HELP gave kitty 1st ever shot @ 1u now hearing its not right

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mojokitty13

Member Since 2013
Today at noon I gave my newly diagnosed kitty Mojo his very first ever insulin shot which was 1u of Lantus just as the vet told me to. She said to give him one 1u shot every 24 hours. His sugar was at 552 when the vet did his full panel and diagnosed him 01/09/13 when I got the insulin today thanks to DCIN I did not pretest him before the injection because he had to wait so long already and his sugar was so high :( but did check it once the tester was charged (received all supplies at the same time) 5 hours after injection and his sugar is a 292. So my questions are

Question #1
Is it better to give 1u every 24 hours or .5u every 12 hours? If twice daily why?

Question #2
If every 12 hours how much do I give him on the next dose and when do I give him the next dose since I already gave him a 24 hour dose?

Question #3
Also need to know how to switch injection time to 9 am? Here again I only agve him the first injection at noon because he had already waited 3 days for his first injection and his numbers were very high.

Thank you all for your help in advance
Cassie
 
Re: HELP gave kitty 1st ever shot @ 1u now hearing its not r

Hello again Cassie!
I am sensing you are a little overwhelmed so here are my responses..

1. Please refer to the previous post you did, sienne is an expert and I think all the experts would agree that twice a day is the way you should dose lantus in cats ....because lantus only lasts twelve hours. She also provided a formula for you to calculate his dose.. What does that work out as? http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=86820&p=929420#p929433

2. Your next dose is normally 12 hours from the last one. But, and I stress this is not something we recommend all the time, you could skip tonite since you are just starting out and start him fresh at 9am tomorrow morning on the new dose from the formula.

3. You can move the shots by 15 minutes each time or half an hour a day. So for example tonites shot is due at midnight, instead you could give it at 11.45pm. Then tomorrow mornings shot at 11.30am and so on. That's assuming of course you don't skip tonites as I said in 2.


Let us know what the dose works out as from siennes formula and what you plan to do about the timing.
Wendy
 
Re: HELP gave kitty 1st ever shot @ 1u now hearing its not r

Congratulations on getting your first BG test!!

If you like and trust your vet, you might not want to immediately contravene his/her dosing instructions (as long as there is no clear danger in following them) until you can check again with the vet on Monday (or tomorrow if there are office hours).

The vet I had when my first cat went diabetic started the cat on 1U once/day. When I learned that twice/day shots were the norm, I called to ask why Max wasn't getting that. The vet's explanation was that she didn't like to overwhelm people just starting out caring for a diabetic because they might choose to put the cat down if it appeared to be too much work. Similarly, she didn't tell them right away about home testing.

There is nothing wrong with starting with once/day shots, as long as Mojo isn't flirting with ketones. (Sadly, DCIN didn't send you Ketostix but you can get them at a human pharmacy for about $14 and test his urine for ketones.) If he is eating well, drinking well, and not recumbent or staggering, it is unlikely he is flirting with ketones (from a clinical standpoint). Another clinical symptom, but only when the ketones are extreme, is breath that smell like nail polish remover (acetone).

If you decide to move to twice/day shots without first speaking with your vet, giving him his next shot tomorrow morning is fine.
 
Re: HELP gave kitty 1st ever shot @ 1u now hearing its not r

Cats' metabolisms are twice as fast as people or dogs, so lantus does need to be given twice a day. Vets tat are more familiar with treating dogs (mine was one of these) may not realize this. Let me get to my computer and I will post the document for you to print and give to your vet that explains this.
 
