New here, please help

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There are a few low carb dry foods you could give her although obviously it would be better if you give her wet, Innova Evo Cat & Kitten 8%, Wellness Core Grain-Free Original Formula (tan gold bag)11%, Nature's Variety Raw Instinct chicken 7%, and Young Again zero Carb 0%.
 
Update on Maggy for Saturday morning

BG before test was 229

Litter box isn't FULL of Maggy pee anymore. There was significantly less pee in the box.

I have two water cups (one at kitchen sink, one in upstairs bathroom sink) and they normally have needed to be filled at least once a day if not more. Now they go down slowly (like they used to). I dont see Maggy drinking alllllll the time.

Maggy does seem hungrier than before though, is this because he's eating protein instead of carbs and fat?

How much canned food (5.5oz) should one 10 - 13 lb cat eat in a day? 1 full can? 2 full cans?

Thanks for all of your help so far. Couldn't have done this without you all (especially the couple of mental breakdowns I've had while trying to do BG tests!
 

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rowley978 said:
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How much canned food (5.5oz) should one 10 - 13 lb cat eat in a day? 1 full can? 2 full cans?...
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Per Cat Info, daily calories should be about 13.6 x optimal lean weight in pounds + 70. For a diabetic cat and because diabetes doesn't let the cat use all the calories it consumes, increasing that by 50% is OK until regulated. According to Dr. Lisa's list, Friskies Ocean Whitefish & Tuna Dinner 5.5 ounce can (which is one of the primary food I feed to my cats) is 49% protein, 43% fat and 9% carbs--and the caloric value of a 5.5 ounce can is 171 calories. So there are approximately 31 calories per ounce. A regulated cat that weighs 13 pounds should then consume (13.6 x 13 = 176 +70) 246 calories. Therefore, for a regulated cat whose optimal weight is 13 pounds--he/she should eat about 8 ounces per day; roughly 1 and 1/2 cans of wet food, if you feed the variety mentioned above.
 
Most people keep a notebook where they write down the test times, the insulin doses, how the cat is feeling.

We have a standardized color coded spreadsheet we use for keeping track of the BG numbers, the units of insulin given, any additional remarks like how much food is being eaten, any test results. The instructions are here : http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207 It's a google template that you copy so you'll need a google account. Then , when you link it into your signature, we can see what is going on and advise you on maybe getting a test at a different time to see how Maggy is reacting to his insulin.

You can even share the spreadsheet with your vet.
 
Maggy is a beautiful cat and you are doing great! I know how hard this is at first. You do get used to it and so does the kitty. Great job. You are on your way. This community is a life (and cat life) saver for sure!
 
We are through our 2nd full day of 1/2 unit shots. Maggy was 232 at his PM preshot test. I'm definitely in a routine now. Just need to get my cat that won't eat wet food, to eat something! I feel bad for her. She has always been a cat that only ate like 10 pellets of food at each sitting.. but did that about 20 times a day. She's so skittish, so its hard to get her to eat. I have been able to put her in a bathroom by herself, but she still only eats 10 pieces, and she waits at the door for me. She turns her nose up at all the different pates I've opened for Maggy and Sam. I'm going to get some of the dry food thats alright for diabetics (though I'm going to still do wet food of course), and maybe if I leave it out, she'll eat more? Or, do you think she'll eventually get hungry enough, and eat the wet food?
 
Here is a wonderful article by vet Dr. Lisa Pierson on transitioning tips. http://www.catinfo.org/docs/TipsForTransitioning1-14-11.pdfMaybe one or several of these idea will work for your cat. They did for mine.

One of the tips, is to use the cat's natural hunger drive to get them to eat. You want to do this safely and it can take time. A cat not eating anything for a day or two can lead to hepatic lipidosis, life threatening and harmful to the liver.
 
Do you think you can get the spreadsheet set up? it would really help to see how she is doing and if/when a dose change is needed..
 
I don't have time to do the spreadsheet, but here are my stats just copied from my own spreadsheet.

