HELP- Newbie- Confused what to do- TIME SENSITIVE

Status
Not open for further replies.

bettyandhank

Very Active Member
Hi-
We have been lurking on the board a little while. Can catch you up on our backstories later but need guidance on a more immediate situation now.
Hank was diganosed just over 2 weeks ago. I was not clear on many things including how far along he was. He looked pretty good and I mistakenly thought he was responding to some diet alterations (he was already on some pretty good low carb canned food, but eating dry as well) while I was trying to sort through things, educate myself, figure out the financial aspects, maybe change vets, etc... Meanwhile, he was not and was continuing to lose weight and get weaker.
I wasn't comfortable with the first vet, communication was lacking. They would have done a curve first before prescribing. While i was looking around for where to go instead, he started not looking so good. He was increasingly not interested in food. When I tried to get him back in there just to hurry to get him some treatment, there were some access issues, calls not returned, and lost a couple days. We found someone else to take us last Wednesday.

Counts at the vet's office that day were 440 (One touch ultra mini) 388/404 THEIR meter (the Animal One) so a 40-60 point difference. Not sure who is high/low.
I don't believe he had eaten ..not much if so. Likely there was some stress, but wasn't outward or obvious. He seemed fairly comfortable.
He was however losing weight, nearly 1 lb in under 10 days. i think he had lost 2+ lbs before we went to the first vet. His BG at diagnosis 10 days earlier was 375.

I did ketone test the night before this last visit and showed scant amount. I am new at this and there is most defiantely margin for error. They stick tested and got slight amount in blood but not in urine.

They put him on 1U Lantus twice a day to start. He did not recieve a dose there as I had to fill RX, get all the supplies, and get on our 'schedule' for that night.
I have been completely overwhelmed, lost and unsure a million times over since then. I am on sucgh a learning curve and amd unsure and don't know what I'm doing most of the time.
I began writing here several times before, but there is never enough time. This has all become my full time job. I just kept messing up, doubting, wasting syringes, and test strips. Will save for another conversation...so I can get to the point.

I have obviously now figured out how to test. I have only been doing it PS AM/PM. We got on insulin Wednesday night, so it's day 4.
Because he hasn't been feeling great for awhile, his appetite isn't great. He is eating, but modestly. I usually have to coax him to take bites. We are on good food. I may have tried to transition him too quickly off his dry initially and upset his stomach.
He was already eating Wellness canned before all this, we just made it more the primary food and rotated in other new low carb canned as well. Much of it he hasn't liked..I am now sprinkling some Evo dry on the wet on occasion to try and get him to eat.

The vet was very concerned that he EATS now. He is overweight, but has been losing too rapidly. She was worried about fatty lipidosos.

I have a million questions at any moment and don't have the judgement to know what to do yet. It is a foreign language and I am on a learning curve. The vet gave me VERY few instructions. Just the shoot 1U 2 times once a day. I had never given a shot in my life and have worried if i was doing it right, did get it, too much/little, I don't want to harm him. Target ranges weren't discussed...when NOT to do it, etc..
I am too new and not comfortable enough to alter dosing instructions.

So after the BG read at the vet on Wed. (noon), I was unsuccessful in the next several attempts to test. ( I know i hurt his little ears trying)
I got a 414 PM/ PS on Thursday night.
277 AM/ PS Friday
355 PM/PS Friday
373 AM/PS Sat.
349 PM/PS Sat.
159 10:13 AM/ Sunday! Questioned giving dose I call emergency clinic- nurse advises against- tells me to re-check and call back in 45
188 11:10 AM appx. 1/2 hour after food- emergency vet (nurse) says still don't give it. They say to ignore schedule. Cat is not
regulated. His counts too low to give the shot. he is still in normal range. I would Hypo him.


The (main) vet office instructions were for right now just to give it. They said ideally 12 hours apart, but up to 2 hour window either way worst case. They said NOT to alter the dose. I have been within 1/2 hour windows on time so far. Today we were running a little late. His shot last night was 10:17 PM. it has now been 14 1/2+ hours.

I DON'T KNOW WHETHER TO GIVE THE DOSE, SKIP THE DOSE, ALTER THE DOSE (makes me nervous).

I have skimmed the site but there is too much info. to absorb all at once.
He seems ok, is not acting sick. I don't want to test him to death. He is too new to this all, is clearly not regulated.
He will have been on over 2 weeks of diet change, and as mentioned, was already on good food so won't get the monumental change as if he were coming off the really bad stuff.

I got him to eat a little.... a few bites, of some Instinct canned between the 2 BG checks.

