i'm new here- increase dose????

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dollsinmyeyes

dollsinmyeyes

Member Since 2012
Hey I'm a 26 year old nurse, with a newly diabetic cat.

The vet prescribed 4 units of lantus BID, and after last weeks fructosamine level of 678, told me to start gradually increasing Satan's insulin by one unit every few days, and to do urine ketone tests to judge if it needed to be increased. I than asked if it would be okay to do blood testing. (AND I AM SO GLAD I DID)

Last night was our first adventure in blood glucose testing on the cat. I managed to get a sample last night, and one this morning. THE NUMBERS CONFUSE ME
last night his blood sugar read out as 42, I'm hoping i got a low test value because the strip was out for a long time, I know as a nurse in people if hte strip is out too long, it's not good anymore and reads low. So I fed him his meal, 1/3rd of a can of DM, and some saucy stuff to get him to eat it. and than attempted a few more times to get him to let me check his blood sugar, but poor kitty thinks i'm trying to kill him and doesn't want to come out of the bed except to cry for food.
2 hours later i gave him 2 units of lantus, and left dry food out, went to bed, kitty slept on the foot of the bed fine all night.

this morning at 6am his blood glucose was 102, so i'm going to hold his insulin, because i have to go out till 11-12am. bc i have a drs appointment.


any advice on what to do would be great. the vet was clearly not quite right in the just increase his insulin levels more if his bs is in the 40s, or even 100, at meal times. i don't want to kill my cat. I am so glad to have found this message board

thanks

-melissa and satan
 
Re: i'm new here and i could use some help.

Hi


You did the right thing of not giving him 4 Units of Lantus.


Fructosamine of 678 is very high but if you have been feeding him dry food that could very much explain such high numbers.


What has he been eating for menue so far up to becoming diabetic?


If high carb dry food is taken away and one only feed low carb wet food or low carb dry food, the glucose level will drop significally, so you should go very easy on the insulin dose you are giving then.

Others will come along and write more. I am in Sweden and can't advice you on good low carb food over there besides that you have a look at Binky's food list.
 
Re: i'm new here and i could use some help.

Welcome to the FDMB family, Meliisa and Satan (LOVE the name!)! cat_pet_icon

I'm heading out the door for work so will keep this short. In my signature is a link for Janet and Binky's food list. We aim for at least <10 carbs for food. While Satan is eating the MD, great, but most cats quit eating it in short order (they just don't like it much). The MD can be returned to your vet if this happens (or if you decide to quit offering it - just tell the vet Satan wouldn't eat it).

Going all wet canned low carb is best for trying to manage a diabetic kitty.

A normal, non-diabetic kitty's BG will range from 40-120. The numbers you are getting do not call for insulin, but i'm sure other Lantus users will be along to help you soon.

Have a great day and welcome again! cat_pet_icon
 
Re: i'm new here and i could use some help.

Good morning Melissa and Satan, and welcome.

Great news that you're testing his blood sugar at home and congratulations on successful testing! I'm certainly no expert in dosing, but readings of 42 and 100 are troublesome for that high of a dose. Four units of any insulin is a very high dose to start out with, and you might want to consider reducing it significantly until you get more data from testing that would indicate that high of a dose is needed. Most people on this board (and they have a tremendous amount of experience with feline diabetes, much more than most vets) recommend a starting dose of one unit twice per day.

The Lantus advice givers will be along shortly, I'm sure. In the meantime, a little more information for them will be helpful. When was Satan diagnosed and how long have you been giving the 4 units twice per day? Have you changed is diet since his diagnosis? If so, how long after diagnosis? What brand and type of foods are you feeding? What type of meter are you using?
 
Re: i'm new here and i could use some help.

Hi Melissa,
I'm very glad you are familiar with human diabetes because you are spot on about 4U of Lantus being too much to start for Satan. Thankfully you are hometesting already, even though I know it can be challenging to get Satan used to the routine.

I can't spend a lot of time online this AM before work, but here are some links to get you started with using Lantus and keeping Satan safe.

Information on remission in cats:http://petdiabetes.wikia.com/wiki/Remission#Proposed_Mechanism_for_Feline_Diabetic_Remission

BG levels for cats: http://petdiabetes.wikia.com/wiki/BG_levels

Protocol for tight regulation with Lantushttp://www.tillydiabetes.net/en_6_protocol2.htm

Hope these help. Also, if you change diet to low carb, Satan may not even need 2U of insulin BID. 1U is much safer to start, even if he is an large or overweight cat.
 
Re: i'm new here and i could use some help.

Wanted to drop in and say welcome! I was ( my sugar Bean is in remission) a PZI user, so I will let the lantus folks do more advising. But, I will say that 4 units seems terribly high - wow!
and if the diet has changed, so will the amount of insulin.
Just wanted to say welcome and bump this thread up some!
 
Re: i'm new here and i could use some help.

Not a Lantus user but wanted to say "Thank God you were hometesting". Way too high a starting dose and by you immediately getting in to the hometesting you saved your kitty's life.
 
