I brought Kitty home from vet

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Deb & Wink said:
We need a test at +2 today and we will decide what other tests to do from there.
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I feel so bad for testing her so often! Her poor ears are probably so sore. She didn't want me touching them earlier. I used a warm, wet towel on her ear earlier, and the blood came out MUCH better. I'll do that from now on so I don't have to stick her multiple times.

Deb & Wink said:
Catsicles. Freeze cat food for later use. Some of us mix water in first. Put cat food in non-stick muffin pan. Freeze solid. Pop out and store for later use. As they gradually defrost, your cat can have some food to nibble on for the day.
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Castsicles..Ha! I'll give that a try! Thank you for this info.

Since changing the other cats over to wet food, my youngest cat has turned into a firecracker. He was like this when he was a kitten, but lately he's been only playing a little while and sleeping a lot. I guess he has more energy now..it's driving everyone crazy! Ha!
 
You don't want to dilute the blood drop, so put the warm wet towel in a plastic bag. Or dry the ear off really well.

A rice sock works well to warm the ear. Put a couple of tablespoons of rice or dried beans or lentils or peas into the toe of a cotton sock. Tie the top closed. Heat in microwave until warm but not hot. Place against the ear to warm the ear.

Or vigorous rubbing of the ear. That's what I use for Wink.
 
What was the +2 reading?

I'm sorry Missy. We're not trying to make things too difficult for you to handle. I know how busy people's lives can get.

The first week or two is the absolute hardest. It does get better as you develop a routine and learn how to handle different situations, trust me. We've all been where you are now.

You need to take care of yourself too, your dad, your home, your other furry family members. It's hard.

If we ever ask you to do something and you absolutely can not do it, push back. We'll try to explain why it is so important or come up with another recommendation. There is some flexibility.

Yesterday, we were really concerned. We know how to manage those low numbers at home and can guide you . Your other option would have been to take her to the emergency 24 hour vet.

Since today is her first day on the Lantus, we like people to get a few more tests. The first 3 days or so, it's suggested to get a test at +3, +6, and +9.

I asked for that +2 today instead of a +3 to see where she was going with the BG numbers. That +2 can often tell us what direction she is headed in, up or down.
 
I took your advice and made the rice sock. She loved it and she didn't even cry or pull away when I stuck her. I'll be using that from now on!

Her BG at +2 is 276.
 
That 276 at +2 is a good number. Not much different than the AMPS (morning or AM pre-shot) test. I think we can wait until +4 for another test.
You can give Kitty more food throughout the day until two hours before the PMPS (evening or PM pre-shot) test. Maybe a small snack, a couple of teaspoons at +4 with that test. I'd rather see you give her mini-meals today than let her eat too much at once.

So far today we have
AMPS 298
+2 276

Check your PM's please.
 
This is looking like a bounce to me..a reaction to dropping low yesterday. Ie

When a cat is first diagnosed, the blood glucose has probably been high for a while. As the insulin starts to take effect and numbers start to come down, the liver has to learn to adjust to the lower numbers. We call this "liver training school". But before it relearns that low numbers are ok, when the BG drops to a number lower than the liver is accustomed, or if BGs drop low, or if the BG drops suddenly, the liver”panics” and reacts by releasing counterregulatory hormones and glucagon. This drives the BG back up. This is what we call a "bounce". Bounces can take up to 72 hours to clear so we are generally careful about increasing doses during the bounce. Once the bounce clears, then you can see the "real" numbers and determine if the dose needs to go up or down.
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So I'm guessing this means that we will be sticking with .5 units for a few days in case this is a bounce? I have no idea what I'm talking about. Haha!
 
So I'm guessing this means that we will be sticking with .5 units for a few days in case this is a bounce?
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Good guess!

Since you just started on the Lantus this morning, 7/20, we have you keep this same 0.5U dose for 5-7 days (10-14 cycles) anyway. UNLESS, Kitty drops below 50. That is an automatic reduction. High flat curves also tell us to increase the dose faster than is typical. ECID. Every Cat is Different. We are finding what will work best for Kitty.