** Any suggestions? Do we just skip this dose? i don't want to mess things up, lose any progress, etc.. I know it takes several days to adjust. we are right in that crucial period. I don't know how to proceed. Why on a Sunday when I can't call them.???


Oh, the nurse at the emergency vet left me with the impression that even if it is hours from now and you give the shot, you just change the schedule accordingly.(ie: next one 12 hours form then) That is contrary to how I understand it. Plus it would likely then be the middle of the night. Even beyond whether or when to give THIS dose... How to we adjust for the subsequent dose and to get back to schedule??? (appx: 10AM / 10PM)


Thanks you for any words of wisdom.


betty & Hank
 
Hi Betty. Shoot it. He's high enough and you've got ketones in your history.

As to his appetite, I would start with having your vet run a test for pancreatitis, it sounds like a flareup. That test is a special test called fPLI and will tell you if that's what is happening. 30%-50% of diabetic cats are thought to also have pancreatitis. It's easy to treat and we'll help you if he comes up positive, so don't worry about a positive result. Also of concern is possible ketoacidosis, so we must be cautious in assigning a specific name to his illness.


PS just to be absolutely certain, your cat is at 188 right at +14.5 hours past his last shot? Just want to make sure I did not misread.
 
Hi-
Thank you. No, that is not right. The 188 was the 2nd test i did today after getting him to eat some and waiting 1/2 hour. That would have been roughly 13 hours from his previous shot.

I am very nervous about altering the dose. And now, the schedule. We are just too new at this for me to rely on my judgement. the Doc was very specific about me not changing anything. He is just getting started on this and is NOT yet regulated. My big alram was the drastic lowering of the number. 200 points since last night. i have ONLY tested pre-shot and pre-food each time.

The emergency vet (nurse) having checked w/ the staff vet, would NOt have me give it to him..it sounded like even at 200 it was questionable. It is now 2 hours since my last test. And 3 hours overdue for our shot.

He is asleep. Do I wake him up and test again first (hate to). Is it too late in the time-cycle to give a shot if his counts are higher? What count should i look for to determine whetehr to shoot?
Do I give whole dose if so?
How do I adjust tonight's schedule?

Sorry for so many questions. A phone would be so much more effective.

Please any more thought are appreciated. I don't want to screw anything up.

thanks!!!!
 
Please test and report back with the +15 number so there's no confusion. 200pt drops happen, lantus is an insulin that builds up in the system, plus you appear to have removed the dry? Scary but also such a good sign. He's healing!

First, take a deep breath. You are not going to mess him up, I promise. I would like to commend you on everything you've learned and done and I also need to commend the vets and staff that you have been talking to. They have all given you sensical advice, even the one who didn't want you shooting 200. Your vet appears to be phenomenal if I am reading what you are saying correctly. We know you can shoot well under 200 here, and we know how to both monitor and intervene in low numbers. We promote 100% safety here, and common sense will always be used. We'll help you, and we'll do everything we can to make sure you understand fully the insulin, the disease and how the treatments are working for you and Hank. It IS a huge learning curve, and it will take some time for you to learn, so don't feel flustered or embarrassed. We all were you, we all knew nothing, and we all remember it well.
 
!!FOLLOW UP- HELP- Newbie- Confused what to do- TIME SENSI

just re-tested- NEW BG- 226

2 hours and 15 minutes since last reading of 188 (no shot given)


3:15 minutes past dose time due. Do we give full dose?

How to adjust for tonight? amount/ time?

THANKS
 
Welcome--I was also a lurker, until what my vet was telling me just sounded so insane, such a high dose of humilin N compared to what was said here, I put my foot down & said NO!!--I was also sort of on health forum, & was not really understanding what was what-
So I went to a vet specialist who put her on lantus, and I came here--to this lantus forum.
Life for my kitty began when I started listening here..The protocol here has resulted in 110 kitties going into remission since 2008..
That's good enough for me.!
Dont be afraid to consider other opinions & ways besides your vet's--The thousands of cats & owners that have passed through this website has amassed so much info on feline diabetes, more than any vet could possibly know--
Our cats are our full time jobs here..Studying our cats is our job here--Making them well again is our goal.
Hope we can help- you too.
 
I am on hold w/ different emergency clinic. That was a nurse at the other clnic telling me i am in normal range and if it were his cat, he would not do it. He wouldn't have done it unil 300. He had to hang up when an emergency walked in.
I remain confuse- the opinions are contradicting.

