Help please - 1st day with Lantus-Numbers black & red !!

[Ti-Mousse (GA) Pepe (GA)]

I just updated quickly my new spreadsheet with the few numbers I had, as vet never told me to test. At least it gives a portrait (not that good....) ! I started Lantus with 0.5 unit bid today; unfortunately Ti-Mousse seems to be getting fed up of low carb canned food and this morning he spotted Pepe's kibbles which we forgot to put away :-( He had a ball but I was so mad at myself!! Should I increase dose tomorrow ??? Could it be the kibbles that brought the BG up ?

 

[Olive & Paula]

Welcome. The dry will raise the glucose. It will drop in next day or so. You hold the dose your giving. Lantus Is a depot insulin and it has to build. That takes about 6 cycle (3 days). So glucose will probably be high. They are getting some of the dose you give but not all just yet. I know it's easier to say but just hold tight.

Are you feeding different flavors of low carb food? It helps keeping them from getting board with it.

 

[Chris & China (GA)]

Here's your previous post (we put the link to the prior post into the current one so it's easy to go back and see what's been said)

Yes, the kibbles will cause the BG to be higher....some cats can eat only 2-3 pieces and go up 200+ points!

It's too soon to worry about increasing the dose. Lantus takes 5-7 days to "build the depot". If you're doing SLGS, you hold each dose for at least 7 days.

Is there a particular reason you want to do SLGS? TR will allow you to change the dose as often as every 3 days (once the depot is established) so if kitty isn't getting into numbers we want them in, we can increase more often. Holding a dose that's not working for 7 days can lead to glucose toxicity setting in (which means they're body has a chance to get used to those high numbers even with insulin)….and you may end up having to go to an even higher dose to "break through".

If you can test at least 3-4 times a day, you can do TR.

 

[Ti-Mousse (GA) Pepe (GA)]

Welcome. The dry will raise the glucose. It will drop in next day or so. You hold the dose your giving. Lantus Is a depot insulin and it has to build. That takes about 6 cycle (3 days). So glucose will probably be high. They are getting some of the dose you give but not all just yet. I know it's easier to say but just hold tight.

Tks, I was really worried; I'm so relieved. So I'll keep on going and keep testing and WATCH FOR THE KIBBLES ... In low carb food, he only likes fish (salmon, hearing), which I guess he should not have too much. He used to have FFeast before being diagnosed but after, I gave him only very low carb food and no FFeast. I'll have to change the diet. Thanks again

 

[Chris & China (GA)]

Fancy Feast are fine...as long as it's the "classics" (pate's)…..they're low carb and a lot of us feed them!

It'll make your life a lot easier if you just get rid of the kibble altogether and feed everybody a low carb diet. Not only will it help keep your other kitty healthier and reduce their chances of getting diabetes, it also means if Ti-Mousse gets into their food, it won't matter!!

 

[Ti-Mousse (GA) Pepe (GA)]

Here's your previous post (we put the link to the prior post into the current one so it's easy to go back and see what's been said)

Yes, the kibbles will cause the BG to be higher....some cats can eat only 2-3 pieces and go up 200+ points!

It's too soon to worry about increasing the dose. Lantus takes 5-7 days to "build the depot". If you're doing SLGS, you hold each dose for at least 7 days.

Is there a particular reason you want to do SLGS? TR will allow you to change the dose as often as every 3 days (once the depot is established) so if kitty isn't getting into numbers we want them in, we can increase more often. Holding a dose that's not working for 7 days can lead to glucose toxicity setting in (which means they're body has a chance to get used to those high numbers even with insulin)….and you may end up having to go to an even higher dose to "break through".

If you can test at least 3-4 times a day, you can do TR.

To tell you the truth, I thought the best chance for Ti-Mousse (he's meowing right now for food..) was TR if I could do the testing all day long. If you say that 3-4 times a day is OK, I'm going to consider changing to TR. He's got very few veins in his ears because being frozen to death when I got him; that's why I opted for SLGS which did not asked for as many testings.

