Max & I Are Struggling

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Max@20

Max@20

Member Since 2017
I can't believe that after 2 1/2 years of injecting Max twice a day I just now discovered this Lantus-specific portion of the website. I've a lot of reading ahead but at this moment, I really need guidance, and it may be too late. Max is 20 years old. I just started home testing eight days ago because he was really going downhill and the vet wasn't being helpful. (I know. You can't make me feel any worse than I do already.) I now test twice a day before feeding his higher protein, lower carb canned food then giving him his shot. His numbers are appalling: 400s, 500s or sometimes high enough it doesn't read other than "HI." I've increased him over the past week from 2 to 2.5 to 3 (3 starting Monday eve.) He still read 583 at 6:30 am this morning before I fed him and gave him his shot of 3 1/4. He's lost a lot of weight, obviously, (under 7 lbs. now, should be 9) and his neuropathy is getting worse. I had to treat him for hypoglycemia back when he was on Prozinc before the vet switched us to Lantus a year ago, so I'm definitely scared of overdosing. Have I doomed my boy through my ignorance? Could my insulin be bad? I've had it less than 3 weeks.
 
Hopefully a pro will come along and give you some advice. In the meantime, here is the link with the instructions for how to set up a spreadsheet http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
This will allow others to view Max's numbers and give advice.

Also, people either follow start low, go slow (SLGS) or tight regulation (TR) here. I will post the links to both for you to review.

SLGS - http://www.felinediabetes.com/FDMB/threads/lantus-levemir-start-low-go-slow-method-slgs.129446/
TR - http://www.felinediabetes.com/FDMB/threads/lantus-levemir-tight-regulation-protocol-tr.1581/

You are right, there is a ton of material to read, but hopefully this will help you to get started. Please ask any questions, everyone here has been extremely helpful to me.
 
Hello and welcome!
Max is very handsome gentlemen and doesn't look his years at all!

Please let us know if you need assistance setting up spreadsheet - someone will help out. I had mine set by somebody else for me and was coached as to how to use it. I am not into electronics at all.:rolleyes:

Max@20 said:
I just started home testing eight days ago because he was really going downhill and the vet wasn't being helpful. (I know. You can't make me feel any worse than I do already.)
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No shaming here, and no question is small or stupid.

Please keep posting any questions or concerns you might have.
 
Welcome! There is a wealth of information and experience here, you have come to the right place. As others have said, step 1 is getting a spreadsheet up and running-- it's the first thing advice-givers look to before offering opinions. There are a number of different reasons why Max might be in high numbers right now-- seeing some of the data you've collected on his BG patterns will help start to sort out what might be going on. If you have trouble setting it up, just holler!

A couple of questions for you as well: you say the vet hasn't been helpful, but has Max been seen recently to rule out other health issues? How has his eating/drinking and litterbox behavior been, any recent changes besides the weight loss?

Don't beat yourself up-- you've been caring for Max through two years of shots now, that's already a lot more than most people would do! :bighug:
 
CLICK Here for amazing VIDEO story of neuropathy recovery.
The entire thread that I linked here talks about treatment of neuropathy - scroll down to post #18 (numbered at the bottom right of each post). I want you to have a look and to cheer up - even hardest and most overwhelming conditions can overcome!
 
Tanya and Ducia said:
CLICK Here for amazing VIDEO story of neuropathy recovery.
The entire thread that I linked here talks about treatment of neuropathy - scroll down to post #18 (numbered at the bottom right of each post). I want you to have a look and to cheer up - even hardest and most overwhelming conditions can overcome!
Click to expand...
Thank you! It breaks my heart to see him so weak. Max's dad built a little ramp so he can get into the litter box more easily with his weak back legs.
 
Nan & Amber said:
Welcome! There is a wealth of information and experience here, you have come to the right place. As others have said, step 1 is getting a spreadsheet up and running-- it's the first thing advice-givers look to before offering opinions. There are a number of different reasons why Max might be in high numbers right now-- seeing some of the data you've collected on his BG patterns will help start to sort out what might be going on. If you have trouble setting it up, just holler!