Re: i'm new here and i could use some help.

HI Melissa, welcome to you and Satan. I'm a newbie myself (Sitka dx'ed in December) but wanted to welcome you. I also use Lantus and from everything I've learned its a 12 hour insulin more designed for long term glucose management. Everyone here (and fortunately my vet as well) advocates starting at 1 unit and staying with a dose for at least 4-5 days. I'm certainly glad you are home testing because as a nurse you know hypos are dangerous. Sitka's numbers the first three weeks were all over the map. I stayed with a 1 unit dose and now she is very consistent with numbers in the 150 to 250 range. So I think you need to lower the dose, hold it for a few days, see how Satan's numbers are running before changing the dose. There is a spreadsheet you can download and use so you can see how Satans glucose numbers are trending. Give your little furbaby a pet from me. Jan
 
Re: i'm new here and i could use some help.

Hi, thank you everyone for your prompt attention,

i should have been more clear,
satan was diagnosed 12/23 after i noticed his thirst and increased urination. so to the vet we went, they were skeptical, and than said he was very much so diabetic, and that i should start him on 4 units of insulin, lantus bid, and to bring him back in a few weeks for a follow up blood test,
after a month of lantus, on about 2 weeks in we switched to the purina DM wet food, this week i switched to purina dm dry food mixed with his old friskies dry food.

satan pre-diabetes would eat 1.5 cans of food a day, pretty much anything, mostly friskies. and some dry food, maybe a cup a day. when i thought he was diabetic, i changed him to some of the foods listed on the diabetic cat lists (ex binkys)


vet instructed to start him eating 1/2 a can a day + leaving out 1/4 cup of dry food for him. - 1/2 a cup of dry when i go to work at night because i am often gone 15 hours at a time. which sucks for regulating the cats blood glucose but i have to work.

i started off giving him as directed by the vet 4 units of insulin when i could 12 hours appart, and on my own accord would give 3 on the doses that i knew the next one would be early, and 4 units when i knew the next dose would be late.

1 month fructosamine level of 678 was after following the above insulin schedule and the above feeding schedule,

yesterday in the AM i had given him the 4 units, fed him as i have been, and took his blood sugar at 6pm(ish) got 42, fed kitty, gave 2 units at about 8, tested blood sugar again at 6 am. was 102, fed kitty, with no insulin.
i am going . or have been trying. to get him out from under the bed now that i am back from my drs visit. kitty doesn't trust me. he was okay with insulin shots. but he's not into this ear pricking thing


i hope i clarified everything.
 
Re: i'm new here and i could use some help.

alright so 11:25am blood sugar 519
he was probably very upset and stressed. because it took 3 or 4 ear sticks to get the test done. my poor kitty

i am going to give him 2 units of insulin right now, and try and keep him on the 2 units every 12 hours as much as possible and as soon as i have a few days off, hopefully this wednesday i am going to do a curve, poor kitty is so unhappy with the ear sticks. he wont even let me pet him, and hes quite a cuddly cat.

thank you everyone.

any continued advice would be great.
 
Re: i'm new here and i could use some help.

It helps to give a special, low carb, treat that is only for pokey pokes time...something he will learn is special...just like he is! :-D

I also made sure I would pick Poopy up and love on him, even when he didn't want it and would turn away, so he didn't associate me picking him up as always being pokey poke time.

He now comes to me and purrs during pokey pokes...he wants that treat! (And knows momma bean still loves him. ;-) )
 
Re: i'm new here and i could use some help.

Welcome to FDMB.

Sue/Oliver posted on the Lantus board that you were seeing some "odd" BG numbers for Satan and asked that some the us that are familiar with Lantus in cats stop by.

First, I'm somewhat surprised that Satan will eat DM. Most of our kitties are not fond of the stuff. (Read the label -- it's primarily animal by-products.) While the carb count isn't awful (7%), you can do better. In fact, you could be feeding a premium, human grade quality cat food that's lower in carbs and costs less than the prescription diet. There's no magic with DM. Lisa Pierson, DVM has an excellent website on feline nutrition that you may want to take a look at. We also have food charts -- Janet & Binkys and this spreadsheet with nutritional values -- that can guide you through finding low carb food that Satan will like. While lower than 10% is viewed as low carb, most of us feed substantially below that. (I feed my guys Wellness chicken or turkey -- 4% carb.)

With respect to dose, was Satan started at 2.0u BID or did you work up to that dose? If it was 2.0u, that's a large starting dose. It's not surprising that you are seeing wide swings in BG numbers. I suspect that once you get home testing under your belt, you'll see that Satan's numbers are dropping and then he's bouncing into high ranges. I would not do anything yet with his food until you feel a bit more comfortable with home testing. Many cats experience a drop in numbers if you reduce the carbs in their food. You may find it helpful to set up a spreadsheet so you can keep track of Satan's numbers. It will also help us if you want input regarding dose if we can see your cat's progress.

