Introducing Lucian

[nckitties3]

Hi all! Lucian will be 14 in a couple months, diagnosed 01.04.13 and I'm Debbie, the spastic caretaker! :lol: I have had him home since Friday morning 01.11.13 and it has been the most frustrating, stressful thing I've had to deal with in a very long time. Lord, what a weekend it was! Doesn't help any that I was fired on Thursday, so it's sort of a double whammy.

Lucian came home with a vet dose of Lantus 3 units bid, which, after I found this site and the multitude of info, I though was much too high for a 7 lb cat with a low carb diet, so I reduced it to 1 unit bid, low carb food and now NO carb treats and he seems to be doing better, considering he was running 700 at the vet hospital, but no ketones, from what they said. So I feel like he's getting comfortable anyway. I plan to keep him on this dose until I run a curve on him this weekend, then maybe some of you experts could chime in and let me know what you think.

I have a better meter and strips on the way from ADW, stuck with a truetogo right now and have to buy the expensive strips until it gets here. Tried to get a mid test yesterday, but it wasn't happening, he was not cooperative, so I've taken the 'kitty burrito' route and it's working fine and he doesn't even get mad about it. Has his treats after I unwrap him and looks for more. :smile:

Both his water intake and output are much closer to normal, he rarely goes toward the water bowl, except maybe after a treat and he's not flooding the litter box anymore. He does eat often, every 3-4 hrs, but he always ate 'at will' with dry food before this, so maybe that's how often he's always eaten. Hard to tell, when you keep a full bowl out all the time. But now he's on canned, high protein, 50+, low carb, 6 or less, food and I have to feed him every time, he doesn't like leftovers. So he gets about 1/4 can with a couple tbsp of water, he likes it soupy, about every 3-4 hrs. Fortunately, my feral 18 yr old female will clean up what he leaves, so it doesn't go to waste. I have 3 cats and they are all on canned food now, after what I've learned about cat feeding. All this time, I thought I was doing right :YMSIGH: can't beat yourself up over it.

Anyway, just wanted to give you a run down, of course I posted on the cat health board, spazzing out over the weekend, but they got me calmed down and sent me here. :lol:

 

[MommaOfMuse]

Re: Introducing Lucian and his spastic mom

Welcome Deb and Lucian,

I don't stop by here to much these days as my girl has switched from Lantus to Levemir (my choice).But I do try to swing by when I notice a new post.

Oh I remember how frustrating and down right scary it was when I first heard those words "Your cat is a diabetic" even after nearly 3 years and multiple diabetic cats ago. I still remember that first shot and shaking like a leaf, even though I had given my own animals their vaxs for years and years. Unfortunately my very first diabetic didn't live very long after she was first dxed, but I didn't know then what I know now for caring for a diabetic. And while yes, in the beginning it is oh so frustrating and nerve-wracking it does get much much easier, I promise!!!!!

How do I know that because I have 12 healthy and happy civies (non-diabetics) running around this house and I elected to adopted not 1, not 2 but 3 more as diabetics..I currently still have two of those diabetics, sadly Musette my second diabetic passed away this spring from anemia after she was miss dxed by a vet at an ER vet, but my first guy has been in remission now for 2+ years and my third Autumn is working her way down the dosing scale and headed that way herself. Plus despite all the healthy kids here we also lost our oldest furry son this November to cancer and have already started looking for number 4 diabetic to adopt. Now as frustrating and as scary as those first few weeks were when my first girl was dxed, if it would have continued to be that much of a PITA to care for a diabetic cat I most certainly wouldn't have adopted 3 more and be looking for number 4. :lol:

You and Lucian will eventually find your groove and it will become something that is very much like brushing your teeth. I have literally rolled out of bed, tested Autumn, given her, her testing treat, recorded the number and crawled right back in bed and gone back to sleep, and then I had to get up in the morning and check her meter in the morning to make sure I didn't just dream I tested her.. :lol: :lol:

But if no one has told you yet, we call this journey that you and Lucian are now on a Sugardance, and just like learning any new dance it is frustrating, you will dissolve into tears, you will trip and fall down, you will somedays feel like you have 2 left feet etc, but once you learn the steps and practice, practice, practice there will come a day as you gracefully glide across the dance floor that you will wonder what you were so scared and upset about in the beginning. The only problem with this dance which makes it unlike any other dance in the world is only your dance partner (Lucian) hears the music that you two are dancing to, but we can teach you how to follow his lead even if you can't hear the music.

Hang in there it does get easier with time and practice and when in doubt post here, or on health or even in the Lantus TR group and someone will be around to answer any and all questions. We will hold your hand and Lucian's paw through it all.

