Need help quick - should I give shot?

[Kathleen Einwich]

My cat Bet's levels have been normal to low for since Sunday, and I deferred shots as per advice here. Then this morning it was 327 (!) and I gave ~.75 of Lantus. This evening his level was 124 and I don't know if I should shoot or not. I met with Sharon14 today and she was kind to give me the proper type of syringes so I can give a measured shot instead of guesswork. I need to know y'all's thoughts on whether I should give Bet any kind of shot tonight considering his latest level. It has been suggested before if he is around 120 to not shoot.

The glucose reading was taken after over two hours with no food.

@Ana & Frosty (GA)
@Bobbie And Bubba

Thanks in advance.
Kathy Einwich

 

[Chris & China (GA)]

Do you have plenty of supplies and can you test as much (and as long) as necessary tonight?

 

[Kathleen Einwich]

Do you have plenty of supplies and can you test as much (and as long) as necessary tonight?

Yes, I do.

 

[Kathleen Einwich]

Sharon gave me larger lancets too, which made for better blood production and a faster test...less time for Bet to struggle.

 

[Kathleen Einwich]

Do you have plenty of supplies and can you test as much (and as long) as necessary tonight?

I fed after I took his test, a whole can of FF. I get the drift that I should test a few more times during the night, I guess waiting a few hours to see how his levels go but I don't know if or when I should give him a shot. His shot was due at 9pm. I guess if it goes up a lot I should? TIA.

 

[Chris & China (GA)]

Next time you're not sure about shooting, don't feed! By feeding, the tests you're getting are now food influenced. When you stall, don't feed and test again in 20-30 minutes to see if the number comes up on it's own without any food.

If it does, it's usually going to be OK to go ahead and shoot as long as you have plenty of supplies

Can you adjust your shot times or is it too late? Or did you go ahead and shoot?

 

[Kathleen Einwich]

Next time you're not sure about shooting, don't feed! By feeding, the tests you're getting are now food influenced. When you stall, don't feed and test again in 20-30 minutes to see if the number comes up on it's own without any food.

If it does, it's usually going to be OK to go ahead and shoot as long as you have plenty of supplies

Can you adjust your shot times or is it too late? Or did you go ahead and shoot?

I didn't shoot. My normal habit is test with no food for at least two hours beforehand, then shoot, then feed. Looking over your spreadsheet, it appears that you continue to give shots even though the levels on your cat are quite good. I am going to operate on the assumption that the shots will continue to be necessary but I won't give any until tomorrow morning. It would be near impossible for me to get up at...like 1am or something on a regular basis to test and shoot. But I will watch his levels tonight to see how he does in the meanwhile, not testing until at least 3 hours after I last fed him. Sharon mentioned the "depot" (?) that probably caused his drop in levels over 4 days...maybe that's why he didn't need any shots. I'm going to give him .5 units in the morning at 9am after testing unless you say different. Thanks for your suggestions and if you have any more let me know.
Kathy Einwich

 

[Darnell & Sprocket (GA)]

Hi Kathleen.
You kitty has some beautiful numbers for just starting insulin. Thats a good sign.
Have you read the information of how Lantus works? Its very helpful to learn this.
And which protocol your going to follow. Also how to handle low numbers or a hypo?

These articles are good to print and learn.
They help alot. I printed them out so I could read when I was up late monitoring.

So what did you do? did you shoot?
Or give a reduced dose?
or skip?
IMHO. Since your new to this I would say a reduced dose and monitor (test) every 2 hrs to learn how the insulin works and when your kitty starts dropping to his/her nadir.

Or skip and learn more about the articles I mentioned.
Your starting well.
☺

 

[Darnell & Sprocket (GA)]

Well Chris replied as I wrote. I didnt want you hanging if she didnt get to respond back. I know how hard it is to wait for answers.
Been there.
You made a good choice.

 

[Chris & China (GA)]

Sharon mentioned the "depot" (?) that probably caused his drop in levels over 4 days...maybe that's why he didn't need any shots.

The "depot" is kind of like a spare tank.....when you shoot, some goes to work and the rest goes "in the depot" and then it's slowly released back into the bloodstream. That's why Lantus works as well as it does for as long as it does.

What time do you usually shoot?

