Here I am. Advice? Please.

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sch

sch

Member Since 2012
So, I have my spreadsheet set up and I am not sure where I go from here. Can someone give me some advice? I want to say- this morning when I tested Caesar- he was at 300. I gave him his injection and about an hour later he seemed unusally disinterested in what was going on around him. I was wondering if the 300 reading was a bit false because he does stress up before we get his bg accomplished. I am concerned about overdosing him..? We take him outside daily for supervised trips to the yard for a grass eating session..and he was not interested at all when normally he cannot wait to get out there. I am concerned about this.

I was going to do a re-test, however,I know how it stresses him and decided I may not get a proper answer.
 
I don't have any advice for you, since I'm new too. I'm in a similar situation as you - just started a spreadsheet, new diagnosis, etc. You seem to be voicing a lot of the same questions I have. I hope you don't mind my poking my head in here when I see responses. Good luck to you and Caesar! He sure is a cutie!
 
Aww.. thanks for that.. your kitty looks like a cutie, as well! and.. poke away! ( :mrgreen: ) I just feel lost. I am not sure what I am supposed to be doing- really looking for direction here. I notice several views to my post.. but I hope someone will give me some direction..
 
Without mid-cycle tests we can't tell you why he was disinterested in things around him..he could have been just be bored that day, or he could have been going too low or lower than what he is use to. Lantus doses are based off the lowest point in the cycle (the period between one shot and the next) without those tests we can only guess what it happening. Normally the lowest point on Lantus is right around +5-+7, some cats are a little earlier and some are a little later. Its only with testing that you are going to figure out where it is for Caesar and it can move around slightly from day to day.

Anytime something seems off with Caesar your meter becomes your best friend. Also just because he isn't acting low doesn't mean he isn't low. My girl Autumn the other day tested at 24 but she was acting fine, I wouldn't have caught it if I hadn't tested and then I would have been sitting there later that evening scratching my head on why she was high for her pm shot.

Now that said it doesn't mean that you have to test him every hour of the day but you do want to test before each shot, and if you can get it right around where the nadir (lowest) point should be, and then one last test right before turning in for the night, since some cats run lower at night than they do during the day. Also like I said above if something just seems off...thirstier than normal, hungerier than normal, acting spacey etc. It maybe nothing, or it maybe because he is dropping too low or too quickly or he may just be being a cat, and doing what cats do.

Mel, Maxwell, Autumn & The Fur Gang
 
Ok, thanks. well.. being that I am brand new to this (4 days into home testing) that is why I need advice. I have been reading others posts and all of the answers other people are getting and so I just thought someone may just have some other kind of advice or look at my numbers and tell me if I am dosing him ok or whatever, but, I will just keep doing what I am doing.
 
Hey you're doing great, only four days in to home testing. It is just getting those in-between tests so we can help you figure out what's going on and if you need to do something else. Sorry if I sounded a little short earlier I was rushing aroud trying to do 5 things at once. As I have 13 cats, 2 of which are diabetics, a large dog, a house that I'm trying to get remodeled and trying to get a new business up and running so forgive me if occasionally come off abrupt.

How is the testing going by the way, I know you were saying it was stressing Caesar out. If we can help make it easier on you and him let us know since I have adopted all my diabetics as diabetics I've got quite a few tricks up my sleeves on how to make it something they look forward to, rather than hate.

Mel, Maxwell, Autumn & The Fur Gang
 
Sorry if I sounded a little short earlier I was rushing aroud trying to do 5 things at once. As I have 13 cats, 2 of which are diabetics, a large dog, a house that I'm trying to get remodeled and trying to get a new business up and running so forgive me if occasionally come off abrupt.
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That's ok. I understand that. I guess I am just at that point of, ok..I'm set up and now what? But I don't feel like I have gotten the answer to that. I am not sure how to ensure I am "noticed" by those I need help from. I just read another newbie's thread who got tons of detailed advice, so I guess I can just take from that. I had, up until now, been getting lots of responses but not on here, just being "viewed."
I am guessing I will just keep doing what I am doing, do a curve once a week and ask again? I know I only have 4 days of info but I just don't feel confident or completely understand how all of this is supposed to work.
It is harder when I do not have a supportive vet yet. Makes one feel...alone. I do not want to be that right now. I am not even sure I am in the correct insulin support group.
 
Hi Jill! It's newbie Melanie (and Ninja). Is this where we are supposed to post now related to Lantus questions – and not the general forum? For what it’s worth, I found this article helpful: http://www.felinediabetes.com/dummies.htm -- once you get past the beginning stuff (keep scrolling down), it talks about goals of regulation, what curves should look like, when to increase dosages and what to look for. If you have already read, just disregard.

Since I am new too, this all seems pretty complicated to me as well; but I think this article does a pretty good job of explaining things. The good news is that the article says, once you get your kitty regulated - you will "get a big chunk of your life back" ... which was music to my ears. LOL!! From what I am reading, it looks like the hard part is in the beginning -- finding out what dose and type of insulin works best for your kitty -- to keep them their BG in the 100 to 200 BG range most of the day.

