Need to Give Next Insulin - Last Reading 67

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carfurby (GA)

carfurby (GA)

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My name is Carla. My cat Furball was recently diagnosed with diabetes. I started 2 units of Lantus today 12 hours apart. Furball's glucose this morning was 247. I checked the glucose at 6PM and it was 67. I hadn't fed her yet or given the 2nd shot. I called the vet and was told to feed, check the glucose in an hour and if it is above 60 to give 1 unit. This makes me nervous as I won't be able to check on her during the night. Does this sound correct?

Sorry if this is in the wrong place. I couldn't find any sub forums. Thanks for any suggestions.
 
I think someone more experienced will check in soon but don't shoot any insulin into a number that low with no data.
 
Just a general rule for new diabetics. Until you have the data to shoot lower numbers, we generally say not to shoot under 200, but to wait 20-30 minutes without feeding, and retest.
 
Thanks for the replies. Since my vet told me to feed Furball, I gave her some food. I will be testing again in about 20 minutes to see if her number has gone up.
 
The problem with that is food will usually cause her BG to rise. Don't worry since you've already fed her. How much food did you give her?
 
I feed her twice a day. She eats 3/4 of a can of 9 Lives Tuna and Egg or 9 Lives Super Supper. She ate the Super Supper tonight.
 
you just started lantus today? had she been getting any other insulin prior to today?

if not, there is no way you're going to shoot any insulin into a number 60 something or anything near that. that could easily harm your cat.

can i ask that you don't plan on shooting any insulin until we gather some more info from you? i want to keep your cat safe and until we have some more info, we can't safely lay out a game plan for you so if you can give us some time to collect some info from you it would be greatly appreciated. i'm gonna let this go and then start writing my questions in another post just to get this out there before any insulin is given
 
Today is the first of any insulin for Furball. The vet started her on Lantus. I will hold off on giving her another shot. I was thinking 67 was way too low to give her any more insulin. I will post her glucose level after I test her in about 10 minutes. Thanks for your help.
 
BTW, welcome to the group. I'm glad you found us! Cindy can help you from here, I'm not experienced enough to give dose advice. :smile:
 
ok, questions :-)

and i'm sure i might initially miss a couple but i or someone will think of them

have you just recently changed to those foods you mentioned? or has she been getting those all along?

what was going on that led you to take kitty to the vet and finding out she had diabetes? what symptoms did she have?

has she been or was she recently diagnosed with any other health problems? infection? bad teeth? injury?

do you know if a fructosamine test was done to diagnose the diabetes or did high glucose show on routine bloodwork?

did the vet show you how to draw up 2 units in the syringe or did you have to figure it out yourself? and either way, can you describe to which line on the syringe you are drawing the dose to? i.e. first line, second line, is it noted with a 1 or 2 or any number?

now, to see if i can explain a couple things quickly. lantus works in such a way that you rarely see any effects of the first shot or two. it "builds up" in their system, actually starting to work after a couple or few days of shots. soooooooo, for you to see this much of a response on the first day is pretty odd and could be an indication that she doesn't really need insulin or not so much of it. i know that is totally counter to what you have been told in the last few days by the vet but it is totally possible and having the answers to the above questions will help the very experienced people here figure out which one it might be. more than likely yes, she needs insulin, but just not so much.

gotta step away from the computer for a few so if you can start with the above questions i'll be back in just a few, as i'm sure others will be too
 
Do you know what the numbers were that the vet got that made him decide on a starting dose of 2 units? The "normal" starting dose around here seems to be 1/2 to 1 unit every 12 hours. Was the diagnosis just "diabetes" or were there other conditions mentioned by the vet?

With a reading as low as you got this morning of 247, and a drop of that much, (I'm not a lantus user), I would think that a lower dose going forward would make sense. I'm sure other people with experience with that insulin will be by shortly to help out.

Welcome to the board, by the way!
Carl
 
At the beginning of February Furball was not wanting to eat. She was also peeing a lot in the litter, in addition to squatting and just dripping a little. I took her to the vet and she was diagnosed with diabetes, a urinary tract infection and an ear infection. I believe it was just bloodwork that was used for the diagnosis. Furball has always had problems with one ear, so the ear infection was no surprise. At that time, I was told to change her diet. She used to have dry food around during the day and be given some canned food at night. I phased out the dry food within a week and changed her to the 9 Lives Tuna and Egg or 9 Lives Super Supper twice a day. At first she only would eat 1/2 a can. After a couple of weeks, she wanted more and it worked out to 3/4 of a can each time. This past Tuesday I took her back to the vet after monitoring her glucose levels twice a day for the past several weeks. The initial reading from the test the vet did the day she was diagnosed was 324. After her diet change, her levels have been between 270 something to 290 something. Since her levels were not coming down any more, the vet wanted to start insulin. I work during the day and wanted to be at home to monitor her when I gave her her first dose, so I waited until today to start. Yes, the vet showed me how to draw the insulin into the syringe and had me practice with saline solution. I draw it to the 2nd mark on the syringe for 2 units. I am going to go test her glucose level now. I will post the result. Thanks for the help.
 