I didn't get enough info. at the vet I went to to address situations like these. they were pretty much saying, for now, no matter what, to give his 1U insulin every 12 hours, period. Also, as i recall, to still give the dose up to 4 hours past, otherwise skip. That window is quickly approaching.
(we are at 3 hours 45 minutes late (15:45 since last shot)

I don't know what the 'normal' range is. His reading being in the mid- 100's, when it has only been in the 300's- low 400's, except a single reading of high 200's 2 days ago is why I questioned dosing him.

i have not been doing mid-period tests as of yert, so have no idea where his mid period ranges have been. He has likely been diabetic for some time before I figured it out.

The food change is 2+ weeks in now, so i do not beleive i can attribute this change to that. He has not eaten any of his Innova dry (carb) in 2+ weeks. I have given him some very small amounts of Evo dry here and there, sprinkled on his canned, etc... to coax him to eat.
he is not anorexic, he is eating...just modestly. A few bites between naps.
I have been heating it a little, bringing it to him, coaxing, ...and he will eat bites throughout the day. He's just not scarffing it down.
even before he was sick he was more of a grazer. His appetite is just off some now.
His weight however seems stable since Wednesday.

It is now almost 4 hours past his shot time due 10AM. We have given it as late as 10:30. Last night was roughly halfway in between.
If I add the 3-4 hours tonight, it would be 2AM. We DON't Want to get on that cycle.


I also want to mention again, my meter tested against the vet's was 40-60 points HIGHER. (they tested theirs twice for 2 different readings)
If there's was the more accurate, then he conceivably was even under 100 this morning.

BTW, if we do it, do I adjust the dose> ( a 'skinny',??)


thank you!!!!
 
There's no need to adjust the shot yet, so let's not put the cart before that horse LOL I doubt he was under 100. Your meter is just fine, and measuring accurately. Generally they would tend to read lower than actual, rather than higher. Safety zone for humans, in other words.

Yes it should be 12-12, but sometimes real life intervenes. I like your vet.

The reason you are getting conflicting opinions is because they do not want something bad to happen based on phone advice. They will always tell you not to shoot when you call with a question, just in case something bad happens. They don't know you're testing and they don't know what your level of involvement in treatment of your kitty is. If in doubt skip the shot and shoot tonight since you are so far off schedule now.

Testing midcycle is the best way to know how the insulin is working for your cat. Sometimes your cat can have their lowest number at preshot and go high during the cycle. It fluctuates as the cat learns how to use the insulin. The only way to truly know is spot checks throughout the cycles. We can teach you how to do that. For now, be sure to read the stickies at the top of the lantus forum which explain much of how the insulin works. Also important are handling instructions and learning the "shed" and how it affects things. Don't try to memorize them, just familiarize yourself with it. It will all begin sinking in soon :)
 
Hi,
Just wanted to say welcome. I think you've gotten excellent advice. I am a new lantus user and wish I could give you more technical advise but I am still learning how this all works myself. I had a diabetic kitty before. I lost him about a year ago after treating for 4 years. I am proud to say that he died of old age, not diabetic complications. He was on a different insulin and lantus is a whole new ball game but I feel better about it and how gentle it is. Home testing made all the difference. I was able to see how he was feeling and adjust his insulin accordingly. THis helps with vet expense and my vet was completely on board with home testing. There are a variety of ways to make sure that testing is affordable. If you have any questions just ask. everyone here is willing to help! You're doing fine. After a while it just becomes part of your daily routine.
See you!
 
I don't want to get in the way here, but I did want to say please don't sweat the meter issue. These meters are not designed to be 100% accurate. They are allowed to be off by 10 to 20%. At a BG of 400, 10% is 40 points. At a BG of 100, that same 10% is only 10 points.

You'll get some excellent advice here from some knowledgeable people. I know I did!

Best of luck!
 
UPDATE- HELP- Newbie- Confused what to do- TIME SENSITIVE

Update: We are going to skip the dose for now.
I hope it's the right thing.

I am just confused and unsure a million different ways. Time was crucial so I called a different emergency animal clinic feeling my window to give the shot or not was closing. they were tied up w/ emergencies & I had to call back and lost another 15 minutes. They kindly transferred me to a staff vet willing to talk me through.

She said we could have given 1/2 dose, but it would really mess schedule up. By then we were 4 hours 15 minutes past his shot due time (16:15 from the last. If he was acting ok, eating some, etc.. she'd probably wait. She said even in the emergency clinic they don't test hourly and advised me to leave him be for now. She said we could give tonight's shot early then.

