Jerry - newly diabetic

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HappyCat

HappyCat

Member Since 2013
Jerry is approximately 10 years old based on previous information given. My husband has had him for about 5 years and I've known him for over 2 years. He was taken in as a rescue, had been bouncing home to home and was saved from a dog likely to eat him or try. Jerry immediately became my cat, he loved me the second he met me. My husband hadn't even noticed that instead of saying "meow" that he screams "mrow" quite insistently and will carry on conversations that way at different energy levels. That has become an inside joke in our home as a point of emphasis. Needless to say Jerry is a big part of our lives.
I first noticed he was ill in mid June 2013. It started with a moldy litter box. I had no indication why so I was determined to make sure the box was very deep cleaned and humidity kept down but it kept happening. It suddenly hit me in the beginning of July immediately after my birthday what was wrong with him. I had connected the dots, research on the matter confirmed diabetes with the frequent moldy litter box and very frequent drinking and urination.
From there things were just very painful. In general not to mention going through surgery and a couple hospitalizations I couldn't afford to take on his diabetes. I looked everywhere for help, I didn't want to get rid of him but if someone could afford to take care of him it didn't feel right to stand in the way. I've seen shelters have very ill cats FIV positive and other conditions I figured surely they could and would save him. Instead I was told time and time again that he was unadoptable - that there were wait lists but it wasn't first come first serve it was in order of adoptability so his phone call would never come. That was the worst feeling ever, to be told an extremely happy interactive cat was unadoptable due to his age and illness leaving me to know what would happen to him if I couldn't get help.
Just when I thought things were over and I had hit a dead end I found Jerry a guardian angel. It's no exaggeration when I say that Diabetic Cats In Need saved his life. I knew nothing about diabetes especially in cats. The knowledge and resources and solution were helpfully provided making it all possible and much less scary. The vet visit on August 6 confirmed my suspicion that he did in fact have diabetes and he was prescribed 3 units of insulin twice a day. It was a very pleasant experience I adored the staff and Jerry purred the whole time even after having his blood drawn. He has no complaints of a pate diet it's just been hard to determine what he actually needs to eat as it used to be just a treat and he absolutely loves it. He weighs 15.3 pounds I think he's actually lost weight.
His pre-insulin blood glucose levels were the following:
7/30/13 - 386
8/4/13 - 435
8/6/13 - 473
8/9/13 - 393
Jerry started Lantus on August 9 and I'm hoping for great things. Help has arrived and good news is on the way! To this day he's such a happy cat, he never gave up so I didn't want to give up on him. Now I didn't have to and that's so incredible.
Beginner's comment: It seemed absolutely terrifying at first but was easier for me to process piece by piece to get over the shock. Once getting over the initial research and getting into the healing I'd say it's more difficult to do the blood glucose testing than to actually administer the shot. I imagine I'll get into the swing of things though.
---Sarah and Jerry (the Happy Cat)---
 
Welcome Sarah! My name is Debbie. So glad you are hanging in there with Jerry. He sounds like a keeper.

When my cat, TooToo, started insulin 2 weeks ago, his numbers were up there with Jerry's. The past several days he's been down around 100 pretty consistently. No more super wet kitty box or sitting by the water dish all day like he was doing.

Follow the advice given here. It might take a bit to get into the swing of things but you will. The members will help you with numbers, dosing, providing info on your cat, etc. You will get your questions answered.

You CAN do it without spending tons of money.

You will want to provide information on your cat such as his dosing, etc. if you will set up a signature with information about your cat and a spreadsheet that will help. I'm pretty new at this but ask and someone who knows the answer will help you. Best of luck and keep posting!
 
Great - You are home testing! Please check around +5 to +7 hours after the shot to see how low he is going.

The dose of 3 units is a bit higher than we'd expect and you indicated you were now feeding a lower carb diet. That could take him too low.

Based on his weight, the dose calculation is lean weight in kilograms * .25.
15.3 lbs gets a starting dose of 1.7 units.

Lantus is a depot insulin and the effects build up over time. You've done about 2 doses of Lantus so far and we need to see if he's getting into trouble by going too low.

Just in case you need it
Hypo instructions
Low number instructions[/.url]

For good info on feline nutrition, check out [url=http://www.catinfo.org]Cat Info. There's a printable chart of food info for most common US brands. We recommend selecting foods with less than 10% calories from carbohydrates. An inexpensive choice is Friskies pates.
 