Re: HELP gave kitty 1st ever shot @ 1u now hearing its not r

Here you go: http://www.uq.edu.au/ccah/docs/diabetesinfo/link5.pdf. Note where it says "Better glycemic control is achieved with twice daily dosing rather than once daily." and "When SID [once a day] dosing is desired or demanded it is important to note that better glycemic control and
higher remission rates will be obtained with BID dosing. SID dosing only provides similar control and
remission rates to lente BID[twice a day]). "
 
Re: HELP gave kitty 1st ever shot @ 1u now hearing its not r

Thank you very much for all your answers and support I don't know what I would be doing without FDMB ;-) Luckily he doesn't have any signs of ketones because I'm not so sure how I would go about testing his urine as he is a very private kitty were that is concerned.
There is nothing wrong with starting with once/day shots, as long as Mojo isn't flirting with ketones. (Sadly, DCIN didn't send you Ketostix but you can get them at a human pharmacy for about $14 and test his urine for ketones.) If he is eating well, drinking well, and not recumbent or staggering, it is unlikely he is flirting with ketones (from a clinical standpoint). Another clinical symptom, but only when the ketones are extreme, is breath that smell like nail polish remover (acetone).
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If need be I will gladly go get the Ketostix I feel very very fortunate for everything DCIN sent me actually overwhelmed with appreciation and am thankful beyond words they saved my Mojo boys life! But he is showing no signs at all of ketones and he is eating plenty but not like he is starving like before he got his injection, drinking a normal amount of water maybe slightly more but not constantly like he was and is not recumbent or staggering thankfully. He is actually talking to me again he is a very very vocal cat and meows his side of the conversation and always has his two sense which he had pretty much stopped doing until this afternoon a few hours after his injection and now the chatting has returned :) just finished my second blood glucose test he is a rock star and loves his catnip pillow DCIN sent him pretty much think he will let me do anything as long as he has his pillow! Still am undecided on whether to switch to twice a day until I get the hang of things I do have a 14 month old baby so it is that much harder for me. However I really appreciate all the advise and help and will keep you all posted!


(((HUGS)))
Cassie :)
 
Re: HELP gave kitty 1st ever shot @ 1u now hearing its not r

mojokitty13 said:
I'm not so sure how I would go about testing his urine as he is a very private kitty were that is concerned.
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Just for future information. For a private kitty you can put aquarium gravel (non-absorbent) into a clean litter box instead of litter and then dip the Ketostix into the urine after he leaves the box. Also, some people are successful putting a layer of plastic wrap over the top of litter to collect the urine.
 
Re: HELP gave kitty 1st ever shot @ 1u now hearing its not r

So once again confused please help! So I gave Mojo his first ever injection 1-12-13 of 1u of lantus (he was prescribed 1u every 24 hours) I could not do a preshot glucose but his numbers from the vet on 1-8-13 when tested was 552. So as soon as the meter was charged I tested him 4 hours after his sugar was 292 then tested again 8 hours after shot his sugar was 318 and just a little bit ago at 12 hours after his sugar was 484. So I'm in freak out mode and not sure what to do the 12 hour number seems super high ??? So my question is do I give him a shot now of .5u to bring his levels down? and dose him again in the morning or wait till morning and do .5 unit in morning and the other half 12 hours later? I know you all have said twice a day is better but I'm super concerned about it being so high the last time and am wondering if I should give him and extra .25u or .5u tonight since he is so high! Please help so I can get some sleep tonight :) thank you for your support and answers
 
Re: HELP gave kitty 1st ever shot @ 1u now hearing its not r

I'm not a dose expert and it doesn't look like anyones awake in the other forum. You haven't shot in 12 hrs? correct.
With lantus you don't wanna change the dose day to day. It is more effective with the same dose for a few days, then a gradual
increase or decrease. If you shot 1 unit 12 hrs and the lowest it went was 292. You can shoot another 1 unit as long as it's been 12 hrs since the last 1 unit shot
Don't mess with the dosage until you have somebody overseeing your cat. Keep at 1 unit as vet rec. but every 12 hrs
 
Re: HELP gave kitty 1st ever shot @ 1u now hearing its not r

Hello there, Sorry nobody was around to answer your question here. I hope you followed Shellys recommendations and didnt give an extra shot. The key to Lantus is consistency.. it can take a day or two to settle into a dose and you may see NDW (new dose wonkiness) until then which is all normal - but you need to hold the dose UNLESS he drops under 50 and gets a reduction.