 

[Kathleen Einwich]

Hi Kathleen.
You kitty has some beautiful numbers for just starting insulin. Thats a good sign.
Have you read the information of how Lantus works? Its very helpful to learn this.
And which protocol your going to follow. Also how to handle low numbers or a hypo?

These articles are good to print and learn.
They help alot. I printed them out so I could read when I was up late monitoring.

So what did you do? did you shoot?
Or give a reduced dose?
or skip?
IMHO. Since your new to this I would say a reduced dose and monitor (test) every 2 hrs to learn how the insulin works and when your kitty starts dropping to his/her nadir.

Or skip and learn more about the articles I mentioned.
Your starting well.
☺

Thanks so much for your suggestions, Darnell. I've been reading a LOT since I started this. I saw that Lantus is a slow starting and long-lasting insulin, and I have been having fits getting supplies locally - meter strips, syringes. Everything is a learning experience. Bet is really hard to get tests from - the better he feels, the more he struggles, and he is strong! I'm going to buy one of those "cat sacks", though the gift of a larger lancet that I used tonight made a big difference. No shot tonight but I will in the am. I'll be testing Bet in an hour or two. I'm not sure they finished all of the food (two floors in the apt). I'm just confused because Bet's levels are all over the place, mostly normal to low, since Sunday. When he had his first glucose curve done at the vet's his levels were very high (probably stress, noise, dogs) but here at home they have been nowhere near that - until this morning's test. Weird.

Any other suggestions you might have I would very much appreciate. Thank you so much.
Kathy Einwich

 

[Kathleen Einwich]

The "depot" is kind of like a spare tank.....when you shoot, some goes to work and the rest goes "in the depot" and then it's slowly released back into the bloodstream. That's why Lantus works as well as it does for as long as it does.

What time do you usually shoot?

9am and 9pm. I test right before that.

 

[MrWorfMen's Mom]

Looking over your spreadsheet, it appears that you continue to give shots even though the levels on your cat are quite good. I am going to operate on the assumption that the shots will continue to be necessary but I won't give any until tomorrow morning.

Kathleen, you are still trying to find a good dose for Bet so please don't think that you, like Chris, can give insulin when Bet's pre-shot BG is low. Chris is very experienced and knows China's reactions to insulin "like the back of her hand" so to speak. You need to get more data to understand how Bet reacts so for now it's best to post for help if Bet's BG is under 200.

It would be a good idea for you to start posting over on the Lantus forum when you need dosing help, instead of in Health. Health is usually for more general questions that don't need a response in as timely a fashion as dosing assistance. On the Lantus forum, there will often be more than one person following your progress and offering assistance so when someone who was helping is not immediately available you can still get assistance and give insulin on schedule.

You made the right choice tonight and in time, you too will be able to make judgment calls. It's a steep learning curve but we can help make it easier for you to understand what Bet is up to and how to handle whatever curveball he throws at you.

 

[Chris & China (GA)]

9am and 9pm. I test right before that.

Is there any way you can change to an earlier time? If not, I understand but it would allow you to get some PM tests without staying up really late.

When China was first diagnosed, I thought "OK, I can do this....I'll just shoot at 11/11" (I am NOT a morning person!!)

After the first couple of times I ended up staying up all night until 5-6am doing tests, I decided that as much as I hated mornings (and I still do!), I'd drag my butt out of bed at 6am....that way I could always get at least a +2 (in case I had a doctor appointment or had to take my mom someplace) and since I was a nightowl, I could easily get a +6 or +7 on the PM cycle when most cats tend to go lower....and then I could sleep without worry.

I'm still dragging my butt out of bed at 6am but I can almost always go back to bed and sleep for a few hours.

 

[Kathleen Einwich]

Kathleen, you are still trying to find a good dose for Bet so please don't think that you, like Chris, can give insulin when Bet's pre-shot BG is low. Chris is very experienced and knows China's reactions to insulin "like the back of her hand" so to speak. You need to get more data to understand how Bet reacts so for now it's best to post for help if Bet's BG is under 200.

It would be a good idea for you to start posting over on the Lantus forum when you need dosing help, instead of in Health. Health is usually for more general questions that don't need a response in as timely a fashion as dosing assistance. On the Lantus forum, there will often be more than one person following your progress and offering assistance so when someone who was helping is not immediately available you can still get assistance and give insulin on schedule.