Numbers in the 40s on Lantus are on the low end. When you see numbers below 50, a dose reduction of 0.25u is warranted. For now, I would not suggest that you give a shot if Satan's BG is below 200. Until you have a better sense of how his numbers are ranging, you want to be sure he will be safe after you give an injection and not risk hypoglycemia if you're not available to monitor. Because we typically make dose changes in 0.25u increments, you may want to look into getting syringes that are marked in half unit increments. Most of us order our syringes on-line or use Walmart's Relion syringes.

With regard to testing, are you giving treats? The best way to acclimate your cat to getting his ear poked is with treats and lots of praise/affection. Many of us use freeze dried chicken or salmon, jerky style treats, or even cut up cooked or raw chicken as a treat. (Basically, anything that is pure protein works just fine.) Satan gets a treat regardless of whether the test is successful or not. The idea is to provide a positive reinforcement for his putting up with the ear poke so he associates the poking with a treat. Cats really will work for food! You want to make sure you are testing between the vein and the outer edge of the ear. If you poke the vein, you get a lot of blood. You also want to use a wider gauge lancet in the beginning -- something like a 28 gauge lancet. The wider lancet will make it easier for you to get blood with fewer pokes.

Home testing and food are the best places to start on this journey. There is a great deal of information regarding Lantus in the starred, sticky notes at the top of the Lantus board. We follow a particular approach to dosing on that board (Tight Regulation) that has a very strong track record for getting a newly diagnosed cat into remission. It does require a bit more work than a "Start Low, Go Slow" approach. Which ever method of dosing you opt for once you've had a chance to get the basics down is fine. The support is here for you. The people on FDMB are extremely generous with their time and their information. If you have questions, please ask. We're here to help you and your kitty.
 
Re: i'm new here and i could use some help.

again, thank you

satans bs tonight at 6pm is 551,

clearly his diabetes is out of wack.

i have to go to work, and will give 2 units insulin


for clarification: the vet had me start him on 4 units bid a month ago,

i am going to cut back to 2 units, and work back up, because something was out of wack with the vets instructions,

i will continue to do the low carb / dm food.

thank you sue/oliver and sienne gabby, and everyone else who stopped by to offered advice and help

i am quite a little bit of a nervous wreck with regards to kitty, who won't eat his post prick chicken. he's not my friend these days. and i feel a lot less alone in this cat diabetes mess. and i am reassured that he despite his blood sugars, looks and acts pretty normal. aside from the distrust.

-melissa
 
Re: i'm new here and i could use some help.

That is very odd your vet prescribed such a high dose right away. Curt was in the 400-500 range during his intial test and diagnosis at the vet last week and they only put him on one unit of PZI. I have not been home testing yet but he seems to have improved almost immediately despite being only 5 days into the shots. Although he still seemed very happy and playful, he was losing a lot of weight and drinking constantly. He tested 260 today about 6 hrs post shot and they told me that was very good. I imagine anything more than 1 unit would make him go too low. :( I also have to work 10 to 12 hours more at a time so Im not really home to observe him, which is really worrysome at times, so i understand. I hope Satan gets regulated soon.
 
Re: i'm new here and i could use some help.

dollsinmyeyes said:
vet instructed to start him eating 1/2 a can a day + leaving out 1/4 cup of dry food for him. - 1/2 a cup of dry when i go to work at night because i am often gone 15 hours at a time. which sucks for regulating the cats blood glucose but i have to work.
Click to expand...

The dry food left out dyuing the day is probably why your cat's blood glucose levels are high. Even a low carb and/or grain-free dry food can keep blood glucose levels too high.

Solution to long work days that most everyone here uses: a programmable timed feeder and fill the compartments with low carb canned food :thumbup canned food will be ok if left out all day. Some people add water to the canned food or freeze canned food into cubes to slowly defrost for meals later in the day. The PetSafe 5 compartment feeder is a popular one.
 
Re: i'm new here and i could use some help.

Most cats like to graze throughout the day though... Curt eats 4 or 5 bites and then walks away... probably does that every 30 minutes throughout the day. Im not sure if I should stop this or if its okay?
 
Re: i'm new here and i could use some help.

My opinion is that your cat was started on a huge dose and may now be in a chronic rebound situation. I'm not well versed in how to bring them out of that, but personally, I would totally drop back to 1 unit bid. I wouldn't shoot low numbers right now at all. I'd even be tempted to let that criteria ride a little high, like at least 250 before shooting so you can get out of this wild swinging.

I would also get something he LOOOOVES to eat, deli chicken or turkey or bacon or something, and start plying him with that when testing. Not sure if you know how lantus works, but the cat builds up a shed and once capacity is reached, you can start getting some major action. He was soooo low and now has swung so high, it seems to be a matter of time before he starts crashing down again. With testing, you can figure out where to go with dosage, but I sure as heck would pull way back. Practice testing with treating and write those numbers down so you can see what is going on more specifically. I'd say you should talk to your vet, but I'm not really sure what this vet's experience with diabetes is considering the dosage. Once you get a handle on things, you could consider switching to a better low carb wet food from the list Sienne gave. He will be your friend again, and pretty quickly if you reserve that special yummy for testing time. Thank goodness you are testing.
 
