New Diabetes Parent

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fun2doimpossible

fun2doimpossible

Member Since 2013
My cat Clyde was diagnosed with diabetes this week. Clyde is about 12 years old and all black. He currently weighs about 15.9 pounds. He'd down from the 19 pounds he weighed in Dec 2012 when the vet had me cut back the amount of food I was feeding him, so any weight loss wasn't a sign of something going on since we were trying to get him to loose weight.

Three weeks ago, Clyde had started peeing on my dirty laundry. I thought he wasn't happy with me since it corresponded to when I had to change the brand of litter. (Walmart was out of the regular stuff I use.) After trying 4 different types of litter I was finally able to get his regular litter. The peeing continued and on Monday, I took him to the vet to get him checked out.

They tested the urine sample I brought in and ran some blood work. His bg was 510 and was diagnosed with diabetes. Since then, he's on 1U of Lantus twice a day and I've changed his diet from Iams dry senior cat food to a mixture of Fancy Feast Classic and EVO wet cat food. (Clyde and his brother Max love the wet food and have been inhaling it. They used to only get it as a special treat.) Since coming back from the vet there hasn't been a single accident.

Clyde is going in on Tuesday for his first glucose curve. (The vet gave me the option to do this at home rather then bring him in. Until he's stabilized they recommend that if I do it at home it's done on a day when they are open. Unfortunately this was not an option this time.) Long term, I am planning on learning how to do home testing. He is getting his first shot at 6am when Max wakes me up for their breakfast :smile: and the second shot when I get home from work, between 5 & 6pm. I typically feed them right when I get home.

I have couple of questions that hopefully someone can help me with.

At a most basic level, how much wet food should I be feeding each cat at each feeding? Does it change with Fancy Feast Classic vs EVO? Last night I used a 5.5oz can for both cats and divided it in half. This morning, Max wasn't crying for his breakfast at 6am. Did I feed them too much? I put the same amount out this morning. I set Clyde down right in front of the food dish and he ate a two bites before getting up and walking away.

I have made arrangements for someone to give Clyde his shot when I have to work late or have something going on and don't think I can get back in time. The problem is Clyde is a ghost. At times he seems afraid of the world. He runs away from cat toys, sudden moves, loud noises, etc and only comes out and wants affection on his terms. Basically a typical cat :smile: Anyway he likes to hide. I've found him under my bed, the bed in the guest room, under the sofa, basically any place that makes it difficult for someone to either find him or get at him. (When he was younger, until I figured out how he was getting up there, he hid up in the drop ceiling in the basement.) I really don't want to confine him to a room. Short of emptying everything out a room, ever room I could put him in would still have hiding spaces and if Max is not in the room he will scratch to be let in and if in scratch to be let out. A cat is always on the wrong side of the door. :smile: Does anyone have any suggestions on what I can do to make him more "people friendly" or at least make it easier for them to find him? In the event that they don't find him and give him the shot what should I be doing?

I was thinking of prefilling syringes with the correct dose that they could use. Is there any drawbacks/issues I should be aware of with this?

Is there anything else that I should be doing that I'm not doing?

Will
 
Welcome.
It is good that your vet supports home testing the BG. You can use a human meter.
Get the person who will administer the shots to frequently come over before shots are necessary so Clyde and the person can become accustomed to one another.
Pre Filling syringes with Lantus is not recommended, The lubricant in the syringes degrades the Lantus.
 
Hi Will and sugardude Clyde and welcome to the FDMB.

Sounds like you are slowly adjusting your routine to help Clyde. Let us know how this first curve at the vet goes. We'd be very conservative on any dose changes, simply because in many cats, vet stress can easily raise the BG's 100-180 points.

Hope your vet knows about and recommends dosing changes in 0.25 and/or 0.5 units. It can be done, with 3/10 cc syringes with 1/2 unit markings on the barrel like Walmart Relion brand syringes.

How much food between the 2 cats? Roughly 15 calories per pound +70. An average can of Fancy Feast has around 90 calories. I'd have to look up the EVO. Which canned EVO is it that you are feeding?

ECID. Every Cat is Different. My 12 pound Monet eats 6 ounces, 7 pound Delta eats 4 ounces, 10.5 pound Wink eats 6-7 ounces.
 
Welcome Will and Clyde. Glad to see you here. I am pretty new myself (two months) and I am finding it a great place to learn and to get support.

donaleen
 
Thank you for the warm welcome.