You made the right choice tonight and in time, you too will be able to make judgment calls. It's a steep learning curve but we can help make it easier for you to understand what Bet is up to and how to handle whatever curveball he throws at you.

OK, thanks, I'll post there from now on. It was suggested I get help with this from you knowledgeable folks before proceeding with tonight's mini-debacle but I am glad I now know the proper place to do that.
Kathy

 

[Chris & China (GA)]

Chris is very experienced and knows China's reactions to insulin "like the back of her hand" so to speak.

Very true....I've been doing the sugardance for over 5 1/2 years now......and China is a very easy cat to work with because when she runs too low, or drops quickly, she comes and DEMANDS food. Her "meow" is even different. I can tell the difference between her "hey mom, it's a good time for a snack don't you think" meow and her "Mom...get up NOW and feed me" meow

Don't worry...You'll get there too. As we always say, this is a marathon, not a sprint!

 

[Kathleen Einwich]

Is there any way you can change to an earlier time? If not, I understand but it would allow you to get some PM tests without staying up really late.

When China was first diagnosed, I thought "OK, I can do this....I'll just shoot at 11/11" (I am NOT a morning person!!)

After the first couple of times I ended up staying up all night until 5-6am doing tests, I decided that as much as I hated mornings (and I still do!), I'd drag my butt out of bed at 6am....that way I could always get at least a +2 (in case I had a doctor appointment or had to take my mom someplace) and since I was a nightowl, I could easily get a +6 or +7 on the PM cycle when most cats tend to go lower....and then I could sleep without worry.

I'm still dragging my butt out of bed at 6am but I can almost always go back to bed and sleep for a few hours.

Oy! Yes, I can, and the cats would appreciate being fed earlier...they want to be fed at 6pm anyway, it's their old wet food feeding time - which is why I wind up feeding at 9am, 3pm, 6pm, and 9pm, and often at 3am. I was using the alarm clock to get me up until the cats started doing that at 830am. That sounds like a good idea.

Thanks so much for the suggestions. Bet's ears are going to suffer, though, and I hope he gets more used to this. He does hate the test. The neosporin is helping a lot.
Kathy Einwich

 

[Darnell & Sprocket (GA)]

Thanks so much for your suggestions, Darnell. I've been reading a LOT since I started this. I saw that Lantus is a slow starting and long-lasting insulin, and I have been having fits getting supplies locally - meter strips, syringes. Everything is a learning experience. Bet is really hard to get tests from - the better he feels, the more he struggles, and he is strong! I'm going to buy one of those "cat sacks", though the gift of a larger lancet that I used tonight made a big difference. No shot tonight but I will in the am. I'll be testing Bet in an hour or two. I'm not sure they finished all of the food (two floors in the apt). I'm just confused because Bet's levels are all over the place, mostly normal to low, since Sunday. When he had his first glucose curve done at the vet's his levels were very high (probably stress, noise, dogs) but here at home they have been nowhere near that - until this morning's test. Weird.

Any other suggestions you might have I would very much appreciate. Thank you so much.
Kathy Einwich

Its definitely a crash course in feline diabetes 101 but you will get it.
Supplies can sometimes be hard to get in local stores. If so, you can get alot at ADW diabetes.com.
Your kittys numbers being all over is because of the bouncing. When kitty is in bgs they are not used to their liver will kinda freak out and make the bg bounce. It can last 1-4 cycles ir longer for some.
You have to keep the same dose unless they earn a reduction. Here is where the protocols come into play.
IMHO, With your kitty I would start at half unit for 7-10 days & test as much as you can to help learn how his patterns will go. People here can help you learn that.

I have a difficult 'rulebreaker' rebel kitty too.
He is good with tests and injections though. I taught him to 'assume position' where I make him go flat down on the table on his bed with his belly touching the table. And make sure the feet are flat too and not in a mode to take off. Now I just tell him to assume position and he does it. lol.

