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Kandi and Oliver said:
I tried to talk to my vet about him being on two units and if it was too much yesterday on the phone and he talked about possibly even increasing him this week?? I am deeply worried about what I should be doing. He is due for a shot in the next hour. Should I go against vets instructions and change to one unit? I’m so conflicted on knowing what is best and just scared to make the wrong choice
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Hi Kandi. Merlin and I are a week into this adventure. Yesterday I was texting with his vet and told her that his BS was 46 (about 4.5 hours after the morning dose of 2 units) and she mentioned possibly increasing to 3 units. I started feeling panicky too.
 
Kelley and Merlin said:
Ugh, I think I've been poking Merlin wrong. It's a struggle each time I test him. I haven't been testing right on the tip of the ear, more on the marginal vein. :banghead:

I just told him I'll get better at it, I promise. He just looked at me like sure you will... :oops:
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Kelley same with Oliver. I have been profusely apologizing to him. And telling him it will get better and we are both learning. Ahh I just found out Monday! We are in this together!
 
Kandi and Oliver said:
Kelley same with Oliver. I have been profusely apologizing to him. And telling him it will get better and we are both learning. Ahh I just found out Monday! We are in this together!
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Also keep me posted about what you do regarding the insulin dose and your vet trying to increase it since we are in the same boat it would be really helpful!
 
Kelley and Merlin said:
Merlin and I are a week into this adventure. Yesterday I was texting with his vet and told her that his BS was 46 (about 4.5 hours after the morning dose of 2 units) and she mentioned possibly increasing to 3 units. I started feeling panicky too.
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Increasing dose in that case makes about as much sense to me as lengthening the rope of a bungee jumper whose hair is already skimming the rocks at the bottom of the gorge. How is this not a no-brainer (on the vet’s part, not yours)?

Best wishes to you both, by the way. It’ll all get easier and start to make more sense soon.
 
Kandi and Oliver said:
Also keep me posted about what you do regarding the insulin dose and your vet trying to increase it since we are in the same boat it would be really helpful!
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Kandi, I did lower his dose to 1 unit for last night and this morning, but please talk to the ladies here before you do anything like that. I figured if it doesn't come down enough, we will manage through until the next dose. So far, so good. Even with 1 unit, he dipped down to 52 this afternoon. Of course his AMPS was much lower today at 174. He is also eating extremely low carb.
 
I finally just got my first reading. I could cry. Poor boy. 271

what do I do from here?

He is on the Hill’s food from the vet. Combo right now until I can weed out the dry food completely but the vet wants me to leave out some dry food so he has access if he needs it in the beginning.

I’m thinking I am going to be switching to fancy feast. Just have been learning to give the shots and testing him etc. but will keep you guys posted on that.

Also what’s is AMPS? Not understanding this and trying to learn the numbers and how/when it fluctuates and how to respond.

Thank you guys sooo much!
 
Also he did have some dry food right before and I have him his morning insulin around 9:30am. Also I figured out what AMPS means. :)

I don’t really know if I’m asking this question correctly, but basically I’m wondering what a normal/good numbers are through the day in relation to pre-shot/post-shot/eating etc.

Also what can I give him as a treat?
Kandi and Oliver said:
I finally just got my first reading. I could cry. Poor boy. 271

what do I do from here?

He is on the Hill’s food from the vet. Combo right now until I can weed out the dry food completely but the vet wants me to leave out some dry food so he has access if he needs it in the beginning.

I’m thinking I am going to be switching to fancy feast. Just have been learning to give the shots and testing him etc. but will keep you guys posted on that.

Also what’s is AMPS? Not understanding this and trying to learn the numbers and how/when it fluctuates and how to respond.

Thank you guys sooo much!
Click to expand...
 
I finally just got my first reading. I could cry. Poor boy. 271

what do I do from here?

He is on the Hill’s food from the vet. Combo right now until I can weed out the dry food completely but the vet wants me to leave out some dry food so he has access if he needs it in the beginning.

I’m thinking I am going to be switching to fancy feast. Just have been learning to give the shots and testing him etc. but will keep you guys posted on that.

Also what’s is AMPS? Not understanding this and trying to learn the numbers and how/when it fluctuates and how to respond.

Thank you guys sooo much!