My vet seems to know what she is talking about with diabetes in cats. One of her own cats is diabetic. She gave me a lot of information to take home, which mostly mirrors what I've found so far on here. The syringes I have only have 1U markings on the barrel. When I run out and get the prescription refilled I will need to ask the pharmacy for the syringes with 1/2U markings, without a line to measure against I don't see myself being able to accurately measure a .5U.

I will look at the Cat Info page for more information on feeding them. I'm rotating them through the different duck, beef, chicken & turkey, and venison EVO foods. Deb & Wink if I understand you correctly, for Max to loose 4 ounces (drop to 14.65 lbs) he should be eating about 290 calories a day and Clyde to loose 4 ounces (drop to 15.65) should be eating about 305 calories a day. Based on the information on EVO's website, a 5.5 oz can has between 210-218 calories. So if they've each getting a half can per day, I'm underfeeding them and they should actually be eating about 80 more calories of food a day.

How much should he actually eat before you give him his injection? I've noticed Clyde inhales his breakfast at 6am but in the evening when I get home from work he will take a couple of bites and then around four hours later eat the rest of his food. Is two bites enough, if not do you have any suggestions on how to get him to eat more around the time he is supposed to have his injection?
 
The concern with too rapid weight loss is that fat breakdown may overwhelm the liver and cause hepatic lipidosis, which severely deranges normal digestion and may be fatal. it is very expensive to treat due to hospitalization.

Dr Pierson describes how to do it safely on her site and you might discuss that with your vet and make a plan for safe weight loss for you cats.
 
Deb & Wink if I understand you correctly, for Max to loose 4 ounces (drop to 14.65 lbs) he should be eating about 290 calories a day and Clyde to loose 4 ounces (drop to 15.65) should be eating about 305 calories a day. Based on the information on EVO's website, a 5.5 oz can has between 210-218 calories. So if they've each getting a half can per day, I'm underfeeding them and they should actually be eating about 80 more calories of food a day.
Click to expand...

ECID. At the beginning, Wink was eating 11-12 ounces of canned food a day. That was before he went into remission, OTJ, and his body was not processing all the food he was eating properly. He naturally lost some of his excess weight. In fact, he was losing too quickly for my comfort but the vet and shelter did not agree and thought he was overweight.

The formula I gave for feeding, was a rough estimate for normal cats. But since ECID, you need to try different amounts of food with your cats, to see how much they can eat without gaining or losing too much weight, and keeping that weight loss slow and steady.

My civie Monet was 4.5 pounds overweight. I spent a 15 months taking that weight off him, slowly and steadily to prevent any problems and keep good muscle mass on him. Weight loss was around 1 - 2% a week, which was just about perfect. My vet was very pleased with his weight loss, but it's very hard to accept what looks skinny to me as normal and healthy.

You might want to weigh your kitties on a regular basis. Simplest method is to hold the cat in your arms, step on your bathroom scale, note weight, let cat down, note weight and subtract to get an estimate. You can also buy a more accurate baby/infant scale to weigh your cat. New or on craigslist or ebay may be some ideas to find a used baby/infant scale. Weigh every couple of weeks to get an idea of how your cats are doing.

Slow and steady wins the weight loss race.

For now, I'd not be too concerned with getting your cats to lose weight. I suggest getting a handle on the diabetes first, and then see about the food. Once I switched all my cats to all low-carb canned food, portioned controlled the amounts fed, they do just fine. I do monitor on a weekly basis, and adjust the food intake if needed.

Spreading out the food into mini-meals helps to take some of the load off the pancreas and often provides more steady BG levels. Personally, I feed 4 meals a day, 2 breakfasts a couple hours apart and 2 dinners a couple of hours apart. This works for me and my schedule.

People here that work will often either free feed if that works for their cats, buy a timed feeder to give meals at different times during the day or make cat food 'cicles. Cat food 'cicles are taking the canned food out of the container, perhaps mixing with a tablespoon or 2 of water, plopping mixture into a non-stick muffin cup, and freezing. Or pop the food from the can onto a cookie sheet, cut into smaller portions (I like quarters). Pop them out once frozen, store in a Ziploc in the freezer and leave one out to defrost slowly during the day for your cats to nibble on.
 
Hello and welcome to the board!