Lantus is a depot type insulin. This means some of it goes to work right away and the rest of it goes into storage within the cats body, to be slowly released later. That is what give Lantus it's nice long duration and those nice u shaped curves. This Sticky from the Lantus TR forum explains the depot. the insulin depot.

Off topic: Doesn't it get confusing to have one cat named Miss Kitty and one named Kitty? I've been wondering about that since last night. :o
 
Ha! It's not confusing to me! I have had Miss Kitty for years. Kitty was what my Uncle called his cat, so I just kept using it. She answers to it, so I'm cool with it. Honestly, my Uncle called her Kitty or Missy, and since I'm a Missy, I can't call her that. That would be weird. :lol:
 
There is another google document, a Profile that you can create to tell us about your fur family. Make it fun. Include pictures. Tell us stories of how your cats joined your family. Tell us a little about you if you want to share.

There is an additional document you can create to provide even more information about your cat. This is also optional to create this google document and link it into your signature. The profile is in addition to the synopsis info in your signature. See this link on the how to's of profile creation. http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=79123
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+6 reading is 267. She's hungry, so I'm going to give her some more pate.

I set an alarm on my phone for 7:20 PM so I know that she can't have any more food until I check her BG before the 9:22 PM shot. Can I give her a good amount of food while I'm giving her the second shot? She's only had a little bit while I gave her the first shot and a snack earlier. It definitely helped with the first shot since she was preoccupied.
 
yes you can give her a complete meal when you give the insulin tonight. You can even give her lots of mini meals throughout the day/night too.

To be honest, once Maui started to eat wet food, I treated it the same as dry. I served meals and any uneaten food at meal time sat out for nibbling throughout the day. Now, I also add 1 can of water to 1 can of food. This keeps it moist longer and ensures she gets plenty of water in her system, so much so that for a couple years she stopped drinking water from the bowl.
 
Hillary & Maui said:
yes you can give her a complete meal when you give the insulin tonight.
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Thanks, Hillary, and thanks for the tip about adding water to the food!

Wendy&Tiggy said:
Great job on the spreadsheet - its going to be really useful for everyone! Am looking forward to seeing the PMPS!
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Thanks, Wendy! I'm looking forward to the PMPS now, too! I hope it's not too high. I am hoping that the diet change will make a big difference and maybe she won't need any insulin. I guess I'll have to wait a few weeks to see. I'm thinking positive thoughts!

Question: I read somewhere that it was a good idea to hold the syringe filled with insulin in your hands for a little while before injecting the cat. The cold insulin may not feel very good and holding it in your hand warms it up. Do you guys do that?
 
Question: I read somewhere that it was a good idea to hold the syringe filled with insulin in your hands for a little while before injecting the cat. The cold insulin may not feel very good and holding it in your hand warms it up. Do you guys do that?
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With that tiny dose, no. If you were shooting say >5U, then you might want to warm it up a bit.
 
Oh yeah..duh...sorry!

Kitty hasn't had any food since around 5:45, so I'm going to test her at 9:00. That way, if no one is online to guide me, I can wait a while and not miss the 9:22 time I'm aiming for. I should probably start this process a little earlier tomorrow. Did you say I could do 15 minutes earlier tomorrow, Deb?
 
You can do 15 minutes earlier , 2 times a day.

Or 30 minutes earlier once a day.

So for example.

You could do tonight's shot 15 minutes early, tomorrow AM shot 15 minutes earlier, tomorrow PM shot 15 minute earlier...

Or tomorrow mornings shot 30 minutes earlier. PM shot 12 hours from am shot.
 
If she needs a shot this evening, how many times do I need to test her after I inject her? I don't want to be up TOO late. Ha! I've been staying up until around 1:30 AM lately, but it's kicking my behind.
 
We always like to see a before bed test.
If a +2 is earlier by an hour or so from the before bed test, then get a +2.

If the before bed test has dropped a lot from the PMPS, you might want to leave out some LC food for her and maybe even set your alarm to get a +6 and/or leave out more LC food.

I define a lot as > 50 points an hour or more than 50%.