What about if he finds a few kibbles that we forgot.... this was my big concern to ge with TR !!

NOW, if I go with TR, what should I do now? Start from scratch with the dosage? Thanks!

 

[Ti-Mousse (GA) Pepe (GA)]

Fancy Feast are fine...as long as it's the "classics" (pate's)…..they're low carb and a lot of us feed them!

It'll make your life a lot easier if you just get rid of the kibble altogether and feed everybody a low carb diet. Not only will it help keep your other kitty healthier and reduce their chances of getting diabetes, it also means if Ti-Mousse gets into their food, it won't matter!!

You're right about getting rid of the kibbles; my only problem is that my little minou Pepe only eats kibbles and he is about to probably have one eye removed because of cancer in January :-(

My second problem is that in the US you have Classic FFeast pate that we used to have in Canada, but I realised recently that there is no mention of Classic on the FFeast pate anymore here. Does it mean that the formula changed for Canada - maybe impacting the % of carb ? I'm waiting for Purina Canada to contact me. Probably won't be of any help, but I'll see!

 

[Ella & Rusty & Stu(GA)]

Give the same dose that you gave today: 0.5 unit. You don't have to start all over again. Just make a note on your spreadsheet that you are following TR. When you switch to TR it simply means that you are using that protocol rather than SLGS. As Chris has said, Lantus is a depot insulin. That means that it builds a depot of insulin in the cat's body. When you begin Lantus it takes about 7 days to establish the depot. During that time some of the insulin goes into building the depot. So less of it is available to work on Ti-Mousse's blood glucose. Every time you change the dose the depot needs to re-calibrate. This usually takes a couple of days. You can read about the depot and how it works in the "Stickies".
The dry food was probably a major factor in those high numbers!

 

[Chris & China (GA)]

but I realised recently that there is no mention of Classic on the FFeast pate anymore here.

It's just called "Pate" in Canada, not "Classic"

Here's some at WalMart in Canada

 

[Ti-Mousse (GA) Pepe (GA)]

Give the same dose that you gave today: 0.5 unit. You don't have to start all over again. Just make a note on your spreadsheet that you are following TR. When you switch to TR it simply means that you are using that protocol rather than SLGS. As Chris has said, Lantus is a depot insulin. That means that it builds a depot of insulin in the cat's body. When you begin Lantus it takes about 7 days to establish the depot. During that time some of the insulin goes into building the depot. So less of it is available to work on Ti-Mousse's blood glucose. Every time you change the dose the depot needs to re-calibrate. This usually takes a couple of days. You can read about the depot and how it works in the "Stickies".
The dry food was probably a major factor in those high numbers!

I'll read the Stickies about the depot and keep up with the 0.5 unit and update my spreadsheet.

I wish I could thank all the ones that are there for my Ti-Mousse helping us ; thanks Ella, you're bringing life to life (I hope it makes sense?? In French it does )

 

[Tricia Cinco(GA) & Harvey]

Hi and welcome to Lantus & Levemir Land, the nicest place you never wanted to be.

It's wonderful that you are home testing. It's the best way to keep your FD kitty safe.

To do TR, it's best if you can get at least two tests in each cycle, and more when you can. Always get a pre-shot reading, to be sure it is safe to give insulin, and then a test somewhere mid-cycle, depending on your schedule. More tests are always good - no such thing as too much data. If testing on the ears is an issue, you might see if Ti-Mousse will let you poke the pad of his foot.

TR recommends a starting dose of about .25 units per kg of weight, so that would put you at about 1.25, if you decide to switch. You hold the dose for 6-10 cycles, unless kitty goes below 50 on a human meter/68 on a pet meter, which earns a .25 reduction.

There are other low carb foods besides Fancy Feast, but some are pricier and I don't know what is available in your part of Canada. Have you looked at Dr. Lisa Pierson's website, catinfo.org? There is a very helpful list of canned foods there that shows the level of carbs in may different brands. She also has a section on transitioning a cat from dry food, if you're interested in trying that with your civvie. Another possible solution to kibble raids is a feeder that can be programmed to only open for a specific cat - it works with their microchip. They are kind of expensive, but some people feel they are worth it.