Its great you have a vet that supports home testing - she obviously knows that curves at the vet are inaccurate due to cat stress, expensive etc. Plus that home testing is key to keeping your cat safe from hypos especially as many go into remission with a low carb food and Lantus. I am confused though why you cant do a curve when the vet is closed? Its just testing... We recommend you always test before the shot as you dont want to shoot when too low.

If you are going to be home late and know in advance you can move shot time by 15minutes each shot or 30minutes a day to accommodate the new time. And/or you could train him to come running for treats? If you do home testing prior to each shot, many cats learn it also means treats and come running for their tests which would make it easier for someone else to find him too. Or they can shoot while he is eating. Missing the occasional shot is ok too.

Wendy

PS syringes with half unit markings: Relion 3/10cc 30 & 31 gauge short OR BD Ultra fine 3/10cc short OR Terumo Thinpro Insulin Syringe 31G 3/10cc OR Kroger 0.3cc 8mm, 31 gauge

PPS I wouldnt prefill syringes but you could create a reference syringe with food colouring in it so they can compare it to that.
 
Deb & Wink said:
For now, I'd not be too concerned with getting your cats to lose weight. I suggest getting a handle on the diabetes first, and then see about the food. Once I switched all my cats to all low-carb canned food, portioned controlled the amounts fed, they do just fine. I do monitor on a weekly basis, and adjust the food intake if needed.
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That is my thought as well. I wanted to make sure I understood the formula and was actually feeding both Clyde and Max (my non-diabetic cat) enough food and not starving them since rapid weight loss is not a good thing with cats. :smile:

Deb & Wink said:
People here that work will often either free feed if that works for their cats, buy a timed feeder to give meals at different times during the day or make cat food 'cicles.
Click to expand...

I've been putting down enough wet food for a serving for each cat for the day. Very rarely the eat it all at once. Most of the time, they eat a quarter of it when I first put it down and then the rest of it throughout the day.

Wendy&Tiggy said:
Its great you have a vet that supports home testing - she obviously knows that curves at the vet are inaccurate due to cat stress, expensive etc. Plus that home testing is key to keeping your cat safe from hypos especially as many go into remission with a low carb food and Lantus. I am confused though why you cant do a curve when the vet is closed? Its just testing... We recommend you always test before the shot as you dont want to shoot when too low.
Click to expand...

They have no issue with me learning how to do a curve or doing it when they are closed. He was just diagnosed on Monday. They just want the first curve done when they are open so they can immediately start to figure out how to adjust his dosage since I'm still learning what I should be doing and how everything works. Right now, I know just enough to be very dangerous :-D It's my understanding that after they complete the curve they are planning on showing me how to properly test his BG before I take him home.

Wendy&Tiggy said:
If you are going to be home late and know in advance you can move shot time by 15minutes each shot or 30minutes a day to accommodate the new time. And/or you could train him to come running for treats? If you do home testing prior to each shot, many cats learn it also means treats and come running for their tests which would make it easier for someone else to find him too. Or they can shoot while he is eating. Missing the occasional shot is ok too.
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I need to find something Clyde likes. He's never been one for any cat treat I've ever brought home and he is afraid of cat toys or at least finds them uninteresting. :smile: (Max is the exact opposite. He will show up for any cat treat and loves any toys I bring home.)
 
Does he like being brushed? Damp mopped? (I have a 4 year old that comes into the bathroom so I can give her a wet mom cat swipe or two!)
 
Clyde will eat chicken or tuna, but he doesn't seem to like it enough to come out for it. He does not like being brushed or damp mopped.

If I'm in the kitchen, he will poke his head around the door if he hears a can being opened, and then promptly disappear if he sees someone other then me.

Anyway, he survived this weekend with my parents giving him his shot on Sat night. They had to lift the mattress up to get him out from under the bed.
 
Would you be willing to add some data to your user control panel, profile tab, signature? It sure would help us to help you better.

We like to see your first name, cats name age and sex, diagnosis date, meter used, insulin used, food being fed, any complicating medical conditions your cat has like IBD or CKD. It's very helpful to us to have this information available at a glance, right in your signature. You can look at mine for an example.
 
On Tuesday, a BG curve was done on Clyde. Following the curve, the vet decided to increase his Lantus from 1U to 2U b.i.g. He gets his am shot around 6am, and the pm shot around 5:30pm.

Time Level
7:25am 316
10:30am 338
1:30pm 329
4:30pm 364

The levels definitely look better then the 510 he was reading last Monday.
 
Thank you so much for putting those little bits of information in your signature.

