new and open to feedback...

[fredrika]

Hi All,

Jen here (former mom to Fredrika, my calico who had diabetes for three years up until about 2003 when she went on to bigger and better at age 18)

i am recently fostering a sweet little lady and am looking at a 145 BG from her pmps (?) evening pre-shot number. per everything i read here, with Lantus you don't give a shot with a number that low. been thinking about it since i took the reading at 5:40 and decided to post and make sure that's the general consensus.

her numbers have been a bit jumpy, probably from a number of variables that, hopefully going forward will be known and trackable. ie: i got her saturday, things were "different back in the day" when i had freddy so i'm trying to catch up on the reading/learning and my own curve. i don't know what they were feeding her, but i am giving Wellness Core mixed with Evo Cat/Kitten "ultra low carb" (she doesn't like the Evo as much, so mixing it to start). all other things considered she presents as pretty happy and healthy otherwise!!!

feedback welcome!
thanks!
Jen
ps: not up yet on all the lingo, go easy on me!

 

[Sue and Oliver (GA)]

I didn't use Lantus but here is what the Lantus support group says about shooting low numbers: viewtopic.php?f=9&t=147

Any way you can get her to get wet lo carb instead of dry? That could possibly make the difference in her needing insulin or not. Have you seen this website by Dr. Lisa on dry versus wet? www.catinfo.org Wellness Core is 11% carbs (and dry which creates other problems) I don't know about the Kitty Evo..... We try to feed under 8-10%

 

[Lisa and Witn (GA)]

If you are getting 145 when feeding her dry, if you switch to canned food, she may not even need insulin. That is a great number for cat on dry.

 

[Carl & Polly & Bob (GA)]

Hi Jen,
Welcome to the FDMB!
OK, you are hometesting, and using Lantus, correct? Both are great to hear. Lantus is a terrific insulin for treating FD, and home testing is the best thing you can do for your sanity, and for kitty's health and safety. Good for you!

The "normal" advice given here with any new member is to not shoot a number below 200. The primary reason for that is because when you are just starting out, you don't have the historic data yet that will show you what a given dose of insulin will do, or what her BG numbers have been. You said she is a foster. Was she getting insulin prior to coming to live with you? If so, do you have any specifics like how long, what doses, what her BG may have been before, whether from home tests or vet tests?

For now, not shooting at 145 is the right call. In the future, you'll find that many lantus kitties are routinely dosed with numbers in the 100-200 range. It's just not totally safe right now without the data to back it up.

When Fredrika was with you, did you use lantus? Are you familiar with the protocol?

Food - the Wellness Core is one of the lowest carb dry foods available, so if she absolutely has to have dry, that's one of the least of the evils. It is listed as having 11% carbs.
You've had her since Saturday? Can you give us an idea on her numbers to this point? How about the dose? How much is she getting? Do you know if she has any history of ketones, or any other complications besides "just diabetes"?

If you've dealt with feline diabetes in the past, it isn't going to take you long to "catch up". This place can be somewhat overwhelming at first, but don't try to soak too much in too quickly. Just ask questions as they come up, and keep us informed so we can try to help you and kitty out, okay? Oh, and what is your "sweet little lady's" name, so we don't have to call her "kitty"?

Again, welcome!
Carl in SC

 

[Sienne and Gabby (GA)]

Welcome, Jen.

In addition to the food issue that others have mentioned, what is the dose you're giving your foster kitty?

It sounds like you've gotten a few tests. If you're not familiar with Lantus, dose changes are based on the nadir, not on your pre-shot values. This being the case, it's important to get at least one spot check per cycle in addition to your pre-shot tests.

 

[fredrika]

Thanks everybody, nice to meet you!!!

i thought i would get an email with a reply so i wasn't being rude...but i didn't get an email so i thought there were no replies... i just saw these and have finally found the little button to be notified of a reply!

NO dry food for us here!!!! I have only been feeding wet, and she would eat the wellness core, but not the evo, so i was mixing the two. now she's fine with just the Evo (wet!) and i give tiny bites of boiled chicken for a snack now and then.

