HELP, found high BGL, what's next?!

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Shawny2u

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Hello board members, my male cat Tubby almost 11 years old (20LB) was off insulin for 4 years. His BGL was in 70-85 range for most of this time but two nights ago after coming back home from two month trip tested him and I was appalled by the new readings. His BGL read 367 I thought that must have been a mistake so tried 8 hours later and have realized by then he is back to his diabetes again. This morning I called his vet and asked for PZI insulin which he was on at the time, I was told PZI is no longer available. Tubby will be going for blood work at his vet clinic this morning. Could someone tell me whether it is true PZI is no longer manufactured? And what are the recommended INSULIN nowadays.
I am panicking and need your help here. I NEED HELP as how to resume his treatment or any advice at this point!!!!
Thank you in advance!

His BGL numbers fluctuated between 300-400 in last two days as I tested him at home.
 
hi, i can relate. my tom was otj for 2.5 years now back on pzi. i am using the pzi until it's all gone then i plan to move over to prozinc. yep pzi is over!
i can't do the rigours of lantus. that is my personal choice. if you can it is likely the better choice. pro zinc is an insulin we are still learning. i do trust it.
welcome back to sugar land...and try not to worry. may be a temporary set back.
have you checked you cat for any infections, teeth, bladder?
 
Hello,
I have been away from this board for such a long time that simply don't remember how to navigate.
A few minutes ago responded with general information and Tubby's other problems but as it was saved
some how ended up as a draft where I can not find where drafts are being saved. Could someone please
tell me how to find the draft I saved, where to look for it? I'm embarrassed but this is the price you pay
for being away for so long....
Thank you kindly!
 
shawn it's most likely on the old board. we switched to a new board in january.
what exactly are you looking for?
 
Shawn,

Right now you have 2 posts on the board that are the same. One is this one and one is this one: viewtopic.php?f=28&t=28833. It is easier if you only have one running.
 
I think they're both on this board - you posted two almost identical posts. The other one is here : http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=28833
I'll just copy my answer from the other post here, since you found your way back to this one...

Hi and welcome back to the sugarcat dance!

Who looked after your cat when you were away? Do you know what was being fed? It is possible that the BGs are elevated due to high carb food, or the stress of you being gone, or even an infection somewhere. It's important to remember that diabetes does not go away, but can be controlled, and sometimes the sugars will elevate for some reason. Definitely make sure the vet checks his teeth and urine for any sign of infection, and that any hi carb food is removed immediately.

With a bit of luck, and prompt use of insulin (the new PZI has already been mentioned to you), the sugars will come back under control, and he can go back to being in remission. Since you are already familiar with using PZI, it would be a good choice. Lantus and Levemir are also good. Please stay away from Vetsulin and Humulin N ...

Good luck and keep us posted!
 
The draft as it was called is not the same posting that is appearing twice in here. That is another reason
I'm confused posting the thing twice because I never thought the first one was posted!!
I will try to explain what exactly happened maybe then someone can tell how to retrieve my "lost posting"
which I have explained in detail about Tubby's situation. I have written a rather long text to tell Tubby's
story in the same box as I'm writing right now, replying to questions was asked by some of you good people
trying to understand more about my cat and his recent downfall. after finishing the text there are three
boxes at the bottom of this text area: "Save--Preview--Submit" I hit "Preview" to check for any correction
or so on, after making a few changes hit the "Save" button to save the changes at this point I saw some
kinda message like "your draft is saved" and didn't give a choice to post it!!! That draft must be hidden some
where on this site, anyone knows or is aware of such "Drafts"?? If so where is my hidden post, how do I
find them?
Thank you!
 
Try clicking on "user control panel" (upper left) then there should be an option "manage drafts". Maybe it's in there?
 
Wow....thank you Charliemeow, you were so right. It worked like a charm and followings
are what I found with Charlie's help. Thanks again Chrlie!

Hello and thank you all for kind and prompt replies!
Just came back from his vet and he is recommending Lantus as a sub. for PZI.
as you all mentioned this particular insulin. Tubby was in good hands but I'm not sure what
they may have fed him despite my instructions on his diet. There are other issues with Tubby,
he was diagnosed with hyperthyroid and cardiomyopathy about a year ago which he is on
medication for them. However his teeth are in bad condition but they wouldn't recommend any
type of surgery due to his heart condition. This is his cardiologist's instruction and
she also mentioned when his heart becomes stronger they will consider surgery option.
He will be going on Lantus starting tomorrow when it is available to me. I will be reporting
his progress or lack of as I proceed with his treatment. I need to ask everyone's opinion
as how many unit/units I should start with keeping in mind that his BGL average is about
350 for the last 2 days. His vet recommended to start with 1 unit twice a day for a
week when the insulin will settle in. Then if he is not responding positively and/or his BGL
still high he will raise the dose and will keep it for another week. I'm not sure if this is the
proper way because 4 years ago the most effective method I learned after experimenting
several different ways of administering insulin, I kept his insulin level at the normal range at all time until his
pancreas kicked in and created adequate amount. Now is this something that anyone tried here or
what is to board member's opinion the most efficient method? I do understand that each cat
will respond differently and it could be a very tedious road ahead, believe me I was there before!
I do appreciate any inputs and thank you all for being so kind.
 