If she drops fast very early in the cycle, like by +2, give her some HC food.
 
I plan on getting a reading around 8:45 tonight, and if needed, giving her a shot around 9:00. I'm sure I'll be up until 1:00 AM, so I'll do a +2 and a +4. Is anyone on here that late at night?
 
Yes, west coast people and those in Arizona are 2 hours earlier than you. You're 1am is only their 11PM.

If no one is on this forum (you can check by looking at the bottom of your screen), you can post over in the Insulin Support Group (ISG) Lantus (glargine) Tight Regulation. Lantus TR for short. That is the most active forum later at night.

If you have a problem and need immediate help, go up to the very first post in this topic and click on the little edit icon. Change the post icon from none to the 911 icon. That get's peoples attention fast. Used for health emergencies, such as your cats numbers dropping really low, <50 in your case. Shout for help at a BG of 100 if you need to. Tell them this is only your first day using Lantus and you are not used to those low numbers. They'll understand.
 
I'm sorry that I keep asking the same things over and over again. I know the answer, but I'm so scared I'm going to mess it up, so I ask again. Hopefully I will get the hang of this soon and I won't need to bug you so much. You guys have been a life saver, and I'm so thankful that you are all here. Thank you for being patient.
 
No worries.

No apologies needed. Ask as many times as you need to. We may say it a bit differently each time. That can help you to understand.

Bug us all you want or need to. It's why we're here.
 
Good morning. I see you got a blue AMPS and I am glad you skipped since you dont have the data to support a shot yet. Please mark "skip" in the AM dose column. But can you get a +3 just to see how she does?

The diarrhea could be from too rapid a food change - you may want to do it more slowly.

Wendy
 
Hi Wendy,

I just checked her BG again and it's 82. That's pretty low, especially since her AMPS was 142. What should I do?
 
I wrote on the insulin support forum about her low AMPS and asked if I should go ahead and feed her. I forgot to check the "notify me when a reply is posted", and I missed a message that said not to feed her yet. I had already fed her some LC Friskies canned food.
 
I just gave her a little bit more pate. I was worried since there was such a big drop from 8:30AM. She hasn't had any insulin since 9:00 last night.
 
There is a little hangover but it should be wearing off soon and she will likely start to shoot back up.

Given this is just your second day on lantus this tells me he dose is too high. Tonite ( assuming she is over 200) I am thinking you might want to reduce to 0.25. Do your syringes have half unit markings?

Heres how 0.25 looks
025unit-1.jpg
 
You did NOT give insulin this morning - correct?

If yes - then relax sit back and test her in a few hours. This is really good!

If you did give insulin (And I think you did not - based on the ss) - then I would give her a teaspoon of medium or high carb food - or just the gravy from the high carb food. Even mix the gravy with some low carb food. The reason, while these are excellent numbers, you are very early in the process and I don't want to see her drop to 50 or less during the cycle.

But I'm thinking no insulin was given, so do a happy dance and just monitor her....maybe you will get lucky and she will be in normal range for PMPS too!
 
That's correct, I did not give her any insulin this morning. I'd do a happy dance, but I'm exhausted. Haha! My 5 other cats are giving me the stink eye for not paying them any attention lately, and the house looks like a tornado came through it.

Normal ranges for the PMPS would be wonderful!
 
Too high is better than too low. Just read your PM. Sorry no one was on last night to answer your question. Even over in TR, there is usually someone on late at night.

Rising BG is fine. It's the low numbers that are an immediate concern. Even numbers in the 300-600 range are not an immediate danger to your cat. The high numbers can do slow damage over time but are not an immediate concern.

Remember our mantra "Better too high for a day, than too low for a minute."

Lesson for today. Let's talk a little about ketones. Nice article on the FDMB home page, under Education about Ketone testing.

Infection + not eating + high numbers (>300) may mean you want to do ketone test on the urine. There are other circumstances where you want to ketone test.
1. Any time the numbers are over renal threshold (>230-280) is a good time to get a daily ketone test.
2. If you know your cat is prone to ketones, that is another circumstance where you want to get daily ketone tests.
3. If you are not home testing, it's one of the secondary monitoring tools.
4. Just because you want to make sure your cat does not have ketones.