Re: i'm new here and i could use some help.

ThomasCat said:
Most cats like to graze throughout the day though... Curt eats 4 or 5 bites and then walks away... probably does that every 30 minutes throughout the day. Im not sure if I should stop this or if its okay?
Click to expand...

It's true dry food makes regulating blood sugar harder, especially the higher the carb. I always left wet food down for Pearl though. And I fed her pretty much breakfast, a lunch, dinner and bedtime. It's way more about the carb count than having specific and strict feeding times. Pearl was never comfortable under 100 and she seemed to know that she needed to eat to feel better if she got low.
 
Re: i'm new here and i could use some help.

When I put my cat on wet low carbs his insulin needs fell through the floor (from 3U twice daily to 0.25 at present). So removing the dry food might help.
He wasn't happy with the ear testing (my first fortnight of it was miserable hell, or maybe that's how I'd describe Akbah)
now we have a routine in which
-i hold the warm sock to his ear and stroke him 30 times, I had to make him stay for that but he decided he likes it
-then i prick his ear (after 10,000 pricks, his ears are easy to bleed now, so this has become suddenly easier for the rather grim reason of constant sticking)
-then I hold his ear with the tissue and stroke him 20 times, he likes it more or less but is more interested in the next bit
-then I give him a bit of low carb treat, which he loves more than the world. but I think i've discovered that the low carb treat has sugar and we have to stop with it and find another. sigh.
-or sometimes instead of a treat i brush his cheeks with the brush. he absolutely loooooves the brush so this works.
BUT it has taken a while for us both to work out this routine. I had to be pretty pushy for quite awhile and it involved a fair bit of dragging grumpy cats out from under beds and being avoided.
 
Re: i'm new here and i could use some help.

Welcome to the FDMB. LIke Sienne, I'm also popping over from Lantus Land.

She explained that it appears Satan has been getting into very low numbers and then bouncing back up into high ones. This is caused by the liver reacting to numbers it is not used to and so, in trying to protect the body, releases counterregulatory hormones and glucagon into the blood to bring the BG back up to what it come to perceive as safe numbers.

One of the things that might help Satan is if you put Neosporin with pain relief ointment, not cream, on his ears after you poke.

Dry food is slow to raise the BG but then it keeps it elevated for quite a long time...every cat is different (ECID) and so it's difficult to know how long it would affect Satan's BG. As you slowly convert Satan from dry food and DM to low carb foods, you will have to be sure you can monitor/test him as his BGs should come down. But again....it is important for you to be able to test to monitor him before you make the switch. And we also highly recommend that you never shoot insulin without testing first.

As Sienne stated and is important for you to understand, there are two protocols you can use for lantus but in neither do we raise or lower the doses by the increments your vet has suggested. By doing so, then you could easily be missing his "fitting dose" or the dose where you can get him into normal numbers of 50-120. Both protocols give you information on when to take him up, when to reduce, and by how much.

In my signature block are links for Handling Low Numbers and Dealing with Low Preshots. As Sienne stated, for now and until you build up more data, you should probably not shoot any number below 200.

We're all here to help so please let us know when you have questions.
 
Re: i'm new here and i could use some help.

just wanted to add my welcome, melissa. i'm also a lantus user that follows the Tight Reg protocol. you're surrounded by people who are glad to help you with whatever you need.

first thing is getting the hometesting down. that's what keeps satan safe while using insulin.

second is addressing the food issue - canned low carb is the very best. you can leave it out for hours and it will be fine. add a little water to mookie it up so it doesn't dry out.

if you're techy enough to get the spreadsheet, it really helps. those of us who use lantus can "read" the spreadsheet numbers and trends and tell you what you need dose-wise.

i agree with the "don't mess with the food until you're testing" because you don't want to cause a hypo incident from taking away the carbs without adjusting the dose simultaneously.

we've all been in your shoes. we understand it's overwhelming. we understand that most vets aren't all that experienced with feline diabetes and the quirks of using lantus. some are, but many are not. we'll do our best to give you a hand. we understand feline diabetes - all of us do it 24/7 all year around.

we'll teach you what you need to know to keep satan (ha - bet there's a story there!) safe and help him get back to feeling good.

ask questions. and breathe - he didn't get this way overnight and it will take a while to help him recover. but now you're not alone in it. :YMHUG:
 
Re: i'm new here and i could use some help.

Thank you again.

I am at work, and I am printing out whatever I can. so i can read and figure out what is the best thing to do for now.

I am going to attempt to set up the spread sheet when I get home, and I will feed him what he wants. and keep it to canned foods that are considered lower carb foods. When i go to work at night I am reluctant to leave no food out until i can get some sort of auto feeder, so ill continue to leave out some dry food, but just a little bit. he only ever eats the dry food if he is desperate anyway.

