My Cat, Marley was Diagnosed this morning...

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AmySawyer

Member Since 2014
Hi, my name is Amy, I am a new member. I live in the Bahamas & My 7 year old cat Marley was just diagnosed this morning. I am a complete wreck, but after reading a lot on this site, it has helped me feel a lot better, & like this is a manageable disease.
Most of Marley's life, she has been a fat cat, weighing at about 14 - 15 lbs. Last October, my husband & I went away for a few days, & my mom was taking care of our animals while we were gone. When we returned, we noticed something was just not right with Marley. She looked like she had lost a bit of weight. We also have another cat, a male named Ziggy who is very food dominant, so we thought maybe he was the reason she had lost a few lbs. We decided to monitor it for a while & see how things went. Well, since October, we switched her to wet food & she put back on 2 lbs, but she still just didn't seem right.... Yesterday, when we got home from work, she ran out to see us as she normally does, & we noticed she appeared to be limping..... I immediately called my vet & told him what was going on, as he was already up to speed with her weight loss issues... he told me to bring her in this morning so he could check her out. After doing some research of my own online, I came to the assumption it could be feline diabetes. We took her in first thing this morning, & when he did the blood sugar test, her blood glucose level was at an alarming 660 :( I immediately felt sick to my stomach & wished that I had brought her in from back in October when we first realized something was going on with her.
Marley is a very difficult cat to take to the vet, so that was our last resort. I have a pretty good relationship with our vet, so I think that he will work closely with me to get this under control. I am taking her back later today for him to show me how to administer the insulin shots. He said initially she will need 1 shot twice a day with her meals until we can figure out the right balance that gets her glucose levels under control. We also talked about prescription food, which he said will help as well.
Like I said, I am very new to all of this, so any feedback or advice or words of support would be greatly appreciated. I am so thankful that there is a group like this that I can look to for answers, as I live on a small island & our vet is only here twice a week. I am one very scared fur-mom right now :(
Thanks in advance for any support offered.
Amy
 
Hi Amy and (extra) sweet Marley-cat! Welcome to the club! You're in exactly the right place to learn to handle this.
 
Welcome Amy and extra sweet Marley! You landed in the BEST place you never wanted to be... :-D

First, BREATHE! and another one....

Now, feline diabetes is NOT a death sentence, it's very treatable. Any idea what kind of insulin he'll be putting Marley on? Cat's metabolism is about twice as fast as humans - this requires 2 shots a day rather than 1. One shot a day will wear off before 24 hours. There's several different kinds of insulin - Humulin/Novalin N, ProZinc, PZI, Lantus, Levimir...when we know what kind, we can guide you a bit better.

Have you considered home testing? You wouldn't give a child insulin without testing to be sure it's safe, why would you shoot your kitty blindly? It's not hard but you may hear differently from your vet. My vet thinks ear testing is torture - it's NOT! MY two extra sweet boyz come to me when they hear their meter beep! They also come get me if I don't realize it's shot time. Would they do that if it was torture? Nah....! Many vets don't know HOW to test other than a vein blood draw. We do our own testing and our own curves to determine dose changes.

BREATHE again!!! Smile....you found the right place here. People here LIVE feline diabetes - many vets have very little experience.

BIG HUGS!
 
Welcome Amy & Marley,
Listen and learn from these experienced people that will be contacting you,they have a wealth of knowledge on FD far more than any vet.They will guide you and be with you every step of the way to getting Marley stabilised.
Best of luck. Diane & Bailey
 
Hi Amy,

When you go to the vet today, there are a few things of which you should be aware:

1. Type of Insulin: Several insulins work well in cats, such as PZI, Levimir and Lantus.

2. Home Testing: Since Marley is not a fan of the vet's office (few cats are!), home testing is essential. You can use any human blood glucose meter, although people on this site have had the best luck with the Relion confirm/micro variety. This is the Wal-mart version and is relatively easy to get and cheap. You can order it from online as well, if you don't have a Walmart near you due to your island home! Your vet may also mention a pet specific brand called Alphatrak. This also works well, but the test strips are about 3 times as expensive as the Relion. I would strongly suggest home testing! You will save money and have better regulation of Marley's blood sugar.