The dosing protocol we use here, only increases in 0.25U or 0.5U increments, depending on the nadir or low point of the cycle. Most vets seem to advise dose changes in 1 U increments.

Hope this increased dose is not too much for Willie and has not bypassed a good dose for him.
 
These numbers were at the vets? Thats low considering he would have been under stress - he might even be too low at home. Are you planning to home test soon?

Wendy
 
Wendy&Tiggy said:
These numbers were at the vets? Thats low considering he would have been under stress - he might even be too low at home. Are you planning to home test soon?

Wendy
Click to expand...

The curve was done at the vets. I am planning on starting to home test as soon as the meter comes in. (The local Walmart was out of the Relion Confirm. It seems to be a recommended and popular model on here.)
 
I use a Relion confirm myself to test Wink.

Since we all live in different time zones around the world, we express the shot and test times in a +hour format. The shot time is 0 and each hour after that is one hour. So a test 2 hours after the shot is +2, 5 hours after is +5, etc.

Time Level
7:25am 316
10:30am 338
1:30pm 329
4:30pm 364

Taking your numbers that you gave us here, with 6am as your morning shot time (what we call the AMPS or morning pre-shot test)
AMPS ?? not done
+1.5 316
+4.5 338
+7.5 329
+10.5 364

The evening pre-shot test, is called the PMPS (PM = evening or PM and PS = pre-shot)
 
I got the meter today. It's a Relion Confirm.

I locked us both in the bathroom and petted him until he was purring nicely and after several pokes, managed to get a drop of blood out of Clyde's ear. I'm not sure if I did it right and got enough blood for an accurate reading. The link https://docs.google.com/file/d/0B3LPtmGIw3yeWGZ0V3R2eFpqaVk/edit?usp=sharing shows the result with the strip in the meter.

If it is an accurate result, he was 126 for the PMPS.

From the picture does it look like I did it right? If it looks like I did it correctly, at 126 I am not planning on giving him his evening shot.

I will attempt to test him again in the AM.
 
Welcome to the vampire club!

Usually, you'll get an error message if there is a problem with the test.

And you're absolutely right - no shot for beginners!

Here are some glucose reference ranges used for decision making using glucometers. Human glucometer numbers are given first. Numbers in parentheses are for non-US meters. Numbers in curly braces are estimates for an AlphaTrak.

< 40 mg/dL (2.2 mmol/L) {< 70 mg/dL for an AlphaTrak}
- Treat as if HYPO if on insulin
- At nadir (lowest point between shots) in a long term diabetic (more than a year), may earn a reduction.

< 50 mg/dL (2.8 mmol/L) {< 80 mg/dL for an AlphaTrak}
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50 (2.8).
- At nadir, often indicates dose reduction is earned.

50 - 130 mg/dL (2.8 - 7.2 mmol/L) {80 - 160 mg/dL for an AlphaTrak}
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. (May even go as low as the upper 30s (1.7 mmol/L){60s for an AlphaTrak}; if not on insulin, this can be safe.

= 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- the lowest level pre-shot for ProZinc, PZI, or other non-depot insulins.

> 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

200 mg/dL (11.1 mmol/L) {230 mg/dL for an AlphaTrak}
- no shot level for beginners; may slowly reduce to 150 mg/dL (8.3 mmol/L) {180 mg/dL} for long-acting insulins (Lantus, Levemir, and ProZinc) as data collection shows it is safe

180 - 280 mg/dL (10 - 15.6 mmol/L) {may be 210 - 310 mg/dL for an AlphaTrak}
- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.

>= 280 mg/dL (15.6 mmol/L) {may be >=310 mf/dL for an AlphaTrak}, if for most of the cycle between shots
- Uncontrolled diabetes and thus at risk for diabetic ketoacidosis and hepatic lipidosis
- Follow your insulin protocol for dose adjustments
- Test for ketones; if more than a trace level of ketones, go to vet ASAP.
 
126 is great!!! Let see how he is in the morning. Dont shoot unless he goes over 200. Like BJ says, 14 days of 50-130 and he is in remission

To help sustain his pancreas at this point you want to give him frequent mini meals instead of a few big ones.

Wendy
 
For the AMPS Clyde was 346. It took about 20 minutes to get the blood sample. He kept moving his head wanting me to change where was I scratching him and it took a couple of tries before I got a drop.
 
The PMPS was 151, taken approximately +11.25 hours from AMPS. He seemed more relaxed with me doing it on my bed then in the bathroom.