I do think I put him into some rebound sort of cycle of hyper/hypoglycemia with too much insulin. Shouldn't have listened to the vet. I questioned the doses and the proceedures, and she poo-poo'ed it. But probably because she just doesn't know. But clearly you guys do. and I guess i will soon.


Since is came up about his name, Satan is a 11 year old cat I've had since he was born, he was the run of the litter, all white except for his tail, one spot on his back, and his devil horn shaped spots, he is one of those sweet large cuddly devoted cats, at least until i started poking him with needles all the time. he's also a big cat! he weighed about 25 lbs prediabetes, and isn't too fat now at 20 lbs, the vet said he's not obese but not thin, but he's more scrawny than i've ever known him to be his whole life.

I am very eager to have a day off when I can start testing his blood glucose all day long, and I think i will keep him on 2 units of lantus BID because his levels are too high, unless after reading both protocols i think something might be better.

Im going to see what i can get as tasty low carb treats. the bacon idea might work. he likes meat. he won't eat freeze dried stuff though.

how much do most people with 20lb cats feed their cat? I was probably over feeding him pre-diabetes, cuz i fed him whatever he wanted to eat. The vet directed me to start feeding him a lot less than i used to. and i feel like he's always starving. he always wants food. :x poor kitty

and again thank you! hopefully soon enough ill get this all managed and sorted out. a few nights ago i debated trying to find him a new home, or
 
Re: i'm new here and i could use some help.

There's a list of low carb treats here: http://www.felinediabetes.com/FDMB/viewtopic.php?f=14&t=9172 There are some non-freeze dried treats you can feed.

The general rule is to feed about 20 to 25 calories per pound of ideal body weight. Since diabetic cats can't utilize food nutrients properly and are always hungry, you generally want to feed as much as the cat wants but without causing a huge weight gain. A 20 pound cat might need a 5 ounce can split into small meals throughout the day.
 
Re: i'm new here and i could use some help.

If Satan likes meat...cut up a raw chicken breast. I put about half a dozen 1/2" cubes to a baggie and freeze them, thawing one baggie at a time. I microwave one cube for 5 seconds to take the chill off. Each time you poke, Satan gets a cube. Poopy goes nuts for his raw chicken!

Not only is it a yummy treat, it's good for their teeth and zero carbs! :-D
 
Re: i'm new here and i could use some help.

The massive size of your cat might explain the very high initial dose. Some protocols advise a starting dose of 0.25-0.5u bid per kg of ideal weight depending on how high the blood glucose is at the time of diagnosis. If your cat is not a major fatty at 20lbs (~9kg), then you've got a really large cat and 4u might not have been totally unfounded from your vets standpoint. That said, starting low and working your way up is definitely safer from a hypo point of view, especially if your work has you gone for long periods of time. Changes in food can have a big impact in insulin requirements, so careful monitoring is a good idea whenever you switch things up.

How many calories per day depends so much on the individual cat that the ranges of calories per pound are really just crude starting points. I just aim for feeding a consistent amount each day and monitor the weight changes over a couple of weeks. Adjust the calories up or down accordingly.
 
Re: i'm new here and i could use some help.

home from work. managed to corner kitty and do a glucose check, 346 at 10 am, which is 15 hours post his last lantus 2 unit shot.
at least its a better number than 42, or 559. i will continue to do checks before every insulin shot, and tomorrow i will do a curve


all your hints were very helpful...

the neosporin with pain relief helped with the prick, as did not using a lancet device and just poking his ear. today we got our stick over with one try. yay. i also lured him near me with a little bit of ham.... he had a bite or two of his wet food. i am going to work on switching to some tastier choices than the DM. he's not such a fan of chicken. he's picky. he likes saucey cat food. that im sure isn't good for a diabetic cat.
he still tends to eat almost anything i leave out. he's always hungry. oy vey. he's been known to steal cheese off pizza if you don't pay attention.

and tomorrow i will work on the spreadsheet.

you are all too kind. Thank you (everyone i can barely keep track) so much.

i am much happier tracking his blood glucose. the way the vet wanted me to do things just did not sit right with me
and i am glad you all agree.

-m
 
Re: i'm new here and i could use some help.

Thank YOU for wanting to take care of your baby!


We (Simba & I) don't do ear testing, we do paw testing and here is pictures of Simba being tested. http://www.kattdiabetes.se/70116292 His treat is to be held by me and cuddled and then he gets kisses and hugs. He is very tolerant as long as I use the left back paw and as long as he doesn't have to go to the loo :-) He was easy to teach to sit and do this, since 1. the nurses at the hospital started him off with getting paw tested, and 2. this is how they sit when we cut the nails so he wasn't uncomfortable sitting like that.

I was terrified in the beginning when given the first insulin shots and doing the blood testing, that he would scratch and bite me.

Good luck with the testing and getting the spread sheat!
 
Re: i'm new here and i could use some help.

dollsinmyeyes said:
he likes saucey cat food. that im sure isn't good for a diabetic cat.
Click to expand...

You're right, the gravy tends to be high in carbs, so good to have on hand in your hypo kit but not so good for regular feeding.