A couple of questions for you as well: you say the vet hasn't been helpful, but has Max been seen recently to rule out other health issues? How has his eating/drinking and litterbox behavior been, any recent changes besides the weight loss?

Don't beat yourself up-- you've been caring for Max through two years of shots now, that's already a lot more than most people would do! :bighug:
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I've taken him twice in the past two weeks. The vet just recommends increasing the dosage but not much beyond that. No other advice. The second trip was because I wanted to make sure my glucometer hadn't gone haywire with the high readings. It hadn't. He drinks constantly, pees a lot, and not surprisingly, it's sticky because of the high BG. He wants food because his body says he's starving. He's been eating more or less a 3 ounce can in the morning and another in the evening. When he asks for food during the day, I give him more. I track everything in a log book and have for 2 1/2 years—food, insulin, litter box, etc. Oh and fluids. Just gave him 100 ml lactated ringers because he's SO dehydrated. None of this is recent, just gradual deterioration. :( Will work on the spreadsheet this afternoon. Sigh.
 
Welcome Max and his mom! There are many on this board with a lot of knowledge. Its great that you are home testing! Are you using a pet meter or a human meter? Since Max isn't well regulated yet, he will be hungry. If he wants to eat, feed him as much as he wants. And don't be afraid to ask questions!
 
I'm using a One Touch Ultra Mini, a human meter loaned to me by the animal sanctuary where I volunteer. I took it to the vet so I could see how it compared when they tested him and there was only a six-point difference.
 
Karen & Lily said:
Welcome Max and his mom! There are many on this board with a lot of knowledge. Its great that you are home testing! Are you using a pet meter or a human meter? Since Max isn't well regulated yet, he will be hungry. If he wants to eat, feed him as much as he wants. And don't be afraid to ask questions!
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Sorry! My reply didn't show up as a reply to your question. Here's what I answered: I'm using a One Touch Ultra Mini, a human meter loaned to me by the animal sanctuary where I volunteer. I took it to the vet so I could see how it compared when they tested him and there was only a six-point difference.
 
Max@20 said:
No. From your question, it looks like he should be. I need to check out the link that Tanya and Ducia posted.
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Ah, ok. Well the number one thing to do to resolve the neuropathy is to get the blood glucose levels under control, but b12 Meth can have a significant impact as well. Many use Zobaline https://www.amazon.com/ZobalineTM-Diabetic-Cats-60-tabs/dp/B008G3LI2M/?tag=felinediabetesfdmb-20

if you need help setting up that spreadsheet there are people here that can help.
 
Okay. Max's spreadsheet is done--for the eight days I've been home testing. It's ugly. (BTW, the directions were outstanding.)
 
Max@20 said:
His numbers are appalling: 400s, 500s or sometimes high enough it doesn't read other than "HI." I've increased him over the past week from 2 to 2.5 to 3 (3 starting Monday eve.) He still read 583 at 6:30 am this morning before I fed him and gave him his shot of 3 1/4.
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Hello and welcome. Lantus is dosed quite differently than Prozinc. Instead of looking at the preshot numbers, we primarily look at the nadirs or low point. That means trying to get a test somewhere in the middle of the cycle if we can, cause that's where the low points are. Getting a test before bed is also really helpful. And since Lantus is a depot insulin, we hold the same dose for at least 3 days (6 cycles) unless kitty earns a reduction by going below a certain point. That point depends on whether you are following Tight Regulation or Start Low, Go Slow for dosing guidance.

Thank you for doing the spreadsheet, that really helps us help you to help Max. First a question, that 41 you got on the 24th, did you double check that? If we get a number that seems out of sync with the rest, we'll usually test again to make sure it wasn't a test error. If it was a true test, then Max needs less insulin (less than 3 units), not more. Too much insulin can also cause high numbers. Another mechanism that can cause higher number is what we call a bounce. From the New to the Group Sticky Note:
Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

You might want to try reading the Sticky Notes on the top of this Forum. There is lots of info, feel free to ask questions.

Moving forward, I would try to gather a bit more information how low the dose is taking Max. Get some mid cycle tests if you can. Figuring out his onset and nadir will help you figure out the good times to test.
 