We gauge the effectiveness of Lantus by how low the glucose goes.
We determine if it is safe to give insulin by the pre-shot glucose levels. We suggest new users not give insulin if the glucose is under 200 mg/dL when just starting out. As you collect and record test results, you will be able to give insulin at lower glucose levels.

To help you track the test results and share them online for feedback, we use this spreadsheet chart.

You don't want the glucose to go below 50 mg/dL at the lowest point between shots (the nadir).
 
Welcome Sarah and Jerry!

I'm happy to read Jerry was prescribed Lantus and you are hometesting. A few questions:

What time zone are you in? What time did you give Jerry his shot? When was the last time you checked his BG and what was the number?
 
Thank you for the welcome from all and the input received! :)
We are central time.
It was explained to me that his starting dose may be a little high which is possible due to my vet not using Lantus.
I was told to give him 3 units twice a day so I've planned 12 hour intervals feeding him the pate with it.
His last reading before starting insulin was 393 at 10:45PM ET last night.
Followed up today at 11AM with a reading of 401 and his next injection.
Due to concern of dropping too low after the shot another reading was done at around 2PM CT at 383.

---Sarah and Jerry (the Happy Cat)---
 
Glad you tested him.

The initial dose of Lantus takes about 5 full days to stabilize due to the cummulative effects. You've gotten a heads up soon enough to be aware the dose could be too high, as it starts to build up.

You'll want to check him around 5 to 7 hours after you give him his dose to make sure he doesn't go below 50 on the glucometer (human glucometer, right?).

What are you feeding him? You mentioned pates?
 
Yes he's using the Relion meter.
So based on his weight and using the Lantus insulin you're thinking 1.7? Kind of hard to tell with the syringes but would I be trying to go closer to 1.5 or 2 or just somewhere in the range as long as not above 2 units then?
He's switched (quite happily) from kibble to pate which used to just be a treat for him. I like to change up the flavors for him I was just told to avoid the bits/shreds with excess gravy or giving too much seafood. He eats Friskies, mixed grill and next is turkey I believe.
Glad to address any issues before they become problems!

---Sarah and Jerry (the Happy Cat)---
 
I'm glad we were able to get the info to you before it could become a problem. It is possible he could be OK, but home testing will protect him if it is too high a dose, as you'll catch it by testing around the nadir - the lowest glucose level between 2 shots.

The Friskies pates are terrific - I feed the 14 at my place the Turkey & Giblets in the large 13 oz cans.

Although syringes don't mark quarter units, folks here will often dose quarter unit increments by eyeballing it. You might drop it down to either 1.5 units or by eyeballing 1.75 units. If you're away from home much, go with the 1.5 unit dose for safety.

Its a lot easier to build up the dose from being a little low than to spend hours feeding and testing him if his glucose goes low. Our saying is "Better too high for a day, than too low for a moment".
 
Since your vet is unfamiliar with Lantus, you may want to provide him with some information on it.

You might provide the link to the University of Queensland Centre for Companion Animal Health page on Information for veterinarians on management of diabetic dogs & cats where there are a number of documents on feline diabetes which we reference frequently
- Information on Use of Glargine (Lantus) and Detemir (Levemir) in Diabetic Cats with insulin dosage adjustments based on home monitoring of blood glucose concentration at least 3 times a day.
- General information regarding Glargine use in treatment of Diabetic Cats.

Plus, print and share the Roomp & Rand article which is the basis of our Tight Regulation protocol.
 
Hi Sarah--

So glad you tested Jerry at 2 pm.

I didn't introduce myself & my boy: Gobbles is my 11 year old, neutered male cat who I adopted from a local shelter, when he was a teenager (I cannot believe that someone actually dumped such a one-in-a-million cat, but I'm sure glad they did). He was diagnosed in November of last year and had his last insulin shot 6 months later. He is currently in remission, or "OTJ" as we here at FDMB call it (off the juice). He was on Lantus and we were following the Tight Regulation Protocol. I highly recommend it to anyone with a sugar cat who can conform to the program. Oh, and I'm Kat--we live in Ohio.

You really are doing a great job. Keep up with the testing--it will keep Jerry safe :-D He sure sounds like another one-in-a-million cat!

Everything will be okay. We've been in your shoes. Feline Diabetes is very treatable and I'm glad you're getting much-needed help. Your boy is obviously in good hands with you.

Please ask any questions you may have--the only dumb question is the one that isn't asked! Maybe easier said than done, but be patient allowing the Lantus to work.

