Introducing myself....DOSING QUESTIONS

Status
Not open for further replies.
KJ & Alfred

KJ & Alfred

Member Since 2013
My 11-year old Alfred was just diagnosed on Thursday. I have read a lot on this very helpful board since I found it. I'm really moved at how helpful you all seem to be, especially welcoming to yet ANOTHER newbie.

I'm just two injections in and looking forward to when it doesn't feel so overwhelming and scary. I'm giving Alfred 2 units of Lantus. The vet has discouraged home testing at this point, despite my objections. I don't care for this vet or have much confidence in her. Unfortunately I live in a small town with only one option. There is another vet 80 miles away who treats my other cat for seizures and I have a call in to her. This vet also discouraged any change in diet until he is better stabilized. He gets both dry and wet but understand that I should transition him to just wet. He wasn't obese at all, so I'm not sure what food will be best for him in the future. My vet offered no information on this yet.

Thank you for letting me join. I know I will learn so much from all of you.
KJ in Alaska
 
Re: Introducing myself....

Hello, and Welcome :-D

Unfortunately, I think most (a very very high percentage) of vets don't encourage home testing. I think I am the only one at my vet's office that home tests.

I would just buy a human glucometer and some lancets and test strips and begin testing. A lot of people use the ReliOn meter and strips from WalMart as they are very inexpensive. You'll want to test before every shot before giving insulin, and try to get a mid-cycle test as much as you can (I can't get mid-cycle tests on the days I go to work, so I set alarms to test mid-cycle at night time, and get day time mid-cycle tests on my days off). The Lantus dose is based on the lowest number in the cycle, that's why this is important. And, home testing is important, as when your cat is at the vet his BG will be higher simply from the stress of being at the vet.

I would encourage you to read the Starred Stickeys at the top of the Lantus Tight Regulation forum.

Please ask all the questions you have, and we will help you to help your Alfred.
 
Re: Introducing myself....

Hi KJ, and welcome!

First, let me say that you are in the best place in the world to help Alfred! A lot of vets discourage home testing, but ultimately, he is your cat and you get to make the decisions. We all home test on FDMB, and when following the unique protocol designed by experts, members, and vets, many cats diagnosed within 6 months of illness are able to go into remission!

Transitioning Alfred to wet is a great idea. In fact, many cats are diet controlled and able to go OTJ (off the juice) just by switching to a low carb diet. Many of us feed Fancy Feast Classic Pates, but there are other options. I will grab the link to a food list compiled by Dr. Pierson, DVM, that lists the nutritional facts for most commercial canned cat foods. Another member, Rhiannon, pared down the list to low carb foods here. For diabetics, it is recommended that you feed less than 10% carbs. I would NOT switch Alfred entirely to wet until you have a meter and are able to test him. His bg levels might plummet putting him at risk for hypoglycemia. To that end, make sure you put together a "hypo" kit to have in case of emergencies. You can read more about this in the Lantus forum (link below)

Secondly, home testing is the surest way to regulate Alfred's diabetes and stay on top of this disease. Many of us use the Reli On Prime (available at Walmart) because it is one of the most economical glucometers available. A bottle or Reli On prime test strips costs only $9.

We use spreadsheets to keep track of our kitty's blood glucose readings. You will see links to our cat's "SS" in our signatures (bottom of our posts.) This is so other members can easily access our records and so we can keep track of our cat's progress. You can follow this link for instructions and the template for using the SS. link to spreadsheet template

Since you're using Lantus, I recommend you check out the Lantus forum and read through the stickies at the top of the page. Lantus tight regulation forum There is a lot of useful information there that will hopefully answer many of your questions.

In LL (Lantus Land) we test at least before every shot (am and pm) and do several spot-checks throughout the day. This is important for regulation and to find the correct dosage for Alfred. Lantus is a 12 hour insulin, so for most cats, insulin reaches its peak half way through the cycle (+6 hours after the shot.) We call this the "nadir".

Again, welcome! Wishing you and Alfred all the best :)
 
Re: Introducing myself....

hi KJ - welcome to the board!

Glad that you've found us :-D

My vet, like most, also discouraged me from home testing - they said it was too difficult, the cat would hate me etc.. But, as I was told here, its your cat - you can do what you want and what know is best for your cat.
There have been a few threads today on home testing - if you read them and need some more advice, let us know.
Home testing is really important - a cat can go hypo and die if given too much insulin. Also, a cat's need for insulin can change due to diet changes, its pancreas starting to work again or something else. That's why we test before every shot.

