? New diagnosis... still so confused about all of this!

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MélanieW

MélanieW

Member Since 2017
Hello everyone!
I must admit I've been reading this board for the past week and finally decided to write a post to ask for advice. I will apologize in advance for my not so good English. I'm from Québec (Canada) and spend most of my time speaking and writing in French.

My cat Noah had been drinking a lot and peeing a lot for the past month or so and on December 22nd I brought him to the vet and was told he had diabetes. Noah is a big cat (20 lbs). He has been eating dry food (Orijen, Royal Canin for urinary problems) all of his life. Bought him all kinds of wet food and he is not interested AT ALL. Same problem with my other cat (not diabetic). They just love that (apparently not good at all for them) DRY FOOD. I switch to Purina DM but from what I'm reading it isn't that good either.

After the diagnosis, I was told to start Noah on a dose of 2 units of Lantus twice a day. I was told to go back in a week later (December 28th) and his glucose level was still at 23.4 mmol/L pre-injection (I was told I need to multiply this number by 18 to get the number in mg/dL - 421). The vet told me that I should buy a glucose meter (he recommended the Bayer Contour next as the one he sold in the clinic was really expensive). I went home and tested him four hours later and his level was down to 15.5 (277), but the vet had told me that morning that unless he had a value below 10 (180) that I should increase the dose by 0.5 units.

The vet recommended testing only once a week before the morning injection and 4 to 6 hours after the morning injection. So I did test again on January 4th and got 19.5 (351) before the morning shot and 18.7 (337) four hours later. The vet gave me a sheet explaining how to up the dose according to the numbers I got so I had to up the dose by 0.5 units again.

Even since that day I've been testing a couple of times during the day since I'm so paranoid about hypoglycemia and his results are always between 15.5-18.5 (279-333). He seems to go lower about 4 hours after the night dose. I know I should do a spreadsheet, but I would need more data before I could make one. Should we test every hour on the same day? Or tests during different periods for a couple of days? I work from home most days so this would be very easy for me to do.

I feel a bit overwhelmed and want to provide the very best care for my Noah. The diabetes seems more stressful for me than him... he doesn't mind his injections at all and let's me prick his ears to test his blood. I'm just nervous about giving him too much insulin and worry about hypoglycemia. He is already on 3 units twice a day and so far from the numbers I'm getting I will have to up his dose again in four days...
 
Welcome from next door in Ontario. Your English is fine. While I'm not experienced enough to give dosing advice, I do think you have enough information to start a spreadsheet, and that would be of great benefit for the veterans here.
 
Welcome. Since testing isn't at all stressful I suggest you test at a minimum before each insulin shot, and 2-3 hours after or at least an out the door test if you need to leave sooner. Lantus is dosed on the lowest point in the cycle which is usually at 5-7 hours after injecting. Too much insulin can look just like too little because if a cat hits numbers lower than tgey are used to they will bounce high. If you don't test before shooting your cat might be too low to shoot and could go hypo if you can't monitor. Read the stickies on TR and SLGS and make you you have a hypo kit ready. If you go to catinfo.org you can get ideas on getting a cat switched from dry to wet food. There is also a lower carb dry food called Young Again that can be ordered on line.
 
I'm in Gatineau and work in Ottawa so hello and thank you for your warm welcomes. This seems like such a great place and it feels great knowing that I can talk with people experiencing the same thing I am. There is so much to learn and I just want to do my best to give my cat the best chance possible at remission.

Thank you for the info tiffmaxee. I will try switching again to wet food and make sure to read the pages you suggested. I'm working on getting a partial spreadsheet with the numbers I have so far, but I did not get that many as the vet suggested testing only one day per week before the morning injection and four to six hours later. I will not be home all day tomorrow, but I will do my day of testing on Sunday.
 
Hi Melanie and Noah and welcome (from just below your southern border in northern NY state),
You are doing very well already, testing and trying to get Noah and your other kitty off of dry food. The link Elise sent you--catinfo.org-- is excellent. Here we test every day (not just once a week): before the morning and evening shots and optimally somewhere in the middle of the 12-hour cycle. That way we get a better idea of how low the dose will take the cat. Lantus is dosed according to the lowest number of the cycle: the nadir. If you base your dose on the pre-shot, you will almost certainly be giving too much insulin. Be sure to read the informational posts ("Stickies") at the top of this Lantus forum. It's a lot of information to digest, but you don't have to learn everything at once. Start with the "New to the Group" sticky.
We are all here to help, so don't hesitate to ask questions.

Once again, WELCOME!