I would highly suggest setting up a spreadsheet. Also, you may want to weigh Jerry weekly and keep track of his weight :mrgreen:
 
Hi Sarah,

It's me, Jennifer from DCIN. Just wanted to pop in and welcome you. You're getting great advice here and the folks here are wonderful. I know you and Jerry are in the best of hands. Give him some chin scratches and tell him from me that he's a lucky little man to have such an awesome mom.
 
I'm thrilled with all the helpful information and warm welcomes! An extra special thank you to Jennifer and DCIN to getting the happy cat healthy and referring me to such a helpful site! :)
I will be trying the reduced dose of Lantus at his next interval. Although it may take time I'm definitely looking forward to a healthier cat and litter box and expect good things.
I'm definitely curious if anyone has any suggestions as to a scale. I've wondered about him and other cats, especially him as I'd have guessed 18-21 pounds instead of 15.3. He's still got his side and belly fat but his spine is more pronounced than previously so it'd be nice to track everyone to track health/diet results.
It's great for everyone to come together for support and advice. "It takes a village" and it's helpful and eases some of the stress. I will be sure to pass on the chin scratches well wishes and heart warming support! :)

---Sarah and Jerry (the Happy Cat)---
 
For weight/body condition, check this Body Condition Scoring Chart and identify where you think he would fall.

Its OK to be able to feel, with light to moderate pressure, the tips of the vertebrae, the ribs, of the hip prominences. If, however your fingers fit between the ribs or vertebrae, or you can clearly see the hip prominences, he is likely underweight.

A digital scale will help you track his weight. It can work to weigh yourself holding the cat, then subtract your weight.
 
I don't think he's underweight yet just has probably lost some weight in general. I'm very interested in checking out a digital scale just to know.
Tonight's reading was at 355 before his lessened dose from 3 units to about 1.5.

---Sarah and Jerry (the Happy Cat)---
 
It takes about 5 days (10 shot cycles) for the first dose level of Lantus to stabilize and for any later dose levels, it takes about 3 full days (6 shot cycles), before you can assess what, if any adjustments you need to make.

By checking around the nadir - somewhere between 5 to 7 hours after the shot - you'll be able to follow a Lantus protocol for dose adjutment in another 4 days. One protocol, Tight Regulation, has gotten about 84% of cats to diet controlled status (off insulin) in a clinical trial. It is described in the Lantus Tight Regulation forum here.
 
Jerry - diabetes related to joint pain?

So just curious... Is diabetes related to joint pain? Since forever Jerry had used a hooded litter box. With the onset of his diabetes he had to get switched to an open box as the step into the hooded box really seemed to bother him. While I was informed lantus takes awhile to fully work just wondering if that's a good sign that he's not just able but willing to use a hooded box again I almost couldn't believe my eyes. Could be weight loss but I was proud and also we were already down from 4-6 bowls of water per day to 2. I appreciate any input on the matter thank you!

---Sarah and Jerry (the Happy Cat)---
 
Human diabetics may get nerve pain from their diabetes, so it seems plausible cats might too. Both human and feline diabetics may develop neuropathy where the nerve function is impaired. In cats, you see 'plantigrade stance' or walking/standing on the hocks and wrists of their limbs, unable to stand up fully.

In addition to regulating the diabetes, if you supplement with methylcobalamin, a specific form of Vitamin B12, that helps treat the neuropathy. In a couple of months, supplementation may reverse it completely. Jasper's Story describes a cat with this condition and how the treatment was found.
 
So happy Jerry is improving. Regarding the joint issues, my kitty was having similar problems. The vet diagnosed him with arthritis at the same time she diagnosed the diabetes. Since being on insulin, however, the joint issues have disappeared just like you mention with Jerry. The vet even sold me expensive arthritis medicine which I never used. I don't know why she didn't mention diabetic neuropathy. Sounds like Jerry is feeling much better!
 
Thank you all for the input. He has a journal right now but spreadsheet may be easier to seek patterns. He's beyond unpredictable right now besides higher in morning lower at night.
I'm very proud of Jerry - for his patience, happiness, decrease in water consumption and using the hooded box again. However his rollercoaster numbers have me concerned. Before his AM shot he was at his highest reading yet of 485. I gave him his lantus dose of about 1.75 with pate. 12 hours later he was at a record low of 156! Was told by vet his target is 100-140 so I didn't do his pm dose as I want him to be safe. He's never broken 200 but then down 329 in 12 hours! What do I do come the am? At what point besides this 156 do you not use insulin? Any further input? Thanks for your help.

