Introduction: Em and Jezebel

[morrieb1]

Good afternoon all,

I've been lurking here for a while and its been a lifesaver in terms of better understanding my Jez's illness and the reasoning behind my vet's decisions and recommendations.

Jezebel (Jez) is a six year old torty -- I often call her Ugly Girl (lovingly of course) because there is nothing the least bit symmetrical about her markings - its as if someone set a toddler loose with a paintbrush. She's my "emo kittie" - I inherited her from my son because as a young cat she would scratch herself until she bled...she's still got scars on her neck, in fact. Vets couldn't find any physical reason behind her behavior and recommended prozac or something similar. I kept her for a weekend when my son went out of town, and ended up not giving her back. Turns out she mostly just needed a dependable routine to keep her calm - something young single men aren't really good at

Flash forward to now. I was out of town a couple weeks of November, had a house guest for much of December and went off again on a trip the start of January. And I have two cats who were allowed to freefeed dry food when I was away.....so I blamed the signs I did see on cattitude rather than illness. I came back from my last trip, picked Jez up to say Hi and realized she'd lost weight......I had trouble getting her to eat, she wouldn't drink much eather - fortunately we got to the vet in time and she was diagnosed on January 14 - and discharged to me on the 16th with instructions for 1 unit Lantus BID and to change her diet to Purina DM. Fortunately she didn't have an issue making the switch to wet - unfortunately that meant both my furkids had to switch and as we all know, that stuff isn't cheap.

She had a `12 hour glucose curve done a week later and they told me I could change the dose to 1 u once a day.......and after a followup glucose curve - 20 hours this time) they told me to continue on with the 1U a day in the am - that she was quite high preshot, but they'd had to give her some dry food to get to eat so they thought that was just a spike. At this point, I was frank with the vet that I just couldn't afford 230 dollars a week for testing and that I was going to try to home test. She said that diabetics could be a difficult and expensive disease, but that with the data we'd gotten, I could wait six weeks to bring her back and they could do the fructosamine test to see how well her glucose was being managed. I mentioned that I was going to try home testing - she wasn't particularly enthusiastic about it, but she didn't tell me no.

I've switched the food to Fancy Feast Classics and Authority Chixcken and I've gotten the hang of testing, in fact, I'm running a BG curve today. What seems to have happened is that Jez has a late nadir, so at +12 she's lower than my vet thinks is safe to shoot (and I'm sure she's thinking its easier for me as well). My concern is that she's really high AMPS (350 or so) and so I'm wondering if its safe to add that shot back in (maybe holding off for an hour or two after she's eaten) and see if that helps.

Or maybe i shouldn't be worrying and that PS number really isn't that high.

And apologies if I should be posting the question part on a different board - sometimes once I get going my fingers just won't stop

Nice to meet you all and thanks for being such a great source of information and comfort.

Em

https://docs.google.com/spreadsheet/ccc ... sp=sharing

 

[Courtney and Kismet]

Hi Em, welcome to FDMB, the best place for sugar kitties and their beans!

It sounds like you have a good understanding of the disease and home testing. I am glad you were able to find a more affordable food! You might want to check out the Lantus support group, there are advice givers there who can help you with dosing advice, testing, and everything else you need for Jez. I am going to let them know over there that we have a new Lantus kitty, and someone with more experience should be along shortly to answer your questions.

 

[rhiannon and shadow (GA)]

Hello. And Welcome to FDMB!
It sounds like you've got a good start ... good job lurking and learning from others..

I can't give advice on dose but I will bet that they will help you find a good dose that you can shoot twice a day. Missing a pm shot
will make your am numbers higher..

Looking forward to seeing you over in the tr lantus forum ... Everyone is very friendly and will want to help.

 

[morrieb1]

Thank you both - I'll head over to that forum and ask my question.....as good as Jezebel has been today, its clear she's getting tired of all the earpricking and she really wants to eat......but I'm trying to keep the furballs on the same schedule they have during the week when I'm not home so they have to wait just a bit longer.

But its definitely going to get ugly soon - I'm getting lotsa stinkeye...

Em

 

[Courtney and Kismet]

Yw Here's the direct link: viewforum.php?f=9

In your subject header, include date, Jezebel's name, recent bg readings, and select the question mark icon and write "question" in the subject line following other info. It gets busy in there, so flagging your post might help you get attention.

 

[Dyana]

If you are home testing, you don't need a fructosamine test. A fructosamine test tells the average BGs over a specific time period, and you can just look at your spreadsheet for that.