Ella & Rusty
 
Hi from So Cal! Gussie and extend a warm welcome too! You are so lucky! You have landed in the very best place for you and Noah!
Don't feel alone, the notion of a hypo terrified all of us! What really helped me was reading lots of threads or condos as we call them, where folks had cats whose numbers were dropping low. It helped me realize that using the techniques and with help from folks here a drop in numbers was manageable and it was possible to keep my cat safe. That didn't mean when Gussies numbers dropped low I didn't freak out, I admit, I did! but I knew there was help...and he stayed completely safe! True hypos are most often averted....the beauty of the help here, they know what they are seeing and how to help prevent them.:bighug:
Ask every question that pops into your head...it's all very confusing and only starts to make real sense as you experience it.. there are no dumb, silly questions! We've either heard or asked them ourselves!:)
That you are here and testing is wonderful!!
Again,
Welcome!!!:bighug:
 
Your English is perfect. Congratulations on catching your kitty's symptoms so quickly. Many of us were not so observant as you.
This is a complicated disease. To make your life more complicated, we use a lot of shorthand and acronyms here. I found that very confusing at first. Here's a link to a lot of the acronyms and odd words that we use in this message board:
http://www.felinediabetes.com/dictionary/cat-health-dictionary-fdmb.htm

Welcome.:)
 
Thank you so much to everyone! I'm trying to catch up on reading and making sure I can memorize as much as possible. What a wonderful place and group of people. I will probably ask a lot of questions as I'm still trying to adjust to this "new" lifestyle. I'm not sleeping much right now, but at least it will make testing easier. I'll work on my spreadsheet this weekend so I can get so advice when I need to decide if I should up his dose next week.
Again thank you for sharing all the useful links and I look forward to getting to know all of you and your furbabies.
 
Hi Mélanie, and welcome to Lantus & Levemir Land - the nicest place you never wanted to be.

I think your English is excellent - better than some native speakers I know! ;)

You will find we are a very friendly bunch, and we all love kitties. We were all new once, and we remember how overwhelming it all was, so don't be shy about asking questions. The only dumb question is the one you don't ask!

If you can get that spreadsheet set up, it would be very helpful. It doesn't matter how little data you have so for. There is one that has a tab for World readings and a tab for US readings. https://docs.google.com/spreadsheets/d/1JQ136YHkxNhhku9AML_OKGHkrg3Ixe27BWAdWONlnP0/edit#gid=5 You would enter your readings as you get them off your meter in the World tab, and the spreadsheet will translate them and fill in the US tab. If you have any problems, let us know. We have several people here that are very good at setting up the spreadsheet and can help.

As you read the stickies, you will see that we recommend dose changes in increments of .25, rather than the .5 your vet has been advising. That is because, in a cat, even .25 can make a difference. Do you have syringes that have half unit markings? Unfortunately, there are none with quarter unit markings, so when you have to shoot .25 or .75, you have to eyeball it and make your best guess. With Lantus, consistency is the most important thing.

As others have mentioned, we strongly recommend you get a test before EVERY shot,to be sure it's safe to shoot, and at least one mid-cycle test. If you look at some of the spreadsheets of other cats here, you'll see lots of tests at different times. Some of us, myself included, are "testaholics" and test a lot. You don't have to do that to follow TR, but it is important to get those mid-cycle tests so you know how low the dose is taking your cat. Lantus dosing adjustments are based on that lowest number.

Since Noah is currently eating dry food,the method you would follow would be Start Low Go Slow. If you can get him weaned off the dry food, you would be able to switch to Tight Regulation. Others have mentioned Dr. Lisa's site, Catinfo.org. Here is a link to her tips on transitioning a cat to moist food. She also has a list of many of the most common commercial canned cat foods and their carb %.

Lastly, I see Kathy gave you a link to the FDMB glossary. We also have a slang dictionary that includes a few more of the terms we throw around a lot.

If you aren't totally overwhelmed yet, you aren't human! Remember, we're here to help! :bighug:
 
Hi from BC!

I am new to all of this as well. Glen was diagnosed in the middle of December. My vet did the same thing and said to give him 2u twice a day and to come back in a week or 2 for a curve. She said monitoring wasn't that important. I strongly believe if I hadn't found this place and started testing my cat that day, Glen would have had a serious hypo or worse.

I am far from knowing what to do and question almost every injection but there is usually someone here to help. Glen doesn't seem to be following the usual rules with diabetic cats ;)

Luckily for me, Glen took himself off of kibble. He just stopped eating it. I think he is tired of the flavour. Needless to say, I am weaning my other cat off of it and giving more canned. Once this kibble is gone that's it. I'm not buying anymore (except for the sample bag of orijen to add to hypo kit).

Glen is eating more and more raw food so thinking that has something to do with his low numbers.

Anyways, you are doing great and I'm so glad you found this place and all these helpful folks!
 
WOOHOO I see your spreadsheet for Noah!! Well done!

You've mastered home testing and you have a spreadsheet - that's the worst part already.