---Sarah and Jerry (the Happy Cat)---
 
Since you are just starting out and we don't have much data we don't know if the 1.75U is too high or just right. What we do know is that Jerry's diet has changed - dry food has been removed and that will bring sugar down naturally. How many times a day is he eating the canned food?

I might consider a lower dose, perhaps 1/2 Unit BID or 1 Unit BID and start collecting some BGs at different times so we can see what dose might be best for Jerry. The spreadsheet will help you see patterns and also help others better advise going forward. I see that Wendy wrote to let her know if you need help with that. I think that would be a great way to go. You have so much going on, one less thing to try to learn (putting together the spreadsheet and linking to your signature), I think that would be a great idea.
 
A big FDMB welcome to Sarah and Jerry (the Happy Cat)! I love that part of his name! :-D

Let us know what other questions you may have. We're here to share our experiences and knowledge.

If you put this in your signature, you don't have to retype it every time.
Copy this and go to the upper left of your screen, click on User Control Panel, Profile tab, Edit signature and paste it into the free-form text box, submit to save, just like you do to post. I wasn't sure which Relion meter you were using so I put the Confirm? in there for you. Please change it if it's a different meter.

---Sarah and Jerry (the Happy Cat)---
age 10, male, Dx 8/6/13 Relion Confirm? w/Lantus
Friskies pates, US, Central Time Zone
 
Do these readings and doses soulookd right to you?

Fri
PMPS 393 3IU

Sat
AMPS 401 3IU
+3 383
PMPS 355 1.5IU

Sun
AMPS 485 1.75IU
PMPS 156 ? dose?

Just trying to get a handle on his numbers
Wendy
 
Thank you to Deb and Wink for the welcome and the suggestion for the signature. I'll be changing that here soon I just thought I'd check in with you good folks first. :)
Wendy and Tiggy thank you for your help trying to dissect these readings further for me for accurate dosing. That information is correct. There was no Sunday PM injection as I had been worried about doing an injection at his 156 reading.
This morning he was at 475. I was shooting for 1 unit but ended up being just above 1 maybe 1.25.
Admittedly this is a bit harder and scarier than I thought. I never expected a 329 point variance in the day and to suddenly be at 156 missing the 200's entirely.
He needs a third ear on top of his head and while I'd miss petting his head it would make things much easier! I was so concerned with finding out how to do the shots that I now wish I had someone work with me to perfect testing before things got so intense I've definitely gotten better over the last couple of days but it sometimes still takes a couple of tries so I generally do one ear for one testing and one ear for the other testing. He was a bit bruised after my first couple rounds but he's getting better as am I at doing it. Previously I couldn't do many mid dose testings due to the bruising but as we're both getting better at the experience that's going to be something that we work on more to help diagnose his needs. Disappointingly enough my vet had only said to do testing before the shots twice a day so that's definitely a "if I only knew then what I know now" thing. Anything for the Happy Cat though.
Beyond that I'm definitely interested in a scale to track what's going on with him. It's hard to perfect his diet as it's not really a diet to him - him having a diet of wet food is like telling a person that they're on a diet of chocolate and ice cream he LOVES wet food and doesn't care that it's pate he probably even prefers pate as less gravy = more room for food! Originally he was eating twice a day but I didn't want him to make an association of stuff he loves just coming after testing and with a shot I wanted him to know he'd see me and be brought stuff for just regular happy visits no strings attached so it's been 3 times. I've just made it a point of the 2 times being meals and the 3rd just a little snack of the pate. Kind of hard to gauge as kibbles kind of like a buffet and the wet food would dry out if it ever lasted long enough to. I would ask him how much he needs but I wouldn't know what number "mrow" or "mrow-row-mrow" would translate to and he'd probably just tell me what he wants NOT what he needs. Definitely a learning experience.
I also don't know if this would be helpful to anyone or if anyone knows if this is a common link but I've been thinking and may have very well pinpointed where things went wrong with him. I was engaged and married last year, my husband got me a kitten as an engagement present and she helped with the stress so much I was completely and utterly in love with that cat. She was unfortunately and tragically killed during her spay due to negligence she was overdosed. Something I would never wish on anyone and that's what makes him nerve wracking with the diabetes I just lost a cat, a kitten even, this time last year saying see you soon never thinking it would be goodbye. The kitten's mom wasn't in a good home she had back to back litters exactly 4.5 months apart I ended up buying the kittens to get them out and I even saved Mom too. How this relates to Jerry is though the worst experience of my life I did get to experience kittens for about 1 year 3 months which is a whole lot of continued cuteness. How I'm now concerned this has harmed him is it was nearly impossible to keep him out of that kitten kibble! I'm wondering if in addition to protein if it had a lot of fat in it and that's how he just woke up having diabetes out of the blue. It got to the point of having to feed them at designated times so he wouldn't eat it but I'd try to leave them some while we slept as well as his food out and the kittens' food was always GONE in the morning not 1 kibble left. Maybe he is just that unlucky to hit about 10 years old and get diabetes but I'm seriously wondering if his love of kitten kibble is what caused this since kitten food has been in his home from the end of April 2012 until August 1 2013. No weight to prove it but we think he got fatter in that time and skinnier than he ever has been with the onset of diabetes. Food for thought so to say.
Curious if anyone has any thoughts on that or any advice in general. For instance since it's a multiple hour process what do you do with a reading of 156 and anything else I should know? We're going to get him at a low dose and work up if needed. Grateful for all the help here as this is very touch and go and want him to be safe. Thanks to my guardian angel and all those coming together for him!