carfurby said:
Yes, the vet showed me how to draw the insulin into the syringe and had me practice with saline solution. I draw it to the 2nd mark on the syringe for 2 units.
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Is it a 30 unit insulin syringe? This picture shows where the 2 unt line is. The markings are the same for a 50 unit insulin syringe, if your vet happened to give you those.

carfurby said:
At that time, I was told to change her diet. She used to have dry food around during the day and be given some canned food at night. I phased out the dry food within a week and changed her to the 9 Lives Tuna and Egg or 9 Lives Super Supper twice a day.
Click to expand...

Those are good low carb choices. There are other 9 Lives varieties and many other brands you can feed as well. Have you seen Binky's food charts, the Pet Food Nutritional Values chart, and Dr. Lynne's Wet Food Shopping List?


This past Tuesday I took her back to the vet after monitoring her glucose levels twice a day for the past several weeks. The initial reading from the test the vet did the day she was diagnosed was 324. After her diet change, her levels have been between 270 something to 290 something.
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Many people on this board feel that once you are testing blood glucose levels at home there is no reason at all to bring the cat to the vet's office for an all day curve or even fructosamine testing. A vet office curve or even a simple blood glucose test is often inaccurate because many cats get so stressed out that their blood glucose level skyrockets.

Was the 324 reading from a simple blood glucose test or afructosamine test? The fructosamine test gives the average blood glucose level over the past few weeks and is the test that confirms diabetes, along with physical signs like excessive peeing and losing weight.

carfurby said:
Furball's reading was 188. It has been just over 1 hour since I fed her.
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Personally, I would skip insulin tonight. Your cat will be ok with one missed insulin shot. Tomorrow morning, test her blood gluocse as usual and if the number is over 200 give insulin and feed as usual. 2 units is a kind of high dose for a new diabetic. You can dose 1 unit or even 0.5 units if you are more comfortable with that. Stick with a dose for at least a couple of days. Don't jump around to different doses beause Lantus does not work that way.

When you get a chance, read the stickies at the top of the Lantus board to understand how the insulin works for cats: http://felinediabetes.com/FDMB/viewforum.php?f=9
 
i like that 188 much better in all honesty :-)

now we need to decide what is a safe amount of insulin to give. something to remember is you can always increase the dose if a dose doesn't work but once the insulin is in them, if it's too much, you can't take it back out so it's better to start at a lower dose and work your way up.

i'm thinking 1/2 unit but let's see what others think about that too before doing anything
 
The syringes I have are 50 units. The marking chart is just like what the vet showed me in her office. These were given to me by someone else and the vet told me it was okay to use them. The vet gave me a copy of Binky's food chart. I checked out the web site and started my search on feline diabetes from there. I found my paperwork from the vet visit where Furball was diagnosed. She just did bloodwork. She did check her glucose level when I took her back for a 2 week checkup. She looked at my log where I have been checking her glucose, but she didn't do any other tests. We waited 2 more weeks and then started the insulin.
 
Hi, welcome to FDMB! This is the best place for information on feline diabetes. I'm sorry you need to be here :-D but it's a great place. How much does your cat weigh?
Liz, Zener's other mom
 
Since her diagnosis, I bought a baby and toddler scale to monitor her weight. At the beginning of February she was 11 pounds 13 ounces. Today she was 11 pounds 8 ounces. Some days she doesn't want to eat as much as usual. We just went through a couple of days like that earlier in the week. Is it okay to give her a full dose of insulin if she doesn't eat all of her food? My vet said it was okay. Thanks.
 
carfurby said:
The syringes I have are 50 units. The marking chart is just like what the vet showed me in her office.
Click to expand...

You can use the 50 unit insulin syringes for now. Ideally, though, you want the 30 unit ones that have half unit markings so you can easily measure half unit doses. It's not easy to eyeball half unit doses on a 50 unit insulin syringe because the lines are so close together. Your vet can give you a prescription to buy 30 unit insulin syringes from the Human pharmacy. Wal Mart (if you have one nearby) has the Relion brand of insulin syringes which do have half unit markings. The Relion insulin syringes are not expensive. There are other brands of 30 unit half unit marked insulin syringes out there: MonoJect, BD, GNP, UltiCare. Some people here buy online from Hocks.com or AmericanDiabetesWholesale.com


The vet gave me a copy of Binky's food chart.
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Great vet :thumbup Check out the other food charts I put in my previous post. There are a lot of good low carb foods you can feed. Of course, if 9 Lives works for your cat and your budget, you can stick with that :smile:
 