We are hoping that you can make a spreadsheet like the kind we use, so that we can help you with the dose.
Someone will provide you with the link on how to set one up. We are just used to all using the same format.

Lantus works best if given twice a day in cats as their metabolism is higher than humans who give it once a day.

Hopefully, we'll be able to get you set up with a dose that you can shoot BID (twice a day), like 0.50 units every 12 hours. Lets see what others have to say about that.

As far as feeding before the shots.. we advise that you do not feed for the 2 hours before giving the shot. We want you to test at every PS (shot) time and if her numbers are high enough to shoot the insulin and feed her, all within about 5 minutes. Lantus does not have onset (the time the shot of fresh insulin starts to have an affect on the numbers) until about 2 hours after the shot is given.

 

[morrieb1]

If you are home testing, you don't need a fructosamine test. A fructosamine test tells the average BGs over a specific time period, and you can just look at your spreadsheet for that.

We are hoping that you can make a spreadsheet like the kind we use, so that we can help you with the dose.
Someone will provide you with the link on how to set one up. We are just used to all using the same format.

Lantus works best if given twice a day in cats as their metabolism is higher than humans who give it once a day.

Hopefully, we'll be able to get you set up with a dose that you can shoot BID (twice a day), like 0.50 units every 12 hours. Lets see what others have to say about that.

As far as feeding before the shots.. we advise that you do not feed for the 2 hours before giving the shot. We want you to test at every PS (shot) time and if her numbers are high enough to shoot the insulin and feed her, all within about 5 minutes. Lantus does not have onset (the time the shot of fresh insulin starts to have an affect on the numbers) until about 2 hours after the shot is given.

Thank you Dyana - I did have a spreadsheet - oddly enough I thought I got it from this site but it doesn't look like yours (though the color coding is similar). I don't have a printer available at the moment but once i do, I'll print mine, find that other one, and transfer all the data to it. https://docs.google.com/spreadsheet/ccc ... sp=sharing
Maybe I've not set up the sharing on this properly - I'll search the forum for the instructions and get that fixed.

Fortunately I wasn't feeding until after the shot(s) (or rather simultaneously as a distraction) so that part works fine. I just gave in and fed them a bit ago - so if I am to shoot tonight - two hours after eating would only be +12.5 so that would hopefully be close enough.

I didn't think I'd need a frucosamine - my vet offered it as an option rather than spending so much money on curves - I wasn't hometesting yet, and I have a feeling they don't encourage their clients to do so.

Em

 

[Denise & Honey]

hi Em

welcome to the boards - I just checked and I can see your spreadsheet but it doesn't look like the one we are currently using.
Here's a link that explains how to get the ss working and a template for it:
http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

Great job on the home testing - that's usually the most difficult part to master so you really are doing well.

You've probably read that lantus is a depot insulin and usually given twice per day as cats metabolize it faster than humans or dogs.
One of the dosing experts will work with you on that so I'm just one of the welcoming committee ;-)

Denise

 

[morrieb1]

hi Em

welcome to the boards - I just checked and I can see your spreadsheet but it doesn't look like the one we are currently using.
Here's a link that explains how to get the ss working and a template for it:
http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

Great job on the home testing - that's usually the most difficult part to master so you really are doing well.

You've probably read that lantus is a depot insulin and usually given twice per day as cats metabolize it faster than humans or dogs.
One of the dosing experts will work with you on that so I'm just one of the welcoming committee ;-)

Denise

Hi Denise,

Nice to meet you. Your Honey brought a smile to my face - I'm a sucker for longhaired orange kitties and always had one around until my Pumpkin passed on a year ago and I decided two furkids was enough.
I'd love to give Jezebel the best possible chance at remission - and it sounds like to do that I need to go back to twice a day. My veterinary practice is high tech and I've gotten very good care there for many years, but with a dozen vets, I rarely can book the same one twice in a row, so its not likely I can get a single vet handling this treatment - not to mention I really can't afford a weekly office visit/consultation, so I'm hoping the folks here can help me with the best way to proceed.
For now, I'll get this curve finished up - run it as long as I can into the evening....and then try to get the spreadsheet switched and post in the proper place with the proper header tomorrow and see what the dosing experts say.

Thanks for the welcome and your help,

Em

 

[Wendy&Tiggy(GA)]

Hello and welcome to the board,

Moving over to the tight regulation forum would be a good idea for you. They will recommend you shoot twice a day instead of once and will likely recommend a dose change too. What syringes do you have? do they have half unit markings on them? Those will really help because with some cats even a drop of insulin can make a big difference!

