New here -Introducing Yoko and her mom -QUESTIONS at the end

[Gabrielle]

Hi everyone, I am Gabrielle and my kitty's name is Yoko, she is 10. She was diagnosed about 4 months ago and I think I caught it pretty early due to her urine output. I knew something wasn't right.
I have specific questions at the end, here is her history thus far:
Her numbers were in the mid to high 300's and my vet initially had her on 2 units of Glargine. I also switched her to the Purina DM dry food. She went back for another curve a week later and he had me bump her up to 2.5 units. I went out of town about a month after that and boarded her and they did another curve and she had dropped to about 65 at the initial reading. When I picked her up 2 days later I was told her blood sugar had gone back up (high 200s) and to drop her back down to 2 units. No one seemed to think home testing was necessary.
Because of reading in here I have been working on getting her on wet food and tried many. I finally got her on 50/50 friskies can and the dry. Since I have used my instincts on what she requires and have several times given her BCDs of 1 unit. I took her in for another curve 1 week ago (about 1.5 weeks into wet food). The night before the appointment I did not give her any insulin as I sensed not to and of course none in the morning before taking her in. Here is the outcome of the curve (but not really a curve as they did not give any insulin) as best I recall 1) 58, 2)58, 3)under 100. 4)239 5) 329. These were done between 9 a.m. and 5 p.m. I was told to drop her to 1 unit and bring her back in 3 weeks.
My instincts tell me that even 1 unit may be too much at times, she is never totally lethargic to any degree that I am very concerned, but slightly less active. I bought a ReliOn meter yesterday. I won't give her insulin without knowing what her numbers are anymore. I tried to test her last night with no luck (thank god she is an easy going kitty) so I skipped the dose (she does seem perkier). I tested her this morning with luck and she is at 262 with no insulin in 36 hours and 13 hours since her last meal. I gave her 1 unit and will test again before her next meal (please see questions).

I am open to any advice and/or thoughts on this I am really confused right now about what the best approach is. Thank you so much

I am reading articles and learning, but have some questions I would love answers to as I read through all the information. I am just getting to the point of feeling overwhelmed by this. I am soooooo grateful for any help!

1. Yoko does not always eat her food when I give it. She will eat a little and leave it until later. I still give her insulin (Glargine) about 20 minutes after feeding. Is this ok? Should I take the remaining food away? Leave a little? She will eat more dry food at once, but her numbers are much better on canned food. Help!
2. At what BG reading should I opt not to give Yoko her 1 unit of insulin? I have read the FAQs page but I am still a bit confused.
3. Right now I am testing her before meals. Is this the best time? Should I do it after meal and before insulin?
4. Testing twice a day until her next curve, how do I keep her ears from getting scarred or sore?
5. I had her on Friskies canned because she will eat it. The vet was concerned it's too caloric as he wants her to lose a little weight. I also prefer something more natural and just bought 2 cans of WIld Calling- I am not seeing any recent info on it. Does anyone feed this?

 

[Sue and Oliver (GA)]

Re: New here -Introducing Yoko and her mom -QUESTIONS at the

1. Yoko does not always eat her food when I give it. She will eat a little and leave it until later. I still give her insulin (Glargine) about 20 minutes after feeding. Is this ok? Should I take the remaining food away? Leave a little? She will eat more dry food at once, but her numbers are much better on canned food. Help!

Your feeding routine sounds fine. She can graze on the wet food. Some people leave it out during the day; some freeze it so it melts during the day. There are two schools of thought here: Feed twice daily when shooting. Feed several small meals during the day. Either one is fine. It depends on your schedule and how your cat eats.



3. Right now I am testing her before meals. Is this the best time? Should I do it after meal and before insulin?

Testing before meals is best. Food can raise blood glucose levels. If she is really hungry and difficult to test then, you could give her a small snack - maybe a few pieces of a low carb snack to keep her busy.

4. Testing twice a day until her next curve, how do I keep her ears from getting scarred or sore?

It helps if you can hold the place you poked for a few seconds to minimize bruising. Some people like to smear on a tiny bit of Neosporin with pain relief to help.