Mel, Maxwell, Autumn & The Fur Gang

 

[nckitties3]

Re: Introducing Lucian and his spastic mom

Thank you so much, just knowing there are others to help, makes a world of difference for me, mentally.

 

[KPassa]

Re: Introducing Lucian and his spastic mom

Welcome Deb! I'm think it's safe to say that most of us spazzed out when we first got the diabetes diagnosis. I see you're already well on your way and have already started posting on the Lantus TR board now. :thumbup Yes, unfortunately the "Relaxed" Lantus board is a bit quiet at times. ohmygod_smile It looks like you've been given quite a lot of information in the last few days and you're seeming to take it all in stride. Can you believe how much you've learned only since Saturday?!? In a month's time, you'll be such an old hat at things that you'll look back and not even be able to remember what the fuss was about. :lol:

But if no one has told you yet, we call this journey that you and Lucian are now on a Sugardance, and just like learning any new dance it is frustrating, you will dissolve into tears, you will trip and fall down, you will somedays feel like you have 2 left feet etc, but once you learn the steps and practice, practice, practice there will come a day as you gracefully glide across the dance floor that you will wonder what you were so scared and upset about in the beginning. The only problem with this dance which makes it unlike any other dance in the world is only your dance partner (Lucian) hears the music that you two are dancing to, but we can teach you how to follow his lead even if you can't hear the music.

Mel, I just wanted to tell you that this was such a poetic representation of everything I've been through the last few months that it brought tears to my eyes. Thank you for such beautiful words.

 

[nckitties3]

Re: Introducing Lucian and his spastic mom

I have to agree, that is beautiful. I'm so emotional over all this, it takes next to nothing to bring me to tears.

But a little sunshine - my Lucian has today experienced 'kitty crack'! Those freeze dried liver treats.....he wants the whole bag! :lol: He is sitting by my chair, talking to me, meowing, wanting me to give him more. I know his numbers are still too high, but he sure perked up!

I'm going to try to stay up and get a +4 if possible. I'm very worried about his high numbers.

 

[BJM]

Re: Introducing Lucian and his spastic mom

If you follow the dose adjustment guidelines in the other Lantus group, you'll be able to increase 0.25 this weekend.

I'm curious why you note you are witholding food overnight. Many cats go lower overnight already.
You need to keep the feeding somewhat consistent both day and night, as Lantus works best when as much as possible is kept consistent.

 

[nckitties3]

Re: Introducing Lucian and his spastic mom

I don't withhold food, I'm asleep and he won't eat it if I leave it out, it has to be fresh and mixed with water.
Because of my own health issues and meds, I can't get up during the night to test or feed, like I said, leaving it out doesn't work, even my old feral female won't eat it after it sets.
I don't know what I'm doing, I'm in the TR group cause at least they are there when I need help, I don't know what I'm following, I'm trying to get Lucian's numbers down and doing a pretty lousy job of it. I have spent 5 days reading this site and I am almost as confused as when I started and that isn't doing Lucian a bit of good obviously.

 

[MommaOfMuse]

Re: Introducing Lucian and his spastic mom

Okay so what is confusing? Lets see if we can get that sorted out for you.

Now as far as Lucian's numbers you have held the 1u long enough so now it is time to raise the dose a little and see if youcan get him to go down a little more. As high as his preshots I think you are probably go up either .25u on the conservative side or even .5 as long as you are around to watch him and test.

Remember what I said about the beginning of learning this dance...that you are going to be frustrated, dissolve into tears, and feel like you have 2 left feet...right? Well that is where you are right now....Trust me Ginger Rogers and Fred Astaire didn't start out dancing together like we see them in old movies...They stepped on each others toes, they fell on their butts and probably had many less than complimentary words with each other..lol. But boy when they finally got it down they sure did look great on that dance floor.

I remember when I first started out and would look at old timers spreadsheets and want to cry because Musette's looked nothing like that she was all over the place, but what I wasn't seeing were those early days for any of them, I was looking at numbers that they were getting after months and months and sometimes years of testing, tweaking doses and dancing with their dance partners. Very few cats do what my Maxwell did and go Bang OTJ those that do are the lucky ones. I have seen cats here go into remission like Maxwell in a matter of weeks or months and I have seen cats that it has taken years to get them there, and then there are those here that will always be on insulin and that's okay too.