This tech at the vet who got him on the insulin (not who diagnosed him) said to shoot for 2 hour windows, and if it's been 4 hours then skip the dose. I believe this was for future reference once regulated. We are in such a crucial period now, I just don't want to mess it up or harm him. They gave very minimal instruction. I'm not even clear on whether in fact he was ketoacidosic or not. i think if he were, it was scant and early.

I have constant uncertainty right now. This has literally consumed us full time and i can't keep it up. Other obligations are screaming. It's taking every minute & I'm exhausted.
i don't even have all our supplies yet. And now running out of starter strips and lancets.
**Cindie, thank you for the newbie kit, wherever you are!**

This is taxing in so many ways. I am in information overload. Am trying to research and educate as possible...but there is simply too much to absorb & so many hours in the day. It is daunting.

I am also incredibly strapped financially. Have spent so much already and no idea how we will do this.
I have got to get strips & lancets quickly- but every dollar counts. Have tried to research on the board.....but there is SO MUCH INFO.

WHAT IS THE cheapest/ quickest place for:

one touch ultra strips (what is 'blue' vs regular ones)
lancets (and which ones to get)
Lantus (we were able to get a single solo star pen to start)

i was thinking I had enough for another week or so, but hadn't factored so many strips in one day. and was re-using lancets, which I don't think has been best.
I'm not sure if I order today or tomorrow i will get what we need before we run out. Every dollar matters right now.
I have been at a pharmacy or shopping supplies online nearly every spare moment trying to figure everything out for days now.

A kind pharmacist give me injection training as mine weren't going very well. I have tossed several syringes both with & without meds due to foul ups. it's like burning $$.

I MUST tend to some other things today.

Appreciate any ideas for supplies. Have tried researching for assistance & discount options, but there is so much to weed thorugh and it is too time consuming. And some of that precious time cost us w/ Hank.

How early should I give the shot tonight? (normal time 10PM last shot 10:17 PM last night)

if we go early...how to get him back on shedule?



THANK YOU SO MUCH everyone for all the wisdom & advice. Really.
When things settle down, I'll put up a picture of my amazing baby...I am totally in love with him. he is just the best boy ever. I just want him to get well.


PS: Shelly...I had a Cosmo. He's been gone for years..but we were together over 18!!

betty & hank
 
Hi Betty

Welcome to the Lantus forum.
I noticed you are asking on ways to save some $$, especially for those strips.

One option for strips might be the Relion meter, available at Walmart. The meter itself is from $9 to $12 and a pack of 50 strips is about $20...a pack of 100 is about $50
A lot of members use the Relion, mainly because the strips are economical as opposed to the One Touch (believe me I know - I used that one too and the strips just did me in!)

Also, the Relion is a reliable meter as well, is the other reason.

Just an option.
 
First, take a couple of deep breaths. You are absolutely correct - the front end of this learning curve is enormous. Pretty much everyone who lands here is overwhelmed. We've all been there and we will help you get up to speed.

You have already overcome two of the bigger hurdles. You are giving shots and you are home testing. Everything else hinges on these two factors.

You gave a late shot today. If you will post Hank's BG numbers at around +10.5, it will give us a window to work with you to adjust shot time in order to get back on schedule. You do not change the dose in order to accomodate a schedule change. In most cases, you can shift a shot time by a total of 30 min. per day depending on where your cat's numbers are. You can do this by shifint 15 min. at the AM and the PM cycle or 30 min. at one time during the day. Shooting early = a dose increase whereas shooting late = a dose decrease. A small change of 15 min. doesn't really have a huge impact.

I would disagree with the advice you've been given about a 2-hour window. That might be true for insulins other than Lantus. It is not the case for Lantus. You have a max of a 30 min. window and you then need to adjust the time of the next shot so there's still 12-hour dosing.

Testing: Getting AMPS and PMPS is great in terms of knowing where Hank's BG is so it's safe to shoot. BUT, you need to start getting spot checks during the day. Lantus dosing is based on the lowest point (the nadir) of the cycle. You are still in a phase of gathering data. This is an important time. It helps you to understand how Hank is responding to Lantus -- when the insulin starts to work, when his usual nadir is, and when it starts to taper off. All of this is crucial for helping you to know how much insulin to give and whether or not to give a shot. If you look at the subject lines from the condos (that's what we call each kitty's thread for the day), you will see that some people are shooting very low numbers. This is safe but it's safe only because the people giving those shots have the data to support that action. If you read the sticky, Data Ready to Shoot Low Numbers, it will give you some idea about whether or not to skip s shot until you have the data to support shooting.