This morning marked a small change in their diet. I switched to the larger 13.2 oz cans of Evo from the 5.5 oz cans, so Max & Clyde are splitting a single 13.2 oz can of Evo a day rather then two 5.5 oz cans. Max is no longer crying wanting more food. :smile: (I did see the suggestion about many smaller meals. I need to get some type of wet food delivery system in order to do that since I'm at work during the day.)

Does anyone have an idea of what these numbers indicate if this pattern continues to hold? He is scheduled to go to back to the vet on 10/1 to see how he's doing. I was planning on attempting a glucose curve on Sat, but I don't know if I'll get accurate numbers since I have to shampoo the carpets from his accidents prior to him getting diagnosed. (The shampooer I'm borrowing I can only get that weekend.)
 
Testing around the nadir - the expected low point between shots - is used to determine how well the insulin is working. Whenever possible, try to get some mid-cycle tests - on a day off, before bed, setting a clock for the middle of the night, whatever you need to do to get some of these tests.

We'll be able to give you better feedback if you use our spreadsheet/table, too. Instructions are here

Each row is 1 day.
It reads left to right.
You enter the date.
You enter the morning pre-shot test (AMPS).
You enter the units given (U) in the morning.
You enter the evening pre-shot (PMPS).
You enter the units given (U) in the evening.
If there are any notes you want to make, you jot them down (ex stressors, food changes, meter changes, signs of illness, etc).
If you do any tests between the 2 shots, you enter them in the column which reflects the numbers since the shot.
A test 2 hours after the shot goes in the +2 column.
A test 5 hours after the shot goes in the +5 column.
A test 6 hours after the shot goes in the +6 column; the nadir, or lowest glucose level, may be around this time.
 
Like BJ said, preshot tests really dont give enough data to know whats going on. Dose changes are always based on nadir (or low point) of the day so I usually recommend 4 tests a day if you want to keep the cat safe from dropping too low, or want a better picture of whats going on - is he going too low? or not low enough? Just preshot tests dont tell you that.

- always before the shot - this is mandatory as you don't want to shoot when too low. As a newbie this too low number is 200 but is reduced over time once you have the data to know if its safe.
- mid cycle - 5-7 hours after morning shot depending on your schedule. This is to see how low he is going. The low point "nadir" is what you base dose changes on since you don't want him dropping too low (under 50).
- before bed (2-3hours after Pm shot) to get an idea of what his overnight plans are. If this number is less than the pre shot test number you may want to set the alarm for a test a few hours later as this implies an active cycle.
 
Please PM me. I'd be happy to get our standard format SS (spreadsheet ) setup for you and linked to your signature. It only takes me a few minutes and I'd be glad to help you with this.
 
You may find this helpful

Here are some glucose reference ranges used for decision making using glucometers. Human glucometer numbers are given first. Numbers in parentheses are for non-US meters. Numbers in curly braces are estimates for an AlphaTrak.

< 40 mg/dL (2.2 mmol/L) {< 70 mg/dL for an AlphaTrak}
- Treat as if HYPO if on insulin
- At nadir (lowest point between shots) in a long term diabetic (more than a year), may earn a reduction.

< 50 mg/dL (2.8 mmol/L) {< 80 mg/dL for an AlphaTrak}
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50 (2.8).
- At nadir, often indicates dose reduction is earned.

50 - 130 mg/dL (2.8 - 7.2 mmol/L) {80 - 160 mg/dL for an AlphaTrak}
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. (May even go as low as the upper 30s (1.7 mmol/L){60s for an AlphaTrak}; if not on insulin, this can be safe.

= 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- the lowest level pre-shot for ProZinc, PZI, or other non-depot insulins.

> 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

200 mg/dL (11.1 mmol/L) {230 mg/dL for an AlphaTrak}
- no shot level for beginners; may slowly reduce to 150 mg/dL (8.3 mmol/L) {180 mg/dL} for long-acting insulins (Lantus, Levemir, and ProZinc) as mid-cycle data collection shows it is safe

180 - 280 mg/dL (10 - 15.6 mmol/L) {may be 210 - 310 mg/dL for an AlphaTrak}
- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.

>= 280 mg/dL (15.6 mmol/L) {may be >=310 mf/dL for an AlphaTrak}, if for most of the cycle between shots
- Uncontrolled diabetes and thus at risk for diabetic ketoacidosis and hepatic lipidosis
- Follow your insulin protocol for dose adjustments
- Test for ketones; if more than a trace level of ketones, go to vet ASAP.
 
fun2doimpossible said:
...I did see the suggestion about many smaller meals. I need to get some type of wet food delivery system in order to do that since I'm at work during the day...
Click to expand...