Since he is eating dry food, you will want to follow the Start Low Go Slow dosing guidelines. If there comes a time when he can be transitioned fully to low carb wet food, then you would have the option of following the Tight Regulation Protocol if you wanted. It requires no dry food be part of the regular diet, however. With SLGS doses are held for a week at a time, then adjusted based upon how low that dose has gotten the cat during that week.

If he remains completely over 300, let's revisit that sooner, however. You've got 2 days already at this dose, I'd suggest you ask the question about dose again on Sunday, so he has 4 days on it. You're doing a super job of getting tests in. Great job.

Here is a thread that might be helpful to you in finding information that we typically use in this group: "Where Can I Find?"

As as many questions as you have. There are no dumb questions here and we have all been in your shoes, trying to help our kitties get better as quickly as possible. Glad to have you and Noah in the group!
 
Welcome to the group!!

Great job on getting your spreadsheet (SS) up and running. Please remember to always get a pre-shot test. Getting into the habit of testing before giving a shot is very important. That pre-shot test is your only way of knowing that it's safe to shoot.

Please ask questions. The people here are very generous with their knowledge and time. We love questions!!

 
Good morning from here in Connecticut USA and welcome to lantus and levemir land, Melanie and your handsome Noah! Wonderful, knowledgeable and caring people ("Beans" is slang here for our kitties' humans/beings!) here and through thick and thin.

I won't add to any dosing or protocol suggestions except to echo what others have already suggested and shared....and to say that starting out with the Start Low Go Method Guidelines makes a whole lot of sense to me and especially while transitioning your tribe from kibble to wet food.

Also it's very true that spreadsheet information really helps you and those far more experienced than me to begin to understand and help with Noah's patterns. It's great that you started that right away. When I started here, I couldn't see/comprehend what others were seeing in the spreadsheet data. But it will come together!
Wishing you a happy New Year and again welcome!
Sina
:bighug::bighug::bighug:
 
Thank you to everyone. I can't believe how friendly this board is and how good it feels to have people make sense of what is going on with my cat. I'm still doing testing and updating my spreadsheet. I'm hoping I can get some help with the dose as Noah's numbers are still pretty high and today he seemed to be a bit weird. I was able to get my other cat to eat wet food today, so at least I know it's possible, but Noah did not want any. I guess he is not feeling that great (with numbers this high) and I shall try again tomorrow. I bought some Wellness wet food today (tried looking for Fancy Feast Classics but could not find any; fellow Canadians is the name different in Canada?) and wanted to try and order Young Again, but apparently the Canadian customs has been seizing some food and sends it back to the sender.
 
Forgot to add that dose are only in 0.5 increments on my insulin pen. So I don't think I would be able to increase by 0.25.
 
MélanieW said:
Thank you to everyone. I can't believe how friendly this board is and how good it feels to have people make sense of what is going on with my cat. I'm still doing testing and updating my spreadsheet. I'm hoping I can get some help with the dose as Noah's numbers are still pretty high and today he seemed to be a bit weird. I was able to get my other cat to eat wet food today, so at least I know it's possible, but Noah did not want any. I guess he is not feeling that great (with numbers this high) and I shall try again tomorrow. I bought some Wellness wet food today (tried looking for Fancy Feast Classics but could not find any; fellow Canadians is the name different in Canada?) and wanted to try and order Young Again, but apparently the Canadian customs has been seizing some food and sends it back to the sender.
Click to expand...
In Canada the Fancy Feast pates that are good to feed FD kitties don't have "Classics" in the name.
 
MélanieW said:
Forgot to add that dose are only in 0.5 increments on my insulin pen. So I don't think I would be able to increase by 0.25.
Click to expand...
Hi again, Melanie & Noah,

I was just going to give you the same information that @Kris & Teasel did (above). We use those pens as if they were small vials (which is, really, what they are). You don't have to take the cartridge out of the pen, just get U-100 syringes with 1/2 unit markings and insert the needle into the rubber gasket of the pen and draw out a little more insulin than you need. Then slowly twist the plunger of the syringe until you arrive at your dose. The Canadians will be able to tell you which syringes are available in Canada; @Wendy&Neko always used BD syringes. In general the syringes with 31-gauge needles (very thin) are preferable.
(The Lantus pens are intended for humans, who typically use much larger doses of insulin, so they don't need to measure 1/4 and 1/2 units. You don't need the needles that come with the pens. You can take them back if not opened. )

Noah's spreadsheet looks good. Congratulations on getting it up so quickly.
 
Hello and welcome from another west coaster (BC), but on the continent.:bighug: As Ella mentioned, I always used the BD Ultrafine II syringes with my girl. The needles were so fine she barely noticed when I poked her. I used a magnifying glass an digital caliper to measure my dose. When my Neko was on smaller doses, she would react to changes as small as 1/8th of a unit. But when people are new, we recommend starting with those .25U changes, because that works for most cats. As Julie mentioned, we may revisit that if Noah's numbers stay higher.
 
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