Wendy&Neko said:
Hello and welcome. Lantus is dosed quite differently than Prozinc. Instead of looking at the preshot numbers, we primarily look at the nadirs or low point. That means trying to get a test somewhere in the middle of the cycle if we can, cause that's where the low points are. Getting a test before bed is also really helpful. And since Lantus is a depot insulin, we hold the same dose for at least 3 days (6 cycles) unless kitty earns a reduction by going below a certain point. That point depends on whether you are following Tight Regulation or Start Low, Go Slow for dosing guidance.

Thank you for doing the spreadsheet, that really helps us help you to help Max. First a question, that 41 you got on the 24th, did you double check that? If we get a number that seems out of sync with the rest, we'll usually test again to make sure it wasn't a test error. If it was a true test, then Max needs less insulin (less than 3 units), not more. Too much insulin can also cause high numbers. Another mechanism that can cause higher number is what we call a bounce. From the New to the Group Sticky Note:
Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

You might want to try reading the Sticky Notes on the top of this Forum. There is lots of info, feel free to ask questions.

Moving forward, I would try to gather a bit more information how low the dose is taking Max. Get some mid cycle tests if you can. Figuring out his onset and nadir will help you figure out the good times to test.
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Thank you, Wendy (and Neko). I took Max to the vet on 6/21 at 3 p.m., the day before the 41 reading, because he was running in the 400s and 500s. She told me to increase to 3 units. I actually just increased it to 2.5 that evening but then 3 the next morning. He was 348 at 9 a.m. the next day after getting 3 units at 7 a.m., then 41 at about 4:30 p.m. I checked it twice because it was such a shocking (to me) drop. It was 40 the second time. So no insulin that evening. Was that the wrong thing to do? I was afraid that if I gave him 3--or any--he'd go completely hypoglycemic. Of course, then he was off the charts the next morning and has continued too high since then. So now I'm not sure how much to give him. Since Monday's evening feeding, he's had 3, then 3 and 3 yesterday, then 3.25 this morning. (I feed and give shots at 7 a.m. and 6 p.m.) Just tested him two minutes ago: 499 at just before 3 p.m. so +9.
 
Welcome. I'm glad Wendy beat me to it! It's really important to get some mid cycle tests in. Too much insulin can look like too little when you see the readings. Many drop at night like my Max did. I love the name by the way! If they drop low they can bounce to the roof! So let's see what happens.
 
I am glad you tested that 41 twice, good instincts! That tells me 3.0 units was too much. I would go to either 2.5 units or 2.75 units, and hold the dose for at least six cycles, unless you see another low number that says that dose is too much. The no insulin that night was fine given the amount of data you have on Max, but did mean higher numbers after that as he bounced and the depot stabilizes from the skipped shot. Bounces can take up to six cycles to resolve, so just be patient and keep shooting the same dose.
 
Wendy&Neko said:
I am glad you tested that 41 twice, good instincts! That tells me 3.0 units was too much. I would go to either 2.5 units or 2.75 units, and hold the dose for at least six cycles, unless you see another low number that says that dose is too much. The no insulin that night was fine given the amount of data you have on Max, but did mean higher numbers after that as he bounced and the depot stabilizes from the skipped shot. Bounces can take up to six cycles to resolve, so just be patient and keep shooting the same dose.
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Thank you SO much for the advice. It makes complete sense to me. I'll back him off a bit to 2.5 or 2.75 and give it six cycles. And I'll test more throughout the day at the same time. Fortunately, he doesn't seem to mind the quick stick; he just doesn't like me holding his ear! I've also ordered Zobaline for his neuropathy. I realized after watching the video last night on how to pull the insulin from the pen that I'd been contaminating it by pushing air into it. Yet one more thing I've learned in the past 24 hours since I discovered this forum. I wish vets were more forthcoming about resources such as this one. I realize it's not a substitute for veterinary care and guidance but it's a tremendous help.
 