JL and Chip said:
Sigh. If I had a nickel for every newbie who showed up here saying that exact same thing. :)

It’s hard to go against your vet’s advice, especially when the counter information is coming from strangers on the Internet. Yep, completely understand your concerns and hesitation, and you’re wise not to trust us blindly. HOWEVER, using N is a bit old-school, so unless the vet advised you that it’s not a great choice for cats, he might be a bit behind in his continuing education on feline diabetes. And that concerns me. I think you need to trust your “Spidey sense” on this — in other words, your instincts are good and you should be questioning his advice and how to proceed. After all, Oliver’s safety depends on it.

How about this: get your lancets, keep attempting to test, and post here with results (or ask for more testing help if needed) before you give the next shot. People here can give you advice and tell you why they’re recommending something, which will in turn help you learn and analyze as well.
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JL and Chip said:
Increasing dose in that case makes about as much sense to me as lengthening the rope of a bungee jumper whose hair is already skimming the rocks at the bottom of the gorge. How is this not a no-brainer (on the vet’s part, not yours)?

Best wishes to you both, by the way. It’ll all get easier and start to make more sense soon.
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I just did his second successful test. Before his night insulin (which I am still considering downing the dose or taking him off. Just trying to consider everything right now and test him to see what I need to do.. Also haven’t successfully been able to get him to pee for me to test keytones yet)..it’s super high :/ 476

what do I do???
 
Kandi and Oliver said:
I just did his second successful test. Before his night insulin (which I am still considering downing the dose or taking him off. Just trying to consider everything right now and test him to see what I need to do.. Also haven’t successfully been able to get him to pee for me to test keytones yet)..it’s super high :/ 476

what do I do???
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Just in case anyone sees this before morning or tonight while I am still awake, I just tested him again two hours after his last shot and he’s at 257.
 
Hi @Kandi and Oliver
The best thing you can do is get some data now that you’ve had success testing (welcome to the Vampire Club, by the way :) ).

As @Diane Tyler's Mom posted above, the starting dose of N for a cat who is eating at least some dry food is typically 1u twice a day. You can certainly lower to that dose and collect data, or you can remain at the 2u and test frequently in order to see how 2u is working in Oliver. The thing about N is that it tends to be a bit harsh in cats — hits hard, drops BG relatively rapidly, then wears off before the next shot is due. I encourage you to re-read this entire thread and also read (and re-read) the N Primer located here: https://www.felinediabetes.com/FDMB/threads/beginners-guide-to-humulin-n-novolin-n-nph.231593/

@Chris & China (GA) also posted info about Lantus insulin and purchasing from Canada. Lantus is an excellent choice with a more gentle action in cats and was the first-choice option of all of the Internal Medicine vets I took my cats to. It’s usually easier to work with and worth considering, since you seem to want to do everything you can for Oliver. For what it’s worth, I remember well having no clue about normal BG ranges or different insulins or how powerful such a tiny amount of liquid could be. You’re asking the right questions — it’ll all start to make more sense soon, just keep at it. :)

I don’t typically like to give dosing advice but there are others here who will. The spreadsheet will help you track the data you collect as well as help others interpret the results.

Finally, remember you do NOT want to remove all dry food unless you’re monitoring BG carefully. Removing dry food and feeding strictly low-carb canned can dramatically reduce insulin needs.

Please keep posting updates and asking questions. And let us know what you decide for your weekend trip.
 
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JL and Chip said:
Hi @Kandi and OliverFinally, remember you do NOT want to remove all dry food unless you’re monitoring BG carefully. Removing dry food and feeding strictly low-carb canned can dramatically reduce insulin needs.
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How much dry do you feed per day? Currently, Merlin is on a completely low carb wet diet. I'd like to add a little of his regular dry back in because 1) he likes it and 2) it will help me stretch the more expensive wet food. Is there a best time of day to give it?
 
JL and Chip said:
Hi @Kandi and Oliver
The best thing you can do is get some data now that you’ve had success testing (welcome to the Vampire Club, by the way :) ).