I trick Poopy by adding water to his food to make "gravy". He laps it up!
 
Re: i'm new here and i could use some help.

Brian said:
The massive size of your cat might explain the very high initial dose. Some protocols advise a starting dose of 0.25-0.5u bid per kg of ideal weight depending on how high the blood glucose is at the time of diagnosis. If your cat is not a major fatty at 20lbs (~9kg), then you've got a really large cat and 4u might not have been totally unfounded from your vets standpoint. That said, starting low and working your way up is definitely safer from a hypo point of view, especially if your work has you gone for long periods of time. Changes in food can have a big impact in insulin requirements, so careful monitoring is a good idea whenever you switch things up.

How many calories per day depends so much on the individual cat that the ranges of calories per pound are really just crude starting points. I just aim for feeding a consistent amount each day and monitor the weight changes over a couple of weeks. Adjust the calories up or down accordingly.
Click to expand...

According to the AAHA dosing guidelines, the max starting dose even when using a weight based formula should not be more than 2u: http://www.aahanet.org/PublicDocuments/AAHADiabetesGuidelines.pdf
 
Re: i'm new here and i could use some help.

I hope things are going well! Hang in there.

25 pounds...wow. When can we see a picture? :lol: (preferably next to some standard sized object to compare scale and size :-D )
 
Re: i'm new here and i could use some help.

my felix, who we fondly referred to as The Moose, weighed 24 lbs at one point. poor guy was on a diet for the last couple of years of his life. 1/8 cup of dry food am and pm. and he always seemed hungry and never seemed to lose weight! i loved that "little" guy!

btw, cats need to have very slow weight loss. i don't recall the percentage, but it's slow. their livers can clog with fat if it's too fast. usually newly diagnosed cats are starving. their bodies aren't getting the nutrition they are eating as long as their blood sugar is uncontrolled. his appetite should improve as his numbers improve.

just reminding you to NOT switch completely over to low carb canned food until you've got the testing down. with lantus we are looking for 4 tests a day to keep the cat safe. one test before each shot to make sure it's safe to shoot - for a newbie we recommend not shooting under 200, and a test somewhere mid-cycle so we can see how low the dose is getting the cat. lantus dosing is based upon the low numbers of each cycle.

sounds like you've seen both the Start Low Go Slow and the Tight Regulation Protocols. do you have questions we can answer for you?

the way lantus works - it wants consistency. same dose, same time of day, 12 hours apart, mostly the same food & carbs. if you change things around you'll get wonky numbers and it's hard to see what the dose changes need to be. a late dose acts like a dose decrease and if you shoot early it acts like you've increased the dose.

i'm not sure about giving a cat pork - i read somewhere that cats can't digest it. that's the reason it's not in any cat foods. i think i'd look for something else.

good job on getting the test in today! wahoo! you're doing great and it only gets easier!!!
 
Re: i'm new here and i could use some help.

Julia & Bandit said:
According to the AAHA dosing guidelines, the max starting dose even when using a weight based formula should not be more than 2u: http://www.aahanet.org/PublicDocuments/AAHADiabetesGuidelines.pdf
Click to expand...

Yep, and according to http://www.uq.edu.au/ccah/docs/diabetesinfo/link3.pdf (Marshall and Rand, protocol for an infrequently monitored cat), there's no mention of an absolute max starting dosage. I'd definitely agree that it was a scary high dose and a good thing Melissa was testing. I guess my point is it's not easy for a generalist vet to keep up to date on every new advance especially given how fast things change and that the expert specialists often disagree, and even often disagree with themselves a few years later.
 
Re: i'm new here and i could use some help.

Ann & Scatcats said:
Thank YOU for wanting to take care of your baby!
We (Simba & I) don't do ear testing, we do paw testing and here is pictures of Simba being tested. http://www.kattdiabetes.se/70116292
Click to expand...

That's interesting, I'm glad you posted that link. I have wondered about paw testing but when I tried I didn't get any blood and I was scared to hurt Ak. I couldn't find any pictures of where people put the needle. My next question is, what angle to you go at? Straight down into his paw? Or across?
 
Re: i'm new here and i could use some help.

unfortunately i can not help but give his shots off sometimes.

i work 12.5 hour shifts as a nurse.and it takes me about 14-15 hours to get home. and if i work 2 nights in a row i am only home for 9 hours.

i know this is not ideal but i can't afford to take care of myself much less the cat unless i work

so off schedule i will be i suppose. and hopefully not killing my cat.

15 hours post last lantus 2 unit shot. satans bs is 568. im giving him 2 units and feeding him half a can of food. i tried to feed him less yesterday but he ate it all and cried for more......... poor kitty likes to eat.

ill give up the ham. - i went with ham bc someone suggested i fed him bacon as a treat, and i knew he was fond of ham-

turkey is okay right? he seems to be sort of lured in with the ham.

and again for clarification purposes...... i gave satan a month of 4 units lantus bid wiht out checking his blood sugar. and i feel rather guilty about not trusting my own gut that that was wrong. it seemed so not right to me. i should have investigated further....... thankfully he seems fine.

tomorrow i will do my best to do a curve. and we'll be on q 12 hour shots whenever i can manage to get them done....... i wish i didn't live alone right now. so someone could help! hahaha. i need a cat sitter.


on the spread sheet---- what does amps and pmps? is that hte blood sugar when you give teh shot??

thank you all again. you are great!
 