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Max@20 said:
Max's spreadsheet is done--for the eight days I've been home testing. It's ugly.
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Great,thank you! Wendy gave you good dose advise in post #23 but if you have any other questions for tonight shot or would like to hear more opinions simply edit your title (go to the original post, upper right cornet Thread Tools-click on Edit title) and retype it to whatever concern you have at the time. Like "dose advise for tonight" or whatever is on your mind. You will get more eyes on your post if you chose ? as your prefix - there is drop down menu on the left of the title line. Posts go down on the forum as new ones are posted after it. To "bump" your post up you can simply reply to your own post. For instance my reply will move your post up.
I am new (-ish) myself to dose advise (but I would reduce as Wendy was saying) but want to offer my wholehearted support and the very best wishes for Max's speedy improvement. If you have the chance brows thru other ppl SS - you will see many were in similar discouraging numbers but achieved great results. And so will you and Max. :bighug:
 
Oh super! Thanks for the tips. I saw the prefix but was in panic mode ("Aaack, my cat is 20 years old and his numbers are off the chart and he feels rotten and he's going to die RIGHT NOW unless I find out more info," was running through my mind.) I do have a more general question. Sometimes he won't eat much at meal time--less than 1/4 of a 3 oz. can. Do you know what that means in terms of giving his shot? I worry about dosing him if he eats only a few bites. On the other hand, I know what happens if he doesn't get a shot at all. I may have read something about this in one of the Sticky Notes but I'm a bit on information overload.
 
Max@20 said:
Oh super! Thanks for the tips. I saw the prefix but was in panic mode ("Aaack, my cat is 20 years old and his numbers are off the chart and he feels rotten and he's going to die RIGHT NOW unless I find out more info," was running through my mind.) I do have a more general question. Sometimes he won't eat much at meal time--less than 1/4 of a 3 oz. can. Do you know what that means in terms of giving his shot? I worry about dosing him if he eats only a few bites. On the other hand, I know what happens if he doesn't get a shot at all. I may have read something about this in one of the Sticky Notes but I'm a bit on information overload.
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Lantus is a slow onset insulin so he doesn't need to have a full meal on board. I think he should be OK with a 1/4 of a 3 oz. can. Will he continue to nibble afterward?

You senior kitty is very handsome! It's good care that gets them to a ripe old age. :)
 
This site has been a life saver for me, Wendy is very active and give great advice, as other folks who have been around for a while. My cat also has severe neuropathy. I have taken the advice given and am seeing a bit of improvement. It is a slow process, so patience is important. I use Zobaline, Cosequin and just started adding fish oil. All suppose to help a bit. With your cats age, I would recommend the cosequin (hope I spelled that correctly) as he probably has arthritis. The is also a shot that you vet can give, I don't remember the name of it in the US, which is suppose to work well. @Wendy&Neko will know the name, as if I recall correctly she had let me know what the equivalent was in Canada (different name).

Good luck, and welcome
 
Max@20 said:
Sorry! My reply didn't show up as a reply to your question. Here's what I answered: I'm using a One Touch Ultra Mini, a human meter loaned to me by the animal sanctuary where I volunteer. I took it to the vet so I could see how it compared when they tested him and there was only a six-point difference.
Click to expand...
Ok good. I was going to suggest a human meter if your were using a pet meter since the human meter test strips are much less expensive. Not sure where you live but many of us here in the U.S. use the Relion brand, which you can get at Walmart.
 
Max@20 said:
Sometimes he won't eat much at meal time--less than 1/4 of a 3 oz. can. Do you know what that means in terms of giving his shot?
Click to expand...
Sorry, I think metric. Every Cat Is Different (ECID)But: I feed my cat small portions thru the day and her pre-shot meal size is 1 Table spoon (increased recently). Is it about what he eats? My cat's dose is smaller, of course, but you scaling down Max's dose tonight, aren't you? I say it makes great title for your post - shots & food questions - with ? prefix.

One of the good things about Lantus is it won't kick in for a couple of hours so if the pre-shot meal is a tablespoon you have another hour- hour and half to offer some more food. It is important that there is food on board when insulin onsets - begins taking effect. If you are worrying he wont eat any more - there are tricks to "induce" an appetite - easiest is to sprinkle some grated Parmesan cheese on top of his regular meal. Some cats would go for a bit of oregano - common spice popular in Italian, many ppl have in @pantry.

How is his appetite?
 