---Sarah and Jerry (the Happy Cat)---
 
After poking for the test, apply direct pressue for a minute or two while the hole clots. This will reduce seepage into the surounding tissues (bruising) and minimize the scab.

Got a scarfer, huh? Try smearing the food across a plate thinly; he'll have to work harder to eat it. And/Or freeze some of it to thaw and be nibbled throughout the day. Or consider a timed feeder PetSafe 5 Mini-meals/timed feeding actually helps the diabetic by not dumping all the calories in at the same time.

The folks in the Lantus Tight Regulation forum routinely shoot insulin on low preshots - lower than 100, even. Starting out, however, its about collecting test data to see how Jerry responds to the insulin. As long as his nadir is 50 or above, he is OK. Figuring out the best dose to keep him in good numbers is a process, with many steps back, forth, and around! We call it the sugar dance!
 
Dry food can definately trigger diabetes, cats just aren't able to handle high % of carbs and often when you move them back onto a low carb diet, they go into remission.

If you can get your spreadsheet set up ASAP we will get better idea of what's going on and we can go from there..

Wendy
 
Here are some glucose reference ranges used for decision making using a human glucometer:

< 40 mg/dL
- Treat as if HYPO
- At nadir (lowest point between shots) in a long term diabetic (more than a year), may earn a reduction.

< 50 mg/dL
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50.
- At nadir, often indicates dose reduction is earned.

50 - 130 mg/dL
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. (May even go as low as the upper 30s; if not on insulin, this can be safe.

> 150 mg/dL
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

180 - 280 mg/dL
- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.

>= 280 mg/dL, if for most of the cycle between shots
- Uncontrolled diabetes and thus at risk for diabetic ketoacidosis and hepatic lipidosis
- Follow your insulin protocol for dose adjustments
- Test for ketones; if more than a trace level of ketones, go to vet ASAP.
 
Thank you for everyone's help input and patience.
I couldn't even begin to make a spreadsheet I was very confused, my husband will be helping me with that tomorrow.
I gave Jerry a rest yesterday but today we have at least started nadir readings as I'm getting better with the testing.
Yesterday was a strange day both readings before his shots were exactly the same a 443 reading before each shot.
Today he was 312 this morning and doing the nadir testing 6 hours later he was at 191. After his incredibly low PM reading Sunday he's been decreased to 1 unit of the lantus.
Hope this is at all helpful. We're trying for good things!
 
He is improving, so that's good.

Time to start reading up on Lantus, so you have a better understanding of how it works and can decide if you want to follow a Tight Regulation protocol or the Start Low, Go Slow protocol.

Tight Regulation has the best chance of obtaining a diet regulated status and requires vigilant blood glucose testing.

Start Low Go Slow may be better for those who have difficulty getting much testing done for whatever reasons, and perhaps have scheduling difficulties.

If you look to the lower right of the page, you'll see a drop down arrow. Click on that to jump to the top of the different subforums here and explore them.
 
Hi Sarah,

I can help you with the spreadsheet and link to your signature if you want. Just send me a PM.

Do you have a google account? If not, set one up first and then PM me. I do the setup for lots of people.
 