Re: i'm new here and i could use some help.

amps = morning preshot before food or insulin
pmps = evening preshot before food or insulin

When I say before food that is before his actual meal, not his testing snacks...And yes turkey is great! A lot of the time I get a whole turkey when they are on sale and then cook it, debone it and freeze what I'm not going to use up in the next couple of days, and defrost the rest as needed for Musette's pokey treats. :-D With 13 cats, who all want a treat when their sister gets her ears poked ...One turkey goes a long ways for very little out of pocket for mom.

Mel, Maxwell, Musette & The Fur Gang
 
Re: i'm new here and i could use some help.

turkey it will be for the next set of pokes.

ahhh satan is back to his purring self. although still kind of scared of me touching him, i haven't heard him purr in days, when usually it just takes me calling him to set off a purr...

one more question and than i have to go to bed. and stop obsessing over my cat.

any one have any advice to avoid poking through cat ears? it happened with the lancet device, but i think i get better results free poking, but i keep piercing his ears. and it makes me feel terrible... maybe

and i thought getting blood out of newborns heels was hard..... (i'm a l&d nurse) cat ears. oy vey. its torture for me and him still. his right ear will never bleed enough for the machine to not error. i'm using a bayer contour. i find it errors a lot. sucks up the blood and tells me its not enough. i think i'm spoiled by the accucheck we have at work that requires a massive amount of blood but you have 10 seconds to add more drops.


thank you mel and brian, and so many other people who have offered their advice.

spread sheet will be worked post my nap. i've been keeping a notebook so far.

thanks again
 
Re: i'm new here and i could use some help.

I started out free handing and now I've moved to the lancet device. I am able to have it on just the second shallowest depth now. Once I figured out where to poke, I could use a shallower poke. Also, toward the tips of my cat's ears is a thinner area, so I have poked through before. But on my cat, it's easier to get to the outside of the vein up higher (further from that foldy thingy!) so the shallow setting works nicely for us there. When I was free handing I was creating much larger bruises. I know that some people like each method, so you just have to figure out what works in your hands!
Thicker gauge lancets, smaller number, may help also--you can get a better poke with not as much depth. However, I found the wider ones to be HARDER to freehand because they weren't as sharp and my hand was hesitant.
Interestingly, I can also get a good stick on the opposite edge of the ear than is shown on any demo. Sometimes I do that now too. My cat has white ears, though.

Look here for advice I got. Yeah, I was still figuring this out on Jan 11 so you will learn fast!
http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=60857
 
Re: i'm new here and i could use some help.

I have to second the 26 or 28g lancets. I had a terrible time getting any blood until I switched to those. I feel a little bad b/c I think they hurt a bit more, but then I was no longer poking her 20 times to get a drop of blood, so I think they were better overall.
 
Re: i'm new here and i could use some help.

I have recently found that if I do a prick, and look and pause, nothing happens. But if I do a prick, then keeping the tissue behind the ear for a base, gently slide my finger along the edge of his ear from his head to the spot where I pricked, a drop of blood comes out. Ah, friendly drop!
 
Re: i'm new here and i could use some help.

I use the Contour as well, and I wasted a lot of strips on errors at first. But you learn to distinguish the proper blood droplet size. The Contour uses .6 microlitres which is small. The blood has to touch the end of the sipping track. Older meters require 3-5x as much, maybe more. Just make sure you warm the ear up... a minute at least. A small amount of Neosporin or vaseline can help the blood bead better and not soak into his fur. And after you do the poke, gently stroke his ear towards the poke spot to help the blood bead up. I use the lancet device on the middle depth setting and I rarely put it through Scooter's ear any more, usually only if I push on his ear too hard. And even when I do, it doesn't cause any issues. You will get the hang of it. Just always remember to give him treats, even with the unsuccessful pokes.
 
Re: i'm new here and i could use some help.

Hi,
I'm also a lantus user and Racci is a big cat (about 18 lbs). She was getting 4.5-5U bid but is in the process of changing to 4-4.2U bid BUT she started out at 2U of PZI at that time and was gradually increased by half units and switched to Lantus which has been much better for her. I am about to update her ss, sorry. I have crps/rsd so can't always type. but you can look at old history if you want on 2 ss's. I would start him on 2u given his weight and only bid given Lantus and it's way of building up as the experts have told you. You have been given great advice. I just wanted to let you know that large doses are not uncommon on lantus for big cats, just not a good way to start for the reasons already given. I agree with everything else you've been told, just don't think 1U will do much for him.

Good luck & welcome!