However I have a recommendation of my own, please come over and start posting daily in the tight regulation forum for more support. On that forum we test and put our results in a spreadsheet and create a new topic every day for the experts and supporters to look at. So they can help advise whats going on with your kitty on a daily basis.

The link to the forum : http://felinediabetes.com/FDMB/viewforum.php?f=9
Creating a spreadsheet :http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207
New to the group - how to get all set up http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=18139
 
Re: HELP gave kitty 1st ever shot @ 1u now hearing its not r

Thank you all last night I was quite overwhelmed with his spike in sugar but I did NOT give an extra injection however I did decide this morning to give him .5u and then I am going to give another .5u in 12 hours so still giving the recommended 1u a day just in two injections :) as most here have advised me to do just that! I am doing another curve today testing him every 3 hours between injections and am tracking it on a spreadsheet. He was really high this morning at 524 when I tested him 30 minutes after he ate his breakfast and right before his first injection. He is feeling and acting more like my Mojo than he has in some time now so I know he is feeling better and he is being such a good boy with his ear pokes and injections and WOW does he ever love his new catnip pillow using as a reward after ear pokes and injections. I have always given him catnip and he likes it but is not crazy for it like he is his new pillow :) Thank you all so very much I don't know what I would be doing if it wasn't for all the wonderful help here at FDMB! I will keep you all updated

(((HUGS)))
Cassie
 
Re: HELP gave kitty 1st ever shot @ 1u now hearing its not r

If you shot 1 unit 12 hrs and the lowest it went was 292. You can shoot another 1 unit as long as it's been 12 hrs since the last 1 unit shot
Don't mess with the dosage until you have somebody overseeing your cat. Keep at 1 unit as vet rec. but every 12 hrs
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so yesterday I was told here on FDMB it was totally fine to give two injections 12 hours apart as long as each one was half his prescribed dose. he was prescribed 1u every 24 hours which would be .5u every 12 hours right? So i am wondering why the full unit every 12 hours is your recommendation sorry to question you just want to be sure I am getting it right and not going to give him to much! Thank you for your help

Cassie
 
Re: HELP gave kitty 1st ever shot @ 1u now hearing its not r

Cassie,
I'm sorry no one was here last night also, that's unusual.

I'm glad you decided to split the dose like that - GREAT JOB! I KNOW how overwhelming this is at first but we've all been in those same shoes so really DO understand. You go from hearing the word 'diabetes' in commercials and suddenly you're thrown INTO that world without really even knowing what 'diabetes' means! You have to start cramming, trying to learn not only what it means but how to deal with it too. Most info out there is about human diabetics but that's not our world...our 'extra sweet' babies have 4 feetz! This site has saved MY kitty - we've got 1 1/2 years under our belt now, KT knows his schedule. If I slip on a testing time, he reminds me! He's still really not 'regulated' but he's wierd.... ;-)

We weren't trying to be mean when lots of us said to split the dose - even many vets don't know this. WE live feline diabetes 24/7 that a 'normal' vet can't do. Learning begins at the bottom, please don't ever feel anyone is intentionally being rude or mean here, that's the LAST thing on any of our minds! We're here because we all have (or had) diabetic kitties and not only need help ourselves but want to help others too.

BIG HUGE HUG and WELCOME to the sugar dance!

===========
You posted question while I was typing so I'll add:

First, don't EVER hesitate to QUESTION if you don't understand just like you did - don't feel bad. We WANT you to clearly understand what we're saying. Questions are GOOD things!