I don't use Lantus so I can't answer your dosing questions, but someone will be along. I haven't heard of the Wild Calling. You might post the ingredients and we might be able to tell whether it has high carb ingredients. Many people, including me, feed Friskies. Ironically, I fed Science Diet Light to my diabetic cat and am convinced that is what caused his diabetes. He never lost any weight while eating it. When I went to wet low carb food, he lost 2 pounds.

 

[dirtybirdsoaps]

Re: New here -Introducing Yoko and her mom -QUESTIONS at the

Welcome to FDMB,

I will may be able to give some tips but I am not familiar with your insulin and the protocols for it so hopefully someone else will chime in, Hidey was on Prozinc. Alot of vets dont mention or dont encourage home testing, I don't get it but its not safe and good for you for taking the initiative. Relion meter is what most of us here use.

1. Yoko does not always eat her food when I give it. She will eat a little and leave it until later. I still give her insulin (Glargine) about 20 minutes after feeding. Is this ok? Should I take the remaining food away? Leave a little? She will eat more dry food at once, but her numbers are much better on canned food. Help! Not eating all her food is ok as long as she eats, and so is leaving it for her to finish later. Eating makes the pancreas work. Thats why alot of people on this site, myself included, do mini meals. Its easier on the pancreas.

2. At what BG reading should I opt not to give Yoko her 1 unit of insulin? I have read the FAQs page but I am still a bit confused. For beginners, its advised not to shoot when 200 or less

3. Right now I am testing her before meals. Is this the best time? Should I do it after meal and before insulin? Yes, but it is always good to get a +6 or around there to see how the insulin is working.

4. Testing twice a day until her next curve, how do I keep her ears from getting scarred or sore? Neosporin will help with this. Make sure to use the ointment NOT the cream, and get the +pain. Also a warmed rice sock, or some other type of warmth helps get the blood flowing. I used a damp paper towel warmed for a few seconds in the microwave, but make sure its warm not hot.

5. I had her on Friskies canned because she will eat it. The vet was concerned it's too caloric as he wants her to lose a little weight. I also prefer something more natural and just bought 2 cans of WIld Calling- I am not seeing any recent info on it. Does anyone feed this? Here is a link to the preferred food. Its best for it to be 10% or less for carbs, most here feed friskies or fancy feast, but be cautious when changing foods and make sure to keep testing. DM is not one of the low carb foods. Changing to a low carb food can drastically reduce bg. Don't forget to change the treats as well. We recommend freeze dried chicken or something similar. Also as to the calories, wet food is a lot less calories than dry. I feed mine 5 cans a day (between 3 cats) to make sure theyre getting the right amount of calories. http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf

 

[BJM]

Re: New here -Introducing Yoko and her mom -QUESTIONS at the

Lantus/glargine is what we call a depot insulin. When you inject it, small crystals form. These slowly dissove to work. That is the depot. Also, the effect of the injections overlaps, as not all the depot is gone when you shoot at the next time. That helps keep the numbers from swinging too widely.

Lantus reaches a peak effect after the shot sometime around +5 to +7 hours later. Getting tests then will let you see how well the insulin is working. You want it above 50 mg/dL, for safety. See my signature link Glucometer Notes for more info on meters and what the numbers may mean.

Feeding the dry food is part of why the glucose levels have been high and the difficulty in losing weight. The insulin helps store the glucose as fat when it isn't needed for energy. When I switched all the cats in my household to canned, low carb food, a couple lost weight without even trying. This may be because the volume of canned food is pumped up by moisture, which the dry food lacks (imagine the size of 15 fresh grapes vs 15 raisins) and the cat feels full sooner.

Changing the food to low carb canned may reduce the insulin needed from 2 to 3 units, based on 2 members cats (my Spitzer dropped 2 units; the other person's cat dropped 3 and went off insulin very soon after that)

 

[Gabrielle]

Re: New here -Introducing Yoko and her mom -QUESTIONS at the

I am feeling bette,r I am SOOOO grateful for the replies. I do believe that the recent switch to canned food is what has created the lower numbers. I will start testing about 6 hours after insulin as well to see how it is working. Thank you all, this site is wonderful!!