The general guideline for new diabetics is (0.25 u * weight in kilograms) so if your cat weighs 11 lbs 8 oz = 5.30 kg, that would be 1.3u (call it 1.25u) or maybe just 1.0 u to start out. Dose changes are made in 0.25u steps. It's safer to start lower and gradually increase. I am not a dosing expert so hopefully someone will come along who can recommend a dose with more certainty. Also, Lantus should be given every 12 hours, as consistently as possible.
Liz
 
Since it's only been an hour since feeding that 188 is likley to have food involved. Can you wait another hour to test and shoot then (numbers permitting) or will that throw your schedule out too much - you will need to shoot again in +12 from whatever time you shoot (can move the shot back again but it will take four days)? If it will throw you off too much skip this shot
 
I'm going to skip the shot tonight. I have to go back to work on Monday and have to be able to give her the shot at 6:30 a.m. Thanks for the help.
 
I would start with only 1U for the next shot - please make sure Furball doesn't eat for two hours before the shot so you know you are getting a clean number. Also you are welcome to join one of the lantus forums (TR or Relaxed) to post regularly so we can monitor the situation and get to know you guys :-D This is where all the lantus experts hang out.

Great that you are home testing already btw
 
I don't know what the difference is between TR and Relaxed Lantus. I'd be happy to join one of the forums. I was thinking 1 unit tomorrow would be good. Thanks.
 
sounds like a good plan to me :-)

we're closing up shop here for the night but i see plenty of others have jumped in so you're in good hands :-)
 
The difference is the protocol itself. "Tight Regulation" is what it sounds like, and depends upon following a set of guidelines found here:
http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581 It's a lot of reading, so don't try to absorb it all in one sitting!
LANTUS (GLARGINE) - Tight Regulation
Lantus users who follow an intensive protocol often called Tight Regulation. Lots of good info and knowledgeable people. If you are not using this protocol but do use Lantus, you will probably be happier in the "Relaxed" Lantus user group.
Click to expand...
"RELAXED" LANTUS
A forum for Lantus users who are not on the intensive protocol known as "Tight Regulation." Please note that there is also a lot of useful information about Lantus already in the Tight Regulation forum.
Click to expand...


You can post in either forum. You don't have to follow the TR protocol to post in TR's forum. Both forums are populated by many long-time very experienced users of Lantus. The TR forum is probably the busiest forum on the board, and people are there around the clock from all over the world.

One of the first tools that will help is a spreadsheet that you will record all of your test data on. Instructions for setting one up are here:
http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207
Once you have that in place, everyone on the board will be able to click on the link to it, and see all of the numbers, which will help us help you.


Carl
 
I'm signing off for the night too. I'll check out the Lantus forum and spreadsheet. If anyone has any other advice, I'll check back in the morning. Thanks.
 
carfurby said:
Some days she doesn't want to eat as much as usual. We just went through a couple of days like that earlier in the week. Is it okay to give her a full dose of insulin if she doesn't eat all of her food? My vet said it was okay. Thanks.
Click to expand...

I'm not sure if you're feeding set meals or free feeding. If you are feeding set meals you will want to break them up into mini meals to give several smaller meals throughout the day (around 6 mini meals per day - a timed feeder can help you with this) feeding just two meals at shot times is not a great option with Lantus. Free feeding (if Furball is not a piggy and it doesn't sound like she is) is a great option on Lantus, you just need to remove the food 2 hours before each shot.

Vyktor's is free fed and his appetite varies (just like yours and mine), he does not always eat at shot time but as long as I know that he is not actually off his food for some reason (illness, dental issues etc) then I go ahead and shoot the full dose.

Great info from Carl I was just coming back to post the same stuff :smile:
 
Thanks for all of the great information. Regarding feeding Furball, my vet told me to feed her twice a day. She is not the only cat I have and if I switched to free feeding, I would not be able to tell who ate what. Mini-meals during the day would be great, but I work. I do not work close enough to my home to even come home during my lunch break. Since I work, removing food 2 hours before each shot would be tricky. It seems I just have to figure everything out as I go along.
 
Feeding small meals helps support the pancreas because it's not being overloaded by big amounts of food all at once. Unregulated diabetics, especially in the beginning, are hungry and need more food than usual.... going for 12 hours without food can't be a good time for them.

You could try using an automatic feeder in a feeding box or placed somewhere your other cats can't reach - lots of people use the Petsafe 5 feeder which you can get on Amazon or at Petsmart.

If I tried to feed my boy 12/12 he would yowl so loud the neighbors could hear, tear the house apart, and when I finally feed him, he would scarf it all down at once and puke it back up 5 minutes later. :lol:
 
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