need help to start with insulin!

Status
Not open for further replies.
K

kalypso

Member Since 2019
Hello!
My name is Sophia, I am writing on behalf of my friend Dionysia who is not fluent in English. Her cat Lisa is a sweet siamese who Dionysia wants to start on insulin. I have written here again, but it is the first time Dionysia decided to start Lisa with insulin, here are older threads about Lisa:
https://www.felinediabetes.com/FDMB/threads/out-of-remission.245523/#post-2781360
https://www.felinediabetes.com/FDMB/threads/too-low-glucose-almost-hypo-sos.234110/#post-2619272
https://www.felinediabetes.com/FDMB/threads/treatment-options-for-diabetes-case.231735/#post-2593158
https://www.felinediabetes.com/FDMB...r-possible-diabetes-case.214788/#post-2399928
https://www.felinediabetes.com/FDMB/threads/diabetes-suspected.214772/#post-2378923

Long story short, Lisa first got diabetes from cortisone treatment for her asthma, she managed to get in remission after treating with pill, recently got out of remission, but this time the pill hasn't lowered her bg levels which are in the 300s.
Dionysia is home-testing with a human bg meter, she is feeding low carb wet food, and she went to a new vet (old one not experienced with insulin) who told her to start with 1unit twice a day and she will see the cat next week. Dionysia is willing to start on lantus, and is determined to start asap. However she has a lot of questions: What syringe will she need to buy? What is the order, first measure, then shoot, then feed? What is the point where you start to count +1, +2 etc and how often does she need to measure after shooting? Also, she will start working in the mornings next Wednesday, so she won't be able to measure bg in the am after the shoot/feed. Is this ok?
 
Go to the Lantus forum and look at the yellow stickies. Lantus is dosed every 12 hours. Can she get up early and shoot two hours before she goes to work? The +2 test, two hours after insulin, will help her figure out what type of food to leave out. She needs to monitor closely the first week. She will need to have middle and high carb food in case the bg is low. An auto feeder will help for while she’s at work or is there anyone that can feed while at work?
 
Can you help her set up a spreadsheet and put in a couple weeks of numbers? What pill? They really don’t work. Since the diabetes was steroid induced there’s a good chance of remission with Lantus.
 
Hi Tiffmaxee
thanks a lot for your replies!
Dionysia doesn't recall last weeks numbers to put them on a spreadsheet, I will tell her to set one up, but bg is in the 300s, her mom can feed the cat but can't measure bg, and Dionysia can't wake up earlier. The pill is solosa glimepiride but it is not working.
I told her to buy 10 mL vial lantus and U-100 3/10cc syringes (with half unit markings if possible).
Do I need to ask the questions on the lantus forum?
 
kalypso said:
Hi Tiffmaxee
thanks a lot for your replies!
Dionysia doesn't recall last weeks numbers to put them on a spreadsheet, I will tell her to set one up, but bg is in the 300s, her mom can feed the cat but can't measure bg, and Dionysia can't wake up earlier. The pill is solosa glimepiride but it is not working.
I told her to buy 10 mL vial lantus and U-100 3/10cc syringes (with half unit markings if possible).
Do I need to ask the questions on the lantus forum?
Click to expand...
Don’t post on the Lantus forum yet. This is the place to start. I’ve tagged a couple people from Greece who aren’t around much lately but hopefully will see the tag. I’ll also pm them now. The reference to the Lantus board was for information on Lantus.
 
kalypso said:
Hello!
My name is Sophia, I am writing on behalf of my friend Dionysia who is not fluent in English. Her cat Lisa is a sweet siamese who Dionysia wants to start on insulin. I have written here again, but it is the first time Dionysia decided to start Lisa with insulin, here are older threads about Lisa:
https://www.felinediabetes.com/FDMB/threads/out-of-remission.245523/#post-2781360
https://www.felinediabetes.com/FDMB/threads/too-low-glucose-almost-hypo-sos.234110/#post-2619272
https://www.felinediabetes.com/FDMB/threads/treatment-options-for-diabetes-case.231735/#post-2593158
https://www.felinediabetes.com/FDMB...r-possible-diabetes-case.214788/#post-2399928
https://www.felinediabetes.com/FDMB/threads/diabetes-suspected.214772/#post-2378923