Melanie & Racci
 
Re: i'm new here and i could use some help.

so i'm working on a spread sheet. i am much less tech savvy than i thought i was . i don't think my colors are showing up right in the spread sheet to highlight the doses. and how sad but i don't even have a clue how to make a signature on a message board

a lot of my shots are given off schedule. on the nights i work back to back i am only home for 9 hours. so i am trying to figure out how i should adjust those doses. but i am just kind of lost. i am off until friday night so ill be trying my best to keep him on a schedule.

i think satan needs more than 2 units of insulin? anyone else agree? or am i just totally wrong? do i need more data? tonight/tomorrow ill be doing as many tests as i can get kitty to let me. at least my testing skill is improving. tonight we got the test over in one prick.

at the moment i am getting very overwhelmed by this all.

think i figured out the signature at least. colors are still not showing up

https://docs.google.com/spreadsheet/pub ... utput=html
 
Re: i'm new here and i could use some help.

It's ok to feel overwhelmed. :smile: We've all been there. :-D

I understand about your work hours. And it's going to be ok. :smile: Keep in mind, when you test later (like when you get home from a 15 hour stretch) the numbers will be higher because the insulin is gone or losing it's effectiveness. Hopefully other Lantus users can chime in about the staggered doses. If I understand Lantus correctly, the "shed" needs to be filled pretty close to the 12 hour mark. I haven't used it so I could be wrong. You might end up wanting to switch to ProZinc due to your schedule since it's more flexible.

Bottom line, do what you can when you can. Something is much better than nothing, ok? :-D

Having more numbers, especially during the cycle, will help determine if Satan needs more, less, or the same amount of insulin. At this point, it's very difficult to tell how the insulin is working for him. :smile:

Don't forget to breathe, and we're here for you. :YMHUG:
 
Re: i'm new here and i could use some help.

as kim i believe requested, my fat pooky cat man


rrr well that upload didn't seem to work. if anyone has any advice on how to post a picture. hahaha. i'll share one.
 
Re: i'm new here and i could use some help.

They are big numbers you got there, I see em. I can give no advice about shooting your cat. I can advise you about the board: wait till some experienced voices kick in. Don't raise your shot without lots of consideration ... and normally people say to wait and get a decent amount of data before changing anything. And sometimes people see high numbers and call it "rebound", and suggest lower doses. So my main thought is, hang on and try to get more numbers in there. See if you can get numbers for the early, middle and late part of a cycle. This will help people to think about what is happening for puss.

I see you've got your signature happening, way to go!!! You're doing so well to get this stuff happening, home testing isn't easy to learn, though its alright once you and your cat are used to the process. You should be proud of what you've achieved so far, its all well worthwhile.
 
Re: i'm new here and i could use some help.

thank you....

satans insulin is due in 1.5 hours, and his sugar was 400 2 hours ago, 500 now, and hasn't really had a meal since 11 am, since i missed whatever part of the curve with lows that would happen i think because i was asleep, i feel like he isn't on a big enough dose at 2 units. he's also starving. literally begging and crying for food. and he's gone back to drinking way too much water in the past few days since i lowered his insulin to 2 units instead of 4......

i am going to feed him and than insulin is due at about 9:45pm, if anyone see this before than who knows more about it, would it be unreasonable to increase his insulin a touch? maybe 2.5 units, 2.25 units? sorry for so many questions....
i'm also going to start investigating a vet nearby who has some diabetes experience.


at least the ear pricks are going well now. being a nurse haha sadly only seems to help in being able to have skill with stabbing things or people with needles.

everyone here is so kind and helpful. i really appreciate your time, knowledge and support. because no one wants to hear about cat diabetes.

-m
 
Re: i'm new here and i could use some help.

Yes you have some high numbers but you also have some very low preshot and late cycle numbers, which could mean that those high numbers are coming from his liver releasing stored sugars and counterreglatory hormones.

With as few numbers as you have it is impossible right now to tell if it is too much insulin or too little insulin as they both look exactly alike without data to back it up...but looking at those low preshots and late cycle numbers I would be inclined to say he maybe getting too much, instead of not enough. Just my 2 cents based on what I'm seeing with limited data.

With as erratic as your work schedule is you might do better working with the "Start Low, Go Slow Protocol" http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=61800 Sometimes throwing more insulin at a cat especially if you can't test often is like throwing gasoline on a fire, the numbers only get worse not better, or the cat takes a sudden dive and you have a full blown hypo on your hands.

Personally, if Satan was my cat I would back off the insulin to 1u or less depending on what his level was when diagnoised and follow the Start Low, Go Slow. While testing as often as you can for Ketones. Satan didn't become a diabetic overnight and he isn't going to be 'cured' in a week either.

Mel, Maxwell, Musette & The Fur Gang
 
Re: i'm new here and i could use some help.

I have posted a question about this on one of the Lantus boards, hopefully they will come over and have a look at this predicament for you.
Is your spreadsheet all up to date? I can't see the bit that would show "his sugar was 400 2 hours ago, 500 now"
Head scratches to Satan. How is he? lethargic? thirsty? Okay?
 
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