As you've started with insulin, you don't want to change to wet food without testing - as his blood glucose level could fall a lot and then he would be getting too much insulin and risk a hypo.
Can you pick up testing supplies today? We can help with the testing process and there are some good youtube videos.

2 units does seem high - most of us start on 1unit or .5 unit - remember, once its in, you can't get it out so its better to be safe.
(initial dose = 0.25 x ideal weight in kilograms)

Great that you are willing to actively manage Alfred's diabeties - that's a huge step forward for him :-D
 
Re: Introducing myself....

The vet has discouraged home testing at this point
Click to expand...
Shame on that vet! It is the most important thing we can do to help our kitties.

You've gotten a lot of info so far so just saying "Welcome" :mrgreen:
 
Re: Introducing myself....

Thank you all for responding. I'm sure you've heard it so many times, but it is so comforting to have other people to talk to who have the experience you all do.
I will do my best to get the home testing supplies as soon as I can and keep Alfred's diet the same for now.

Off to read the suggested topics. THANK YOU!
 
Re: Introducing myself....

I had been doing free feeding with kibbles and was in the process of phasing out the Iams and phasing in Innova's Grain Free kibbles. Both cats were also getting 1/4-1/3 can of Friskies wet food each evening with a tablespoon of pumpkin. A previous vet years ago had recommended the extra fiber from the canned pumpkin b/c Alfred had these terribly hard little poops. Current vet recommended quitting the pumpkin for now so we can be sure he's getting enough food. So the only thing I'm changing is no free-feeding. I'm trying to get both cats on the regular two feedings a day.

I also have a question: I was just reading another thread about tips for leaving instructions for a caregiver and came across this "and not to inject insulin back into the insulin vial/pen if she pulls too much up." Why is this?

ETA: I've been able to answer my own question by reading deeper in the Lantus threads. I can't believe the number of things my vet failed to mention.
 
Re: Introducing myself....

There is a silicon coating inside the syringes and once you draw the insulin, if you squirt some back into the vial you would be adding that silicon to the insulin in the vial. With a pen, they are vacuum sealed? and you could damage the pen if you draw out insulin which alters the vacuum and then put some insulin back in again.

A lot of us feed several mini meals per day, as that is easier for the pancreas to handle than two large meals.

I have been using 1 teaspoon of baby food squash to help J.D. when he gets constipated.
 
Re: Introducing myself....

KJ&Alfred said:
I also have a question: I was just reading another thread about tips for leaving instructions for a caregiver and came across this "and not to inject insulin back into the insulin vial/pen if she pulls too much up." Why is this?
Click to expand...

The reason is that once pulled the insulin can be contaminated by the rubber lubricant in the syringe to make it pull easier. If it is injected into the rest of the vial/pen it can contaminate the whole batch and you have to get a new one. If you had just opened and starting to use it that is a bunch of money wasted. It is better to squirt the little into the sink than to risk the whole batch.

Heather
 
Re: Introducing myself....

KJ&Alfred said:
I can't believe the number of things my vet failed to mention.
Click to expand...

Oh I can! My vet told me to give 3U twice a day and watch for Hypo......never told me what the signs were or what to do about it if I saw it. :o
Not a word about testing or diet or any of the things we need to keep our cats safe. ohmygod_smile

Welcome! Glad you found the board. :-D I'm still a newbee, so I have no advice, but just wanted to tell you that you're in the right place, people here will help you, support you and keep you from pulling your hair out. :lol:

I don't know how Lucian and I would have made it without the support we have here. :-D

Best wishes for you and your furbaby. cat_pet_icon
 
Re: Introducing myself....

This is the part where I post and admit I am freaking out. All this information is just so overwhelming and I'm scared I'm not going to do the right thing. I have another cat who was diagnosed with epilepsy three months ago and I'm struggling right now in thinking of what I need to provide for them. Both my husband and I travel a great deal for work (he's gone now and has been for 10 days) and the stress of thinking of how to cut back on the travel and/or find capable and trustworthy caregivers just seems so daunting! My very first night with Alfred home and just hours after my first very nervous injection, Clyde (my other cat) had a massive seizure. I'm sure I'm not the first person to sit here sobbing at their keyboard and posting similar worries. I just need to get it out there.