Past: Fredrika was on Humulin and was never well controled, she was also older and the vet didn't talk with me about different nutritional foods etc. it was more of an if:then situation, more on the side of black and white vs. the various shades of grey to polka dot seen here so far!

i only know she's been diagnosed since at least Nov 2010, given up to foster care and then to me. the bayer contour record is all over the place with inconsistent testing, no discernable pattern but i know she was on the Lantus and the prescribed dose was 1 u. x2/day.

i did a semi curvy type thing yesterday and this is what i have
11-23
5am - 294 1. u + food
2pm - BG192 gave one chicken bite
4:30pm - BG 194
5:40pm - 145, food given but no shot given - a few hours after this was when i posted the other message)

11-24
5:30am - BG 300 1.skinny unit + brkfst
8am - 155
turkey day at Grams house
5:30pm - BG 223 gave a "fat" .5 units

I will be able to do more tests this weekend, but she's not happy with the ear thing at the moment. i'm sure that will improve when my confidence does, i give food right after if i can, if not, lots of praise and play time. (have you seen those wires at the toy section, the ones with the scrunched up paper bag bits on the ends for like, $2.????? BEST investment you'll ever make in a cat toy!!!)

oh, ketones, i have strips for that, but not sure what to do with them or what they mean, i guess that should be my next read....

Anyway, going to try to include a picture, this is Luna, she's everything you'd ever want in a kitty friend! she's sleeping in the crinckle tube at the moment!

attaching pic, hope it's not too big!!!!

thanks all and Happy Thanksgiving, Luna and I are grateful for all the support!!!
Jen

 

[Sue and Oliver (GA)]

Here is the info on Ketones: ketones Oliver would never pee while we were in the room so we put aquarium gravel into a clean litter box and left him alone.

Be sure to check out the info on Lantus in the support forum: viewforum.php?f=9 Read all the stickies under the grey line to see how it is dosed. It works very differently than Humulin, needing a consistent dose instead of changing the dose based on preshots like Humulin.

 

[fredrika]

Here is the info on Ketones: ketones Oliver would never pee while we were in the room so we put aquarium gravel into a clean litter box and left him alone.

Be sure to check out the info on Lantus in the support forum: viewforum.php?f=9 Read all the stickies under the grey line to see how it is dosed. It works very differently than Humulin, needing a consistent dose instead of changing the dose based on preshots like Humulin.

Ya, i can see why they don't use the Humulin anymore, read some not so nice stuff about it this go round. Thanks for the great tips!!! i'm on it!

 

[Carl & Polly & Bob (GA)]

Hi Jenn (and Luna!)
Thanks for the additional info. The more we know at first, the easier it is to help. You are "ahead of the curve" when it comes to "newbies"!
You already have eliminated dry food, and are feeding low carb canned food.
You are already home testing BG.
You are already using a great insulin in Lantus.
SO, I guess your all set! Only kidding.

But those three things, most first time posters don't already have them in place. So that's great for us to know!

As Sue mentioned, lantus is intended to be dosed the same amount, day and night, and the shots should be 12 hours apart. And you already know that testing before each and every shot is of utmost importance (so that you know that the dose is right for the BG at the time you are shooting it). The other really important test that you would be encouraged to get is right around the half-way point between shots, what we call "+6", six hours after the previous shot. That's the "nadir", the point where the insulin should be at peak efficiency. Sue also mentioned the "sticky" threads in the Lantus forum. All good information for you to have.

The next thing we will need to do is get you started with a spreadsheet. You'll see underneath most people's name at the bottom of their messages, a link that shows a spreadsheet. On the sheet, you will record all the insulin doses, the BG readings, and the times that all of that happens on a daily basis. It is a very valuable to for you to know as much historic data as possible, as over time her BG numbers will display definite patterns. That will help in determining how she is doing on the current dose of insulin. It's very helpful whenever you ask questions, as the people responding will have a better picture of Luna's history and recent numbers.
I know you have tweaked her dose lately, but her "normal" dose right now is 1 unit, BID, right? That's a good dose to start on, and most people who come with higher dose numbers than that are usually encouraged to drop it back down to 1u BID, and "start over". When adjustments are made, they are only made based on the data on the spreadsheet, and evidence that it needs to be either increased or decreased. There will be lots of people, especially in the Lantus forum, that will be able to help you out with dosing and all sorts of other advice. Eventually you will be encouraged to post in the Lantus forum, once you feel comfortable with the board and how it works, and soak up plenty of information!

So, continue to test, and ask any question that comes up. People are here around the clock. Let us know what kind of numbers you are seeing, and we'll help you out with setting up a spreadsheet. Sound like a plan?