3. Low Carb Wet Food: What type of wet food do you feed Marley? For diabetic cats, the food should be less that 10% carbs. You can use the prescription food (probably Purina or Hills Diet DM will be recommended), but it is expensive and mostly pork liver. If Marley likes the taste of liver, she will have raptures over the food. If not, then she might turn up her nose at it. There are other less expensive low carb wet foods that you can get. Some examples are Fancy Feast classics and Friskies Pates. Friskies pates also come in larger cans which is more cost effective! There are two very good sites, that I would suggest you look at for cat food nutrition information. The first is http://www.catinfo.org, a site written by a vet, Dr. Lisa Pierson. The second is a food composition chart http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf, that lists an enormous number of different wet cat foods and the carb composition.

Lastly, take a deep breath. We have all been where you are right now and we understand the stress you are under. You can do this!

Liz
 
Hi fur mom Amy and sweet Marley,

Dont fret too much over the limping, this is almost always reversable with diet and insulin therapy.

As for the prescription foods the vet is talking about, no matter what he says please dont get sold on the prescription dry formula. As for the wet prescription formula, I personally would stay away from that as well, as it is costly and not even as good as some of the easier to purchase store brands. I tried two of my cats on prescription purina dm and both of them got sick and stopped eating right afterwards. Im not sure if it was the food, but its not a stretch to say that some foods seem to upset stomachs more than others.

What you want is low carb foods. Do you have Fancy Feast available in the bahamas? Their pate or classic versions are low carb and almost every cat seem to like them. Hopefully others can link some good readings regarding feline diabetes and appropriate cat food.

You came to a good place for support.
 
Thanks so much everyone for the encouragement & support! I have learned just how strong I really am after a very stressful 24 hours! We got Marley's blood glucose level down to 109 last night! I administered her second shot of insulin myself last night (with help from my hubby) & it was surprisingly easy to do! We have her on Humulin 70/30 & she got 2 shots of that yesterday. She is also now on Hill's prescription diet w/d which she's not very fond of, but eating it anyway... We also got the AlphaTrak testing kit & we are testing her ourselves from home. Yesterday we tested her 6 times as it was the critical first stages of diagnosis. This morning her blood glucose level was 287 (which is a far cry from 660 yesterday morning!) & our vet said that was not too bad considering... I feel so much more at ease today, just knowing that I CAN DO THIS. Marley is such a trooper & I am very proud of how well she is dealing with all of this. Still working out a few kinks with the dosage levels, but hopefully in a week or so we will know exactly what she needs & when.
Again thank you all for the support!
 
She is also now on Hill's prescription diet w/d which she's not very fond of, but eating it anyway...

The Hill's prescription diet W/d dry is one of the higher carb foods available around 37% carb for the dry and 25% carb for the wet. Some vets still think it's appropriate for a diabetic cat to eat, but most of us here feed low carb canned foods and get much better regulation and glucose control.

I have experience using that W/d food. My cat Wink was on that W/d food prescribed by one of his vets. His blood glucose numbers were absolutely horrible. When I switched him, I had to convince him that the canned food was even edible since he was a dry food addict. Shortly after weaning him off the high carb food, he went into remission.

Perhaps Marley will have better luck on that food. If not, post here again and we'll give you some other ideas.
 
Well the w/d food we're giving her is the canned. We are still trying to figure out how much insulin she is going to need each day & at what times so we'll stick with this food for a few weeks & see how it goes, if we're not seeing things start to level out we may switch her back to the Fancy Feast Classics wet food which she loved when we tried that before even getting the diagnosis from our vet.
It seems like in the beginning after initial diagnosis its a bit tricky & kind of trial & error so I am really hoping we can get it figured out soon.
Otherwise, Marley's extreme thirst & excessive urination have already decreased tremendously! In only 2 days of treatment! That makes me feel like we are definitely on the right track :)
 
You said you were home testing. We'd love to have you share some of the BG (blood glucose) numbers with us.