5-Jun 7:05pm 381 1 unit
5-Jun 10:30pm 118
5-Jun 10:50pm 95
5-Jun 11:30pm 95
6-Jun 12:30am 110
6-Jun 2:30am 312

6-Jun 7:00am 315 1 unit
6-Jun 6:30pm 169
6-Jun 7:10pm 156
6-Jun 8:05pm 200 no shot

7-Jun 7:20am 243 1/2 unit
7-Jun 7:10pm 270 1/2 unit

8-Jun 7:10am 229 1/2 unit
8-Jun 7:00pm 232 1/2 unit

9-Jun 7:45am 205 1/2 unit
9-Jun 7:20pm 142 no shot


I gave a half unit this morning, but I think it was a tiny bit under that ( haven't picked up new syringes yet that have 1/2 unit marks). Tonight, given that he was that far below 200, I opted for no shot. In your opinion(s), will I get a higher reading tomorrow that my last 2 or 3 days of pre shot tests?

I'll try and get that spreadsheet done, just so busy. I also have to find dry food that is ok for Maggy to munch on here and there, because I read all of those ways to get a cat to go over to wet food, but they don't really talk about if you have multiple cats..... .thats whats making my conversion very tough right now.
 
Some low carb dry foods.

From Wendy & Tiggys list:
Low carb dry: Innova Evo Cat & Kitten 8%, Wellness Core Grain-Free Original Formula (tan gold bag)11%, Nature's Variety Raw Instinct chicken 7%, and Young Again zero Carb 0%. (available only by mail order, expensive)
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Yes, since you skipped the shot tonight, you can expect a bounce tomorrow AM. I don't think you have enough data yet on how your cat reacts to insulin to give the full dose tonight.

Have you fed? If not, test again in 30 minutes from last test. You may be able to give a reduced dose, 0.25U safely.
 
Wow! Beautiful job of keeping track of all those tests (and all the testing you do). You really are doing great! I'm really proud of you. Keep up the good work! party_cat
 
Sure I could keep up with the chart.

Maggy was at 293 this morning pre shot. He had eaten about 2 hours previous to that test (I couldnt hold him off any longer, I wasnt able to sleep!)


So, I'm going to get one of those dry foods so my middle cat doesnt starve!... I feel so bad for her. I guess I never noticed her eating habits (how she only eats like 15 pieces of kibble each time). Ive been keeping a closed container of their old food around the house with me, so when I find her alone, I open it up and let her munch for a bit. Shes just been skittish forever.

I'm not sure how this is going to work in the long run. She just won't even sniff the wet food I'm giving Maggy. Sam has no problem being on the exact same schedule as Maggy. Poor Bones just doesnt feel that way.
 
Is there a "general rule" on the following scenario...:

Maggy normally gets his shot around 7:30 am and pm. Tomorrow evening I will not be home to do this. I may not make it home until 10ish. Should I give him the shot then, or skip it for the evening, and test/shoot in the AM the following day as normal.
 
The general rule in that scenario, giving a late shot, is that now becomes your new shot time. Next shot should be given in 12 hours. With Lantus insulin, shot times can be moved 30 minutes once a day or in 15 minute increments twice a day.

You can also skip the shot entirely. Pick back up in the morning, knowing the number is going to be higher.

With experience and enough test data, when you know better how your cat would react to the insulin, when the onset is, when the nadir is, how long the duration is. In that case, you could do a reduced shot, like half. Not recommended for someone in your situation, without much test data.

late shot acts like a dose reduction
early shot acts like a dose increase

One skipped shot is only a tiny setback. "Better too high for a day, than too low for a moment. "

This is also when you want to teach another person in the family to test and shoot.
 
You can slowly shift no more than 30 minutes per day, either in 1 chunk or 2 15 minute chunks.

Can you shoot 30 minutes later tonight and tomorrow morning? Then it won't be quite so far from morning to evening shots.

Then, shift back slowly - 30 minutes the next 2 mornings to get back on track.
 
ok, well, even if I do a half hour tonight (gave him shot at 8:00 instead of 7:30), and a half hour tomorrow morning 8:30 instead of 8... then I'm still going to be way off tomorrow night... by like 2 hours. Seems I should just skip it?

In another question... is there a time where I should switch back to 1 unit from 1/2 unit? Maggy has had between 205 and 232 for the past 4 days while doing the 1/2 unit. Today he's been 240 and 268 in the Am and Pm preshot tests. If it keeps creeping up, does that raise a flag for a change?
 
is there a time where I should switch back to 1 unit from 1/2 unit? Maggy has had between 205 and 232 for the past 4 days while doing the 1/2 unit. Today he's been 240 and 268 in the Am and Pm preshot tests. If it keeps creeping up, does that raise a flag for a change?
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No.

