Monitoring a cat when working full time?

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KittyMom777

KittyMom777

Member Since 2014
Hi,
I am new to the forum with a newly diagnosed cat. Here is a bit of background before my question:

Started off with 1 unit Lantus insulin once per day. After three weeks, I put him up to 2 units once per day as I had been home testing him and got really high numbers all the time - 23, 21 etc. Vet didn't really agree with this and said to wait two more weeks before coming in for a glucose curve as it took two weeks to notice an increase. Two weeks later - on Saturday 1st, he had his curve. He had very high numbers just before insulin (28) then suddenly dropped to 6. The vet said this isn't normal and she would have expected the numbers to gradually come down then go back up again. 12 hrs later after I got him home, I tested again and got 28. (the vet had low numbers all day - under 10 and above 4).

So after seeing that the numbers were 28 again after 12 hrs, the vet said to give him 2 units at night too. I don't think its a good idea to do that. Should I split the 2 units in the morning and give 1 in the morning and 1 at night?

Also, how do I keep it 12 hrs apart? I work full time - I leave at 7 am and I am home at 7pm. However, sometimes my train is delayed or I don't get home. If I give late is that a problem? Then what if its less than 12 hrs before the next shot - ie 8pm one night, can I still give at 7am the next day?

I am not home during the day and the cat is home alone. So I cant keep an eye on him if he were to have dangerously low numbers. how do you still maintain a life while caring for a diabetic cat?

Lynette
 
I'm not on the same type of insilun as you are, so i can't advise on that issue. I can say that I feel your pain! I work full time and have four busy kids. This kitty is pushing my schedule limits, but somehow we all make it work because we love them :-) It's very scary and overwhelming, but you will find a way to fit it all in. personally, I decided not to make any changes unless I am going to be home (I have weekends off) just so that I can watch him. Other than that, I just try to get as much information as possible when I am able to observe him. I keep logs of food, bathroom, weight, grooming type habits, etc so that I will notice right away if there are any changes.

I'm sure you will get the information you are asking about soon, hang in there :-)
 
Welcome to FDMB.

You do your best to do 12 hour times; 30 minutes variance isn't too bad. Over time, you may find you have to very slightly adjust the dose to account for timing. Testing will guide you.

Lantus works best with 2 doses per day, as near to 12 hours apart as possible - it weas off by about 12 hours and up the numbers go.. Splitting the dose should keep the cat more stable.

Do any dose increase when you'll be able to monitor. Since it can take 3 to 5 days to see the effects, start an increase 2.5 days before a day off so you can monitor carefully on the 3rd and 4th days. We only increase by 0.25 to 0.5 units at a time ( you have to eyeball 0.25 and 0.75).

You might see about a pet sitter checking in mid-way through the 12 hours whenever you are adjusting the dose, too, for safety.

What are you feeding?
 
Thanks. The reason I am nervous increasing is that he drops very suddenly after the insulin. Still 6 so not too low but if I am not around....? I am home tonight so going to give him 1 unit this evening then check his BG an hour later.

I cant really afford a pet sitter. I am already struggling with the extremely high vet bills and stuff I needed to get for him. He also has a urine infection so had to get antibiotics, a culture test done and his curve. Was a shock when I got the bill.

I am feeding him Purina DM wet (1/4 can) with 1/4 cup Purina DM dry in the same dish twice daily. I don't free feed as he eats all that is put down immediately anyways and my other cat would eat it. She is a whopping 16lb and needs to lose weight.

I tried to wean off the dry but he keeps asking for more food within a few mins of feeding the wet food only. Its high protein low carb so I am not too worried although I know that no dry is better.

Lynette
 
As you're home testing, you can do the curves at home and send the data to your vet. It will give you accurate information about your cat's BG in his home environment and it will save money on vet bills, too.
 
I didn't want to do the first curve myself but I think I will do the next one myself. How often should they be done?
 
