New here...please help

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Janet

Member Since 2014
Hi, my name is Janet and I apologize that my first post here is a small novel but I'm hoping you can help Toonces. Toonces is 15. Here is her story.

One year ago in Januray 2013 Toonces started going on the floor just outside of her litter box. I took her to the vet to see if it was being caused by something physical. He did a Urinalysis, cbc and chemistry profile and they all came back normal. Her bg was 83 at that time. She continued to not use her litter box so I was able to train her to use pee pads.

First part of October 2013 she started peeing in large quantities and guzzling water.

October 23, 2013 There was blood in her urine so I rushed her to the vet. Because of the pee pads, I caught the blood on the first day that it happened. The vet did another full panel test on her and it came back with glucose in her urine and a bg of 335 and a urinary infection. He said she would need shots so he hospitalized her for 6 days and ended up with 3 units of prozinc 2 times a day. She also got an antibiotic shot. He also took her off of the Wellness chicken/herring food that I had been feeding her for the past 3 years and put her on Hills WD

About a week later she had a followup all day test and another antibiotic shot. Her lowest bg was 430 so he upped the prozinc to 4 units.

This pattern of all day vet checks and increasing by 1 unit each time continued until the end of November (so about a month from diagnosis). I finally told the vet that I would have to learn to do blood checks at home because I couldn't afford to keep bringing her in and I had no clue if she were to drop too low in between visits. He agreed and I bought an Alpha track II from him (didn't know I could use human monitors).The vet showed me what a curve was and I did one about every three days and called him with the numbers, which never went below 421. He increased 1 unit each week until she reached 9 units with no improvement and then he suggested switching her to dog insulin.

It was at this point that I googled " insulin resistant cat" and found your site. I read all that I could and was completely overwhelmed, I called the vet and asked if he would switch her to Lantus instead of the dog insulin and he said he would but it is $200.00 for a vial (his cost, which he passed on to me) and it only had a shelf life of 28 days. I showed him your article on Lantus lasting up to 6 months in the fridge (I'm praying that's true because I can't afford 200 a month) and he said he would try it.

So on this past Wednesday, January 8 Toonces went for an all day testing and he started her on 3 units of Lantus. He had me withhold her night time prozinc so she had been 24 hours without insulin when he put her on Lantus. Here are her numbers:
7:30 at home ate 1/2 can
8:45 Preshot 641
8:46 3 units Lantus
9:20 HI
10:20 702
11:30 640
1:30 571
3:30 695
I picked her up at 4:30 with instructions to give her 3 units that night and increase to 4 units the next morning when I could monitor her all day.
5:00 1/2 can Hills WD
7:30 569
8:45 shot 3 units

Yesterday, Thursday Jan 9..I didn't increase her to 4, I increase by 1/2 unit after reading this on your site
7:30 1/2 can Hills WD
8:45 preshot 585
9:00 3 1/2 u Lantus
11:15 528
12:15 610
1:30 555
2:30 501
4:15 533
5:00 1/2 can hills wd
8:30 610
9:00 shot 3 1/2 units

I found your posting on canned food and was appalled to find that Toonces was taken off of Wellness at 7% carbs and put on wd at 25% so I had a can of Wellness and I switched her back this morning

Today's numbers
7:30 1/2 can Wellness chick/her
9:10 Preshot 585
9:15 3 1/2 u Lantus

Looking back now I have so many questions that I was too ignorant and uninformed to even ask the vet. I feel horrible that Toonces has had to pay the price for my ignorance. Last night my husband and I just sat with her in our laps and cried. I don't know if she can be helped.

Here are my questions.
Was she increased way too fast on the prozinc? from 3 to 9 units in 9 weeks.
did the urinary infection and antibiotic shots affect her readings while she was in the initial stages of receiving prozinc
At least with prozinc her lowest number was pretty close to 4 hours after her shot, I have no idea with Lantus.
Her schedule has always been 7:30 am eat, 9:15 shot, 5pm eat, 9:15 shot. Is that ok?
She's eating Wellness now, is there a better food for her?
Should I continue to increase the lantus..I don't want to make the mistake of increasing too fast again
Any help you could give us would be greatly appreciated.
Janet
 
Hi Janet and sugarkitty Toonces and welcome to the message board. Where do you live? Country, state/province, closest city is nice to know.