Since we live in different time zones, we have come up with a + hour format to level the playing field and let us speak in the same times, which are the elapsed time since the last shot.

AMPS = morning (AM) pre-shot test
+1 = 1 hour after shot
+4 = 4 hours after shot
PMPS = evening (PM) pre-shot test.

It's fantastic that Marley is already showing decreased urination and water intake. When those pee patch sizes shrink from being super sticky huge "Lakes" to normal size puddles, it's a great sign and shows what you are doing is helping. It's so nice to see when our sugarkitties start to show some of these signs of improvement and start to return to some of their old behavior like playing more or grooming themselves again.

The Fancy Feast classic foods that you were feeding Marley are actually much lower in carb content than the Hill's W/d. Prices and variety of flavors are also much better than the single flavor available of the Hill's W/d. We've had many members on here say that their cats will refuse to eat the W/d after a short period of time when the novelty of that liver flavor has worn off. So you might want to have a few cans of the Fancy Feast classic on head just in case Marley starts to turn her nose up at the W/d.

Does Marley need to lose some weight? I'm asking because that W/d is a weight loss food, often prescribed for cats that need to shed some pounds.

A wonderful vet, Dr. Lisa Pierson contacted all the pet food companies to get nutritional data and spent countless hours putting together this info and doing calculations to get the protein, fat and carb content of most of the wet foods available in the US and Canada.

Here's the food chart if you are interested in taking a look. The Hill's W/d is on page 29, the Fancy Feast classic pates are on page 5. We normally suggest you look for foods with a carb content of < 10%. The carb content is in the 3rd column of numbers on that food chart.

The AAHA Diabetes Management Guidelines for Dogs and Cats actually recommends feeding your cat "the lowest carbohydrate content food they will eat". This is from a vet published journal back from May 2010 and contains some of the more recent research and treatment guidelines for cats (and dogs). It's from the Journal of the American Animal Hospital Association 2010; 46:215-224.

Limit carbohydrate intake.
Dietary carbohydrate may contribute to hyperglycemia and glucose toxicity in cats.
Provide the lowest amount of carbohydrate levels in the diet that the cat will eat.
Carbohydrate levels can be loosely classified as ultralow (<5% ME), low (5% to 25% ME), moderate (26% to 50% ME), and high (>50% ME).

Please be very careful with dosing that Humulin. It can drop a cats' BG very low, very rapidly. We don't want Marley to have a hypo. Be sure you are testing, then feeding , then waiting 30-60 minutes before you give the shot of insulin. It's a bit different than other insulins people use here and you need to make sure Marley has food on board and is not going to throw up before she gets the insulin shot. The onset is very fast, usually within 45-60 minutes. Please keep her safe.
 
AmySawyer said:
...We have her on Humulin 70/30 & she got 2 shots of that yesterday. ...

The 30 refers to the percent of Humulin R in the mixture and the 70 is the percent of Humulin N.
Humulin R lasts roughly 4-5 hours in the cat; Humulin N lasts roughly 6-8 hours in the cat.
This leaves about 4-6 hours without insulin coverage, depending on the cat.
Both drop the glucose level very rapidly and wear off very rapidly.
It is likely that using this insulin, you may need to shoot 3 times a day to get good control.

I would suggest switching to 100% N insulin if that is all that is available for pets in the Bahamas. If you can get Lantus or Levemir (human insulins) those would significantly better for your cat.

It will really help us if you record your test data in a viewable grid/spreadsheet for use to review and give you feedback. Instructions are here.
 
Sorry it has taken me so long to post on this again! Life is kind of hectic with a diabetic cat when you are trying to figure out dosage levels etc. I will try to post her blood glucose levels at some point, but as of right now they are still very much up & down.