I can relate to that! The vet who diagnosed Saoirse did her first curves which was probably a very good thing given that I was in a right tizz with all the new things I had to get my head around.

I test Saoirse very frequently so I'm not the best to ask about how often to do full curves. Hopefully another member will be along soon to help you with that question.
 
If you can routinely get some mid-cycle tests and slightly vary the times (on different days, choose 1 of these: +5, +5.5, +6, +6.5 +7), you don't need to do a curve.

Anytime you're changing the dose, getting mid-cycle tests or doing a curve is helpful.
When your pre-shots seem high, yet mid-cycle are sufficiently low (50-100 mg/dL on a human meter), doing a curve identifies problems with duration.

If your vet asks for one, do one.
 
It's a bit difficult to do mid cycle tests - by that I think you mean different times in the day? I work full time and commute so I'm out 12 hrs Monday to Friday. I can only really do mid cycle testing at the weekend. Vet wants me to increase to 2 units at night (currently none) but I want to wait til the weekend til I can keep an eye on him.
 
Some folks set an alarm at night. If you ever need to do that, it is easiest to wake up at the end of a sleep cycle, when it isn't as deep. The average sleep cycle is roughly 45 minutes, so pick a multiple of 45 minutes - ex 3 hours, or 4.5 hours.

Otherwise, weekends only is when you'll want to be checking for mid-cycle numbers, or before bed, so you know you can sleep without worrying.
 
BJM said:
If you can routinely get some mid-cycle tests and slightly vary the times (on different days, choose 1 of these: +5, +5.5, +6, +6.5 +7), you don't need to do a curve.

Anytime you're changing the dose, getting mid-cycle tests or doing a curve is helpful.
When your pre-shots seem high, yet mid-cycle are sufficiently low (50-100 mg/dL on a human meter), doing a curve identifies problems with duration.

If your vet asks for one, do one.
Click to expand...

Hi. I read your glucometer notes and I had a question. Nadir means the lowest BG reading after insulin right? Well my cat is at the lowest point almost immediately after getting the insulin. I tested him before insulin and it was 28 mml/L then an hour after insulin it was 6.2. Gradually went up again bug lowest was the 6.2. Is that usual?
 
Nadir is the lowest glucose after a shot. It is usually around +5 to +7 hours after the shot.

Hmm. Whenever you get an unusual number, re-test right away.

Lets look at meter variance, the +/-20% range in which true value likely falls.
Pre-shot 28 mml/L (504 mg/dL) --> 403.2-604.8
+1 6.2 (111.6 mg/dL) --> 89.28-133.92

And, you've been shooting 1 time a day, so the numbers will be wonky. Shooting twice a day, close to 12 hours apart, works better for Lantus.
 
I'm sorry I don't understand your reply. I am not understanding the technological language either. His glucose curve was done by vet and was as follows:

One hour before insulin - 28
Two hours after 2 units of insulin - 6.2
Two hours after that - 7.1
Two after that - 7.3
Two after that 8.4
Two after that 13.1
Two after that - 28
Two after that 23.2

Because of the high numbers 12 hours after shot vet said to give 2 units at night too. Thinking of increasing to just one unit at night and building up to two.

Is that curve unusual? The high numbers were done by me so j thought maybe faulty glucometer? So I tested my non diabetic cat and got a reading of 4.6 so that says its works fine.
 
When Lantus is injected, it forms small crystals under the skin. This is called the depot and is why Lantus is called a depot insulin.
The crystals dissolve slowly and release the insulin to work.
This happens over a little bit more than 12 hours.
When you give Lantus every 12 hours, a small amount of crystals is left from the previous shot.
This results in a small amount of overlap in the depot from the previous shot and the depot created from the current shot.
This overlap allows for smoother, lower numbers across the period between each shot.
When you shoot only 1 time a day, the insulin wears off overnight; thus you are starting over each time you give only 1 shot in the morning.

The curve is faulty because the vet is treating the insulin like an in and out insulin, not like one which has carryover from a depot. Too much is being given in 1 shot, dropping the glucose abruptly and steeply.