As @Diane Tyler's Mom posted above, the starting dose of N for a cat who is eating at least some dry food is typically 1u twice a day. You can certainly lower to that dose and collect data, or you can remain at the 2u and test frequently in order to see how 2u is working in Oliver. The thing about N is that it tends to be a bit harsh in cats — hits hard, drops BG relatively rapidly, then wears off before the next shot is due. I encourage you to re-read this entire thread and also read (and re-read) the N Primer located here: https://www.felinediabetes.com/FDMB/threads/beginners-guide-to-humulin-n-novolin-n-nph.231593/

@Chris & China (GA) also posted info about Lantus insulin and purchasing from Canada. Lantus is an excellent choice with a more gentle action in cats and was the first-choice option of all of the Internal Medicine vets I took my cats to. It’s usually easier to work with and worth considering, since you seem to want to do everything you can for Oliver. For what it’s worth, I remember well having no clue about normal BG ranges or different insulins or how powerful such a tiny amount of liquid could be. You’re asking the right questions — it’ll all start to make more sense soon, just keep at it. :)

I don’t typically like to give dosing advice but there are others here who will. The spreadsheet will help you track the data you collect as well as help others interpret the results.

Finally, remember you do NOT want to remove all dry food unless you’re monitoring BG carefully. Removing dry food and feeding strictly low-carb canned can dramatically reduce insulin needs.

Please keep posting updates and asking questions. And let us know what you decide for your weekend trip.
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I will respond more later but thank you so so much! I’m planning on getting Lantis as soon as I can but literally every ounce of money able to be spent was spent this week $1000+ but am ordering Lantus as soon as I’m able. I’m going to try to figure out the curve today.

Wanting to switch the dose of that’s what I should do. What do you think about me figuring out the curve today on 2 u since that what he’s been on and go from there?

Also, I’m not going on the trip Oliver is more important but I’d be lying if I said I wasn’t devastated, it was a very important trip to me.
Also I did finally get a successful pee test lol and no keytones!
 
Kelley and Merlin said:
How much dry do you feed per day? Currently, Merlin is on a completely low carb wet diet. I'd like to add a little of his regular dry back in because 1) he likes it and 2) it will help me stretch the more expensive wet food. Is there a best time of day to give it?
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I wouldn’t recommend adding dry food back in unless absolutely necessary. Low-carb canned food is the best choice for a diabetic and even a little dry can increase BG and thus insulin needs. It can also potentially reduce the chance at remission. One could also argue that savings on food might be offset by the increased cost of insulin (due to increased insulin dose). Just some food for thought.

There’s some excellent info about feline nutrition and other cat-related issues on Dr. Lisa Pierson’s (author of the current food charts) website at www.catinfo.org
 
Kandi and Oliver said:
I’m going to try to figure out the curve today.

Wanting to switch the dose of that’s what I should do. What do you think about me figuring out the curve today on 2 u since that what he’s been on and go from there?
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I think that’s a reasonable choice. I suggest you post the results here as well as on your spreadsheet, if you have it set up.

Kandi and Oliver said:
Also, I’m not going on the trip Oliver is more important but I’d be lying if I said I wasn’t devastated, it was a very important trip to me.
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Given that the trip is very important to you, maybe there’s a middle ground. If you can get the results of today’s curve, and it looks ok, perhaps you could teach your mom to both test and give the insulin shots, but maybe a reduced dose for safety’s sake. And you could give her the link to FDMB in case she has questions or concerns. Even if you had to leave for the trip a bit later, at least you’d get to go.

Kandi and Oliver said:
Also I did finally get a successful pee test lol and no keytones!
Click to expand...
Excellent!
 
It’s just a weekend trip so if I didn’t catch the ride at 7 PM with my friends who are driving the 11 hr trip I wouldn’t be able to go sadly. I wish I would have known to start testing on Monday and I could’ve figured out the curve earlier and probably could have went if all looked good. Now I won’t have curve figured out until this evening, darn.

JL and Chip said:
I think that’s a reasonable choice. I suggest you post the results here as well as on your spreadsheet, if you have it set up.


Given that the trip is very important to you, maybe there’s a middle ground. If you can get the results of today’s curve, and it looks ok, perhaps you could teach your mom to both test and give the insulin shots, but maybe a reduced dose for safety’s sake. And you could give her the link to FDMB in case she has questions or concerns. Even if you had to leave for the trip a bit later, at least you’d get to go.

Excellent!
Click to expand...
 