I emailed my vet to ask him what he thought about switching Marley to Fancy Feast Classics or Friskies Pates & he didn't seem to like the idea. But I think I am going to do it anyway because after 2 weeks on w/d her numbers are not getting any more stable. Her over all demeanor has improved greatly, getting her strength back & playing & just over all acting more like herself. But I am not happy at all with this w/d food & the numbers it is giving. They are either sky high (usually first thing in the morning at 6am they're in the 400's) or extremely low (usually lunch time or 6pm it'll be under 100!) so I feel like this food is just not working for her. She has had both friskies & fancy feast before & likes them both so I am going to switch her & keep testing & monitoring things (& lower her insulin dose, which I read is best when switching to a lower carb food). We also put our other cat Ziggy who is not a diabetic on the friskies pates & he loves it. After reading up on how horrible dry cat food is, I am glad that I switched him too!

Will try to post her glucose levels on the spreadsheet here as soon as I have some free time between work & dealing with Marley. & will keep you guys updated with how she responds to switching her to the lower carb food.

Thanks again for all of the advice! It is GREATLY appreciated!
 
Until you get the spreadsheet up and running, you can list the glucose tests as

AMPS - morning pre-shot
+# - any glucose test # hours since the shot
Ex, +5 is a test 5 hours after the shot
PMPS - evening pre-shot

Are you still giving the 70/30 Humulin insulin? If yes, that is part of why the numbers are erratic. At most, it will last 6-8 hours from the NPH insulin in the mixture, then wear off.
 
Yes she is still on the Humulin 30/70. My vet wants to stick with this insulin for now... So I don't really have another option with that at this point, so that's why I want to try switching the food & see if that makes a difference.

We will test tonight & feed her the new food & see how it goes.

Will keep you all updated.
 
You can likely just go to a pharmacy and purchase N (NPH) insulin. A script is not required. it would be better than the 30/70 yuo are not using.
 
Go up a few posts for the AAHA guidelines and print out a copy. They recommend Lantus as a gentle, ong acting insulin very successful in controlling glucose levels in Diabetics.

Have you done a curve at home? Test from pre-shot to pre-shot and every 2 hours, then chart it on a graph. That could show him visually how fast the insulin is wearing off (in dogs, it lasts longer; perhaps he has forgotten a cat's metabolism is about twice that of a dog's!)

Read over it, then give it to your vet. He is very out of date.

On your end, can you test and shoot every 8 hours? Otherwise, the insulin is wearing off with 4-6 hours of no insulin. This is a great part of the variability of your numbers. If not, you need to pick up the food by +8 at the latest.
 
Can you buy insulin over the counter in the Bahamas?

If yes, I'd encourage you to go for it.If all you can get is just Humulin N, that is still better than the 70/30 you are using. If you can get Lantus, so much the better.
 
Just spoke with my pharmacist, I can get the lantus over the counter tomorrow morning! Its a bit more expensive than what she's on now but at this point I dont care & would try anything to get her regulated!

Will update after we start using the lantus along with the Fancy Feast Classics food.

I really hope this helps!
 
Also, once I get the Lantus, she will probably already had to have at least 1/2 a unit to 1 unit of the Humulin 30/70 at 6:00am when we test her, as it is usually very high first thing in the morning, how long should I wait before giving her the Lantus? We have been testing at 6am, 12pm, 6pm & 11pm. She usually needs another dose by 6pm when we test..
 
You'll only need to shoot every 12 hours with Lantus, so pick a time am and pm that will work for you. I would skip the Humulin or only give a small token dose and start right with the Lantus, or start in the evening if preferred.

The starting dose should be based on
1) the lower of Marley's current weight or ideal weight
2) in Kilograms (for us non-metric types, that's pounds divided by 2.2)
3) multiplied by 0.25
4) rounded down to the nearest 0.25 units (we routinely eyeball quarter units as best we can on the U-100 syringes)

Really important: stick with the first dose for a full 5 days, even if it seems like the glucose is too high. Lantus effects build up over time.

You'll want to pop over to the Lantus Tight Regulation forum and read over the sticky posts at the top about how to store, use, dose with Lantus, and steer numbers when the glucose seems to be dropping too much.
 
Will read up on the Lantus forum. From that calculation her dose should be between 1 unit & 1.25 units. Thanks for all the info so far! Will keep updating as we go along.
 
