Need help with curve

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squirrelliewrath

squirrelliewrath

Member Since 2012
Hello all I am new,

My cat Imo has been diagnosed with diabetes two weeks ago. He is on Lantus 3 units twice a day. I am doing his curve today. Before his insulation injection today his reading was 498 mg/dl Since then his reading has read high which according to the meter manufacturer is over 600 mg/dl. I have checked his glucose level every two hours and for the last three tests it has read HI or over 600mg/dl. I am not sure what to do next. Is he getting to much insulin or to little. I do not want him to die. I am so scared and do not have the money to take him and put him in the hospital like the vet wants me to do. Please any help of advice will be greatly appreciated.
 
I can understand why the high numbers are scaring you. It is wonderful that you are checking his glucose levels at home. Let's see what we can do to help.

What are you feeding? We suggest a diet of wet low carb (see why on this vet's website: www.catinfo.org) When we switched Oliver from dry to wet, he went down 100 points overnight so it can make a big difference.

Three units is a large dose. Did you start at that dose or did your vet have you start lower and increase slowly? Did your vet suggest that anything else was wrong?

I don't use your insulin but will ask if some Lantus users can offer some advice. You might also go back to your first post on and change the subject line to include Lantus.
 
Welcome to FDMB! :YMHUG: :YMHUG: cat_pet_icon cat_pet_icon We will do all we can to answer you questions and help in any way we can. A little more info will help us understand your situation.

  • --How long have you been using Lantus? At the 3u dose? Anytime you change the amount of Lantus or skip a dose it takes about 3 days for the shed to stabilize. BG can actually go up for a few days w/ an increase of insulin. Lantus forms a reserve in the body so not all of a dose goes directly to work. When the shed is filled some of the shot always goes into the shed and a little of the shed is released to the blood. Until it is filled more of the dose will go into the shed than normal so BG numbers can fluctuate.

    --When are you feeding in relation to the tests and shot? We try to remove the food 2 hours before the preshot test, to have a "clean" number uninfluenced by food. Food will take about 20 minutes to start showing up in the blood stream, so tests given shortly after feeding will be higher than normal.

    --As Sue said , the food can make a big difference. What are you feeding?

    --Are you shooting exactly 12 hours apart? Lantus is pretty fussy about an exact schedule. Longer than 12 hours and it will be like a dose reduction, less than 12 hours and it will act like a dose increase.

    --What meter are you using?

    --Where do you live, city/state? There may be a member nearby who can give some help if you need it. We don't bite! ;-) :lol:

    --Finally (for now) what is your name and what is your cat's name. Just first name, it helps to break the ice and is a lot easier than saying "you" or 'your cat" all the time.
 
My name is Gary and my cat is Imo he is 11 years old. I switched his diet to wet food. He ate it at first but, then refused the food. Imo started to eat the dogs food and any other food insight other than his own no matter which wet food I have tried to give him. Today I got him Purina one beyond. I am trying to get him to eat something because he has lost so much weight. The doctors did his levels a week and a half ago and then called me with the results. The nurse I talked to wanted me to buy a $250 meter to check Imo's levels. She also told me to increase the Lantus to three. I went to walmart and got the Relione micro meter so I could check his levels and do his curve. The nurse from the hospital was so rude because I can not afford the meter or that I could not put him in the hospital. I just wonder if this dose is to high. i have tried giving him nothing but wet food but he will not eat it. We live in Colorado Springs. I have not called the doctor with the readings of over 600 yet because the way they treat us. I thought I would get advice here first from people who live with this day to day. I do give Imo his Lantus every 12 hours no matter what. 12P.M and 12A.M. I always get him to eat around 9:30 am and pm this would be wet food if he will eat it. If he will not eat it I will try to find some chicken or other protein for him to eat. I hoped I answered all the questions that were asked. Thank you all again for any help.

P.S. his next dose is going to be at midnight what should I do for that one? decrease the amount or stay at 3 since sue said that it sounded to high?
 
Don't change the dose, Gary, until you give more advice from Lantus users. It is a high dose, but there are cats that need that much insulin. We don't want to reduce the insulin until we are sure.

I live in Colorado Springs. I have a vet I love but I am not sure she uses Lantus. I do have a friend who likes her vet and she did use Lantus. If you like, I can get that vet's info.

We do have ideas to give kitties to eat the wet food. One thing that sometimes helps is to add some warm water to the food and make it a little soupy. You can also "dress" it with Bonito flakes or tuna juice or Parmesan cheese. What foods have you tried? Lots of cats here like Fancy Feast and Friskies.
 