Keep reading the info on the stickies here, keep posting and asking questions. We love to help!

 

[Chris & China (GA)]

If you say that 3-4 times a day is OK, I'm going to consider changing to TR.

The "requirement" for TR is 1. no dry food and 2. Pre-shot testing and 3. testing at mid-cycle (around +5 to +7) on the AM cycle (if at all possible) and always getting at least a "before bed" test on the PM cycle.

If you work and can't get mid-cycles on the AM cycle, it's important to try to get a couple of tests on the PM cycle and then get extra tests in on your days off.

 

[Ti-Mousse (GA) Pepe (GA)]

Hi and welcome to Lantus & Levemir Land, the nicest place you never wanted to be.

It's wonderful that you are home testing. It's the best way to keep your FD kitty safe.

To do TR, it's best if you can get at least two tests in each cycle, and more when you can. Always get a pre-shot reading, to be sure it is safe to give insulin, and then a test somewhere mid-cycle, depending on your schedule. More tests are always good - no such thing as too much data. If testing on the ears is an issue, you might see if Ti-Mousse will let you poke the pad of his foot.

TR recommends a starting dose of about .25 units per kg of weight, so that would put you at about 1.25, if you decide to switch. You hold the dose for 6-10 cycles, unless kitty goes below 50 on a human meter/68 on a pet meter, which earns a .25 reduction.

There are other low carb foods besides Fancy Feast, but some are pricier and I don't know what is available in your part of Canada. Have you looked at Dr. Lisa Pierson's website, catinfo.org? There is a very helpful list of canned foods there that shows the level of carbs in may different brands. She also has a section on transitioning a cat from dry food, if you're interested in trying that with your civvie. Another possible solution to kibble raids is a feeder that can be programmed to only open for a specific cat - it works with their microchip. They are kind of expensive, but some people feel they are worth it.

Keep reading the info on the stickies here, keep posting and asking questions. We love to help!

Thanks Tricia! If I understand well, if I go with TR, does it mean that tomorrow I increase from 0.5 unit to 1.25 units and maintain the dose for 6-10 cycles with testing ?

As for the food, I have been following Lisa Pierson's food list which is so great, a real bible. The problem with FFeast is that my little old lady Zoe 17 years old eats FFeast; so when I open a can for her Ti-Mousse runs! He prefers that than Fromm !!!

 

[Wendy&Neko]

Over half of the foods listed on Dr. Pierson's food list are also available in Canada. A couple other low carb Canadian made brands are "Canada Fresh" and "Boreal". Fancy Feast is rather high in phosphorus, so not a good choice if there are any issues with the kidneys.

 

[Ti-Mousse (GA) Pepe (GA)]

The "requirement" for TR is 1. no dry food and 2. Pre-shot testing and 3. testing at mid-cycle (around +5 to +7) on the AM cycle (if at all possible) and always getting at least a "before bed" test on the PM cycle.

If you work and can't get mid-cycles on the AM cycle, it's important to try to get a couple of tests on the PM cycle and then get extra tests in on your days off.

OK for the AM cycle ! One concern is that my PM cycle starts a little before bed time, so not much testing there ? Is this a problem ??

 

[Idjit's mom]

Lyane, please wait for advice from @Chris & China , @Tricia Cinco(GA) & Harvey or @Ella & Rusty & Stu(GA) or any of the other experienced members, before you increase the insulin dose. That's a larger increase than is advised here. Your signature says that you are using Caninsulin, so you may want to change that and what dosage you are currently using.

 

[Ti-Mousse (GA) Pepe (GA)]

Over half of the foods listed on Dr. Pierson's food list are also available in Canada. A couple other low carb Canadian made brands are "Canada Fresh" and "Boreal". Fancy Feast is rather high in phosphorus, so not a good choice if there are any issues with the kidneys.