Yes will start with the lower value. I read on the Lantus forum I should use U-100 siringes. Currently I have a box of U-40 siringes, would these be ok? Or should I check with my vet to see if they have (or can get) U100?
 
You need U-100 syringes. Please get them from your vet. A unit on the other syringes is a lot different than a unit on the U-100 syringes. You can order U-100 syringes online from places like Walmart or American Diabetes Wholesale. For now, see if your vet will give you some to get by or see if the pharmacy you are going to has any, and with 1/2 unit marks if possible.


I agree with BJM. Start with the lower dose, especially if you are switching to a lower carb food. You can slowly work your way up, if it turns out to not be enough. I would plan to test more often for the first 5 to 7 days. Lantus dosing is based on the lowest point in the cycle, so you want to catch that nadir test when you can. Post if you get a test that worries you, or if you are unsure about giving insulin because of a low number at shot time.

Good luck with the Lantus ;-)
I hope you get a spreadsheet set up soon. Even if you just start with today's numbers for now, you can go back and fill in the previous days later. You'll want to mark on the spreadsheet when you switched insulins and when you switched food, too.
 
OK spoke with the vet, they have a few U-100 syringes so I will get what they have this morning & they are going to order more for me. Will also pick up the Lantus this morning & use that for this evenings dose.

Her numbers yesterday were as follows...

6am pre shot - 470
gave 2 units of Humulin 30/70 (that is what our vet had been recommending when it was that high) with the U-40 syringe.
Fed 1/2 can of Hills W/D food.
12pm (6 hours post shot) - BG Level 35 (I amost passed out when i saw this!!!)
We immediately fed her 3/4 of a can of the W/D food. (thankfully she was not showing any symptoms of hypo & was willing to eat) She ate ALL of the food.
6pm (12 hours post shot) BG Level - 411.
Gave 1/2 unit of Humulin 30/70 & then fed 1 3oz can of Fancy Feast Classics.
10pm (4 hours post shot) BG Level 300. We left her at that for the night, not wanting it to drop so drastically again.

So far this morning her numbers are...

6am pre shot - 471
Gave only 1/2 a unit of the Humulin 30/70 & fed 1 3oz can of Fancy Feast Classics.

Will test again at 12pm before feeding. We have her on a 6am/12pm/6pm feeding schedule. It may be higher than normal at 12pm since she only got 1/2 a unit this morning, but she also got a much lower carb food so I don't know how that will affect things. I probably won't give her another shot at 12pm just because we want to try to get her on a 6am / 6pm dose with the Lantus starting at 6pm this evening.

Will get the spreadsheet up & running as soon as possible. I have to do it from my computer at work as I only have a mobile device at home & it's a little tricky to do that on my phone.

Will keep updating as we go on.
Any thoughts or recommendations??
 
& I must have set up my account on here wrong cuz it was not 4:23am when I posted that last message. It is 9:15AM right now. ugh....
 
My vet has now recommended vestulin & I already knew from browsing this message board that that type of insulin is NOT a good one to use. It seems I know more about feline diabetes in just 2 weeks of research than he does!!! Very frustrating, but I am staying the course I planned for today & getting the Lantus & the U-100 syringes.

Will update with 12pm & 6pm testing results.

How long should we wait after starting Marley on lantus before we do a curve test? I read about a week on the forum last night... But I have Read so much in the last 12 hours that I am not even seeing straight at this point...
 
Got the Lantus insulin, & got a few packs of the U-100 syringes.

After doing MORE research online, apparently those U-40 syringes my vet had given me to use with the Humulin are NOT the approved syringes & she probably got an overdose yesterday morning when we thought we had given her 2 units with those syringes! :shock: I am extremely frustrated with my vet at this point. So I am just going to consult with you guys on this forum unless I have a serious emergency.

Once we give her the dose (going to go with 1 unit on the U-1oo syringes) of Lantus this evening at 6pm (she will eat her new lower carb Fancy Feast Classics food after that) when should we test her again? & how long do we wait before performing the curve test? We can only do the curve test on a day when both my Husband & I are off work which is only Sundays as it takes 2 people to test her. Should we do it this Sunday?