Hi Gary and Imo,

One thing I wanted to ask...
You said -
I am so scared and do not have the money to take him and put him in the hospital like the vet wants me to do.
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Can you tell us why the vet wants Imo in the Hospital? Did they say that Imo has any other condition besides "just diabetes". Did he mention any infection, or anything having to do with DKA (ketones)? Normally, hospitalization of a cat who is just diabetic is not needed.

Is the Purina One Beyond dry food or canned food? We have to convince Imo that there's no such thing as dry food and that he loves canned food, and we'll figure out how to help you to do that. Are the Friskees you are feeding him the "pate" style, or is it a gravy type that says "sliced" or "bits"?

If he has only been on insulin for less than two weeks, then there's a good chance that the dose is too high. Normal starting dose with Lantus for a cat is 1u, twice a day. But don't change the dose until we get more opinions from people who have used the same insulin with their cats. Ann has, but Sue and I have not.

Do you think it would be possible, once we teach him that canned food is the best thing since sliced bread, to rearrange his feeding schedule? Normally, we feed our cats at shot time, right after testing them. You can also feed at other times during the day or night, but like Ann said, they shouldn't eat during the two hour period before shot time, because it gives you higher readings when there's food in his system. There could be all sorts of reasons why the numbers you are getting right now are "HI", but most likely the reason is NOT that the dose is too little.

I do not want him to die.
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Gary, we know that for sure, because you've gone through the trouble to search the internet and find "us". And we'll do anything we can to make sure that isn't going to happen. This disease is scary at first for everyone. I didn't know there was such a thing as feline diabetes when my vet told me Bob had it. I was just as freaked out as you are right now. But the people here have been dealing with this for years in some cases, with several diabetic cats. There's people here who adopt diabetic cats just because they are diabetic. It's very manageable, and by no means a "death sentence". There is a lot to learn at first, but that's where we come in. We're here to answer your questions and concerns and to help you figure this out one step at a time.

Carl
 
I first took Imo to the vet because he lost a alarming amount of weight. His meow was not right and he was drinking a lot of water. the vet did a blood test and called me the next day and said he had diabetes. I had to bring him back in that day. I got there they told me that he need to be hospitalized given a I.V. and also I had to take a prescription to the pharmacy and get his insulin and bring it back to them. They told me that for this it would be around $900 for the hospitalization. and I had to get the insulin which was $156 plus the blood test $90. I told them I could not afford that. Well their attitude changed and I was now scum. I was able to get the insulin and the I.v. from them and all the test in total that week I spent $550 my whole pay check. I love Imo and I hope this does not sound horrible I will do anything for him but I just did not have the money to spend more. The doctor put him on 2 units of Lantus every 12 hours at first then told me to bring him back in a few days and that they would take his glucose reading and teach me how. I took him and the Nurse took him back and did the test. when I asked her about what she told me last time about showing me how to do the test she just said that she just did it where she took blood the last time and was very mean. She told the doctor the readings and the doctor told me to increase it to three units. She then again tried to get me to but the meter from them that cost $220 I told her I have no money nothing I can not buy gas for my car and I will eat roman for the next two weeks till I get paid again. They told me that there was nothing else wrong with him at this time. She told me that maybe I could borrow one of theirs for the test. Well i called yesterday and guess what she told me "we do not loan out our meters you need to buy one" I am so angry. I got a meter from walmart a Relion. today I started doing his curve which started with me giving him food at 9:30 this morning then testing him at 11:50 which was 498. I gave Imo his 3 units of Lantus at 12:00. I have checked him every 2 hours and I get Hi which reading the book is over 200. the test strips are new I even checked myself which I read 98. I have two cats Imo and Bucky. Bucky is normal healthy 3 year old Siamese. I have tried to give them both the wet food but Imo will not eat it most of the time. Tonight I have tried mixing it with water as suggested and Parmesan cheese. Imo gagged. I then opened a can of Tuna in water for him i do not know what else to do. The Purina on brand beyond dry cat food. he will eat it and when I am not watching he will even eat the dry dog food or sneak up to the table and try to eat my daughters food when she is not looking. For some reason he will not eat the Friskys pate food anymore which he use to love.

I was also talking to a friend who himself is a diabetic and he brought up a good question. could I have some how not given the shot right this morning? could some how it not have gotten through the skin and gotten the insulin in right and some how could it leak out if it did not go all the way through the skin? I Have longer needles than for a regular diabetic.

sorry if it seems like I am rambling but i am trying to give the most complete information I can think of. I hope I have answered all the questions. My brain is going on overload from trying to read everything all the blogs and all the web sources. thank you all again for all the help me and Imo greatly appreciate it.
 
Oops I for got Imo has been on the 3 units of Lantus for four days but he is acting much better more playful and moving around more.
 