Long story short, Lisa first got diabetes from cortisone treatment for her asthma, she managed to get in remission after treating with pill, recently got out of remission, but this time the pill hasn't lowered her bg levels which are in the 300s.
Dionysia is home-testing with a human bg meter, she is feeding low carb wet food, and she went to a new vet (old one not experienced with insulin) who told her to start with 1unit twice a day and she will see the cat next week. Dionysia is willing to start on lantus, and is determined to start asap. However she has a lot of questions: What syringe will she need to buy? What is the order, first measure, then shoot, then feed? What is the point where you start to count +1, +2 etc and how often does she need to measure after shooting? Also, she will start working in the mornings next Wednesday, so she won't be able to measure bg in the am after the shoot/feed. Is this ok?
Click to expand...
kalypso said:
Hello!
My name is Sophia, I am writing on behalf of my friend Dionysia who is not fluent in English. Her cat Lisa is a sweet siamese who Dionysia wants to start on insulin. I have written here again, but it is the first time Dionysia decided to start Lisa with insulin, here are older threads about Lisa:
https://www.felinediabetes.com/FDMB/threads/out-of-remission.245523/#post-2781360
https://www.felinediabetes.com/FDMB/threads/too-low-glucose-almost-hypo-sos.234110/#post-2619272
https://www.felinediabetes.com/FDMB/threads/treatment-options-for-diabetes-case.231735/#post-2593158
https://www.felinediabetes.com/FDMB...r-possible-diabetes-case.214788/#post-2399928
https://www.felinediabetes.com/FDMB/threads/diabetes-suspected.214772/#post-2378923

Long story short, Lisa first got diabetes from cortisone treatment for her asthma, she managed to get in remission after treating with pill, recently got out of remission, but this time the pill hasn't lowered her bg levels which are in the 300s.
Dionysia is home-testing with a human bg meter, she is feeding low carb wet food, and she went to a new vet (old one not experienced with insulin) who told her to start with 1unit twice a day and she will see the cat next week. Dionysia is willing to start on lantus, and is determined to start asap. However she has a lot of questions: What syringe will she need to buy? What is the order, first measure, then shoot, then feed? What is the point where you start to count +1, +2 etc and how often does she need to measure after shooting? Also, she will start working in the mornings next Wednesday, so she won't be able to measure bg in the am after the shoot/feed. Is this ok?
Click to expand...
Hello, Sophie! Welcome! I just saw what a message! My name is Chara and I am from Athens.
I can help you with anything your friend Dionysia needs!
I will send you a personal message here with my details so that Dionysia can contact me tomorrow to help her! Do not worry everything will be fine!!
 
I have translated the instructions on how to make the spreadsheet for Dionysia.
I used the "US Spreadsheet Template for HUMAN METERS" although we are not in the US, because her bg measurements are in mg/dl.
I will put her in contact with Xara too who pm-ed me!
Thank you so much!
 
Hello!

Welcome to the FDMB. :) While I can’t help with translating information I can assure that this is the place to be to help Lisa and hopefully reach remission! My cat Simba had steroid-induced diabetes and treatment wasn’t working out for him until I joined the message board and listened to all the advice that was given here. He has now been in remission for a couple of months. Best of luck! :cat:
 
kalypso said:
I have translated the instructions on how to make the spreadsheet for Dionysia.
I used the "US Spreadsheet Template for HUMAN METERS" although we are not in the US, because her bg measurements are in mg/dl.
I will put her in contact with Xara too who pm-ed me!
Thank you so much!
Click to expand...
Once she’s set up we can help her on the Lantus forum as needed. Can she use Google translator?
 
Yes she can use google translator, should I tell she can write on the forum after she has translated it with google?
 
Hello all again!
Dionysia has set up a spreadsheet, which I have linked in my signature!
She has also bought these on the photos bellow and wants to know if they are ok?

upload_2021-4-29_17-24-55.jpeg


upload_2021-4-29_17-25-8.jpeg
upload_2021-4-29_17-24-55.jpeg upload_2021-4-29_17-25-8.jpeg
 

Attachments

  • upload_2021-4-29_17-24-55.jpeg
    upload_2021-4-29_17-24-55.jpeg
    41.3 KB · Views: 634
  • upload_2021-4-29_17-25-8.jpeg
    upload_2021-4-29_17-25-8.jpeg
    25.1 KB · Views: 633
Lantus is an excellent insulin for cats!

We don't recommend using the special pen needles because it limits you to only being able to shoot whole units. Cats need to be increased in .25 units. She needs 3/10ml, 30 or 31 gauge insulin syringes (hopefully with half unit marks) Then you just pull the insulin out of the pen (use the pen like a "mini-vial")

If the pen needles are all she has for now, I wouldn't give more than 1 unit
 
Hi Chris thanks for your reply!
Do you mean either one of these two? Is 30G or 31G better?
What is the recommended starting dose?
upload_2021-4-29_19-15-9.jpeg
upload_2021-4-29_19-15-16.jpeg
 

Attachments

  • Capture.JPG
    Capture.JPG
    37.4 KB · Views: 184
  • upload_2021-4-29_19-15-9.jpeg
    upload_2021-4-29_19-15-9.jpeg
    37.4 KB · Views: 543
  • upload_2021-4-29_19-15-16.jpeg
    upload_2021-4-29_19-15-16.jpeg
    32.1 KB · Views: 430
kalypso said:
Do you mean either one of these two? Is 30G or 31G better?
Click to expand...
kalypso said:
upload_2021-4-29_19-15-9-jpeg.60716
Click to expand...