Kelley and Merlin said:
How much dry do you feed per day? Currently, Merlin is on a completely low carb wet diet. I'd like to add a little of his regular dry back in because 1) he likes it and 2) it will help me stretch the more expensive wet food. Is there a best time of day to give it?
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Hi there I think it would be best to start your own thread , only because it gets confusing to which cat's post we are replying to.
You can start a new post if you have questions

:cat:Also it would be helpful if you can set up your signature so we know what insulin Merlin is on, meter used, diagnosis date , food etc, I'll post it for you




  • Please set your signature up tomorrow
  • It would be helpful if you can set up your signature
  • On the left, under Settings, Click on Signature. This is where you will put information that helps us give you feedback.
    • There is a limit of two lines which may include two links; you may separate pieces with commas, dashes, | etc. This is where you paste the link for your spreadsheet, once it is set up.
    • Add any other text, such as
    • Caregiver & kitty's name (optional)
    • DX: Date
    • Name of Insulin
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.


tap on your avatar where it says your name ,then hit profile page ,tap on that ,then go up to the very top, upper right hand side and tap on your name ,it will bring down a drop box, tap on signature, the signature will be under settings, tap on the signature then and you can start to add what I posted above, make sure you hit save ,
Welcome to the best place you could ever be and an awesome group of people




https://felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
If you need help setting up the spreadsheet just ask we have members
2 members who will set it up for you


https://felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/
Understanding the spreadsheet
 
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Diane Tyler's Mom said:
Hi Kandi good job setting up your signature, can you set up the spreadsheet, so that
members can look at it , just so they don't have to go through all the posts to
see what's going on with his numbers and dose. Thanks
If you need help we have members here that will set it up for you :cat:
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I might need help as I don’t have a computer or tablet with internet, just my phone and it wouldn’t let me edit it when I tried to open it with a spreadsheet app I downloaded. Thanks!


Have him still at 2 units for now while I’m trying to figure out how he does as I figure out curve..

so far AMPS was 389, 2+ was 293, 4+ was 272
 
AMPS am cycle pre-shot
PMPS pm cycle pre-shot
We test before every shot in every cycle.
The +1 and so on is 1 hour from when you gave insulin.
We're all from different countries so 6pm means absolutely nothing to me, as I'm located in Denmark.
The +6 shows me its 6 hours since the insulin shot, no matter where you are in the world. :bighug::D
 
Hi everyone It' Diane Tylers Mom I just got home after having a bad day dealing with my dad who has dementia, @Kandi and Oliver Private messaged me, she said for some reason she could not post to her thread. I copied it for you all to see.She also said she hasn't updated her SS , there is nothing in her signature saying she has a SS
I just looked back and saw that Bhooma created one for her and asked her to link it to her signature. I'll copy and show you. I guess Kandi doesn't know how to do it. I'm sorry but I can't help her
Eek!
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  1. Kandi and Oliver
    Joined:
    Oct 20, 2020
    I don’t know what’s going on but it hasn’t let me post or reply on the ongoing thread. I’m going to try to send this to you in efforts of reaching out to someone as I really need to come to some type of decision today so I can get Lantus ordered.

    I tried to post this :)


    You guys are the best! Sorry I have not been active on here and updated my spreadsheet yet but I will try to do that today. Here is where I currently stand if you guys could help me know what to do and how to make the switch and how to continue to communicate with my vet about it!

    Oliver had his check up this week and they want to up his dose (which I have not switched him over to yet because I’m trying to decide what to do). They want him to go from 2 units twice a day to 4 units twice a day. And sounds like they will periodically still want to continue increasing this dose with the Novolin (vet mentioned even to 8-10 units). I expressed to the vet that I am not comfortable with the Novolin and would like to switch to Lantus but he doesn’t want me to. Hesaid we should atleast try Novolin for 2-3 months andthat if I switch him to another insulin we will have to start all over with the regulating/figuring out curve/correct dosage etc. So I was supposed to switchto 4 units a couple days ago but I’ve been trying to talk to people/other vets/vet techs to figure out what to do and how to make the switch if I can/should. In that case I’m going to order the Lantus today or Monday. But not really sure what to do in the meantime of waitingfor Lantus to come in as far as his dosage on the Novolin. Up him to 4 or keep him at 2?

    I hope this made sense. What are your suggestions? Iknow that many of you have experienced this with the vet so it’s not only a question of how do I make him let me switch to Lantus but also what to do in the meantime dosage wise with Novolin and once he is on Lantus how do I figure out his correct dosage etc.

    THANK YOU!!!
This is what Bhooma asked her to do #87


I have created the SS and made you the owner of the SS. I hope you got a google notification?

Here's the link to the SS. Please add it to your signature:
https://docs.google.com/spreadsheets/d/12SncfuWz5p4_2O94W2huu9pO4MXIYT1CRD-z_bfKkGQ/edit?usp=sharing

Welcome to FDMB :)
 
@Kandi and Oliver -

Hi Kandi.