One thing that will help you to keep track of Hank's numbers and help us to help you, is if you set up a spreadsheet (SS). The information on how to set this up and link it to your signature is in the Tech Forum. This is the link. There is also information in the Tech Forum on how to set up a Profile. This will provide info on what you're feeding, any health concerns, etc. Also take a look at the sticky's at the top of the Board. These are the starred posts. They will help you get oriented to the Lantus board, our posting conventions, dosing protocol, slang, use of Lantus, syringes, etc.

Please open a condo for Hank on a daily basis. Visit other condos -- we're a social group!! Look at our SS. And, most importantly, keep asking questions.

And sorry for not saying this at the beginning, welcome.
 
I just saw your post. The Walmart Relion meter, strips and syringes (you want syringes that are marked in 1/2 units) are the cheapest. You can find good prices on other types of strips on Ebay or Amazon. I buy my strips for a different meter on Amazon. If you are going to do a shopping trip for supplies, make sure to get Ketostix. These will allow you to test for urinary ketones. A bottle of 100 runs around $15.

It was fine to skip the shot. I just got back from a trip and my petsitter overslept. She would have shot over 2 hours late. I asked her to skip. It's not great in terms of momentum and/or shed building but in your case, for safety's sake, it was a good decision. There are options when you have a number at pre-shot and you don't know whether to shoot. We can go through these with you when you've had a chance to catch your breath. (It really does get easier. I promise!)

Since you skipped your AM shot, you can shoot at your regular time tonight. Skipping a shot lets you get back to whatever time you need to shoot at.

Hocks (there's a clickable icon at the top of the board) has good prices on syringes and they ship quickly. If there is a Walmart near you, that is a good, inexpensive resource for materials. They sometimes run out of supplies, especially the U100 syringes that are in 1/2unit increments. Strips are the biggest expense. You will use a lot.
 
Hi just wanted to say hello, we have all been in your boat and I still am to some degree. Scrabble has been on lantus for 1 month. It is definetely a learning curve (I am still learning). I had so much anxiety when I first started this process and couldn't eat or sleep. It DOES get better I promise!!!!! I was worried too that I was doing things wrong but this site is amazing and I would not have gotten through this month without it!!! Ask as many questions as you need and there will always be someone to help you. As for the supplies I get mine from Walmart too. I buy the syringes, test strips and lancets from there. It seems to be the cheapest. I use the relion micro meter, very easy to use. I promise you will get the home testing thing down too, I found it difficult in the beginning but it gets easier the more times you do it. Well just wanted to say welcome and try to ease your mind. Good luck!!!!!
 
Thanks Everyone.

BTW, Sienne...correction ..we did NOT give a late shot. We SKIPPED the shot. He is sleeping most of the afternoon so not sure on where he is at.

Am confused by some conflicting information posted. His last shot was 10:15PM (CST) last night. Since deciding to skip, I was thinking towards moving his dose time up a little tonight as per the emergency vet I spoke to earlier, the 2 hour window given by the prescribing vet, and impressions I got on here.
Ultimately I want to keep it close to the time we were on...10PM-ish.

I am just learning, but there are SO many differing optionions. I would never shoot for 2 hours off...but thinking I had that latitude was helpful if I don't make it home in time, am asleep, etc... I thought an hour in ANY case. And they mention 4 hours when deciding to skip does or not..
It sounds like on the board it isn't universal. There seem to be a variety of opinions.
Especially now, it is so hard to know what to do while trying to learn this whole new world. He doesn't always make it easy for me to know how he is feeling. His sweet natured-ness can conceal how he is feeling. Or he just sleeps like a cat...so who would know.

What rules should i go by RIGHT NOW as we are just starting out and not yet regulated..for determining whether to shoot or not?

if his count is _____ or higher? at PS

At some point I will get all those things you mentioned done, charts and profiles and spreadsheets..but i can barely keep up as it is just with this part.
I am still figuring out how to give a shot and feeling terrible about poking and prodding of my baby. i just want him to be well.

With the seemingly different opinions about tonight, i can just post again later once we re-test.
My plan is, unless he seems 'off'...to wait and test about 8PM-ish (2 hours before what would have been our regular shot time) and make a determination then as to shooting early or not.

I can post ahead for opinions at that time.

Again, thanks so much for the warm welcome.


betty & hank
 
welcome Betty (and Hank, I can't wait to see his picture!).

Let's try to make this as easy as we can. Tonight, pick whatever time you want his shot time to be (sounds like that is 10:00) and test/shoot then. Fo now, a good "no-shoot" number for Lantus is about 180.