Max@20 said:
Oh super! Thanks for the tips. I saw the prefix but was in panic mode ("Aaack, my cat is 20 years old and his numbers are off the chart and he feels rotten and he's going to die RIGHT NOW unless I find out more info," was running through my mind.) I do have a more general question. Sometimes he won't eat much at meal time--less than 1/4 of a 3 oz. can. Do you know what that means in terms of giving his shot? I worry about dosing him if he eats only a few bites. On the other hand, I know what happens if he doesn't get a shot at all. I may have read something about this in one of the Sticky Notes but I'm a bit on information overload.
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I know all about information overload, we only retain less that 20% of what we take in, so don't be surprised that you repeat yourself a few times, at least you will have an idea where to find the information. I tend to retain more, while going through it, than by reading.
 
Kris & Teasel said:
Lantus is a slow onset insulin so he doesn't need to have a full meal on board. I think he should be OK with a 1/4 of a 3 oz. can. Will he continue to nibble afterward?

You senior kitty is very handsome! It's good care that gets them to a ripe old age. :)
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Ah, that makes sense. I have to meal feed because one of my other kitties is the Giant Sucking Black Hole of Food. However, in the last couple of weeks since Max has gone whack-a-doodle in terms of his numbers, I try to watch (I'm retired and Watching Max Manager is my new title) when he goes into the kitchen on one of his constant water trips. Then I scurry in and put some more canned food in front of him so he can eat a few more bites. He'll have a nibble then go back to the sofa. And thank you. I think he's a handsome boy. If you look just at his face, he looks great. If you look at his body, you'd think I never feed him.
 
Marvin's Mom - Nat said:
This site has been a life saver for me, Wendy is very active and give great advice, as other folks who have been around for a while. My cat also has severe neuropathy. I have taken the advice given and am seeing a bit of improvement. It is a slow process, so patience is important. I use Zobaline, Cosequin and just started adding fish oil. All suppose to help a bit. With your cats age, I would recommend the cosequin (hope I spelled that correctly) as he probably has arthritis. The is also a shot that you vet can give, I don't remember the name of it in the US, which is suppose to work well. @Wendy&Neko will know the name, as if I recall correctly she had let me know what the equivalent was in Canada (different name).

Good luck, and welcome
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Thank you! Yes, he does have arthritis. I've seen cosequin in the store...and my sister-in-law takes it for the same reason!
 
Max@20 said:
Ah, that makes sense. I have to meal feed because one of my other kitties is the Giant Sucking Black Hole of Food. However, in the last couple of weeks since Max has gone whack-a-doodle in terms of his numbers, I try to watch (I'm retired and Watching Max Manager is my new title) when he goes into the kitchen on one of his constant water trips. Then I scurry in and put some more canned food in front of him so he can eat a few more bites. He'll have a nibble then go back to the sofa. And thank you. I think he's a handsome boy. If you look just at his face, he looks great. If you look at his body, you'd think I never feed him.
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So long as he keeps nibbling he should be OK. He should gain some weight as his blood glucose is better controlled, although elderly cats do tend to have a harder time keeping it on. I had a kitty that lived to almost 22 and she seemed to almost fade away to nothing. Mind you, she was tiny to begin with.
 
Karen & Lily said:
Ok good. I was going to suggest a human meter if your were using a pet meter since the human meter test strips are much less expensive. Not sure where you live but many of us here in the U.S. use the Relion brand, which you can get at Walmart.
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I live in Oregon. I've been buying the test strips at Walmart, too, but I've been buying the branded ones which are about $35-ish for 25. I've been going through them pretty quickly and it's adding up. I'll have to check out the Relion. I buy the Lantus at Costco one pen at a time.
 
Tanya and Ducia said:
Sorry, I think metric. Every Cat Is Different (ECID)But: I feed my cat small portions thru the day and her pre-shot meal size is 1 Table spoon (increased recently). Is it about what he eats? My cat's dose is smaller, of course, but you scaling down Max's dose tonight, aren't you? I say it makes great title for your post - shots & food questions - with ? prefix.