Again, will update after the 12pm & 6pm tests.

I pray these changes make a difference in her BG levels.
 
You can probably find the u100 syringes cheaper at a pharmacy than buying them from your vet. Depending where you live, you might need your vet to write a prescription for them (u100, 3/10cc insulin syringes).

After giving the first dose of insulin tonight, I would suggest getting a +2 (2 hours after the shot) test and see how she's doing on it. With Lantus, keep in mind that you might not see any noticeable difference in her numbers the first 5-7 days after starting, so don't get discouraged! :-D This also means that I'd probably hold off on a full curve till next Sunday if I were you. ;-)
 
I got the U-100 syringes from the Pharmacy, they were not expensive at all (considering I live in the Bahamas, & every thing is more expensive here than in the USA!) but they are not in .25 increments, just 1 unit increments....but I have asked my vet to order the ones in the .25 increments & he said he would try to...so we will see if he is able to get them or not. But I will start her with 1 unit tonight at 6pm. & Test her again 2 hours later & maybe even once more after that 4 hours post shot. Will do the curve test next Sunday & see how she is doing with the lantus & the lower carb food.

At 12pm today (6 hours post shot) she was 271 (which is a lot better than 35 yesterday). Did not give her any insulin at that point, fed her another 3 oz can of Fancy Feast Classics (which she LOVES by the way!) & will test again at 6pm & dose then with the Lantus.

I feel like I am at war with my vet now.... but I guess he is not an expert at feline diabetes, & I am just trying to do what is best for Marley. Thank goodness for this forum or I would be absolutely LOST!
 
Unfortunately, they don't make syringes with .25u markings; only .5u markings so you have to eyeball those quarter units (the key is consistency, not accuracy).

With Lantus, you'll definitely want to test every pre-shot to make sure it's safe to give a shot (anything over 200 when first starting out) and try to get as many mid-cycle tests as you can (between 4-8 hours after a shot, preferably closer to around 5-7 hours). A curve once a week doesn't sound like a bad idea if you're not able to get many more tests in throughout the day/night than those 3-4 tests.
 
Ohhh OK. I will let my vet know to look for the U-100 with the .5 measurements. For now we will work with the individual unit increment syringes. I think we will start her off with 1 unit this evening & see how that goes... We should be able to test at least every 5-6 hours. (6am pre shot / 12pm / 5pm - 6pm pre shot / & 10pm - 11pm post shot) Hopefully that will be enough during the week & then try to perform the curve tests on Sundays starting next week Sunday.

I'm still a newbie at all of this so ALL of the suggestions / advice & encouragement is GREATLY appreciated! :smile:

Will post stats later after the 6pm test.
 
Not sure if anyone has linked you to this yet, but we use this spreadsheet around here to help us keep track of the numbers as well as allow us to share the results with others through the link. Please let us know if you need any help setting it up.

AmySawyer said:
& I must have set up my account on here wrong cuz it was not 4:23am when I posted that last message. It is 9:15AM right now. ugh....
Go to the top left of the page and click on "User Control Panel" and select the tab for "Board Preferences." There will be a drop-down where you can set your time zone.
 
THANKS! I couldn't figure out where to change the time zone! lol. Yes others have sent me the link to set up the spread sheet & I will work on doing that Next week from work (as I only have a mobile device to use from home & it's a little tricky trying to set that up on my phone) But will definitely try to get it up & running next week.

Should I post all of her stats so far for the past 2 weeks since diagnosis? Or start fresh once we get her going on the Lantus?
 
You can either leave it off or include the Humulin results. If you do include the testing while she was on Humulin, make sure you put a visible notation on the spreadsheet as to when you switched to Lantus. Most people just add an empty row and write across it "SWITCHED TO LANTUS."
 
OK. Thanks for all of your help!!

Working on getting the spreadsheet set up now. Waiting for google to send me my verification code...
I will probably just post yesterday's test results (just because I know them by heart & I don't have Marley's BG Journal with me at work right now).
 