If you get a lower number than that and you're not sure whether to shoot, you can post here for advice. There is usually someone here to help. Briefly, the options are:

1) stall. Don't feed, wait about 15-30 minutes, and test again to see if he is rising. Repeat until you get a number you're comfortable shooting. Then shoot the full dose and feed. That target will change - for now I'm saying 180, but once you've successfully shot at 180 you'll probably see that it worked out fine, so maybe next time you'll be comfortable shooting 150, etc. Don't worry about that for now, though.

2) shoot a reduced dose. This works if you can't be home to monitor, or if you don't have time to stall. The reduced dose can be any amount less than your current dose, whatever makes you comfortable. At least your putting *some* insulin into the kitty, even if it's not the regular dose. That can keep the numbers from going quite as high.

3) skip. Not ideal, but sometimes you just have to skip it. Numbers will usually go high and it might take a day or two for the numbers to recover, but life goes on. :smile:

About the schedule, ideally you want to stay as close to 12 hours as possible. If you do get farther off schedule than 1/2 hour, it's best to post here for advice. Again, life happens and we've all been off schedule, and there are ways to minimize the impact.

I know this is all overwhelming, let us help you!
 
((((((((((((((betty)))))))))))))))))
You certainly care so much about that little fella! What a lucky guy to have you as his cheerleader.
Your questions are all one's we've asked and even continue to ask at times. You put some great thought into your questions today because of the research you have done.

I agree with Sienne that you are ok for skipping the shot. Ideal, ah...maybe not for the immediate. But in the big scheme of things, you're fine. We have all had to skip, or accidentally given a fur shot.

Hopefully more folks will chime in, but I would think since you skipped this a.m's shot you can now shoot at whatever time you want to have your 12/12hr intervals. You might want to consider spot checks for pm times when you plan this, if possible. Say you do a 10pm and go to bed, can you wake up and do a spot check @ +4 or +6? Or would it be better to move the shot to 8pm, so you can get a +2 or +4 before going to bed? Everyone is different. I do a 6pm/6am, both because of work and so I can get spot checks and go to bed by +6 in pm, and at least a +2 in a.m.

If you ever need to readjust your 12/12 schedule, just ask in your daily condo. Someone will be able to help you maneuver the time.

The 12/12 schedule FREAKED me out because I am all over the place at all different times. I am NOT a morning person either. Somehow I have been forced into one....and no, i still dont like it! :lol:

It's hard when you get conflicting messages from an online community and your vet. Its happened to all of us. I think as you continue reading and see how things are going with your cat, it will become more clear what YOU want/should do. I would encourage you to look at other condos (posts in lantus land) and spread sheets. Its a very good learning tool to see how the protocol really does work.

Regarding supplies:
Ebay is the way to go for strips! You can either bid (which I still have not figured out how to do and win), OR you can find someone selling them with a 'buy now' logo. This will probably be the cheapest way to go. The relion, as others mentioned would be the cheapest way, if you dont want to deal with mail and ordering. Oh, ya- sometimes Ive found amazon to be decent...but Ebay sellars are still cheaper.

walmart relion syringes are the least expensive and have half unit markings, which you will need. I dont find them to be the most accurate when doing super micro doses, but its really all I can afford, so I do the best I can.

okay, gotta run...and shoot my cat! :mrgreen:

Welcome, and keep posting/asking questions!
 
Our posts were almost overlapping. (I didn't go back and correct!)

You're right. There are LOTS of opinions. I don't mean to be ham fisted with vets, but (well, you knew that was coming!), most vets are not as conversant with the use of Lantus, let alone Levemir, as many of the people here. It is no disrespect to a vet. They have any number of different health issues in every species of animal they see to contend with (unless it's a specialty practice). We eat, breathe, and live feline diabetes here. There is also on-going communication with the counterpart of this forum in Germany which has served as a "subject pool" for some of the research that is being done with Lantus. The information here is very current.

The time window you've been given was similar to the one that I was given when Gabby was first diagnosed. It was consistent with a different, shorter acting insulin. I tend to think that many vets who do not prescribe Lantus regularly or have only a passing familiarity with the ins and outs of its use, will use some of the same rules of thumb with Lantus as other insulin. Since Lantus is a longer acting insulin and it's pharmacology is very different from other insulins, those rules do not apply. In general, you want to do whatever you can to shoot on time. Life being what it is, a 15 - 20 min. window is still pretty much "on time." The further from your usual shot tlme, then you make adjustments to get back on schedule in small increments so there is minimal effect on the shed. If you are an hour or two off, and sometimes life happens or you need to stall a shot because of a low pre-shot number, we'll help you get back on schedule. We've all been there.