You're right a lot of what's on Dr. Pierson's food list is available in Canada and this is my go-to list. I am very careful about phosphorus, as one of my kitty died from CKF last May !

 

[Ti-Mousse (GA) Pepe (GA)]

Lyane, please wait for advice from @Chris & China , @Tricia Cinco(GA) & Harvey or @Ella & Rusty & Stu(GA) or any of the other experienced members, before you increase the insulin dose. That's a larger increase than is advised here. Your signature says that you are using Caninsulin, so you may want to change that and what dosage you are currently using.

Thanks so much for the advice not to increase right away; I will wait for the advice of one of you; in the meantime I will go on with the 0,5 unit.

BTW I did change my signature yesterday as I was starting 0.5 unit Lantus this morning; I hope I did it right!

 

[Idjit's mom]

Thanks so much for the advice not to increase right away; I will wait for the advice of one of you; in the meantime I will go on with the 0,5 unit.

BTW I did change my signature yesterday as I was starting 0.5 unit Lantus this morning; I hope I did it right!

It might be helpful to just remove the Caninsulin and dosage from the signature, I didn't see the addition of the Lantus at the end, my error. How is the testing going on little Ti-Mousse's poor battered ears?

 

[Chris & China (GA)]

One concern is that my PM cycle starts a little before bed time, so not much testing there ? Is this a problem ??

Have you considered moving your shot times to earlier so you can test better on the PM cycle? Most cats do go lower at night, so it's pretty important.

When we first started, I figured OK, I can do this!...I HATE mornings (always have) so I figured I'd shoot at 10/10 or 11/11 so I didn't have to get up early...and I'm always up later at night.

After spending a few nights up ALL night long because I shot late and China went too low, I decided that I'd change things up. I started dragging my butt out of bed at 6am so I could shoot at 6pm and still get at least a +6 at night without any problem....and usually I can go back to sleep in the mornings!! I've gotten really good at not really waking up at 6....my eyes open just enough to get the shot ready and test ..….sometimes I don't even really remember doing it (but luckily, my meter tells me I tested at 6am!)

Funny.....I didn't used to have any problem staying up all night

 

[Chris & China (GA)]

I will wait for the advice of one of you; in the meantime I will go on with the 0,5 unit.

If you're going to do TR and can test, I think it would be reasonable to go up to 1U considering his size. We do want to get those numbers down sooner rather than later.

But if you're more comfortable sticking with the .5 for now, that's fine too....we can see how he does over the next few days and consider raising his dose then.

 

[Ti-Mousse (GA) Pepe (GA)]

It might be helpful to just remove the Caninsulin and dosage from the signature, I didn't see the addition of the Lantus at the end, my error. How is the testing going on little Ti-Mousse's poor battered ears?

As you suggested, I modified my signature leaving the Caninsulin but without the dosage; I think it's clearer that way! As for the testing, Ti-Mousse doesn't like me as much as he did.... when I go to him he hides under whatever is there, table, chair, kitchen island... I guess one day he'll understand that it's not that bad, but we have to do it !!!

 

[Chris & China (GA)]

when I go to him he hides under whatever is there, table, chair, kitchen island... I guess one day he'll understand that it's not that bad, but we have to do it !!!

Does he get a special treat each time?

Here's something I wrote up for others for testing...maybe it'll help you too!

It can be really helpful to establish a routine with testing. Pick one spot that you want your "testing spot" to be (I like the kitchen counter because it's got good light and it's at a good height....it also already blocked 2 escape routes due to the wall and the backsplash) It can be anywhere though...a rug on the floor, a table, a particular spot on the couch...wherever is good for you. Cats do much better with a "routine" so making it the same place every time helps.

Take him there as many times a day as you can and just give his ears a quick rub and then he gets a yummy (low carb) treat.Most cats aren't objecting so much with the poking ..it's the fooling with their ears they don't like, but once they're desensitized to it and learn to associate a certain place with the treats, they usually start to come when they're called! Or even when they hear us opening the test kit!