Your vet prescribed 1 unit every 24 hours which IS equivalent to .5 unit twice a day. Most of us adjust doses by ourselves using the historical numbers of testing thus the suggestion to raise to 1u twice a day. Lantus works a bit different than some of the other types of insulin - you need to hold a dose about 5 days when starting to build up the 'depot'. If Mojo were mine, I'd hold this dose for the initial 5 day period then see where the numbers go.

ANOTHER BIG HUG!
 
Re: HELP gave kitty 1st ever shot @ 1u now hearing its not r

We would love if you could post his numbers as you get them or share the spreadsheet as mentioned above so we can see how he is doing?
 
Re: HELP gave kitty 1st ever shot @ 1u now hearing its not r

Hi and welcome! :YMHUG: It can be a bit overwhelming at first and the information dump you experience the first few weeks is enough to make you think you just got a degree in feline diabetes management! But, don't worry; as others have mentioned, once you get over the learning curve and the initial expense, things become much more routine and about as disruptive as having to feed your cat.

mojokitty13 said:
so yesterday I was told here on FDMB it was totally fine to give two injections 12 hours apart as long as each one was half his prescribed dose. he was prescribed 1u every 24 hours which would be .5u every 12 hours right? So i am wondering why the full unit every 12 hours is your recommendation sorry to question you just want to be sure I am getting it right and not going to give him to much! Thank you for your help
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The reason for the seemingly conflicting information (1u 2x a day or .5u 2x a day) is partially because we don't know how much you cat weighs. As Sienne and Gabby mentioned, the initial starting dose is usually based on weight: initial dose = 0.25 x cat's ideal weight in kilograms. For most cats, this is usually 1u 2x a day. Since your vet prescribed you 1u 1x a day and Mojo's +5 (close to nadir) was still relatively high at 292, doubling this 1u dose to twice a day might be ideal.

Again, this high nadir could be from New Dose Wonkiness, so in order to figure an appropriate dosage level, more data is generally needed, hence the more conservative estimate of .5u 2x a day. The method of Tight Regulation with Lantus is based on "Start Low, Go Slow," so if that .5u 2x a day turns out to be too low, you could then increase it as needed. Another saying around here is "Better be high for a day than low for a second."

For help on dose increases/decreases, I second Wendy&Tiggy's recommendation to come on over to the Lantus board and start posting daily. :thumbup

mojokitty13 said:
He was really high this morning at 524 when I tested him 30 minutes after he ate his breakfast and right before his first injection.
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mojokitty13 said:
I am feeding him fancy feast two big meals one morning one at night with a snack portion in between. Is that okay? He was on dry food free fed all day started making the switch to all wet scheduled feedings upon diagnosis.
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One other thing I'm not sure anyone might have touched on is the feeding schedule. First, you want to try to NOT feed them within two hours of their next shot as this can skew the pre-shot (PS) BG numbers. It's also generally recommended for diabetic cats to feed them smaller meals more often. One way of doing this is to add more water to his wet food, which helps stretch out the amount as well as helps keep an overly thirsty diabetic cat well-hydrated.

Also, I've never heard of a catnip pillow till you mentioned it. I'm going to have to look into getting Mikey one. He's also one of those cats that just can't be bothered by catnip in general (and I even held off on giving him catnip for the first 6 months!). Maybe this might perk his interest a bit. :-D
 
Re: HELP gave kitty 1st ever shot @ 1u now hearing its not r

Hi there,
We all have been there. I can't encourage you enough to follow Wendy's advise on the spread sheet and tight reg. lantus forum.........

What Wendy said:
"However I have a recommendation of my own, please come over and start posting daily in the tight regulation forum for more support. On that forum we test and put our results in a spreadsheet and create a new topic every day for the experts and supporters to look at. So they can help advise whats going on with your kitty on a daily basis."