And it's not just that Hank's inherently sweet nature doesn't give you the info you need. Cats are masterful when it comes to hiding illness and pain. One of the weirdly strange benefits of having a diabetic cat is the bond you will form. You will start to notice things you'd never notice before. As Hank becomes better regulated, his coat will feel entirely different -- it will become softer and silkier. There will be a range of behaviors that will reappear. Things you probably thought were gone due to age or some other reason. They will come back. It's a wonderful thing to be a part of.

Take a look at the Getting Ready to Shoot Low Numbers sticky. In general, until you have more data, we use a below 150 BG as a "no shoot" number. (I just saw that Libby posted and suggested 180. Use that as your no shoot number.) Once you begin to fill in your SS and have more data, you will be able to shoot low(er) numbers. And that is a goal to look forward to.

Hank really will understand that the poking and prodding are part of helping him to feel better. People will stop by and mention how their kitties are purring at test and shot time or jump into their 'place' for testing. Give treats so you establish that testing is associated with a treat. It does help. If one ear stick doesn't get enough blood, stick a second time very close to the original spot so the two droplets can merge and you can get enough blood from the two.

You don't have to worry about an early shot. With having skipped a shot, you can adjust the time without worrying. But, either way, post. We want to follow up and see how Hank is doing. And, keep those questions coming.
 
I don't think any of the folks from earlier are on here now. We are new and just been on Lantus for a few days. Skipped morning dose- His numbers were low and I was scared to give it.

NOW we are at the PM time and I am back for some guidance.
He was playful and seemed good earlier. Is now alone in the dining room..very quiet.

I am way to new to get my arms around all this but have been very concerned today about whether this will set us back

I was to report in...so here is the 'heads up'. I will come right back with numbers and direction. I have a feeling with our schedule, I will only get the west coasters for advice.

Will need to shoot soon assuming numbers good to get us back on schedule.

Back in just a minute.
 
nah, a lot of us are night people. :mrgreen: Tonight is quieter than usual, must be because of the Oscars. I'll be waiting for your number.
 
No Question. He tested 371 at 9:41 PM about 23.5 hours from our last shot. I gave his 1U Lantus. He cried a little when I did. I am still uncertain giving shot and not sure if I am hurting him or doing it right. I don't have my technique down. With such a small dose there's not much margin for error.
I am not great getting out the bubble, and I know they take up room. I tap and thump, but it doesn't always work.
I am using a solo star pen as a vial w/ a syringe.

I am too green to do the 'skinny', .1's, all that. I am just hoping it is penetrating correctly. I have been giving it between his shoulders. trying to do the pinch/tent. He is short haired, but still can't see well to check for blood and/or know it is in.

Let's hope tomorrow goes better. Seeing that low number this morning threw me. It could have been good news, with him responding to diet, etc..And a potential healing occuring. Now I'm not at all sure why the drastic change...more of a fluke. How will we ever get regulated.

They would have me just give the dose as prescribed for 5-7 days changing nothing. it's all so confusing..to know what to do. I am definately not there yet..not even close. He really was playing less than couple hours ago.

He did eat a few bites before the shot. he is eating...moderate amounts. I hope enough to fend off any other issues. i checked his notes from the vet on Wednesday, the day we baegan insulin. The ketones detected were 'scant' (5 mg/dl) in his blood and -0- in his urine. I tested the night before and got scant in his urine. We will have had 8 doses since then. Did we lose momentum today as it were?
I am still not clear on how sick he was/is.

Thanks everyone...am so grateful to have somewhere to go with all this inforamtion and questions.

betty & hank
 
you're doing great, there is a lot to learn and it takes a while. All of us here are at different stages of the game, and we've all had a different set of experiences to draw from. That's why it's so good to be able to help each other.

Nice job today, you'll be fine and so will Hank. :smile:
 
HI Betty
What a first day you have had here.
You are in terrific hands here and as it has been said to you before, we have all been there.
I can give you some hints on the mesauring and bubbles.
We are on a much higher dose than you but we did start at 1u like mostly everyone does.
Never push air into the pen. I always measure more than I need, you can go to 2u, tap the syringe gently to remove the air bubble, slowly twist the plunger and you will see little drops coming out of the top. You do that until you get to your 1u line.
You could also practice with a used syringe until you get comfortable.
It is easy to say, don't worry, it will be fine, but the learning curve here is pretty quick.
I also did not believe when people here would say that their kitties come for there tests.
Once you have a routine going, you will see hank doing the same.
They know we are making them feel better and they just understand.
Good luck. We are watching out for you.
Now that you got the shot done, breathe, and have some chocolate.
 