These are perfect. It really doesn't matter if they're 30 or 31 gauge...that just tells you the "thickness" of the needle and both are very comfortable for the cat.

kalypso said:
What is the recommended starting dose?
Click to expand...

Starting dose is usually between .5 and 1.0 unit twice a day. Hold that dose for 5-7 days to establish the depot (unless the cat drops below 50 on a human meter, 68 on a pet meter)
 
kalypso said:
What is the order, first measure, then shoot, then feed?
Click to expand...

Meant to answer some questions too. It's always Test/Feed/Shoot. You want to test to make sure the blood glucose is high enough for insulin, Feed to make sure the cat is at least willing to eat and shoot, usually while their head is still in the bowl. Most of us T/F/S in 5-10 minutes total.

kalypso said:
What is the point where you start to count +1, +2 etc and how often does she need to measure after shooting?
Click to expand...

The "+ cells" correspond to the number of hours since the last shot. So (for example) if she tests/feeds/shoots at 8am and gets another test at 11am, that's 3 hours since the shot, so the test number goes in the +3 cell...if she tests again at 3pm, that's 7 hours since the shot, so it goes in the +7 cell....all the way up to +11 and then the next cycle starts over again.

kalypso said:
Also, she will start working in the mornings next Wednesday, so she won't be able to measure bg in the am after the shoot/feed. Is this ok?
Click to expand...

Some more translating for you! This thread on "Is TR possible with a full time job?" has some good idea's, even if she's not going to do Tight Regulation.
 
thanks Chris!
And how often do you test afterwards?
Dionysia has 0.3ml 30G needles, opened an account here and wants to start writing!
 
Natalie just sent me a pm. Think you should start with SLGS and .50. What time will you be giving insulin? It would be good to post on the Lantus forum.
 
tiffmaxee said:
Natalie just sent me a pm. Think you should start with SLGS and .50. What time will you be giving insulin? It would be good to post on the Lantus forum.
Click to expand...
Hi tiffmaxee,
Thanks for your reply! I don't know who is Natalie. I will start with .50, I will give it at around 8:00 am, now it is 9:12 pm in the evening here! I will follow the SLGS protocol on the lantus forum info.
Sorry I didn't know if it was time yet to post on the lantus forum, I am just starting with this
 
tiffmaxee meant to write Yanna, that's me!!!!!

Thanks Elise for helping Dionysia!!!!!!!
 
Yanna said:
tiffmaxee meant to write Yanna, that's me!!!!!

Thanks Elise for helping Dionysia!!!!!!!
Click to expand...
Thanks Yanna! I had your pretty girl on my mind b:bighug:

The reason I suggest posting on Lantus is because the more experienced people are there and lots of us don’t look on the main forum.
 
You will be shooting at 10:00 p.m. my time I think so I will make sure you are covered by those around then. I will be around for your p.m. cycles much of the time.
 
I have filled the syringe and left it for a while out of the fridge before I shoot, is this the way to go?
Do I have to be careful to anything more?
How much food should I give now?
Will I have to feed again at +2?
 
kalypso said:
hi @Bandit's Mom can you see the spreadsheet now? :) we're all waiting for Dionysia's first shooting!
Click to expand...
Yes I can now. Thank you!

Btw, why does the units (U) column after AMPS show '1'? That is the number of units of insulin given. There was no insulin given, right?

dionysia ke said:
I have filled the syringe and left it for a while out of the fridge before I shoot, is this the way to go?
Do I have to be careful to anything more?
How much food should I give now?
Will I have to feed again at +2?
Click to expand...
You can draw insulin into the syringe just before giving the injection also.

At injection times, you test the BG, feed and then shoot.
It helps to feed small meals through the day. We don't feed 2 hours before the shot time so that you don't get a pre-shot number that is influenced by food.
 
I shooted!!!
I gave her 40gr of leonardo wet food to eat, is it enough?
How often and how much do I feed from now on?
 
Bandit's Mom said:
Yes I can now. Thank you!

Btw, why does the units (U) column after AMPS show '1'? That is the number of units of insulin given. There was no insulin given, right?
Click to expand...