It would be best to give 1 unit of insulin twice a day, close to 12 hours apart, then after 3-5 days, run another curve to see how it is working.
Dose increases should be made in 0.25 to 0.5 unit amounts, so you don't skip over the best dose.
 
One thing you can do for peace of mind is invest in an auto feeder, so kitty has food available when you're out. Since we recommend you feed canned only, one strategy is to mix some water in with the canned food and freeze it in an ice cube tray. That way you can put the food in a timed feeder and it will thaw out slowly/stay fresher until it's time to be eaten. It's hard when you can't be with them, but it's possible. Having food available when you're out is probably the safest thing I can think of. Small adjustments with the dose changes is also smart. Keep posting and peeps here will help. You're not alone!
 
BJM said:
When Lantus is injected, it forms small crystals under the skin. This is called the depot and is why Lantus is called a depot insulin.
The crystals dissolve slowly and release the insulin to work.
This happens over a little bit more than 12 hours.
When you give Lantus every 12 hours, a small amount of crystals is left from the previous shot.
This results in a small amount of overlap in the depot from the previous shot and the depot created from the current shot.
This overlap allows for smoother, lower numbers across the period between each shot.
When you shoot only 1 time a day, the insulin wears off overnight; thus you are starting over each time you give only 1 shot in the morning.

The curve is faulty because the vet is treating the insulin like an in and out insulin, not like one which has carryover from a depot. Too much is being given in 1 shot, dropping the glucose abruptly and steeply.

It would be best to give 1 unit of insulin twice a day, close to 12 hours apart, then after 3-5 days, run another curve to see how it is working.
Dose increases should be made in 0.25 to 0.5 unit amounts, so you don't skip over the best dose.
Click to expand...

Hi. That makes a lot of sense. When he was on only one unit in the morning tho his glucose levels did not lower at all. We put him to 1 and a half units and no change at all. Only on two units did it drop. I am thinking to give one unit at night and two in the morning and test his levels after the night dose. Not going to do anything til I am home to watch him at thx weekend.

Can't use a feeder Tara as my cats don't and never have free fed. One is on a diet for her weight. When I used to go away overnight and left food down for them it was all fine before I left the house. They don't graze.
 
Please give equal doses morning and night.

Lantus works best this way. I'm going to guess that possibly 1.5 units morning and night may work out.
 
Some cats like my Pathes and my past Bailey did best with slightly different does of Lantus AM and PM. My Patches is on 1.5 PM and 2.1 AM. It all depends upon the cat.
 
Larry and Kitties said:
Some cats like my Pathes and my past Bailey did best with slightly different does of Lantus AM and PM. My Patches is on 1.5 PM and 2.1 AM. It all depends upon the cat.
Click to expand...

Yes, I plan to give him one unit in the evening and two in the morning and see how that works for him. Likely he will go to 2 and 2 but I don't want to do that too fast.
 
KittyMom777 said:
I didn't want to do the first curve myself but I think I will do the next one myself. How often should they be done?
Click to expand...
I feel the same way but want to do it at home after the first vet curve.

My vet said that you want to give the shots as close to 12 hours as you can but it's not always possible so don't make yourself sick if on occasion your late on a shot.
 
Robin-S said:
KittyMom777 said:
I didn't want to do the first curve myself but I think I will do the next one myself. How often should they be done?
Click to expand...
I feel the same way but want to do it at home after the first vet curve.

My vet said that you want to give the shots as close to 12 hours as you can but it's not always possible so don't make yourself sick if on occasion your late on a shot.
Click to expand...

I hear you, but my cat drops to his lowest point an hour after insulin is given. I cant risk giving him insulin late because then I won't have a full 12 hours before the morning shot and I leave for work. If he is not at his highest point before I give the insulin I cant give it as he will have a hypo when I am at work. I hate all this, I am out 12 hours a day every day and I can only monitor him properly at the weekend. I live alone so no-one to help.
 
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