One of the good things about Lantus is it won't kick in for a couple of hours so if the pre-shot meal is a tablespoon you have another hour- hour and half to offer some more food. It is important that there is food on board when insulin onsets - begins taking effect. If you are worrying he wont eat any more - there are tricks to "induce" an appetite - easiest is to sprinkle some grated Parmesan cheese on top of his regular meal. Some cats would go for a bit of oregano - common spice popular in Italian, many ppl have in @pantry.

How is his appetite?
Click to expand...
His appetite fluctuates, but it's been a bit better recently. He has certain...ahem...requirements. Food must be pâté. Food must not be refrigerated (and microwaving it does not fool him). Food must be placed just *so* on the elevated platform his dad made so that he doesn't have to strain his legs by crouching. Certain brands are not acceptable. You get the idea. :) In general, he does ok, but with his current BG levels, he's not converting any of it to useful stuff. I have Parmesan. I'll try that when he gets picky. Thanks!
 
Max@20 said:
e has certain...ahem...requirements. Food must be pâté. Food must not be refrigerated (and microwaving it does not fool him).
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Well, I can say Gentlemen when I see one.:) (As I said in post #4.)
Try adding some hot water to his pate - to warm up and to enhance the aroma. I have a feeling that he'll go for Parmesan.
 
Welcome to you and Max. What a handsome senior citizen! Rusty is also senior (17 or 18, perhaps) and has also lost weight (he's a picky eater and is not food-motivated; he "grazes" on his paté). You are doing well by feeding a little at a time over the course of the day. It must be tough to have both a grazer and a "hoover"!
You've got lots of good advice here, so I'll just say welcome. The Walmart Relion Confirm is an excellent meter. It is Walmart's brand name put onto the Arkray Glucocard 01 meter, which you can order from ADW (American Diabetes Wholesale; they have special deals where you can get a free meter kit with purchase of strips. This is the one I use: https://www.adwdiabetes.com/product/4045/arkray-glucocard-01-blood-glucose-monitoring-kit

WELCOME!
 
Max@20 said:
one of my other kitties is the Giant Sucking Black Hole of Food
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Lol, I have two of them! And then two "iffy" eaters. Separate rooms and constant vigilance is the only way anyone gets even close to the proper amount of food!

Welcome to FDMB, Max and Max's Mom! Your Max looks like a real love. I have a senior boy, too, he's 19. Our seniors need just a little bit more personal attention, don't they? Mine doesn't eat very well so he takes Cyproheptadine (appetite stimulant) twice a day. Ask your vet about it for Max, it does help. I also sprinkle all sorts of things over his food - crumbled up zero-carb treats, bonito flakes (a favorite!), Fortiflora, parmesan, the list goes on. He will still only eat about 1/4 of a meal (3 oz can) at a time, but I keep sticking the dish under his nose every 15-30 minutes until he has eaten basically all of it. I also add about a tablespoon of warm water to his food. It helps keep him hydrated and it warms the food just a tiny bit so it releases more aroma (he's lost some of his sense of smell) and is more appealing.

Some of Max's hind leg weakness might be the result of a potassium deficiency, not uncommon in diabetic kitties. It would probably be a good idea to have your vet run some bloodwork on him if he hasn't had it done in a year or so.

I noticed you don't give insulin at the same time morning and night. Lantus works best if you can manage to give the shots 12 hours apart, otherwise it can sometimes act as a dose increase or decrease. However, I also know it can be difficult to work around other schedules, and just life in general, sometimes!

Last but not least, I am going to recommend you get a bottle of ketone test strips and start testing Maz's urine for ketones., if you aren't, already. They are fairly inexpensive ( I get mine at Walmart) and easy to use. If you can't catch Max using the litterbox, we have lots of tips and tricks to help you get a urine sample. Just ask. :):):)
 
Darn! I just ordered the other, pricier stuff: Zobaline. Oh, well. I'll know next time. Thank you!
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@Max@20 - Once you see Zobaline start to work, there will be no doubts that it is worth the money.

The Vitacost version will serve you probably just as well if you want to switch in the future. Lots of people here use it and seem to be happy with it.