Wendy

 

[Denise & Honey]

Actually, I have 3 orange kitties - Honey and Monster are difficult to tell apart and Minkie is a diluted orange tabby - confuses the heck out of the neighbours :lol:

See you on the Tight Regulation Board :mrgreen:

 

[morrieb1]

Hello and welcome to the board,

Moving over to the tight regulation forum would be a good idea for you. They will recommend you shoot twice a day instead of once and will likely recommend a dose change too. What syringes do you have? do they have half unit markings on them? Those will really help because with some cats even a drop of insulin can make a big difference!

Wendy

Thanks for the welcome. I just got the current spreadsheet sorted out and think I have it right now. You asked about syringes - I was using BD that i got from Target - but they didn't have 1/2 unit markings so I just bought some Relion that do, so I should be set as far as that goes....but I hope I don't have to go to drops because even with my readers its not easy to get it right (the joys of aging , i guess).

I fed her at about +10.5 and got a +12 / 155 which is about what I expected....but I figured best way to proceed would be to get a couple more readings (might as well piss her off royally) and then post over on the tight regulation board after tomorrows pre-shot. Frankly, shooting once a day would make life a lot easier - I could get my petsitter to do that rather than have to board her when I travel again. But I'd much rather try to get her into remission over the next few months if possible. I think the disruption of her routine over the past couple of months contributed to the diabetes - she has always been a needy kitty with "issues"...but at least she's not longer a cutter .

You guys are really great - I don't have the words to express how much it means to know I'm not alone in this.

Em

 

[morrieb1]

Actually, I have 3 orange kitties - Honey and Monster are difficult to tell apart and Minkie is a diluted orange tabby - confuses the heck out of the neighbours :lol:

See you on the Tight Regulation Board :mrgreen:[/quoteOh, I so envy you..........my first grownup living alone kitty was my orange maine coon mix Melvin - I took him when a friends girlfriend said it was her or the cat and he was my best friend for more than eighteen years after (I just learned to close the closet so he didn't shred my stuff). He died at the ripe old age of at least 20 (I never did know his exact age). I rescued another longhaired orange boy mostly because he looked a bit like my Mel - but of course he turned out to have an entirely different personality - lovable of course, but different.

I"ve been tempted more than once to bring another one home - I do have a soft spot for the orange ones - but I remind myself there's barely room on the bed as it is

 

[Sienne and Gabby (GA)]

Welcome, Em! Courtney posted on the Lantus board and asked us to stop by.

Unfortunately, I think your vet is on a wrong track. In cats, Lantus really needs to be given twice a day. In humans, Lantus can be dosed once a day but given a cat's faster metabolism, it's a twice a day dose. When you do shoot once a day, you see lower numbers during the 12-hour period after you shoot. Numbers then slowly climb to much higher ranges during the next 12-hour period. This certainly seems to be the pattern for Jezebel.

On the Lantus board, our post and ask for help pre-shot numbers are below 150. if you're not comfortable with shooting numbers in the 150 range yet, then you can always lower the dose so you are able to shoot twice a day. Since you have syringes with half unit markings, you could consider dropping Jezebels's dose and shooting 0.75u. It looks like this:

I hope you'll join us on the Lantus board.

 

[morrieb1]

Welcome, Em! Courtney posted on the Lantus board and asked us to stop by.

Unfortunately, I think your vet is on a wrong track. In cats, Lantus really needs to be given twice a day. In humans, Lantus can be dosed once a day but given a cat's faster metabolism, it's a twice a day dose. When you do shoot once a day, you see lower numbers during the 12-hour period after you shoot. Numbers then slowly climb to much higher ranges during the next 12-hour period. This certainly seems to be the pattern for Jezebel.

On the Lantus board, our post and ask for help pre-shot numbers are below 150. if you're not comfortable with shooting numbers in the 150 range yet, then you can always lower the dose so you are able to shoot twice a day. Since you have syringes with half unit markings, you could consider dropping Jezebels's dose and shooting 0.75u. It looks like this:

I hope you'll join us on the Lantus board.

Hi Sienne - Shooting at 150 doesn't scare me if its permitted - with it being an evening number I can always set the alarm a bit early to check her once at +8 or +9 which seems to be where she settles in. I think my vet was being cautious - but its a big practice and I can rarely get the same vet twice - it makes it difficult to establish a real relationship. I think they'll be willing to work with me - and if not, I'll switch to a vet that will. I have posted (properly I hope) on the Lantus TR forum and although I think its probably too late to shoot tonight (+14.5) - hopefully I'll get guidance as to what to do tomorrow.

Thanks so much for checking in - I appreciate it.

Em and Jezebel