Try freezing half of what you'd give and putting it out to thaw at the same time as you feed the unthawed. He'll be able to nibble on it as it thaws. That'll only cost you a smidge of set up time.
 
Deb & Wink said:
Please PM me. I'd be happy to get our standard format SS (spreadsheet ) setup for you and linked to your signature. It only takes me a few minutes and I'd be glad to help you with this.
Click to expand...

Thank you for your offer to help. I managed to get it online and updated with all of the data I have to date.
 
Great to see the SS. It helps a lot!

Ok I think you might want to try a lower dose. Lantus works best on consistency and you want a dose you can safely give twice a day in order that his blood sugar doesn't go too high by skipping. I would try reducing him to 1.5 and see how that does for a few days. No shooting if under 200 though.

Maybe read the protocol too. http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581



Wendy
 
Wendy&Tiggy said:
Great to see the SS. It helps a lot!

Ok I think you might want to try a lower dose. Lantus works best on consistency and you want a dose you can safely give twice a day in order that his blood sugar doesn't go too high by skipping. I would try reducing him to 1.5 and see how that does for a few days. No shooting if under 200 though.

Maybe read the protocol too. http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581



Wendy
Click to expand...

Hi Wendy,
Clyde was at the vet today for a glucose curve. My vet wanted me to do one for this week, and well I fell asleep part of the way through it over the weekend :oops: during the only time I was home for the entire 12 hour duration, so I had them do it. But I took in a copy of my spreadsheet and between the spreadsheet data, and the results of the curve, my vet gave me the same recommendation to reduce him to 1.5U, which was his shot this evening and hold him there for 2 weeks and then do another curve on him. (Hopefully this time, I can do it during daylight hours and not fall asleep while doing it. :smile: )

Will
 
I've read the protocol, it seems like it makes sense at least once you get him initially stabilized and I understand what my vet's immediate goal of a shot twice a day of about the same dosage.

At this point, would you recommend I attempt a curve at home on Saturday to get more data? That will be the start of the 6th cycle with the change in the dosage.

Also, when you check the PMPS do you do it before or after he's eaten? If it should be after, how long should you wait after he's eaten. I've been giving him his shot after he eats, but testing before he eats on the theory that food would push it upwards.
 
You always test before you give insulin, to make sure it is safe to shoot. It is a pre-shot test.
 
BJM said:
You always test before you give insulin, to make sure it is safe to shoot. It is a pre-shot test.
Click to expand...

Hi BJM,
Thank you for your quick reply. I am testing before I give him the insulin. My question is more of which is the preferred sequence: test, feed, shoot or feed, test, shoot and if the latter how long should I wait after he eats before testing?
 
Its test, feed, shoot within about 15 minutes for long-acting insulins.

For shorter acting insulins - Caninsulin/Vetsulin, N, R - you want 30 minutes to get the food in before the insulin hits.
 
BJM said:
Its test, feed, shoot within about 15 minutes for long-acting insulins.

For shorter acting insulins - Caninsulin/Vetsulin, N, R - you want 30 minutes to get the food in before the insulin hits.
Click to expand...

Thank you. I am doing it in the correct order. :)
 
On 10/1 the vet had me drop his dosage to 1.5U on Clyde. This morning, I did a glucose curve on him and just took the last sample before the PMPS in 2 hours. Based on the protocol and the data from the curve, would I be correct in reducing his dosage to 1.25U if his BG is high enough for a shot? Based on his current numbers, I don't see him being anywhere near 200 around the PMPS.
 
Yes, decrease 0.25 units; you'll have to eyeball it as syringes don't measure quarter unit increments.

Good job on the curve!

Since you are testing well, it is safe to start decreasing your no shot limit. I think you may take it down to 175 - 180 mg/dL this week.

You may wish to check our 2 Lantus forums to get more insulin-specific advice. If you are able to get mid-cycle tests weekends or more often, following the Tight Regulation protocol may even get him to a diet-controlled state.
 
Thank you both for your help. I'm planning on attempting another glucose curve on Friday since I have to work that night and we'll see what happens. Looking over the next couple of months, I can definitely do a curve on Friday or Saturday the vast majority of weekends.
 
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