One of the things that I think is hard to remember when starting out and seeing the OTJ annoucements is that while OTJ is our ultimate wish for all the extra sweet kitties here it isn't the first goal...the first goal is to get the dance steps down, then comes regulation and then IF it is going to happen remission. And if the only thing that happens is regulation would that really be so bad? As long as Lucian is healthy and happy again would it really be a big deal if he had to have two little shots a day? Nope he will just be like thousands of human diabetics out there.

Mel, Maxwell, Autumn & The Fur Gang

 

[nckitties3]

Re: Introducing Lucian and his spastic mom

Thank you Mommaofmuse.

Sorry I didn't reply sooner, been on TR freaking out over Lucian's crazy high numbers. Don't know if you've been over there, I sometimes forget to look at the names on the posts.

Hopefully I'll get some help with dosing before morning, i.e. I think he needs to go up .5 but want some experienced eyes to check him out and give me some advice.

Frustration doesn't begin to describe it.......I have cried more in the last 10 days than I have in the last 10 yrs. Which is pretty wild for someone who is normally very calm and handles whatever comes their way without going over the edge.......not any more! :lol:

Thanks again.

Debbie and Lucian and the Furkids

 

[Blue]

Re: Introducing Lucian and his spastic mom

Thank you Mommaofmuse.

Sorry I didn't reply sooner, been on TR freaking out over Lucian's crazy high numbers. Don't know if you've been over there, I sometimes forget to look at the names on the posts.

Hopefully I'll get some help with dosing before morning, i.e. I think he needs to go up .5 but want some experienced eyes to check him out and give me some advice.

Frustration doesn't begin to describe it.......I have cried more in the last 10 days than I have in the last 10 yrs. Which is pretty wild for someone who is normally very calm and handles whatever comes their way without going over the edge.......not any more! :lol:

Thanks again.

Debbie and Lucian and the Furkids

OK Debbie, I am going to reply just based on the info on your ss.... there are a couple things that caught my eye. I have to tell you that your comments column is amazing because it's the perfect place to gather all of you info to share with others.

1. 1/12 - you note shots times are 8am/8pm.... excellent to know the shot time and if you wanted, if you are sticking with those times, you can add the time in the heading of the AMPS and PMPS columns... put AMPS 8am and PMPS 8pm.
2. 1/13 - you note food at 730 and 1130 .... if you are feeding 30min before your AMPS and PMPS, you are getting food influenced numbers. It is advised that you don't want your cat to eat any foods for the 2hours before a shot time.... that way any food eaten earlier will have gone through the system and your test number will be true..

I don't know if 1/12 was your first shot, and the dose in the am of 3u was what the vet told you to give, but I will say that you want to hold only the initial dose for 5 days / 10 shots/cycles.... after that dose, in your case the 1unit Lantus, you won't need to hold your dose for longer than 6shots/cycles because you give any resistance a chance to pull back.

The general guidelines followed tightly or loosely are based on the below:
"General" Guidelines:
--- Hold the initial starting dose for 5 - 7 days (10 - 14 cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 cycles).
--- Each subsequent dose is held for a minimum of 3 days (6 cycles) unless kitty earns a reduction (See: Reducing the dose...).
--- Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

Increasing the dose...
--- Hold the dose for 3 - 5 days (6 - 10 cycles) if nadirs are less than 200 before increasing the dose.
--- After 3 consecutive days (6 cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
--- After 3 consecutive days (6 cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

Reducing the dose...
--- If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.

--- If an attempted reduction fails, go right back up to the last good dose.
--- Try to go from 0.25u to 0.1u before stopping insulin completely.

Random Notes...
Because of the cumulative nature of Lantus and Levemir:
An early shot = a dose increase.
A late shot = a dose reduction.

A "cycle" refers to the period of time between shots. There are 2 cycles in one day when shooting twice a day.

Many cats take as long as 6 shots before the new dose settles and the owner can see how it's working or not working. As you watch your test numbers in the ss, you may see a gradual improvement, but that's if you are close to a good dose. One of my cats settled after about 3 shots, but my other sometimes took 5 or 6 shots before I could see how his dose was working. Don't worry; in time, you will see how YOUR cat reacts to dosing. It's like tossing a pebble in the water and there are waves from disrupting the surface.... once the ripples and waves have stopped, it's like a dose settles.
I don't know if anyone has passed along what a curve looks like for some cats.... not all though, the below is just a rough guideline:
Curve showing reaction of insulin
Example of a typical curve:
+0 - PreShot number.
+1 – Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 – Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.

Now, one of my cats would rise till about +2 and then she'd drop till about +5, then start to rise to the next ps. My other cat had a very late nadir and he rose till around +5 and then start to drop to the next ps.... his curves looked like a mountain, but my girl's looked like a valley!
Your test numbers, as you gather them, will tell you how YOUR cat handles and reacts to the insulin.