Carl

 

[fredrika]

Hi Guys!!!!

and thanks Carl, i love how you start with the positives first!!!

i downloaded the spreadsheet last night after wrestling with my PC skills for a few minutes but haven't entered any data yet, but i do HAVE the data since she's been with me.

the mornings seem to start with numbers in the 300's so i give the 1.u. but then the evening numbers appear to low to give another full 1.u. -- so I tried a 3/4 u. this morning to even up the am/pm dose? but also because she was a 285 at 5am.
on saturday and sunday i will be able to do some semblance of a curve...
Luna is not liking the ear pricks, what is the easiest way to get the best info? some stuff says every hour, some says every 30 min the first 2hrs, and the last 2 hrs....

thanks so much for all the help everybody!!!
Jen & Luna

 

[Sue and Oliver (GA)]

Send me a pm if you need any help with the spreadsheet.

If you can find a treat she is crazy about, that may help with the ear pokes. You can take her to the spot where you are poking, without the lancet, and play with her ears and heat them and then give treats, without a poke. That may help get her used to the idea and anticipating the treats.

 

[Carl & Polly & Bob (GA)]

Jen,
For now, don't worry or stress about turning Luna into a feline pin cushion. The BG tests you absolutely have to get are the two tests at shot time. Another great one to get is the one at the +6 hours after her shots. At least one of those, and it's usually easier to get the one in the day time rather than the middle of the night.

Generally, the more tests you can get at various times throughout the day, the more data you collect, then the easier it is to figure out what is going on. A "complete" curve is one where you are getting BG numbers every two hours from the AM shot until the PM shot. A "mini-curve" would be every three hours instead of every two.

But there are a lot of things that make that impossible for people. Like their schedules, jobs, the occasional need for sleep, the fact that the rest of your life doesn't come to a screeching halt just because one of your kitties has diabetes.... So we encourage people to do what they can, short of making themselves insane or ill. There will be people who insist that you must get a test every two hours, or three hours or whatever. But, you do what you can do, what works for you. Remember, this dance is not a quickstep. It's a marathon.

It is always helpful when the cats decides to cooperate with being repeatedly poked with sharp things all day and night. At first, most cats really aren't into that. The secret seems to be "treats". They associate the occasional poke in the ear with a reward (and always give a treat whether you get blood or not), and they also notice that the extra attention and pokes and shots is actually making them feel better overall. One day, Luna will be reminding you that it is time for her treat, and won't give you any backtalk when you get out the meter.

This does get easier!
Carl

 

[BJM]

Another useful aid for the ears: pick up some neosporin ointment (not cream) with pain relief and put a small dab on a few minutes before testing.

Also, a thin sock, filled with rice and microwaved until warm, may be used to support the ear and warm it up so the capillaries will bleed easily ... and so you don't poke yourself!

 

[fredrika]

got some YUMMY freeze dried chicken treats... oh boy, and will give scrumtious rewards at you-know-what time. my other issue with the ear prick is that she has a good amount of fur on the top half of the ears which just about renders them useless for holding a drop of blood and i don't want to keep going for the same section. i heard you can prick the inside of the ear????? is this good/bad????

then of course, couldn't resist getting the "santa hat and beard" combo at Petco (the beard has a teeny mouse in it)!!! have to get ready for those Holiday Cat pictures! (that' outta draw some blood... mine!!!)

will attempt the 2 hour curve sat or sunday and see how far i get and then i should have time to plot everything in the spreadsheet. do i ever have to start a new "thread" or can i just use this one forever and ever?

thanks all!!!!
Jen n Luna

 

[BJM]

... my other issue with the ear prick is that she has a good amount of fur on the top half of the ears which just about renders them useless for holding a drop of blood and i don't want to keep going for the same section. i heard you can prick the inside of the ear????? is this good/bad???? ...

Yes, you can prick the inside of the ear.
Also, neosporin ointment with pain relief helps the blood bead up. Put a dab on a couple minutes prior to testing.
Some folks use a small flashlight (held in the mouth, maybe?) or magnifier glasses to help them see the blood drop.

... do i ever have to start a new "thread" or can i just use this one forever and ever? ...

Please make a fresh post with the date and kitty's name each day, with a link to the previous post (copy the address of the page, paste it into the new post, highlight the whole thing, and hit the URL button at the top of the post entry panel so folks can refer back to the previous post.