generally if his nadir is still above 200 you go up by .5 if below then by .25

I need to step out briefly to go test feed and shoot my girl and the rest of the Fur Gang then grab a very quick bath, but you will be in good hands with Terri until I can get back on.

Mel, Maxwell, Autumn & The Fur Gang
 
KIm

Mel has much more experience than I do follow what she says. Please do whatever she recommends. Mel has a couple of diabetic cats at the present time.
I am only giving the you the basic calculation for dosing.
What I am giving you is the Tight Regulation dosing.

Terri
 
Smokey & Kim said:
terri1962 said:
Kim

Dose based on weight is 15.5 lbs which is 6.8kg times .25 = 1.7 units of Lantus. That is the formula for dosing.
I would give him no higher than 1.5

Terri
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And then if his sugars don't come down after a week go up from there by .25? Am I correct (or close lol) on that?
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Well, first try getting him fully off the dry. ;-) But yes, according to the "General" Guidelines, you would most likely increase by .25u. If you've already started posting in Lantus Land by that point, you'll be assisted with when to increase the dose and by how much.

"General" Guidelines:

Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).

Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).

Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.


Increasing the dose:

Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.

After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.

After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.


Reducing the dose:

If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.

If an attempted reduction fails, go right back up to the last good dose.

Try to go from 0.25u to 0.1u before stopping insulin completely.
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