Oliver had his check up this week and they want to up his dose (which I have not switched him over to yet because I’m trying to decide what to do). They want him to go from 2 units twice a day to 4 units twice a day.
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I think this is too big a jump in dose - for any insulin.

I would want to know for certain if the current dose is safe before attempting to increase it.

If it could be demonstrated that a dose increase was justified, I would only be prepared to increase the dose in small increments, evaluating every adjustment for safety and efficacy before attempting any further increases.

Diane Tyler's Mom said:
And sounds like they will periodically still want to continue increasing this dose with the Novolin (vet mentioned even to 8-10 units).
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For a recently diagnosed cat on 2 units of Novolin, I don't think the vet should be jumping the dose up in 2 unit steps, and the prospect of a dose of 8-10 units should not even be on their horizons so early on in treatment.

Diane Tyler's Mom said:
Hesaid we should atleast try Novolin for 2-3 months andthat if I switch him to another insulin we will have to start all over with the regulating/figuring out curve/correct dosage etc.
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For whose benefit is he making these recommendations: his own or your cat's?

The likelihood of Oliver becoming well-regulated is greater on Lantus than on Novolin. Period.

I'm really sorry to have to say this to you, Kandi, but being totally honest your vet's approach to insulin treatment really frightens me. If it were my cat in this situation, I would sooner start at a safe low dose and take the time to gradually adjust it in small increments to optimise my cat's regulation. I would far prefer to be doing this using an insulin far better suited to the needs of diabetic cats (and arguably safer).

Here are the 2018 AAHA guidelines for management of diabetic cats and dogs. As you can see from the table on page 5 of the guidelines, Novolin is only recommended for treatment of diabetic dogs. The recommendation for newly diagnosed cats is to initiate treatment with either Lantus or Prozinc, both of which have far superior duration in cats than Novolin, plus they both have gentler action in cats. Perhaps you could print off the above document and use it to reinforce your request for Oliver to be treated with Lantus?

Are there any other vets in your area? If you get nowhere with your current vet, would you consider switching to a practice with a more progressive, up-to-date approach to treatment of feline diabetics?


Mogs
.
 
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Critter Mom said:
@Kandi and Oliver -

Hi Kandi.


I think this is too big a jump in dose - for any insulin.

I would want to know for certain if the current dose is safe before attempting to increase it.

If it could be demonstrated that a dose increase was justified, I would only be prepared to increase the dose in small increments, evaluating every adjustment for safety and efficacy before attempting any further increases.


For a recently diagnosed cat on 2 units of Novolin, I don't think the vet should be jumping the dose up in 2 unit steps, and the prospect of a dose of 8-10 units should not even be on their horizons so early on in treatment.


For whose benefit is he making these recommendations: his own or your cat's?

The likelihood of Oliver becoming well-regulated is greater on Lantus than on Novolin. Period.

I'm really sorry to have to say this to you, Kandi, but being totally honest your vet's approach to insulin treatment really frightens me. If it were my cat in this situation, I would sooner start at a safe low dose and take the time to gradually adjust it in small increments to optimise my cat's regulation. I would far prefer to be doing this using an insulin far better suited to the needs of diabetic cats (and arguably safer).

Here are the 2018 AAHA guidelines for management of diabetic cats and dogs. As you can see from the table on page 5 of the guidelines, Novolin is only recommended for treatment of diabetic dogs. The recommendation for newly diagnosed cats is to initiate treatment with either Lantus or Prozinc, both of which have far superior duration in cats than Novolin, plus they both have gentler action in cats. Perhaps you could print off the above document and use it to reinforce your request for Oliver to be treated with Lantus?

Are there any other vets in your area? If you get nowhere with your current vet, would you consider switching to a practice with a more progressive, up-to-date approach to treatment of feline diabetics?


Mogs
.
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Hey guy to catch up on responding to everything! But I’m trying to order today. I’m having trouble finding the page on here that I had been looking at last week! Could someone please link it for me or give me the contact information/quick rundown on how to get prescription for Lantus and call to order in Canada?
Thank you so much!!!
 
Am I understanding you dont have insulin at the moment?


I'm going to post this now just in case you do...this NEEDS to be done eventually.
FDMB SPREADSHEET INSTRUCTIONS

Dont worry if you have trouble setting it up we have good people that will do it for you. All you need to do is ask.
 
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