Lantus is also a great option. It is different though than PZI, so I'd strongly suggest going to the lantus insulin support group and reading the stickies posted there.

Jen
 
Thank you for the info. his vet recommended lantus as the most common and very effective drug available nowadays. His numbers are still in mid 300s.
Because of his fructosamine being close to the normal range (lab result showed 502 for two weeks) his vet suggested to wait two weeks with high protein diet
which could possibly bring down his BGL to normal. I personally disagree with him but agreed to wait maximum of one week then proceed with the insulin. Any opinion on
what would be the proper way to handle his condition. Bear in mind that his numbers were consistent around mid 300s since I discovered he was in trouble.
He drinks very much just like he used to before, during the 2006 ordeal. BTW, this is very important to me as how much food he should be allowed per day. He is frantically hungry frequently and gained about 2LB during my absence which brings him up to 20LB. I do appreciate any inputs.
Thank you kindly,
 
Are the mid 300 numbers at home or tested at the vet? I ask because the bg levels can be raised by stress, if the cat is stressed out by all the noises and smells and strange people at the vet's office. Then when the kitty gets home, the bg levels go down.

In general, we say to feed unregulated diabetics more than you usually would. Their bodies are not utilizing the food properly and they can be literally starving. When Oliver was first diabetic, we fed 3-4 cans of Fancy Feast every day. Once his blood sugars were more normal, we went back to 2 - 2.5 cans a day.

What are you feeding? We advocate wet lo carb, between 8-10% carbs. Check out Janet and Binky's food chart:
http://www.felinediabetes.com/diabetic-cat-diets.htm The brand/kind doesn't matter. Whatever the cat will eat that you can afford. We do try to stay away for fish more than once or twice a week. Lots of us feed Fancy Feast, Friskies, Wellness.

His other issues make this complicated. Bad teeth and infection raise bg levels also.
 
His numbers are consistently in mid 300s both at home testing and the vet's lab. I had him on FF since his 2006 diabetes, and have never
fed any dry food what so ever since that time. His hunger as it was mentioned is due to his recurring high BGL but I'm grateful to hear it would be
all right to feed more. I don't know how that could be avoided, he simply is starving most of the time. Now, my question is and I
really need HELP on this one: he is a big boned cat (bangles) at 20LB, I feed him chicken breast and FF can food with high protein
and low carb. how many cans would a big cat like mine should be allowed in a day??
Please keep in mind he is 20LB.
BTW, as I tested him again yesterday morning and a few times after that his BGL was reading the same about 350. I called
his doctor, he agreed we should start with the lantus today.

Any thoughts?
 
Oliver was a 17 pound kitty (after being on Science Diet Lite for years to lose weight...... :oops: ) As I said, we fed him 3-4 cans of Fancy Feast when he was unregulated. As soon as he got back in more normal range, we were able to cut back. We had always felt he was overweight, even as a Maine Coon. The last year of his life, in remission, he got back to a trim 14 pounds.

You want to balance between his not being starved because he is unregulated, and overfed and then wanting to have that much food the rest of his life..... Experiment a little.

Hope you have checked out the Lantus stickies so you know how to handle the insulin and how to start with it? (It is quite different than PZI) viewforum.php?f=9

And try to start your spreadsheet from day one so you (and people who are trying to help) have a good grasp of his numbers and patterns: viewtopic.php?f=6&t=18207

Good luck! Hope you see good numbers soon!
 
Thank you Sue, I am going to pick up his Lantus shortly to start the treatment. I feel nervous but have been
on this road before. But Lantus is a whole different drug than PZI, that troubles me not knowing much about it.
I have been reading a bit here and there about how different this insulin behaves but not enough to feel
confident about it. The fact that it would take much longer than PZI to see the fluctuation of his BGL.
Could someone tell me how much the cost of U100 syringes are? I forgot what they were, it has been a long time.
The local pharmacy is asking $46 for 100 of them and I believe that is way over priced, could someone shed
some light on that for me please.

Thank you in advance!
 
I got ours at Wal-mart for I think right around $13 for 100 with the half unit marks on them. They also had packages of 10 for about $2

Mel
 
You can go over to the Lantus support group and they will have the answers to your questions about Lantus. They can also help you with a starting dose and how to react regardless of what numbers you get. They will want you to have a spreadsheet, as they are very numbers driven. They base the dose on nadirs and want those numbers before they suggest a change in dosage.