Because you're new to treating neuropathy, and because we all want to see Max walking normally as soon as possible, I think it's important to clarify a couple of points of comparison between them. Zobaline contains 3 milligrams of methyl-B12. That's 3000 micrograms.

Vitacost really confuses things by making several different strengths of this particular supplement. The one linked above points to the 500 microgram version. That's 1/6th the dose of a Zobaline. I'm sure that Lizzie meant to point you to the much stronger 5000 microgram (5 milligrams) version instead.

You can find more information on the 5000 micrograms (5 milligrams) version on Vitacost's website here:

https://www.vitacost.com/vitacost-vitamin-b-12-methylcobalamin-5000-mcg-100-capsules-6
 
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Ella & Rusty & Stu(GA) said:
Welcome to you and Max. What a handsome senior citizen! Rusty is also senior (17 or 18, perhaps) and has also lost weight (he's a picky eater and is not food-motivated; he "grazes" on his paté). You are doing well by feeding a little at a time over the course of the day. It must be tough to have both a grazer and a "hoover"!
You've got lots of good advice here, so I'll just say welcome. The Walmart Relion Confirm is an excellent meter. It is Walmart's brand name put onto the Arkray Glucocard 01 meter, which you can order from ADW (American Diabetes Wholesale; they have special deals where you can get a free meter kit with purchase of strips. This is the one I use: https://www.adwdiabetes.com/product/4045/arkray-glucocard-01-blood-glucose-monitoring-kit

WELCOME!
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They're all handsome and beautiful, aren't they?! I spend most of my time in the cat cottage at the sanctuary where I volunteer and they're all gorgeous. Of course. Thanks for the additional info on the meter. I'll definitely switch. I can get the Relion meter and 100 ct. strips for less than the cost of 25 strips for my current meter. Huge cost savings.
 
AZJenks said:
@Max@20 - Once you see Zobaline start to work, there will be no doubts that it is worth the money.

The Vitacost version will serve you probably just as well if you want to switch in the future. Lots of people here use it and seem to be happy with it.

Because you're new to treating neuropathy, and because we all want to see Max walking normally as soon as possible, I think it's important to clarify a couple of points of comparison between them. Zobaline contains 3 milligrams of methyl-B12. That's 3000 micrograms.

Vitacost really confuses things by making several different strengths of this particular supplement. The one linked above points to the 500 microgram version. That's 1/6th the dose of a Zobaline. I think Lizzie intended to point you to the much stronger 5000 microgram (5 milligrams) version instead.

You can find more information on the 5000 micrograms (5 milligrams) version on Vitacost's website here:

https://www.vitacost.com/vitacost-vitamin-b-12-methylcobalamin-5000-mcg-100-capsules-6
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I saw the different strengths on Vitacost, got a little worried about the higher dose (3 vs. 5) and opted for the Zobaline. Thanks for the clarification!
 
@Max@20 - methyl-B12 is a water-soluble vitamin, so any excess that the body can't use just gets excreted in the urine. Don't let that worry you.
 
Squalliesmom said:
Lol, I have two of them! And then two "iffy" eaters. Separate rooms and constant vigilance is the only way anyone gets even close to the proper amount of food!

Welcome to FDMB, Max and Max's Mom! Your Max looks like a real love. I have a senior boy, too, he's 19. Our seniors need just a little bit more personal attention, don't they? Mine doesn't eat very well so he takes Cyproheptadine (appetite stimulant) twice a day. Ask your vet about it for Max, it does help. I also sprinkle all sorts of things over his food - crumbled up zero-carb treats, bonito flakes (a favorite!), Fortiflora, parmesan, the list goes on. He will still only eat about 1/4 of a meal (3 oz can) at a time, but I keep sticking the dish under his nose every 15-30 minutes until he has eaten basically all of it. I also add about a tablespoon of warm water to his food. It helps keep him hydrated and it warms the food just a tiny bit so it releases more aroma (he's lost some of his sense of smell) and is more appealing.

Some of Max's hind leg weakness might be the result of a potassium deficiency, not uncommon in diabetic kitties. It would probably be a good idea to have your vet run some bloodwork on him if he hasn't had it done in a year or so.