I think the frightening part for newbies (like me) is understanding...for example, if my cat Ninja has been receiving 1.5 units of Lantus for one week and is still consistently running numbers in the mid-300's, and the vet instructs me to increase her by ½ unit (to 2 units, twice a day) – is it likely that 2 units is going to put her into a hypo state? In other words… how much would an additional half unit of Lantus typically lower BG numbers in the average cat who is running numbers consistently in the mid-300’s (and yes, I know there is no such thing as an average cat …LOL). Do I have to test Ninja every hour and wake her from sleep to see if she is breathing…etc -- or is this 1/2 unit increase likely to drop her to 300 -- or is there anyway of knowing??

My vet said to test Ninja as normal and send her the results at the end of the week, and that if I could get a curve in this week (or two) that this would be helpful as well.

PS to Jill: You spoke in a post on Sunday about difficulties getting Caesar’s BG testing (having to apply additional restraint) – and I can completely empathize with you. I thought I had the discovered the secret of wrapping Ninja in a blanket (using a modified burrito technique), but Ninja has now decided that this is a game where she gets to play Houdini –I wrap her up and she gets to escape. She seems to enjoy that. LOL! But , honestly, I wasn’t laughing Sunday; in fact I was crying. She escaped 3 times and I finally had to let it go. Like another poster said, our anxiety translates to the cat’s comfort level – and when I’m screaming at Ninja and crying, the odds of creating a stress-free experience for her is zero. I just have to accept that I am not going to be perfect at this; keep trying, and let it go when the stress builds too high. Just wanted to let you know I am with you in spirit on the trials and tribulations of BG testing; and hope that once Ninja is better regulated, the stress will lessen. :)
 
Hi Caesar's Mom,
Yes, you can learn a whole lot of good information just by reading other people's threads, and many times the questions you have will have been answered in those conversations. Sometimes it is hard to get "noticed", depending on the time of day you are on the board. The busiest forums are the Health forum, and the Lantus TR forum, in general. If you ever have a really urgent question that needs an immediate answer, those are the two best places to post them.

I have no experience with the insulin you are using, but 1u is a good starting dose. At this point, just a few days into the treatment, it's hard to tell much, but you're doing great so far. Is testing getting easier? I know it was stressful the first couple of days.

Does you schedule allow you to get tests in between the two times a day you give Caesar his shots? If you can get a test around the mid-way point of the cycles, that will really help you (and everyone here) determine what this dose is doing for him. You don't need to run a whole "curve" every day, but at least one test between shots will tell you a lot. You can run a curve where you are testing every two or three hours on a day where that is convenient, once a week or whatever.

There aren't really any "rules" as to where you should post. You can post here, but the traffic (especially in the middle of the night) is low. You can also post in the Tight Regulation forum, even if you are not following that protocol, or you can post in Levemir (many people there either use, or have used Lantus).

Sometimes you have to be patient waiting for a reply no matter where you post, but in an emergency, there is a 911 icon you can attach to your subject line that is sure to get people's attention.

Carl
 
Your daily routine will now include "test, feed, shoot" every 12 hours, plus whenever you can, test(s) between 5-7 hours after the insulin when you expect the nadir (lowest point) to ocurr.

If you can follow the Lantus tight regulation protocol and get a mid-cycle test or two (almost) every day, plus one before bedtime (or if you tend to wake up at night, take one then), you will be able to adjust the dose more quickly following the protocol described in the Tight Regulation forum.

Otherwise, the more mid-cycle tests you can get, the better, and doing a curve every week or two helps identify if the insulin dose is optimized.

If your mid-cycle tests are consistently high, you'll get a suggestion to increase by 0.25 to 0.5 units.
If your mid-cycle tests ever go below 50, that may indicate time for a dose reduction

If the pre-shot test is below 200 in these first couple of weeks, we may encourage you to stall, or to skip, depending on whether we see the mid-cycle data going low or not.

Whatever you do, always make dose adjustments based on the protocol with nadir data, not with pre-shot data.

It will be helpful to make good notes on your spreadsheet about appetite, thirst, urine output, and fecal deposits, as well as any other health observations (see my signature link for secondary monitoring tools for some ideas). Until regulated, the diabetic is more hungry because they can't use all of what they eat - literally starving amidst plenty. A diabetic will drink gallons as this helps the kidneys excrete some of the excess glucose ... and this shows up in litterbox lakes. As the water consumption reduces, be sure to add a bit to the canned food to help prevent constipation which sometimes ocurrs.
 
Thanks,Carl. I understand what you are saying. I definitely don't expect anyone to be up in the night when I am, answering my questions (I work the night shift, so I am not on everyone's "normal" day/night cycle. It was just that I had so many immediate responses on my first post, things felt a bit muddled as to what to expect or where to go or, I thought I was going to get more responses... or whatever. This is all new to me. I have never used a message board like this before, I don't blog or anything like that, so I am not familiar with any of it. I'm just hungry for help, and I am not one who usually asks for it, but this is new territory for me, and I still feel like I am walking around in the dark looking for a light switch..I am just starting to see a little light .. just now. I want to be sure I am helping Caesar to the best of my ability. I really appreciate all the advice and guidance I have been getting, and I thank you for the information you gave in response!

BJM, Thank you very much for that detailed information. I very much appreciate it :-)
 
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