The link to the forum : http://felinediabetes.com/FDMB/viewforum.php?f=9
Creating a spreadsheet :http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207
New to the group - how to get all set up http://felinediabetes.com/FDMB/viewtopi ... =9&t=18139
 
Re: HELP gave kitty 1st ever shot @ 1u now hearing its not r

More questions please help! Thank you so much for all the wonderful advise so far it is GREATLY appreciated! I am going to join the tight regulation Lantus forum as soon as I get the hang of everything I am doing! I have gone and read a bunch of the posts and it seems like everyone on there is very knowledgeable and will be very helpful too I just already have a ton of things to worry about ie my 14 month old son and 6 yr old daughter, Mojo and his testing and shots and I start a my new job on Tuesday so I wouldn't want to join the forum and not be able to post everyday and keep up with it so for now I am tracking his sugar levels on his SS which I added to my signature and reading all the information you all have sent me links to, my brain is finally not in freak out mode for now so I can not only read it but understand and put it to use :) Today the process has gotten easier however still very puzzled by his crazy numbers just can't wait to get a week or two under our belt and I really hope by then his body will be used to the insulin and stop confusing me so much with all the crazy ups and downs. Is it realistic to think they shouldn't be so all over the place or is that how it is for quite sometime? I have looked at other kitties spread sheets and they seem to vary throughout the day but not as drastic as my poor Mojo. For example today this morning AMPS 1st test 524, at +3 it was 324, at +6 (he ate a snack 30 minutes prior to test) it was 277, at +9 it was 352 and PMPS at +12 was 544 which is almost as high as he was on diagnosis day?????????????? I know it shouldn't be stable by any means or consistent but I just thought with him having the insulin it would at least not go up so so high but I'm probably just too anxious to have it low!

The reason for the seemingly conflicting information (1u 2x a day or .5u 2x a day) is partially because we don't know how much you cat weighs. As Sienne and Gabby mentioned, the initial starting dose is usually based on weight: initial dose = 0.25 x cat's ideal weight in kilograms. For most cats, this is usually 1u 2x a day. Since your vet prescribed you 1u 1x a day and Mojo's +5 (close to nadir) was still relatively high at 292, doubling this 1u dose to twice a day might be ideal.
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I used the formula and Mojo's CURRENT weight 8.6 lbs = 3.9 kg, however that is about half of his IDEAL weight, his IDEAL weight should be about 15 lbs or so he is a big big boy normally and that is when he is not over weight or way under weight like now. His frame is BIG he is tall, long and has big bone structure I think he is 1/2 maine coon crossed with domestic long hair. So my question is please define ideal because to me that is the weight he is normally consistently at before he got sick? Based on the formula given (.25 x 3.9 kg his current weight = 0.975) so 1u, but is the formula to calculate a dose per 12 hours or 24 hours?

Sorry I'm asking the same basic thing again just very confused :( confused_cat Also please see his SS for all the numbers from yesterday and today so far! THANK YOU IN ADVANCE for answering my silly redundant questions
 
Re: HELP gave kitty 1st ever shot @ 1u now hearing its not r

Every 12 hrs. You can go over to tight reg. not having it all together. They are there to help especially
with this stuff. It is a process and takes a while, but the sooner you get an expert overseeing you, the faster
it will happen. Will take a look at your SS
 
Re: HELP gave kitty 1st ever shot @ 1u now hearing its not r

I would shoot 1 unit.every 12 hrs and keep it there for few days. It won't go down as fast as you want, but it will start the process.
Your doing great! You really are. This is a brave act you've chosen and we are all proud of you. There are no stupid questions. Smart
to always ask. and you are not bugging us.
 
Re: HELP gave kitty 1st ever shot @ 1u now hearing its not r

mojokitty13 said:
Sorry I'm asking the same basic thing again just very confused :( confused_cat Also please see his SS for all the numbers from yesterday and today so far! THANK YOU IN ADVANCE for answering my silly redundant questions
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Hey, I'd rather have you ask for clarification than misunderstand something that could be potentially dangerous and it's a lot of information to have to take in all at once, so no need to apologize. :-D

It looks like you have a good start to your spreadsheet, however, you want to share the link to the published version. To do this, go to File -> Publish to the web. Make sure "Automatically republish when changes are made" is checked and "Get a link to the published data" is set to html. Copy the link shown in the box and use that to share in your signature.
 