No wonder Deb and Wink want to help me with a spreadsheet! My fault on the delay for that but I'm very concerned over his dosing so going to post some numbers - sorry for any repetition.
Before insulin:
7/30 386
8/4 435
8/6 473 vet diagnosed
8/9 393 before first shot 3 units
8/10 401 3 units
8/10 +3 383
8/10 355 1.75 units
8/11 485 record high 1.75 units
8/11 156 record low no shot given
8/12 475 apprx 1 unit
8/12 424 1 unit
8/13 443 1 unit
8/13 443 1 unit (not a typo both readings same)
8/14 312 1 unit
8/14 +6 191
8/14 396 1 unit
8/15 379 1 unit
8/15 333 1 unit
8/16 456 1 unit
8/16 +6 310
8/16 342 1 unit

Is this normal? Could the too high dose have effected that record low though occurred after lowering the dose? Does it take more time do I need to wait it out? I don't like such high numbers but want to make sure I'm doing the best for him. Thanks for any input I'm really hoping to get this all straightened out.
 
Ps the water consumption is down to a bowl a day maybe 2 if my husband does it and forgot to tell me but 1 that I know. He's willing and able to use hooded boxes again and even jumping up on stuff to be closer for pets. Knock on wood the molding is getting better but not sure if that's in general or because he's now using multiple boxes. Joints better drinkings better urination getting better but still high numbers. Thanks.
 
When a cat has become accustomed to higher numbers, dropping down to the lower numbers may trigger compensatory hormones which release a stored form of glucose. This raises the glucose back up and then some. we call that a bounce.

This will settle out over time for most cats, so just hang in there.

You've had 5 days on the same initial dose. Check around the nadir today and if it is over 150, tonight's dose may be increased 0.25 units.

Dose adjustments are made based on how low the cat goes (the nadir), not on how high the pretest is.
 
Hi Sarah,

I need one more bit of information from you before I can set up your SS and link it to your signature. Check your PM's please. Thanks.
 
New or experienced to everyone whose been in contact you deserve a pat on the back you guys are pros! Spreadsheet is a good idea just took a while to wrap my head around it all.
Deb and Wink have certainly become Jerry's pals with the continued help of getting the spreadsheet going even despite a bit of difficulty.
Overall we're very grateful of the warm welcomes helpful responses and well wishes. (He's still happy if not happier!)
Please review Jerry's spreadsheet any feedback is welcomed and appreciated whether it be about format or results. I've attached it to my signature but here's the link too.
https://docs.google.com/spreadsheet/pub ... utput=html
Thanks everyone! :-D
 
yay on the SS! Heres my thoughts - not enough data yet.

- Can you get a test before bed (2-3 hours after pm shot) ? We want to make sure he isnt dropping low at night - many cats do. I suspect he might well be given his morning numbers are high ie red.

- Also can you vary the test you get midday so its not always at +6? Cats nadirs vary and not all fall at exactly +6. For example on the 14th when you got the 191 he may have dropped even lower before or after that. So vary test times to try and fill in more data. Also next time you get a blue or low yellow, I would do another test in an hour or two to see if he goes lower.

More tests for the next 2-3 days and if we dont see more blues or even a green, then a dose increase is likely needed.

Wendy
 
Good job on getting the SS up and running.

I'm with Wendy on a few more tests to see what is going on. Jerry may need a dosecrease ( an increase).
 
Hey there. I'm on my phone so not able to update my spreadsheet just yet but wanted to check in and address some things.
First of all thanks to everyone for your help on dosing. No way would he have been good to go on 3 units.
Which brings me secondly to dosing issues. I was worried he may need an increase but he may be fine or need a slight or just nightly decrease. Tuesday was 481 and 316 before his 1 unit dose, 142 about 5.5 hours after pm dose. My vet said his target was 100-140 I believe but I've also read 60-100 is a good range. Being as how 5-7 hours is the peak not sure if he'll drop further. How do you know when to drop a dose? Or any other input? The happy cat is a bit of a yo-yo with his numbers which worries me and I only want the best for him. Thanks for the help guys!
 
If, after using the same Lantus dose for 3 or more days (5 days for the initial dose), you evaluate how low the cat is going. With ProZinc, there is no depot, so you might adjust based on recent previous data.

You may drop a dose when the cat goes too low, ie below 50 mg/dL (2.8, non US) on a human meter.

You may increase when the cat doesn't go low enough - lowest is above 150 mg/dL (8.3, non US).

You also consider how the cat is doing - the 5 Ps (purring, playing, preening/grooming,pee, pooping), weight, thirst, hunger, and any other clues.
 
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