I have not yet been able to get the supplies needed for home testing, but plan to change that first thing in the morning. I am slightly terrified of it all, but am committed to learning and doing the best I can for both of my cats.

Thanks for reading and I've said it in nearly every post I've written so far, I'm incredibly thankful that this forum exists and the members are so dedicated and helpful.
 
Re: Introducing myself....

Deep breaths...it's ok. We have all been there and we are here for you.

It is a steep learning curve but just take it one step at a time.

Key thing right now is get used to shooting the insulin and start testing.

Here is a shopping list for you..

Getting started shopping list
1. Meter ie Walmart Relion prime, micro or confirm.
2. Matching strips
3. Lancets - little sticks to poke the ear to get blood . new members usually start with a larger gauge lancet such as 28g or 29g until the ear learns to bleed. Optional - lancing tool.
4. Cotton balls to stem the blood
5. Neosporin ointment to heal the wound
6. Ketone urine test strips ie Ketostix or ketodiastix - Important to check ketones when blood is high
7. Low carb Treats for the cat - like freeze dried chicken to reward him for the tests.
8. karo syrup/corn syrup or honey if you dont have it at home - for hypo emergencies to bring blood sugar up fast
9. A couple of cans of fancy feast gravy lovers - for hypo emergencies to bring blood sugar up fast

Wendy
 
Re: Introducing myself....

Sorry to hear about Clyde - is he ok now?

I had a similar situation to you - 3 cats, 2 kids under 9 and we like to travel as well.
Then, 1 month after Honey's diabeties dx, 1 of the other cats was dx with hyper-T and an enlarged heart and the vet said he could drop dead any minute!

I did miss out on 4/5 family weekends away - it was hard to wave goodbye to kids and DH with them asking why I wasn't coming too. But, I hoped by working hard and making sacrifices in the beginning, Honey would go into remission and she has!
We have another family trip coming up in 2 weeks and I'm going. I have someone to come in and feed/do lb but they can't test - my cats aren't very friendly with anyone else :cry:

All I can say is you are at the lowest point now - when you don't know what to do or if you're doing the right thing.
It gets better!!!
 
Re: Introducing myself....

Wendy and Denise,
Thank you both so much for the thoughtful replies. Wendy, I have written out the list and will take it to town with me tomorrow. Denise, I'm glad you are getting to go on the next family trip. And happy to hear about honey being in remission!

I know it will get better, but it's so helpful to hear it, too.
Cheers,
KJ
 
Re: Introducing myself....

Any recommended brand of freeze-dried meat treats? I will definitely have to order online, as my tiny town has little to offer.

I just spoke with the local vet and asked again about the 2U dose of Lantus and that I was concerned it was too high since he isn't eating as much as I think he should. He's interested in the food, but will only eat a bit at a time and I think we're barely breaking 6 oz total for the day. He weighs 10 lbs, so it seems to little. I've left a small bowl of the grain-free dry food out during the night but neither cat seems to have had more than a nibble. I know I should be watching everything they eat, but I'm walking that line between trying to regulate it all and not make too many change too fast, especially since I haven't started home testing. She said "we have a lot of play" with that dose. I don't really know what that means, since what I've been told here and what I've read indicate that it might be high. The vet was not entirely receptive about my testing (I asked if I could come in sometime today and be shown how) and while in the middle of asking her questions about his dose and other things, she just said "well, I have to go do some surgeries". I really don't like her.

There is a wonderful vet who I trust very much about 1.5 hours from here and I'm just on pins and needles waiting to talk to her tomorrow (she has been out since Alfred's diagnosis). I just wish I had a better vet in town.
 
Re: Introducing myself....

We use Purebites freeze dried chicken - sold on Amazon (see link at top of page)
I get the super sized pack for dogs - same food, just bigger pieces but it breaks up easily in your fingers.

My 3 cats love it - shake the bag and they all come running!
 
Re: Introducing myself....

Thanks Deb and Denise. I do wish Alaska were closer to Massachusetts (or anywhere, really!) so I could get some help with all this new stuff. I have heard of a friend-of-a-friend with a diabetic cat here in town and there was another woman picking up her newly-diagnosed cat the same day I was at the vet. I'm going to try to get in touch with them and hope that maybe we can either commiserate or trade-off with care-giving. Off to check the websites and get some treats in the mail for Alfred.
 