I noticed you don't give insulin at the same time morning and night. Lantus works best if you can manage to give the shots 12 hours apart, otherwise it can sometimes act as a dose increase or decrease. However, I also know it can be difficult to work around other schedules, and just life in general, sometimes!

Last but not least, I am going to recommend you get a bottle of ketone test strips and start testing Maz's urine for ketones., if you aren't, already. They are fairly inexpensive ( I get mine at Walmart) and easy to use. If you can't catch Max using the litterbox, we have lots of tips and tricks to help you get a urine sample. Just ask. :):):)
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Oh, yes. Three cats here, three different rooms for feeding!

Really helpful info about how you feed your super senior! Great ideas for tempting him. I have to sprinkle 1/4 tsp of Miralax at each feeding for Max's constipation.

I do know about the 12-hour timing. I was rounding a bit. Actual administration of insulin is 7 a.m. and 6:15 p.m., but still, not 12 hours. Looking back at what @Tanya and Ducia wrote about Lantus being slow acting, I could do my 6 p.m. feeding and wait until 7 p.m. for the shot. Would that be better? He's a slow eater and doesn't finish until about 6:20 so it would be only a 40-minute delay until the shot.

It would be easy to stick a strip in Max's urine stream since he has recently started to pee horizontally instead of vertically — right over the side of the box. I'm sure it's because it's painful for him to crouch, poor guy.

Thank you!
 
Max@20 said:
Oh, yes. Three cats here, three different rooms for feeding!

Really helpful info about how you feed your super senior! Great ideas for tempting him. I have to sprinkle 1/4 tsp of Miralax at each feeding for Max's constipation.

I do know about the 12-hour timing. I was rounding a bit. Actual administration of insulin is 7 a.m. and 6:15 p.m., but still, not 12 hours. Looking back at what @Tanya and Ducia wrote about Lantus being slow acting, I could do my 6 p.m. feeding and wait until 7 p.m. for the shot. Would that be better? He's a slow eater and doesn't finish until about 6:20 so it would be only a 40-minute delay until the shot.

It would be easy to stick a strip in Max's urine stream since he has recently started to pee horizontally instead of vertically — right over the side of the box. I'm sure it's because it's painful for him to crouch, poor guy.

Thank you!
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Welcome to FDMB!

I guess I don't understand why he can't get his shot and fed at 7 am and 7 pm? If you fed and shot at 7/7 and it takes him 20 mins to eat, it doesn't really matter with Lantus.

I'm glad you will be able to get some midcycle tests. I would recommend random spot checks for instance +2, +5, +8 and then switch it up the next day. At night, if you can get a +2 and a before bed test, that would be wonderful.

I also think Wendy's idea to hold the dose at 2.5u or 2.75u is an excellent idea so we can figure out what he's doing. I've looked at a lot of SSs and many times when I've seen one look like this, it's because kitty is overdosed. Not always...but it can definitely happen.

However, just in case he has something going on that is making his numbers this high, it's best to hold the dose and do some extra testing to fill in the blanks and see what his BG is doing during the cycle rather than dropping the dose back and having him stay in high numbers for a longer amount of time.

We've seen kitties easily go from 300 to 40 to 300 in a cycle and then go up into red and black as they bounce. If the caregiver hadn't gotten that midcycle test, we'd have never known for sure kitty was dropping low.
 
Max@20 said:
I could do my 6 p.m. feeding and wait until 7 p.m. for the shot. Would that be better? He's a slow eater and doesn't finish until about 6:20 so it would be only a 40-minute delay until the shot.
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I think it is fine. But if it was me I'd rather move my feeding time to 6:20PM, let him eat until 6:55PM - 7PM on his own pace and then do the shoot.
When shots are given 1 hour earlier the same dose acts as an increased one, and that might require more testing on your part. 40-45 min, obviously, lesser than an hour but it might cause the same increased dose effect. Really, if possible, 12 hours gap is the most reliable schedule to access Lantus effect on a kitty. (And vice versa: one hour later shot of the same dose acts as if decreased).

I am really happy to see how many good advice you've got and how fast you are acting: buying meds, etc;Please do not be overwelmed by tons of info we threw at you - it all will settle down and come to Max's service @the time of need.
 
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