I had two thoughts after reading your last post:

1. needles/feeling like you are getting it in...you could get some longer needles "harpoons". They may be felt more than the, what? 5/16"..is that what you are using? But at least you know you are getting it in. Despite doing injections in my cat for years (not just insulin),I switched to these recently so I have no doubt. As I said earlier, I use relion syringes. I could only get them in 29" gauge, which is a little bigger than I desire but not terrible.

2. Maybe put a post on health asking if there is anyone from the board in your area. They could possibly come over and show you different areas to shoot, help give you confidence that you are doing it right, add other suggestions? Of course we keep dosing advice and many other things public. But just to have that support person nearby is priceless. I have someone here, and I could not do this with out her!

I hope you have a good night. Will look for your first official condo tomorrow! :mrgreen:

Nice Job today!
 
Hi Betty and Hank! Welcome!!! You have some very skilled and experienced people helping you this evening. They are patient and compassionate and have helped me and Stu through many anxious moments. It is a lot to learn at once, but you are doing fine. If you don't live near a Walmart, you can order your supplies on their website. I do this and receive my package usually within 4 or 5 days of ordering. We use the Walmart Relion Ultima meter and strips. The meter costs about $10. and the test strips cost $39. for a box of 100. Shipping (by priority mail) is very reasonable. Make sure that you order the strips that are intended to work with the specific meter that you purchase. The Relion Ultima meter and strips seem to be always in stock (their other meter and it's corresponding strips don't seem always to be in stock).

I just read the post you posted while I was writing this. I find that if you push the plunger of the syringe in a couple of times before sticking it into the insulin cartridge it squeezes out the air and you don't get as many air bubbles. You can also draw a little more insulin than you need into the syringe and then gently shoot the excess into a paper towel. When you reach your 1 unit mark, stop shooting out the excess. Try pulling up the tent of skin on the side of either the left shoulder or the right one (not between the two shoulders). That way you can alternate sides. You won't see any blood. The needle is so thin that it should slide right in. He'll get used to it so quickly that he won't even notice. I always shoot while Stu is eating. I say "keep your head down" (since his face is in his bowl the head is already down). Then I pull up a tent of skin on the side of a shoulder, insert the needle quickly just below where I have my thumb, and push in the plunger. Hold it in for a second to make sure that the insulin goes in, and then pull it out. I then put my nose right down into his fur and smell. Lantus has a very characteristic, medicinal smell. If you don't smell anything, you can be sure that it all went into your cat. If you do smell the Lantus, DON'T try to shoot again. Call it a "fur shot" and skip that shot entirely. Hank will be fine.

Ask as many questions as you need. Someone will be there to help you. Don't let the whole process rattle you! Everyone here has had the same experience that you are having now. Hank is in good hands and you are doing great.
Ella
 
Ok, ..the lingo. Condo? (townhouse?)

Randi, Max and Hank could be brothers..or at least cousins. There is quite the resemblance.
...the chocolate is the best idea ever. Whoever invents cyberspace delivery for that in real-time will make a fortune.

I don't think it's the needle, it's the administer. I am getting much better at lancing, however. But quickly running out of strips.
I found a potential discount on the one touchstrips, not sure how much - but it has to be run thorugh in person not by phone. You would have to go place to place to compare. Who has that time? But I will have to do it tomorrow ...our newbie supplies are dwindling.

if I add another test tomorrow...when should i try to do it? i have only been shooting pre-shots.

i sure hope today has not impacted any progress he had made. We are so early in the game. i want to do right by him and for him to feel better.

Thanks' all, for helping me w/ my Hankie. I hope to learn enough to pass it forward some day.



I wrote this long ago and apparenlty forgot to send. Am lost reading all this great info.
I think we should try to do a curve soon,...maybe end of the week.
As i read more about ketones, i do wonder..is he ok? They just didn't elaborate.
She said if he got fatty lipidosis, he had a 50/50 chance of making it and to be sure he eats.
he IS eating....but not huge amounts. He had been losing weight but seems to have somewhat stablized these last few days.
I guess i could be doing the ketone tests at home?
Are there some common sense things I need to be doing now, other than testing and shots?
I have really just been keeping an eye on him, and bringing food and water to him periodically to be sure he is taking bites/sips.
I just read on the other board of someone losing their baby to ketones...
The first vet did note Hank has a FORl (bad tooteh) that needs to come out at some point.
I wonder if there is any infection or connection.
I am not clear on if there are any underlying causes for his diabetes. 2 vets in.


betty



I'm gonna check on him now.

B &H


PS: where is spellchecker on this thing?
 
Status
Not open for further replies.
Back
Top