Re: HELP gave kitty 1st ever shot @ 1u now hearing its not r

It looks like you have a good start to your spreadsheet, however, you want to share the link to the published version. To do this, go to File -> Publish to the web. Make sure "Automatically republish when changes are made" is checked and "Get a link to the published data" is set to html. Copy the link shown in the box and use that to share in your signature.
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Not really sure how to do that I have read and re-read the instructions both that you just gave and the thread on how to get a SS and publish I think it may be because I have a pretty old computer so when I am in my google drive and I am in the spread sheet when go to file there is no publish to the web? I clicked the share button on the upper right side which is how I got it on my signature hummmmm ???????? it asks me who is allowed to see public on the web, only those with the link or only me i have selected public on the web but it doesn't ask if I want to auto republish when changes are made???? and now that you say that when I go look after I update it in excel it doesn't update the document in google drive do I need to change settings in excel? I thought I was pretty computer savvy considering I was an office manager and did all my own tech support with a little help for the last 5 years but I guess not haha lol :) must be that I've been off the last year and now I have a mommy brain only probably just a simple thing I am overlooking but would be happy for any suggestions you have? confused_cat
 
Re: HELP gave kitty 1st ever shot @ 1u now hearing its not r

You want to select the "File" in the online google spreadsheets version (the address should start with something along the lines of docs.google.com/spreadsheet) and not the "File" at the top of your browser. That's where it should show you the "Publish" option. This is also the spreadsheet you want to update because it sounds like you may be updating the excel spreadsheet on your computer instead. If that's the case, you'd then have to manually upload the excel version to your google docs each time you make any changes. It's better to use the online version in google docs.

Let me know if you need any more help. I'm not just computer savvy; I train people in computers as my day job. ;-)
 
Re: HELP gave kitty 1st ever shot @ 1u now hearing its not r

You may have high numbers for a while until you and your vet can work out the correct dose for Mojo.
Chester and I have been through one dose adjustment and I suspect we are headed for another one. We started at 1U of Lantus, then went to 1.5U. That brought his numbers from closer to 600 to closer to 500. Like I said, I suspect we are going to have another dose adjustment, and maybe another after that. It's usually best to start with a low dose that may not appear to do much than to start with a high dose that could really hurt the kitty. Over time, the dose ramps up to what ends up being the correct amount. Some cats are on 5-6 units of Lantus, so there's room to go up if that initial dose isn't quite enough.

That said, Lantus works bet if the doses don't jump around. My vet is a little more conservative than some, and we're only changing dose ever two weeks. Even the tight regulation group recommends keeping the dose the same for 3-5 days before making any changes.

Relax. You're going to be OK. You're doing the right thing for your kitty. I know we want them ALL BETTER NOW, but sometimes the process just takes some time.
 
Re: HELP gave kitty 1st ever shot @ 1u now hearing its not r

Your spreadsheet looks great now and you're getting some good tests in!

That .5u looks like it might be a smidge too low, but I think it might be still a little too early to tell. Feel free to start posting in the Lantus Forum as there are some experts that will be able to help you with this better than I ever could dream and they'll be able to more easily catch your posts (and your questions) than when posting in the main health forum. :-D

MbMinx said:
Relax. You're going to be OK. You're doing the right thing for your kitty. I know we want them ALL BETTER NOW, but sometimes the process just takes some time.
Click to expand...

A saying around here is: "It's more of a marathon than a sprint." :-D
 
Re: HELP gave kitty 1st ever shot @ 1u now hearing its not r

Your SS looks great - did you track today? I think you are ready for the lantus forum now...
 
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