She gave no insulin but 1 pill of glimperide a day, this is why I write 1.
I have updated the spreadsheet now because she shooted her first insulin!
Please let me know if it is ok as it is or I should modify it!!
 
kalypso said:
She gave no insulin but 1 pill of glimperide a day, this is why I write 1.
I have updated the spreadsheet now because she shooted her first insulin!
Please let me know if it is ok as it is or I should modify it!!
Click to expand...
OK. Please take out the 1 from the units column. In future it may confuse others who do not read this thread. They may think 1U of insulin was given every morning.
 
dionysia ke said:
I shooted!!!
I gave her 40gr of leonardo wet food to eat, is it enough?
How often and how much do I feed from now on?
Click to expand...
What is Lisa's weight? Does she need to gain weight? Or is she okay?
How many gms of food do you feed her in a day?

Considering the high BG numbers, she must be constantly hungry? Diabetic cats cannot process their food properly, so they tend to eat more.
 
Bandit's Mom said:
Looking at Lisa's numbers for the last month, do you think 1U would be a better starting dose than 0.5U?
Click to expand...

On SLGS, if they are eating nothing but canned, low carb food, it says to start at .5 so I'd start there. We need to see how she's doing as the depot fills before increasing but once it's full, if she's still running that high, we can increase by .5 to 1U

Starting Dose:
  • 1u BID if kitty is not on a wet/canned low carb diet
  • 0.5u BID if kitty has been switched to a wet/canned low carb diet
  • If the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration
  • Generally, shots are to be given 12 hours apart.
Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
 
Chris & China (GA) said:
You might want to put something over in the "Remarks" column so we at least know what was going on for those weeks
Click to expand...
Did that too! Also note that Lisa was first diagnosed in 2018, went into remission with LC wet food and glimperide pill and is out of remission since early April. But this time the pill didn't work as you can see from the spreadsheet!
I also removed Lisa's info from my own signature so as not to confuse anyone, as it is available on Dionysia's signature.
Let me know if this all is ok!
 
Bandit's Mom said:
What is Lisa's weight? Does she need to gain weight? Or is she okay?
How many gms of food do you feed her in a day?

Considering the high BG numbers, she must be constantly hungry? Diabetic cats cannot process their food properly, so they tend to eat more.
Click to expand...
Lisa weighs 4kg, and she is on the chubby side, so doesn't need to lose weight, but Dionysia doesn't measure gr of food per day.
Now it's time to do the +2 measurement, she will put it on the spreadsheet as soon as she does, she is asking if she should feed after this?
 
kalypso said:
I also removed Lisa's info from my own signature so as not to confuse anyone, as it is available on Dionysia's signature.
Let me know if this all is ok!
Click to expand...
It's great. I thought your cat's name was also Lisa! :smuggrin:

kalypso said:
Now it's time to do the +2 measurement, she will put it on the spreadsheet as soon as she does, she is asking if she should feed after this?
Click to expand...
For now, let her feed as she would normally feed. Once the insulin depot builds and she sees better numbers, we may have to change the feeding according to the numbers.
Remember not to feed in the 2 hours before the shot. Both morning and evening.
 
Thank you all so much for your help I am so glad I started insulin! Do you have any insights on my spreadsheet? I got a yellow value!!!
I also need your help with my shooting schedule. I will start working on Wednesday, and I will work some days in the morning, some days in the afternoon, every week I will get a different schedule. When I work in the morning, I can shoot at 8am, when I work in the evening, I can shoot at 10pm the earliest. What is the best way to work it out?
For example, this weeks work schedule is as follows:
Wednesday(15.30-21.30) Thursday( 13.30-21 .30)Friday(14.00-21.30)
Saturday(11.00-19.00)Sunday(11.00-16.00)
 
dionysia ke said:
Thank you all so much for your help I am so glad I started insulin! Do you have any insights on my spreadsheet? I got a yellow value!!!
Click to expand...
That's an excellent initial response to insulin! :-)

dionysia ke said:
I also need your help with my shooting schedule. I will start working on Wednesday, and I will work some days in the morning, some days in the afternoon, every week I will get a different schedule.
Click to expand...
Can you shoot at 10am and 10pm every day?
 
You can’t switch insulin time by more than 30 minutes every 24 hours so you need to find a time you can shoot consistently. Is that possible? Is there anyone that can shoot for you to keep the time the same each day?
 
My mom will be able to shoot and feed but not measure bg. So if we shoot at 8, I will shoot every day the am and she will some days do the 8pm without a pmps but I will do a +2 measurement. If we shoot at 10, then some days she will shoot the am without amps and without any + mesurements.
What do you think of these two scenarios?
Specifically for this first week, I wish to slowly switch to 10am 10pm, because I will be able to do both myself. I don't work until Wednesday this week so I have time to do the switch.
What do you think?
 
Do you think you can teach your mom to measure the bg? Shooting blind can be risky if the bg is low. If she could do just the test before insulin and you are able to get a +2 that would be good.
 
Status
Not open for further replies.
Back
Top