First, I want to reassure you and your husband that Toonces can be helped. {{{{{Big hugs}}}}} to all of you.

You've already made some great steps in switching from the higher carb Hill's W/d canned food to the low carb Wellness food. We find that our diabetic kitties usually do better on canned food with <10% carbs.

Lantus works differently than other insulins. Lantus has a depot effect which means not all of the shot goes to work right away. You need to be patient and give it time to work and build up the storage 'depot' before you change the insulin dose. Explanation of the depot hereSTICKY: LANTUS & LEVEMIR - WHAT IS THE INSULIN DEPOT?.

Please hold the current dose for a minimum of 3-5 days unless your kitty drops below safe levels (50 mg d/L human meter, 80 mg d/L pet meter like the Alphatrak).

We'll help you through this and get Toonces feeling better. Please continue to test before every shot, so you know the BG (blood glucose) levels are not too low to shoot. With the food change, that can often drop the BG levels 100 points or more.

Please change the order in which you do things. It should be test, feed, shoot all in about a 15 minute window. We want to see that pre-shot test without a food influence. Think you can do that for this evening?
 
Welcome
WD is not good especially if it was dry.
If the Wellness was canned that is a lot better. Good that y changed back
The 3 units of ProZinc seems very high for a starting dose. You may have missed the "right dose)
3 1/2 units of Lantus may be too high especially since y switched back to the Wellness. I myself would reduce the dose but I will let other make suggestions too.

There is no one dose for all cats. Their insulin needs vary greatly. My Thunder is on about 1.1 units Lantus, my Patches on 1.8 units Lantus but my MurrFee is on 11 units Levemir and 3 units N.
Also, feeding and then giving the insulin 1 1/2 hours is not typical and makes finding the right does harder, at least for me. Most users here test, feed and shot in that order and try to do it within 1/2 hurs. Some of also feed small meals throughout the day and night. The key is being consistant.
 
Thank you Larry and Deb. I can change it in the morning since she eats at 7:30 and gets her shot at 9:15. So I would test her at 9 feed her right after the test and give her the shot at 9:15? At night she eats at 5:00 and I don't give her anything before her shot at 9:15, sometimes I will give her a teaspoon of wet food after her 9:15 pm shot. Is the 4 hour span at night long enough for her evening preshot?
 
forgot to ask.. should I be feeding her more often and how much of the wellness wet? She weighed 12 lbs when this started and the vet wanted her to lose some weight. she is 11 pounds now.
 
How is her weight now? Does she look like she needs to lose more? She has already lost a pound so maybe thats enough?

9am- test then shoot then feed.
5pm feed
9pm - repeat - test then shoot then feed again ( even give her more than 1 T - many mini meals are better than a couple big ones. Big meals stress the pancreas)


Also I usually recommend 3-4 tests a day - especially now since her blood could be dropping from the food change

- 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 she is going. The low point "nadir" is what you base dose changes on since you don't want her dropping too low (under 50).
- before bed (2-3hours after Pm shot) to get an idea of what her 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.


Wendy
 
Janet said:
Thank you Larry and Deb. I can change it in the morning since she eats at 7:30 and gets her shot at 9:15. So I would test her at 9 feed her right after the test and give her the shot at 9:15? At night she eats at 5:00 and I don't give her anything before her shot at 9:15, sometimes I will give her a teaspoon of wet food after her 9:15 pm shot. Is the 4 hour span at night long enough for her evening preshot?
Click to expand...

Yes, test at 9, feed right after, give the shot at 9:15 sounds like a good plan.

Yes, the 4 hour span at night is long enough for the food to get through her system and give us a reliable non-food influenced number for the evening pre-shot test. We like to see 2 hours without food before the pre-shot tests. Any other tests during the cycle, we expect to have some food influence.