Some cats develop ketones at lower BG levels. I have not listed all the conditions here for ketone testing.

The point is to 'know thy cat'.
 
I didn't pick up any Ketone test strips at the store the other day. I'm not sure my local stores will have these, I may have to order them online.
 
Most pharmacies should have the ketone urine test strips. Especially if they carry any diabetic supplies. Wal-Mart carries them. CVS and Walgreens carry them.
 
I called Walmart and they do have them. My Dad is going to get them for me so I don't have to leave her alone.

Is there a link that shows me how to use them? I hope she doesn't have to pee until he gets back! Ha!
 
I found another post where you mentioned urine catching tips. I'll check it out.

I believe Walmart carries the ReliOn brand of ketone urine strips. Will that be OK? I'm seeing a lot of keto-stix or Keto-diastix. I just want to make sure I get the right thing.
 
Here are some Urine testing tips

Is she shy around the litterbox? or will she let you get close enough to put the stick under her butt?

You might want your dad to pick up some aquarium gravel, small size, for urine testing use.
 
I've never seen her use the litterbox. Maybe she's shy. I just cleaned the litterbox and added more litter. I also grabbed a spoon rest in case she decided to go. My Dad still hasn't picked those strips up yet. Would it be OK to catch some urine in the spoon rest and just wait for the strips, or will the ketones lose potency after they have been out for a while?
 
Missy,
The strips are just a long piece of flat plastic with a pad looking thing on one end - that's what reacts to the urine telling you the presence of ketones or not. Keto-Diastix tells you 2 things - ketone level AND glucose level in the urine. You just need the Ketostix. I don't think you can use old urine BUT I'M NOT SURE so don't place any bets on that answer. Glad your dad is getting them for you!!!

BIG HUGS, keep it goin' girl!
 
Missy,

You have learned so much, so quickly. You have the SS up and running. You have the info in your signature, and location in your user profile. You have profiles set up for your cats. You've switched your cats to a LC (low carb) diet. You are hometesting. You've been getting those pre-shot and other tests each day.

I think it's time. For you to post over in the Lantus TR forum on a daily basis for help. You already started that last night with your plea for help. You started your daily condo over there for today. I think you are all set.

It's a good idea to keep your questions in a single forum for now. I think that should be in the Lantus TR forum, if you think you are ready for that. Great group of knowledgeable, experienced folks over there. More eyes to keep an eye out for you and Kitty. Very giving of their time.

What do you think? Ready to fledge and leave the nest and go to the next step, Lantus TR forum? You're ready to fly!

I'll still be checking in on you whenever I can. Wendy probably will too.

ETA: Yes on the reduction to the 0.25U. It's only day 2 and the depot isn't full yet. You'll already had to skip one dose and it's only day 2! You may go to no insulin really, really soon. No way to predict that though.

P.s. I would suggest you add your first name to your signature, before your cat's name. Only if you want to of course.
 
I called my Dad to see if he would check to see if there were other brands of those test strips. I only saw the ReliOn brand at walmart dot com, but maybe they have the Ketostix.

Squeaky and KT said:
BIG HUGS, keep it goin' girl!
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Thank you! I'm seriously needing them this week!

Deb & Wink said:
Ready to fledge and leave the nest and go to the next step, Lantus TR forum?
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nailbite_smile If you think I should move over to that forum, then I guess I'm ready. Thank you for everything. I hope they are as helpful as you have been.
 
see you over in lantus land! :)

Interesting she is still dropping. I still wonder if she needs insulin at all. Will be interesting to see what the guys over there say.
 
Wendy&Tiggy said:
Interesting she is still dropping. I still wonder if she needs insulin at all. Will be interesting to see what the guys over there say.
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Yeah, I'm not sure what's causing that. I was about to give her some more LC food as I think she is hungry. I'm only feeding little bits throughout the day, no food 2 hours before shot time, and a meal during the shot.
 
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