It would be good if you can get a before bed test each nite. If you got to bed at 8pm, would you be able to adjust your shot times so that you can get a bed time test?
There are 3 most important tests: before each shot, and just before you go to bed. Because many cats do drop a bit lower, it's a good idea to see how that pm shot is doing before you head to bed and turn out the lights.

For the food, even if your cat won't eat at nite or when you are not around, it's a good idea to leave something out overnite because cats DO self regulate.... if your cat goes low in the middle of the nite, he may look for food to eat and bring up his own numbers. Not all cats do look for food, but many do. If you ever see him eating like he hasn't eaten in days, test him.... he may be very low.

If you are having trouble with testing, try to desensitize him by sitting with him and handling his ears often. If he is still wiggling, you can try to hold him more securely, wrapping with a towel like a cocoon may help him to stay still and to feel safe.

The numbers you are seeing are quite high so don't hold the 1.75u dose for longer than 6 shots, then look at the majority of his lowest numbers, and don't go by just one low number. It looks like he's pulling back into the high numbers, so you will need to pull back yourself.
Measuring doses with .25 and .75u are rough with no lines on the syringe barrel, so you could go with a .25u increase next time and then see if you are still stuck in the high numbers. If still lousy high numbers, go with the .5u increases because you want to get him out of the really high numbers.

It's rough in the beginning. We don't know how long our cats have been struggling with diabetes, so some cats just take a bit longer to get to the regulation point. BUT, they all get there. There are plenty of people to help you, here and in the TR forum. Post where you feel most comfort, OK?

This morn was the first shot at 1.75u, yes? Hold onto this dose for another 5 shots and then look at how his numbers are going. If they are staying high, you can up the dose by .5u. If they look like there is some progress, with ps numbers a tiny bit lower each shot, but still fairly high, go with the .5u. And if those ps numbers are looking very good, dropping lower, and your nadirs are also mostly in the 200s, maybe you are getting close and .25u would be a good increase.


Please know that once you start to see those better numbers, you will know that your efforts were worth it. Keep adding water to his food and test for ketones when able. Leave out a bit of watered food overnite to give him something in case he looks for it.

 

[nckitties3]

Re: Introducing Lucian and his spastic mom

Hi Blue,
I'll try to address everything.

I start 30 min before his shot time, to get his BG, fix his food and ready his shot while he's eating. He doesn't eat 30 min ahead of his shot, as soon as he is done, he gets his shot.
Like this, 7:30 get everything ready, rice sock etc, 7:40 BG - 7:45-7:59 food - 8:00 shot.

The vet told me to feed him immediately before his shot each time. Vet had given instruction to give 3 units, twice a day at 8a-8p. The 1/12 was the 2nd dose, I brought him home on 1/11. I dropped the dose because I completely changed his diet from 'at will' dry food to canned low carb food.

Lucian and the rest of the furbabies, eat often, every 3-4 hrs, with treats for tests and shots. Seems like they are always hungry, since they don't have the bowl to go to anytime they want. Yes, all of them are now on low carb canned foods.

I thought I should have upped his dose sooner, but didn't because of not being able to get up at night to test him. I have my own health issues to handle, a lot of medications and my night meds, pretty much knock me out. No one in TR seems to understand this.

The first week was a major battle for tests, finally got better doing it free hand, but by then he was really sore, so I have been backing off a little, to let his ears heal up.

I usually am out by 10, can only get a +2 or +3 before bed and have to set my clock to get up at 7 to start over. I did get up at 5 for a night test, today.

He has no problem eating at night, if I am up to give it to him, they won't eat it is it's been out for even an hour, it has to be fresh.

Lucian is not a lap cat, I try to pick him up and hold him for a couple min, a couple times a day. His only affection was sleeping with me, but he doesn't do that since the vet, except he took a short nap with me yesterday.

Personally, I felt he should have been increased by .5, days ago, but was told I couldn't if I didn't have the night numbers. From now on I'm going to do what I think best for my cat. I'm not sure his dose is accurate since I can't see it, it's somewhere between 1.5 & 2 units, that's as close as I can get, maybe later I can get a headlamp and such to help me see when he needs smaller doses. Right now, I am unemployed, waiting on Worker's Comp and broke. Everybody keeps telling me to buy this and that, I can't. I'm lucky to keep them all fed right now, not too mention, I have no idea how I will get his insulin when he runs out, I can't even buy my own meds for next month, I don't know how we are going to make it yet.

I have tested for keytones every couple days, so far always Neg.

Thank you for your insight.