 

[Chris & China (GA)]

Re: New here -Introducing Yoko and her mom -QUESTIONS at the

Hi Gabrielle and extra sweet Yoko! Welcome to the FDMB!

Just a quick clarification on one of your questions...If you get a Pre-shot test that's under 200, what we want you to do is "Stall", don't feed, and post and ask for help. Make sure your subject line says something like "Stalling, please help!" so the people that scan the boards can see that you're needing help.

You don't want to feed when you stall, but you can retest in about 20 minutes ....Hopefully in that time, someone will be online to help, but if not, if the number is climbing now (without food), you can pretty safely assume that the insulin is wearing off and go ahead and test/feed/shoot your scheduled dose.

Here's some information on Shooting and handling low numbers that can help guide you in the rare chance nobody is online to help when you need it. We recommend you have this printed out and put somewhere safe (I keep mine in my Hypo kit) so when you need it, you'll know where to find it.

As you get more testing in, that "no shot" limit will come down. When you move to the Lantus TR Forum, it drops to 150...and again, doesn't really mean "No shot", but to stall, don't feed and ask for help. (or follow the "shooting and handling low numbers" information)

It will also be very important for you to get our spreadsheet going so you can keep track of Yoko's test results. If you go to How to set up your spreadsheet you should be able to get that set up (but if you have trouble, let us know so we can help you! Once set up, it's very easy to use....you just enter your results as you get them and the spreadsheet does the rest.

Keep asking questions! The people here are wonderful in offering their time and advice to help another!

 

[Gabrielle]

Re: New here -Introducing Yoko and her mom -QUESTIONS at the

Thank you Chris, so helpful. I was beginning to feel confused and a bit overwhelmed with Yoko's numbers all over the place. Today I tested her at +6.5 hours too so there is a better picture of what's going on and I will start her spreadsheet now. You are all amazing!!

 

[Chris & China (GA)]

Re: New here -Introducing Yoko and her mom -QUESTIONS at the

Great job getting your spreadsheet up!

Now for a little more information for you...It's important that you shoot every 12 hours. I understand your concern in shooting last night's PMPS, but remember, if it's under 200, Stall, don't feed and post and ask for help! As you see by this morning's number, skipping leads to high numbers, so unless you can't be home to test, we want to find a dose you can safely give every 12 hours.

It's just as important (maybe more) to test during the PM cycle. Most cats go lower at night, so you need to at least get a "before bed" test in on that PM cycle. If it's a lower number, you'd want to set an alarm to make sure you wake up later in the cycle to get another test. Sleep deprivation is included in the sugardance....LOL

You don't need to worry about doing curves at your vets office if you're home testing. Results at the vets office are usually influenced by stress anyway and can be up to 200 points higher than when they're relaxed at home! We like to see at least 4 tests per day....the 2 pre-shot tests (always test before shooting to make sure they're high enough to shoot) and then a test somewhere between 5 and 7 hours after the AM shot, and that "before bed" test at night.

If you can get more tests in, that's even better because you'll learn how Yoko is doing even faster! My favorite test is the +2 (2 hours after shot) because it acts like a "crystal ball" in giving you an idea of where they might be going later in the cycle.

If the +2 is about the same as the Pre-shot, you can expect a "normal" cycle, with the numbers gradually going down and then gradually going back up again until it's time to shoot again

If the +2 is lower than the Pre-shot, that's your "early warning system" that you are going to want to get more tests in later in the cycle. It's a good way to know if Yoko is going to possibly go too low. If you can't be home to test later than that, you can leave some extra food down so she can get a snack if her blood glucose goes low

If the +2 is higher than the Pre-shot, that's a clue that she may be starting a "bounce". Bouncing happens because Yoko's body has become used to living at higher blood glucose levels. When you give insulin to bring it down, her liver releases stored sugars and hormones to bring it back up again quickly. As she spends more time in "normal" numbers, her liver will re-learn what "normal" is and stop reacting so much. Yoko's number this morning may very well be partially due to the skipped shot, and also due to a "bounce" because it's probably been awhile since her liver has seen a number like 150

Hang in there! It does get better, and as you get her better regulated, she's going to start feeling better, acting better and you'll swear you're giving shots from the Fountain of Youth instead of insulin!