You also have to remember...you're not poking him to hurt him...you're testing him to keep him safe and understand what's going on inside his body. There's just nothing better than truly understanding what's going on inside your kitty's body and with this disease, the more knowledge you have, the more power you have against it. The edges of the ears have very few pain receptors, so it really doesn't hurt them. Also, if you're nervous and tense, it's going to make your kitty nervous and tense too. As silly as it might seem, try singing! It forces you to use a different part of your brain!

It's also important to make sure his ear is warm. A small sock filled with a little rice and microwaved or a small pill bottle filled with warm water (check temp against your wrist like you would a baby bottle) works well

For new kitties, using a heavier gauge lancet is also really helpful. A 25-28 gauge lancet pokes a bigger "hole" than a 31-33 gauge lancet does, so look for "Alternate Site testing" lancets that are usually a lower number

Finding the right "treat" will be a great help too! Freeze dried chicken, bonito flakes, little pieces of baked chicken...whatever low carb treat you can find that he really enjoys will help him to associate the testing with the treat! China's Achilles heel was baked chicken, so I'd bake a piece, chop it into bite sized pieces, put some in the refrigerator and freeze the rest to use as needed. It didn't take long for her to come any time I picked up the meter!

 

[Ti-Mousse (GA) Pepe (GA)]

If you're going to do TR and can test, I think it would be reasonable to go up to 1U considering his size. We do want to get those numbers down sooner rather than later.

But if you're more comfortable sticking with the .5 for now, that's fine too....we can see how he does over the next few days and consider raising his dose then.

Yes, I agree with you to lower those numbers asap. I'll see how I can change my schedule to be able to test after PM. I'll probably keep the 0.5 tomorrow and go up to 1U Monday when I have everything planned to test after PM shot. Tks

 

[Chris & China (GA)]

I'll see how I can change my schedule to be able to test after PM.

You can make adjustments by shooting 15 minutes earlier per cycle or 30 minutes per day (one or the other) and gradually working your way to an earlier shot time.

 

[Ti-Mousse (GA) Pepe (GA)]

Does he get a special treat each time?

Here's something I wrote up for others for testing...maybe it'll help you too!

It can be really helpful to establish a routine with testing. Pick one spot that you want your "testing spot" to be (I like the kitchen counter because it's got good light and it's at a good height....it also already blocked 2 escape routes due to the wall and the backsplash) It can be anywhere though...a rug on the floor, a table, a particular spot on the couch...wherever is good for you. Cats do much better with a "routine" so making it the same place every time helps.

Take him there as many times a day as you can and just give his ears a quick rub and then he gets a yummy (low carb) treat.Most cats aren't objecting so much with the poking ..it's the fooling with their ears they don't like, but once they're desensitized to it and learn to associate a certain place with the treats, they usually start to come when they're called! Or even when they hear us opening the test kit!

You also have to remember...you're not poking him to hurt him...you're testing him to keep him safe and understand what's going on inside his body. There's just nothing better than truly understanding what's going on inside your kitty's body and with this disease, the more knowledge you have, the more power you have against it. The edges of the ears have very few pain receptors, so it really doesn't hurt them. Also, if you're nervous and tense, it's going to make your kitty nervous and tense too. As silly as it might seem, try singing! It forces you to use a different part of your brain!

It's also important to make sure his ear is warm. A small sock filled with a little rice and microwaved or a small pill bottle filled with warm water (check temp against your wrist like you would a baby bottle) works well

For new kitties, using a heavier gauge lancet is also really helpful. A 25-28 gauge lancet pokes a bigger "hole" than a 31-33 gauge lancet does, so look for "Alternate Site testing" lancets that are usually a lower number

Finding the right "treat" will be a great help too! Freeze dried chicken, bonito flakes, little pieces of baked chicken...whatever low carb treat you can find that he really enjoys will help him to associate the testing with the treat! China's Achilles heel was baked chicken, so I'd bake a piece, chop it into bite sized pieces, put some in the refrigerator and freeze the rest to use as needed. It didn't take long for her to come any time I picked up the meter!

Thanks, with all those tips I should be alright