I was also talking to a friend who himself is a diabetic and he brought up a good question. could I have some how not given the shot right this morning? could some how it not have gotten through the skin and gotten the insulin in right and some how could it leak out if it did not go all the way through the skin? I Have longer needles than for a regular diabetic.
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I'm glad you asked that question, because it hadn't occurred to me. Yes, it is possible that you "missed" with the shot. It happens to everyone occasionally. We call it a "fur shot", where instead of going under the skin, the syringe can poke in, then back out of the "tent" of skin and some or all of it doesn't get into the cat. Usually you can tell because the fur will be wet near the injection site. From what I understand, Lantus has an odor too, so you might even smell it on his fur or on your fingers if you rub the shot site after giving the shot.

If that did happen, it's not a huge deal. And if it happens in the future, NEVER give another shot because the first one missed. You just have to live with it and wait until 12 hours later to give the next shot. The reason for that is because sometimes "some" of the insulin is injected correctly, but you don't know how much. SO you can't shoot more to try to make up the difference.

It is very sad that you have been treated this way by the vet clinic. It sounds like they are all about making the money and don't know much about customer service. I'm sure that Sue will send you information about other vets in your area that would be better for you and for Imo.

So they never taught you how to test? Did you watch videos on Youtube like many of us have? If you haven't seen them, there are lots of them out there if you search for "feline diabetes" on Youtube. They'll show you how to test and how to inject insulin, and a lot of them have lots of helpful tips. Some where made by people who post on this board.

Carl
 
Yes, you could have given what we call a "fur shot". More numbers will give you a better picture of whether this cycle is usual or not.

So he is eating? Even if it's not the food that is best for him, it's important that he eat something. Then we can work on getting him to like wet food. You might want to think about keeping him away somehow from the dog's food. He is more likely to eat wet if he is hungry and that is all that is available. An idea to try next mealtime: grind up some of the dry food he likes and sprinkle it on top of the wet.

This is completely overwhelming at first. But you are doing exactly the right thing - you are learning all you can as fast as you can about this disease. You have the important things going for you already. You know what food is best, you are testing at home and you have a good insulin. Now we will help you fine tune.
 
I just finished watching lots of videos on youtube on how to give shots. I was doing it correctly or it seemed BUT, I did not know that I should not keep giving it in the same place. I always give it to him in the back of the neck. At 12 I am going to give it to him on the side like the vets said I could on youtube. Also, sometimes I could smell it so It would appear that I will have to be more careful and take my time and make sure I do it right. I know better than give him more medication if I do miss or do a fur shot. I thank you for making sure that I know that.
 
I am so mad my vet did not teach me any of these very important things that is it time for a new vet. I also feel sad that i did not know these things but I am so thankful for everyone on here and all the help you give. I am thankful that there are so many resources out there now for the novice like me to get. I will continue with Imo's curve tomorrow to see if giving the injection in a different spot makes a huge difference. One can only pray and hope. I feel that If I am careful with the injection and with it be a different spot his number has to drop. It is the only thing I can think of since his number was down this morning and then it shot up and has stayed up. Again I can not think everyone enough.
 
Hi Gary, I am so sorry that Imo is diabetic but you're in the right place to get help. Could you possibly set up a spreadsheet? Here are the instructions. This is how we keep track of what's going on with a cat so the dosing experts can give you the best possible advice.

Great choice to get the Relion micro. That's what we use after starting with that very expensive meter the vet is trying to sell to you. It's a ripoff.

Zener did not like the wet food at all for a long time. We used a lot of Fortiflora, available on amazon. It's a powder with probiotics plus the flavoring of dry food. It helps a lot to transition from the dry to wet. Have you found Janet and Binky's page? That might give you some other ideas about foods to try with Imo.

We are here to help you. You are doing a great job under very difficult circumstances. Be sure to ask all your questions. Someone here will be able to help you.
Liz, Zener's other mom
 
Most of us were painfully uninformed about our cat's diabetes when we arrived. Everyone here will help you to learn what you need to know to help Imo. The front end of the learning curve is more than a bit overwhelming. It really does get easier.

If Imo is snatching the dog's food or your daughter's food, it's possible that he's eating high carb food which is bumping his numbers up. Couple a fur shot and eating food that's higher than 10% carbs and it could do a lot to explain Imo's numbers. Sometimes, if you smell Lantus, it may be because there's a drop or two on the outside of the syringe. Other times, it may mean you've given a fur shot.

I don't feed Friskies so I don't know if all of the pate varieties are all low carb. You may want to be sure you're feeding foods that are less than 10% carb. One strategy to convert a kibble junkie to lower carb food is to crush the kibble and sprinkle it on the canned food. I'd also warm the canned food either by adding some warm water or warming it in the microwave for several seconds.