If you want help with the spreadsheet, just send me a pm. I have helped others and would be glad to help you. It's not terribly hard if you are a little computer savvy, but it is one more thing to do when you are overwhelmed.
 
About the foods, just feed him what he seems to want because his body right now is not able to process the foods and so he's not getting the nutrients he needs.

Both of mine ate large amounts of foods before they were regulated. Oliver was up to 30oz on some days, and Shadoe often would go through 24oz. Oliver weighs in at 23.6lb and now eats maybe 12-15oz lately. Shadoe weighs just under 14lb and she eats maybe 8oz a day. They are now fairly regulated and that strange ravenous appetite is gone.

Once you start seeing better numbers, you will also see a decrease in appetite.

Be sure to get the syringes with 1/2 unit markings as dose changes with Lantus are fine tuned by .25u often.
 
thank you all for your kind support, Sue i would be grateful if you send me the spreadsheet.
I did shoot 1 unit of lantus at 9PM tonight. Should i test his BG at some point before the
next shot? How do I get to Lantus group here? Before the PS his BG was 297.

I'm nervous and waiting!
 
Sorry we didn't get back to you last night.

Here is the URL for the Lantus group: viewforum.php?f=9 They post a little differently than we do here, so read the stickies at the top of the page first.

Here is the info on the spreadsheet: viewtopic.php?f=6&t=18207 If you have trouble, send me a pm.

You should always test before each shot. We generally tell new diabetics not to shoot if the preshot number is under 200. Then you need to get some numbers about 6 hours after the shot. That is the nadir, or the point when the insulin goes the lowest in the cycle. That number helps you figure out whether the dose is too high, too low or just right. (Just like Goldilocks!)

Good luck! I am sure you will do fine. You are definitely on your way with hometesting and a good insulin.
 
Good morning America and the greatest support group for sugar kitties!
Thank you again Sue, I do appreciate your advices, it helps very much.
I'll start with how things are going with my cat Tubby.

11/5 7:15 pm 398
He was fed dinner mostly chicken breast then right before his pre shot tested again.

11/5 9/15 pm 297 PS
1 unit injected

11/6 5:30 am 384

Its about 8:30 am and I'm getting ready to test him for hi PS. his vet said to give him 1unit every 12 hours.
Is that about right? With PZI I was injecting as soon as he was over 150 and it worked so well that his
pancreas kicked in after couple of months. I know Lantus suppose to be working differently.
Obviously 1 unit is not doing very much however his vet said it'll take 3 days to one week before this
insulin kicks in. I don't know how if that really would be the case. I wish the PZI was available!!!!
Question:
Is 12 hour period the way to go with Lantus?
 
Just to answer your immediate question, the one unit is fine. Lantus is unlike PZI; it builds up a shed so you need to stick with one dose for a while. Be sure to get some mid cycle numbers today so you can see how it is working. And yes, you do need to do the 12 hour cycle. It is not like PZI where you can sometimes shoot early.

I am going to go over to the Lantus support group and ask someone to come over and give you some specific advice. (They will urge you to read the stickies on their page. A lot of the information is there.)
 
Sue's right -- there's a ton of information in the starred, sticky notes at the top of the Lantus Board.

Lantus is very different than PZI. The biggest difference is that dosing is not based on pre-shot numbers. It's important to test before shooting since you don't want to shoot if numbers are unduly low. However, whether the dose is increased or decreased is based on the nadir. Also, Lantus likes consistency. It is important to give shots as close to every 12 hours as possible. Because Lantus is a depot-type drug (what we refer to as a "shed"), shooting early or late has an effect on the shed and the resulting overlap between doses.

The dose your vet suggested sounds fine. Typically, the initial dose is maintained for 5 - 7 days to allow the shed to form and the dose to stabilize. Unless Tubby's numbers drop significantly, you should hold this dose.

We utilize a very specific dosing protocol on the Lantus board. You may want to take a look at the sticky on the Tight Regulation Protocol. It is also a very numbers driven group. Please let us know if you have questions - we're here to lend a hand.
 
hi there

just posting some info for you, from one of the Lantus forum stickies...

This chart might help you with a curve and spot checks ....
You can find in the Lantus forum stickie New To The Group I've included all the links for Onset, Peak, Duration etc.


Learn how YOUR kitty is responding to insulin:
Onset ---> the length of time before insulin reaches the bloodstream & begins lowering blood glucose
Peak/Nadir ---> the lowest point in the cycle
Duration ---> the length of time insulin continues to lower blood glucose

How to do a Curve: you don't have to test every hour. Typically curves are every 2 hours in a 12/12 cycle. Or a mini-curve, about every 3 hours.
Depending on where the numbers are, you may have to re-test frequently and offer food to help steer numbers.