Re: Introducing myself....

And don't forget you can get the dog treats- as long as it is just meat they don't really care! :lol:
 
Re: Introducing myself....

Thanks for checking in with me, Wendy. I really appreciate it. It's going okay. I did pick up a meter and the test strips should arrive in the mail this afternoon. So, tonight will be my first at home test. Alfred seems to be feeling better and his eating/drinking/peeing appears more normal.

I got an Accu-Check Compact Plus meter (there is no Walmart here so unable to get the much recommended Reli-on meter). I will search today for the template to make a SS for Alfred and a chart to understand the numbers using a human glucometer. I'm really anxious to get started on the home-testing so I can feel more confident/knowledgeable about how he's doing.
 
Re: Introducing myself....

Well, after watching more videos, reading everything I could find and even testing my own BG, I was feeling SO confident. When it came time to try it on Alfred -----> UTTER FAIL! There just wasn't enough blood. I tried three times. I know I'll get the hang of it, but I feel so awful. I am especially nervous b/c I'm going out of town in three days and my husband will be on his own. I was really hoping we all be in the routine by now.
 
Re: Introducing myself....

Not to worry..

Are you using a lancet device or just freehanding the lancet? If the device, try it without .

Also do you have something behind the ear to press against? Something firm like a pill bottle

Are you going in at a 45 degree angle?
 
Re: Introducing myself....

And don't forget that new ears are not bleeding ears- there aren't enough capillaries in your testing area just yet to bring in the blood unless you hit the vein. Give it time, keep testing and it will come.

Right now you are just getting the ears used to testing- warm them up good first and give a treat after.
 
Re: Introducing myself & Alfred...DOSING Questions

Ok. I finally got the ear warm enough to get enough blood and get a reading. 173 before the morning shot, which I haven't given yet. I am so confused about the numbers and there is so much info on this site that I'm overwhelmed. I look at your spreadsheets and see that is in the blue range on the lower end of things, which is good right? I also look at the doses many of your cats are getting and think Alfred's is too high. Waiting for 45 minutes to call my vet. Advice welcome.
 
Re: Introducing myself....

Hi and Welcome,
I am a newbie, my Molly had a brief affair with insulin. Wet food (fancy feast classic) and hometesting were the keys for my girl.
The advise you will receive here is amazing! I'm glad you have found this website.
Additionally your cat is beautiful!!!!love those eyes! Breath out , you are in good hands :-D
 
Alfred went to the vet last Thursday for a glucose curve (one week after initial diagnosis) and his numbers at the vet went from 600-something down to 238 (using a feline glucometer) and they told me to increase the Lantus to 3U from the initial dose of 2U. Everything I read here and hear from you all indicates that is a high dose, but when I questioned the vet, she says that "still gives us plenty of room". Thoughts?
 
As I said I'm a newbie, but I do know that stress increases the BG, so the levels your vet got during the curve could be inflated. I would be more inclined to give the lower dose and check + 3 and +6 incase he drops too low. I'm sure one of the more experienced people willbe here soon. Also it's worth starting to post in the tight regulation forum...More activity there.
 
Re: Introducing myself....Where to post next?

So, I've finally started testing (first day - only three tests in) and have set up a spreadsheet. I'd like to think I'll be able to follow the tight regulation, but I'm not sure. I'll be traveling 3.5 weeks of the next 6 weeks and just not sure my husband and/or other caregiver are going to keep it up as often. Should I go to the "relaxed" lantus forum? I'm not totally clear on how to keep up here, but do so value the advice and support.
 
You are welcome to post in either Lantus ISG forum, just Relaxed is a little more quiet than the TR one, as relaxed is usually only truly busy in the early mornings and the evenings, whereas TR is busy all day long.

Mel, Maxwell, Autumn & The Fur Gang
 
You are more than welcome to post in the tight regulation forum, even if you are not following that protocol. It just has more people there that can advise you quickly. I know they like you to post a seperate entry every day ( they call it a condo) and they like you to post it with the date/ cats name and the glucose number. If it is before a shot put AMPS (AMpreshot) if you are skipping the shot put AMBG and likewise for PM, so if you get a number you are worried about you can put for example 3/5 ALFRED AMBG 135 shot advise? and someone will answer you quickly, they also will follow your SS
 
Status
Not open for further replies.
Back
Top