And for testing, he was abused as a baby, so he freaks out with anyone in his face so I come from behind him. Holding him on the table with my chest on his back to leave my hands free to hold ear with left hand and do the lancet n meter with right hand. I also use a folded baby wipe(unscented, alcohol free, all natural) to cover the blood when done and help clot it faster with a few seconds of pressure. It helps alot as he only lets me test one ear. I also use Neosporin ointment on his ear to heal fast.
I think the way I hold him makes him feel secure. Plus I give neck n chin rubs, ear rubs, and compliments like crazy. Couragrous boy, smart boy, warrier boy, And why I tested in beginning so he knew what was going on.
You get a bond when they learn how they feel better with all you do. Takes time n practice.

 

[Sharon14]

How’s Bet this AM?

 

[Kathleen Einwich]

How’s Bet this AM?

He's doing OK, test was 190 at the usual 9am. I not only overslept but turned off the alarm and went back to sleep when it went off at 6am. Geez. I gave him my best guess of a shot of .5. I didn't get much sleep last night, staying up trying to do an additional test after being...essentially yelled at for feeding him right after the test and other matters. I'm not going to post on there anymore. They can be testy. The Lantus forum looks like a zoo but I'll try it.

It was good to meet you yesterday too. I look forward to a lunch sometime, somewhere. So sleepy...got to go out, I am out of cat food!
Kathy

 

[Sharon14]

190 is a good number without a shot last night!
I don’t think anybody meant to yell at you. They were just explaining the protocol and it’s hard to read mood in a text. Read the yellow stickies at the top of the Lantus forum. There’s a ton of info in them. Then you can ask any questions you have.

 

[Chris & China (GA)]

Looking over your spreadsheet, it appears that you continue to give shots even though the levels on your cat are quite good.

I wanted to talk to you about this but we were busy with other things last night!

Yes, she still gets insulin but it's to keep her in those lovely numbers! She went OTJ once, but it didn't stick and I had to put her back on insulin

What we hope to do is have them "earn" reductions to the point where they're needing no insulin at all. With China being a very long term diabetic, I make her reductions even harder to earn.....she has to drop below 50 at least 3 times or below 40 once before I'll reduce her dose and then see if she continues to get good numbers at the reduced dose.....then wait until she "earns" another one....and on..and on

If I stopped giving her insulin right now, it wouldn't take long before her numbers would go up too high again and then I'd have to fight to get her back down where I want her.

essentially yelled at for feeding him right after the test and other matters.

Please don't think any of us are ever yelling at you!! As Sharon said, it's hard to convey a "mood" when it's written text. The only way to learn is to have things explained....so while it might seem that someone is saying you're doing something wrong, the only way to teach is to explain what you did that we don't agree with (and hopefully they also explain WHY we don't do it that way) but sometimes it's more important to just convey the information someone needs at the moment and then (hopefully) remember to come back and explain the "why" part later when things settle down.

We are all here to help each other and want only the best for every single kitty here!

 

[Ana & Frosty (GA)]

I'm sorry I did not get to see this until now, I was very busy with work this week and did not have time to come here much. Seems like you are getting a lot of help already, so I won't repeat what others have said.

 

[Ana & Frosty (GA)]

essentially yelled at for feeding him right after the test and other matters. I'm not going to post on there anymore

I'm sorry that happened, by the way. I actually was also pretty turned off at first due to the "tone" I felt people were using with me while giving me advice when I first joined this MB. But I think people might just be rushing responding to multiple posts and helping multiple people and not really think about how their message might be coming across. I don't think it's meant to be condescending or anything like that.

I hope you do keep posting. But either way, I feel like you have kind of gotten the gist for how to proceed, and if you follow the protocols listed on the Lantus site, I think you will know what doses to give and when.

I know the Lantus forum looks overwhelming, but it's because everyone posts their daily numbers there. You will be able to get good advice if you ever are unsure of what to do in a particular situation.

Whatever you decide, we are here if you need anything.

 

[Squeaky and KT (GA)]

The Lantus forum looks like a zoo but I'll try it

I remember seeing it and wondering what did math have to do with insulin? A sea of '+' numbers and weird alpha letters. It truly only looks like a zoo - each of those lines represent a diabetic kitty and Mama/Papa. The numbers are just test numbers to help people spot potential dangerous situations as the day progresses. Click on any of them, you'll find real people there...

HUGS and remember - we all got that same startling note from our vet - your cat's diabetic...