If Imo is eating (or stealing) higher carb food, it's possible that the carbs are balancing out the insulin dose. If you are going to remove any high carb food, you may need to lower Imo's dose. However, let's see what happens tonight after you give Imo his shot. Without seeing more that today's numbers, it's hard to know if the high numbers are an exception or where Imo's numbers have been sitting. Setting up a spreadsheet and getting a few spot checks will help us to help you.

I would test for ketones. Ketostix are available at any pharmacy. It's a urine test to tell you if ketones are present.

Here are some other ideas re. how to entice a cat to eat:
Cheryl & Winnie said:
Here are some things you can do do entice your cat to eat:

-sometimes in order to get a cat to eat you even have to resort to dry it is more important that they eat. there are a couple low carb / grain free brands -- EVO and wellness core.

-making a buffet to give him choices
- heating food

sprinkle food with :
- forta flora -- a probiotic you can get at vets or online. is very smelly and cats love the taste of it.
- parm. cheese
- smashed crumbles of dry food
- bonito tuna flakes
- halo chicken treats -- crumble into dust over food -- my Wolfie loves this stuff.
- poor a little water from tuna in water over food ( I use low sodium/no sodium added as other kinds in water has veg. broth in it and I assume that means onions, which are toxic to cats-- check labels)
-powdered oregano. yep sounds weird . but some cats like it and it will entice them to eat.

other ideas of foods to offer your kitty to stim appy:
- trader joe tuna for cats
-baby food -- beechnut turkey and broth or chicken and broth. they have no onions or other additives. some babyfoods have onions . please read labels if you can't find beechnut.
- kentucky fried chicken
- deli turkey /chicken
- plain cooked ( boiled or baked ) chicken breast
-canned chicken for people (watch the label that their are no onions)
- chicken broth -- low sodium
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Hi again Gary! It sounds like you may have given a furshot, which sucks, but isn't the end of the world. We kick ourselves and get back to it. I still miss occasionally. I always sniff her fur after a shot to make sure that I didn't miss. I also slip a small piece of tissue over the needle, it absorbs any excess insulin when you are fine tuning your draw. Also be sure not to shoot the insulin back into the vial or pen, there is a lubricant inside the barrel of the syringe and it can effect the insulin if you shoot it back into the container.

You mentioned that your needles were long. Lantus is a u100 insulin (100 units of insulin in 1cc of fluid) and needs u100 syringes. There are also u40 insulins which use a different sized syringe. It should be clearly marked on the side of the syringe, also the u40s always have red caps and the u100 have orange.

Flank shots are a good location. Generally try to avoid the scruff of the neck as there is less circulation there and the insulin is more slowly absorbed.

A lot of members use the Relion it is a good meter and the strips are affordable. I asked before because there are a couple of meters we shy away from, like the True line. I started out with that! :-x

Lastly, remember to breathe! There is so much to learn, but you can do this. We had an equally ignorant vet when we started, it was a great stress reliever to go in and fire him! :twisted: :twisted: After I had a new vet, of course! 21/2 years later and Tess is perky and happy, she tells me so every day.

We'll be waiting to hear your preshot numbers. BTW, listen to Sienne, she really knows Lantus dosing!
 
Imo's preshot number today is 436 at least it is not over 600 he ate his caned food this morning. I took some water (no onion I checked) from the tuna fish and poured it over his wet food. Last night I gave him his shot in his left flank and today I gave it to him in his right flank. In an hour I will check his number again and I hope it is much lower.
 
WOOOOOOHOOOOOO just did Imo's numbers again and we are now at 250 yes I know it is high but it is going the right way and is not over 600 like last night. I am so happy that we are going in the right direction.
 
What a relief to see yellow, but I think you need to watch carefully today. A drop like that after only one hour is a lot. Here is an example of a typical Lantus curve (that is , if cats ever do anything in a typical manner!): We don't use actual time usually, what is important is the amount of time since the shot, thus the +1, +2 etc labels for the tests.

Example of a typical Lantus curve:
+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.
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You see that a +1 test (one hour after the shot) is usually higher than the preshot. When you see a drop in numbers this early it usually means a lot more coming.

Here is a link to some basic Lantus info, New to Lantus.

We usually start a new thread every day so things don't get too long. For you subject start w/ the date, put in Imo's name and AMPS~436 +1~250 , then during the rest of the day go back to that first post and add any other test results. That way others can find Imo at a glance, see how he is doing and give advice if needed. You have to edit the first post for this, that subject is the one that shows up on the list.
 
There usually are no onions in tuna (you do need to be careful w/ baby food though), however, some do add sugar or thickeners to tuna so check for that.
 
Gary,
Was that on a 3u dose?
He should be at or near his "nadir", but if you can check an hour from the last test, you might see a number that is even lower than that 87. From the numbers you've gotten, it's obvious the insulin is working for him. :smile:

CArl
 
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