Yes, feeding her more often, what we call mini-meals, help to spread out the load on her pancreas and level out the BG levels a bit.

Until she is regulated, she'll be hungry so feeding up to 50% more may be needed. As she gets better regulated, her appetite gets more normal and she will eat less. My sugardude Wink went from eating 11-13 ounces a day to 6 ounces. :o :shock: :o

ETA: fixed feed to test
 
Deb you said "Yes, feed at 9, feed right after, give the shot at 9:15 sounds like a good plan" I think you meant
Test at 9, feed right after, give the shot at 9:15 sounds like a good plan

Deb & Wink said:
Janet said:
Thank you Larry and Deb. I can change it in the morning since she eats at 7:30 and gets her shot at 9:15. So I would test her at 9 feed her right after the test and give her the shot at 9:15? At night she eats at 5:00 and I don't give her anything before her shot at 9:15, sometimes I will give her a teaspoon of wet food after her 9:15 pm shot. Is the 4 hour span at night long enough for her evening preshot?
Click to expand...

Yes, feed at 9, feed right after, give the shot at 9:15 sounds like a good plan.

Yes, the 4 hour span at night is long enough for the food to get through her system and give us a reliable non-food influenced number for the evening pre-shot test. We like to see 2 hours without food before the pre-shot tests. Any other tests during the cycle, we expect to have some food influence.

Yes, feeding her more often, what we call mini-meals, help to spread out the load on her pancreas and level out the BG levels a bit.

Until she is regulated, she'll be hungry so feeding up to 50% more may be needed. As she gets better regulated, her appetite gets more normal and she will eat less. My sugardude Wink went from eating 11-13 ounces a day to 6 ounces. :o :shock: :o
Click to expand...
 
Her 4:15 reading is 427

2:15 442
4:15 427
9:15 ps 490
11:15 536


OMG...Toonces' 2:15 reading is 442! I haven't seen it that low in weeks.

Now I don't know if it's the Lantus or the switch back to wellness food. I have to go to the vet to get more testing strips and get back here for her 4:15 test, which I will post. Thank you so much for your help. janet
 
So, are using an Alphatrak for testing? What made me think this, was that you needed to go to the vet for the test strips.

Let us know how the testing goes.

Here are my questions.
1.Was she increased way too fast on the prozinc? from 3 to 9 units in 9 weeks.
2. did the urinary infection and antibiotic shots affect her readings while she was in the initial stages of receiving prozinc
At least with prozinc her lowest number was pretty close to 4 hours after her shot, I have no idea with Lantus.
3. Her schedule has always been 7:30 am eat, 9:15 shot, 5pm eat, 9:15 shot. Is that ok?
4. She's eating Wellness now, is there a better food for her?
5. Should I continue to increase the lantus..I don't want to make the mistake of increasing too fast again
Click to expand...
Not sure we answered all your questions. I've numbered them to help answer them easier.
1. Maybe the increases were too fast. Hard to tell without test data to look at.
2. Yes, a UTI can increase the BG readings.
3. Already covered the schedule in a reply above.
4. Wellness is a better, lower carb food than the Hill's W/d food
5. No, hold this Lantus dose so you do not increase too fast. Please post here if the BG is <200 on a human glucometer, <230 on a pet glucometer. We do not suggest that new members shoot under that 200/230 threshold, at least at the beginning.

The food change may make a big change in the BG numbers, and we may need to decrease the dose if she goes under 50 human meter, 80 Alpahtrak.
 
Yes I''m using the alpha trak II, didn't realize I could do otherwise. The strips are ridiculous..$62.00 for 50. I need to find a better source than the vet if I can. I am also looking for 1/2" needles in the u100 31 guage. The u40's for prozinc had 1/2 " needles and I never had a problem. With the 5/16" I have a hard time telling if the needle even went in the skin.