Example of a typical 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....ETA: around here, with Lantus you'll want to withhold food, feeding after this point may give you a food influenced preshot number (both AMPS and PMPS cycles) so try not to feed after this point.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.

Carryover ---> insulin effects lasting past the insulin's official duration
Overlap---> the period of time when the effect of one insulin shot is diminishing & the next insulin shot is taking effect
Insulin Depot ---> (aka "storage shed" in Lantus Land) "spare tank" of insulin, which has yet to be used by the body
More on the Shed ---> Lantus & Levemir Insulin Depot AKA Storage Shed

With Lantus, dosing is typically based on nadir/peak numbers, after several cycles on same dose. So when you can, collect the data, share your numbers and others will guide you along.
If you like, this is a link to the protocol followed in the Lantus forum:
Lantus & Levemir Tight Regulation Protocol

And yup, a spreadsheet will help members in the Lantus forum help you along, especially with dosing help.
If you are not able to set up a spreadsheet, try to post your numbers as best as you can.
 
Wow...I'm overwhelmed with the last few posters here!!! THANK YOU !
You guys cleared much confusion, I'm beginning to grasp the concept although you will see me
around quite a lot in the future. I will do my homework on Lantus land as much as I can when
time allows. I believe testing every 2 hours would be the way to go at this point to get Tubby's reaction.
I will post the results and sincerely be grateful if some of you with knowledge of Lantus insulin
help me out until I get on my own feet. I promise to learn quick and not be a burden on
you good people!

Thank you all for being so helpful,
Shawn
 
I was reading on the Lanus group "Syringe accuracy assessment" when I realized the syringe
I'm using might not be right one. I'll try to describe the syringe I'm using please someone
shed some light on that whether its the right one by that I mean the amount I consider one
unit is actually true.
It reads U-100 insulin only, BD 3/10 cc with 30 units.
I fill one unit, the first line which is separated line by line within 5 unit marker which continues to the max
which ends up at the last line marked by number 30.

Am I giving the right amount (1Unit) by filling only the first line?
 
It actually sounds like you have a vet who "gets it" to some degree. Lucky you. Keep testing today and post the numbers...
 
Good evening,
I'm back to report that I was testing Tubby every 2 hours since
his pre-shot this morning and his last test of the day before his next injection
will be in a few minutes. His numbers were quite high which I'll be posting them
shortly after his injection. I would have to assume his high BG through out the
day after 9am injection means he is not getting enough insulin. I would
leave that for the more experienced members of this group to analyze.
Will be back to post his numbers momentarily.

Thank you for paying attention to my postings!
Shawn
 
Shawn,

I would really suggest you put your numbers together in this kind of a pattern and post over on the Lantus Support group also. They are the experts on dosing for your insulin. viewforum.php?f=9 I'll ask them to look in here also.

amps # number of units given (amps means morning preshot, then the blood glucose level and the number of units given
+2 (+2 would be 2 hours after the shot, +6 would be 6 hours etc. Put down any numbers you got during the day.)
pmps same pattern as pmps with evening number

Maybe some thing like this ( I made up the numbers)
amps 325 1 unit of Lantus given
+6 257
pmps 300 1 unit of Lantus

They will want a spreadsheet soon, but they should be able to help you with this pattern.
 
I just finished giving his shot after testing. Followings are the results, rather disappointing numbers.
But again today is the first day and I'm hoping it will improve in time.

11/06 PS +12 376 8:56 am 1U
11/06 +2 271 11:05 am
11/06 +4 255 1:00 pm
11/06 +6 380 2:58 pm
11/06 +8 365 5:10 pm
11/06 PS +12 386 9:05 pm 1U

Well, as you can see his numbers are very much the same except between 2 to 4 hours after his
pre-shot. Even then those numbers are significantly high.

Any interpretation is more than welcomed!!
 
Hi Sue, I did send you a message but am not sure if I did it right. I don't know how to navigate here, everything seems to look different than the time I used to post here several years ago.
However if you are willing to help with my spreadsheet I would follow your instructions.

Thank you!
 
Good morning,
I strongly believe 1 unit of Lantus is way too low, so I did increase his dose to 1.5 unit.
I do understand this particular insulin takes several days to have its full effect however
knowing Tubby I know he needed increased amount. I would like to make my postings
on Lantus group side, how do I switch to that side?

11/06 PS +12 376 8:56 am 1U
11/06 +2 271 11:05 am
11/06 +4 255 1:00 pm
11/06 +6 380 2:58 pm
11/06 +8 365 5:10 pm
11/06 PS +12 386 9:05 pm 1U

11/07 +11.5 338 8:24 am 1/3 cup raw chicken breast
11/07 PS +12 423 9:00 am 1.5 Unit Lantus
 
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