OK got the spreadsheet up & running. This may sound like a dumb question, but how do I get back into it now to keep updating it?? If I click on the link in my signature it doesn't allow me to edit it... Still new at this so if anyone can help I'd appreciate it!
 
Spreadsheet looks great! :thumbup

To access the spreadsheet again, go to your google drive and you should see it listed there. Once you find the editable spreadsheet, create a bookmark to it so you don't have to find it in your drive every time (especially if you use your google drive a lot).
 
Thank you SO much for all the help!!! :smile:

Up & running! Will try updating it over the weekend from my phone now that I have it set up.

Wish me luck with the transition to Lantus starting this evening!!
 
Also! As I update the spreadsheet, do I need to click "share to web" each time?? or how does it save my changes every time I update it?
 
Good luck tonight!

AmySawyer said:
Also! As I update the spreadsheet, do I need to click "share to web" each time?? or how does it save my changes every time I update it?
No, it should automatically update as long as you have the box checked to "Automatically republish when changes are made" (File->Publish to the web...).
 
At 6pm her BG was 436 so we gave her the FIRST dose of LANTUS! 1 unit. We fed her the Fancy Feast Classics like 15 mins later. How long should we wait after dosing before feeding? I guess I should have asked that earlier...

Will test again at 9pm & 12am. I'll update my spreadsheet asap
 
Most of us using Lantus (or Levemir) test, feed, & shoot, all within about 5 minutes. You're doing great. Please remember to put a note in your spreadsheet regarding the change of insulins.
 
With Lantus, since the onset isn't usually for a couple of hours, food is not as imperative to have on-board. As long as the cat isn't having any appetite problems, you can still give the shot at the regular shot time even if the cat hasn't eaten. It's actually more important that they eat around 5-7 hours after the shot, if need be (i.e. due to low numbers), since that is the typical peak/nadir of the Lantus cycle.
 
Thanks guys! I put a note in the remarks section on my spreadsheet about the switch in insulins :) hopefully Marley will be ok with eating until 6am, thats the eating schedule we have her on 6am/12pm/6pm feedings. If her numbers seem low at 12am when we test, we will give her more food, but otherwise if the numbers are good at 12am will wait & feed again at 6am.

Also, do I give her a shot at 6am even if her numbers are low? What range should we be looking for at shot time to make sure its safe? (Although she gets fed at both shot times anyway)

I apologize in advance for all the questions I will be asking over the next few days!
 
It's okay, we welcome and want all the questions you have.

On the Lantus TR forum, we usually say if the pre shot test is below 150, to not feed, and post for advice. Here on the Main Health Forum, they usually say to not feed, and post for advice if the pre shot test is less than 200. Is Marley has a lower than normal pre shot test, and you decide to give insulin, you will need to be around to monitor and get extra tests, at least in the beginning.
The reason we say not to feed, and post for advice, is because if you give Marley food, that will spike up his BG numbers. If you get another test say in a half hour after him eating, and you will then not be able to tell if he was dropping or rising or just staying about the same without that food spike.

Does that make sense?
 
Makes sense! Thanks.

Normally her pre shot values are in the 400's. & while we were using the Humulin we would test, give insulin (if BG was over 200), wait 30mins & then feed, but that insulin was much faster acting too.

I'm sure I will have a lot more questions as we make our way thru this...
 
9pm (3 hours post shot & post food) her BG level is 285. Which seems like the onset has started. Will test again at 12am & from what Ive read thats when we'll probably see the nadir level.... What range should we be looking for? & if it's lower than desired range what actions should we take?
 
At nadir, you usually want to see numbers below 100 but greater than 50. But don't get discouraged if you don't see them these first few days (Lantus depot action). If at any time she drops below 50, that's an automatic dose reduction of .25u at the next shot time.
 
Last night at 9pm Marley's BG was 285. At 12am it was 164.

This morning preshot it is 150.... Not sure if I am supposed to give her another shot (& feed) or what I should do. Any suggestions???
 
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