Toonces 4:15 reading was 427
 
Most people here use human meters because the strips are so much cheaper. In the US, the ReliOn meters from Walmart (or generic Arkray Glucocards) are the cheapest for strips. The ReliOn Micro/Confirm has 100 strips for $36 while the ReliOn Prime has $50 strips for $9.

I also prefer the 1/2" needles. They don't come in any smaller gauge than 29, so you're not going to find any with a 31 gauge.
 
Yes, we have reference ranges for human versus pet specific glucometers. Many of us find the test strips on the Alphatrak are simply too expensive to keep buying and testing as much as we want, to keep our kitties safe.

When I first got Wink from the shelter, they gave me an Alphatrak to use and then complained about my using too many test strips. ohmygod_smile I quickly went out and bought a Relion Confirm ($16-18) and 100 test strips ($35) with my own money. The Relion Prime test strips are even less expensive, about half the price of the Confirm. But the Prime needs a bigger blood drop, 0.5 microliters for the Prime versus 0.3 microliters for the Confirm.

You might search ADW American Diabetes Wholesale for the syringes you want. Some people prefer the shorter needle, some prefer the longer needle. They also have the Alphatrak 2 test strips for $49.99/ 50, $98.98/100. A little bit less in larger quantities.

Are you running your hand lightly thru the fur after the shot to check for wetness? Or do you smell a sort of Band-Aid smell from the Lantus insulin? Maybe you have some fur shots going on.
 
Hi there Janet and Welcome ! :cool:

Deep Breath. . .You have come to the right place

Being that your kitty is using Lantus, I recommend you visit the Lantus ISG (insulin support group).
Tons of help specific to Lantus use can be found there.

Please check out the New to the Group sticky, which has a wealth of info.

It sounds like you have made it over the first few hurdles; learning to test kitty at home and feeding wet food only, that is under 10% carbs.
The next step is creating and publishing a spreadsheet for tracking doses and BG readings. You will find instructions on how to do so there as well
Fill in any data you have collected so far. It will help others quickly assess your kitties situation and offer appropriate help.

Hope to see you there :cool:
 
Janet

I sent you a private message if you look up by your user control panel on the upper left corner of the forum page. If you respond to that PM by clicking on what probably says "1 new message" and then clicking on the message, I can set your SS up for you in very short order.
 
Deb & Wink said:
Are you running your hand lightly thru the fur after the shot to check for wetness? Or do you smell a sort of Band-Aid smell from the Lantus insulin? Maybe you have some fur shots going on.
Click to expand...

Deb, yes, I even put my nose in her fur to see if I smell anything. I guess I'm so used to giving 9 unit shots with a half inch needle that it feel like I'm not even giving her a shot with these short needles.
 
KPassa said:
Most people here use human meters because the strips are so much cheaper. In the US, the ReliOn meters from Walmart (or generic Arkray Glucocards) are the cheapest for strips. The ReliOn Micro/Confirm has 100 strips for $36 while the ReliOn Prime has $50 strips for $9.

I also prefer the 1/2" needles. They don't come in any smaller gauge than 29, so you're not going to find any with a 31 gauge.
Click to expand...

Can I use the 29 guage needle? What is the difference between 29 and 31?
 
New question..I did the wait until 9, test feed, shoot @ 9:15 this morning but it was hell. Toonces was so hungry by then (she's used to eating around 7:15) that she would not sit still for her blood test and I had to have help with her, which is not always going to be available during the week days.

Deb and Wink said there needs to be a 2 hour no food time before the ps test. Can I give Toonces a small amount of food at 6:30 a.m and then test, feed, shoot @ 9:15?
 
Yes, you could give Toonces a bit of food earlier,when you get up. Another option is to change your timing on the test,feed,shoot routine. If 6am/6pm would work with your schedule, you could try that. Or 7am/7pm.

Just try to withhold food for 2 hours before the shot. It's not always possible, but it's a goal to shoot for.
 
Needle gauge is how thin the needle is. Higher nimbers are thinner; lower numbers are thicker.
 
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