Lantus dosing changes are based on mid-cycle tests. The lowest point or nadir is used for deciding if the dose needs to be increased or decreased. Most cats nadir is somewhere between +5 and +7 hours after shot. Some are early at +3.5 to +4. Some are late at +8 to +9.5

That is why, getting some other tests in during the cycle is so important. Every Cat is Different(ECID) and you need to test to find when Maggy's nadir is. To complicate things, the nadir time can change a bit.

The pre-shot tests are done to insure the BG's are high enough to give the insulin. You would not want to give insulin if the BG was too low, say 100 for now. Maggy could easily go below 40, which means supporting with food, testing and possibly an emergency visit to the vet to bring those numbers up and prevent seizures and convulsions.
 
I agree with Deb - Lantus works in a curve so the preshot levels are usually the highest of the day and Maggy will drop lower during the day.. how low? We dont know and it could be too low so we dont want to increase the dose until we know. So do you think you can get a mid cycle test and/or a before bed test for a few days?
 
I know nobody should be saying they're "too busy" to get these blood tests during the day in, but i really am too busy. I'm just not home for it!

Anyways, I feel comfortable with what I'm doing for my cats life.

My question is, this morning, Maggy's pre shot test was 195. He got .5 insulin. This evening I fed him at 5:00. I took a blood test at 7:15 and it was 369. I decided to test one more time before eating or shot. I tested a half hour later, at 7:45, and he was 407. I fed him, and gave him .5.

Thoughts on this scenario? One of my conclusions I've come up with is that I didn't do a good job on his shot this morning. I had this weird feeling that I may not have pushed the needle in far enough... I felt around, but felt nothing wet. With such a small amt. of liquid in the shot, even if I had missed, maybe I wouldnt even know it? .


Thanks!
 
I suspect the morning shot was fine, this looks to me like a bounce. You shot under 200 and he dropped low and then his body overreacted and caused his blood glucose to shoot up.. He may have dropped quite low.. Or just lower than his body is currently used to..

I understand not being home but we need to know how low he is going.. If he is dropping too low he could need a dose decrease, he may even be going into remission. But you are at work all day so here's a suggestion..

1. Set up a spreadsheet so we can take a good look for trends and see what we can work out
2. Next time you see a number under 200, on a weekend day or at night preshot, get a test a few hours later and let's see how low he is going

Deal? We can help with the sheet too if you need help

Wendy
 
ok, so given what happened yesterday morning... should I not shoot at 191 this morning? Or do even less than a half shot? I am going to do a curve this weekend for sure.
 
After 191 pre shot this morning.. and not giving him his shot this morning because of that.. I tested him tonight before his scheduled shot, and he was 558, the highest he's ever been! Thoughts on what this means? :?
 
My guess is that he may be going low for him, or dropped quickly enough to trigger some compensatory hormones.

You need to check around +5 to +7 hours after the shot to see how low he is going. You want him above 50 mg/dL. Lower than that risks a hypoglycemic event.

Also, you want to test, feed, and shoot all within 10-15 minutes.
Pick up food about +10 hours after the shot so that when you do the pre-shot test, it is not a food influenced value.
 
Very interesting.. Without a test a few hours later I can't say for sure what was going on.. The lantus could be lasting a little longer in Maggys system and he could have continued to drop even without the shot today.. And then bounce. Or he could have just bounced off the blue.

I hope he does this at least once when you are home to test so we can find out what's going on for sure!!
 
An infobit about sleep. Most humans have a sleep cycle of 45 minutes. Waking during the middle of a sleep cycle is oftern quite difficult, whereas waking at the end of a cycle is easier. Thus, if you need to catch a nap, do so for a multiple of 45 minutes (3/4 hour, 1 1/2 hours, 2 1/4 hours, 3 hours, etc).

Just in case it might be helpful. :smile:
 
We haven't seen a black before so he might not come down as much as in the past. If he does, you might also want a +10 to see if he hits a low before AMPS and what the trend is..
 
It's called bouncing.. Does this help?...

Bounces - what are they and is my cat doing them?
When a cat is first diagnosed, the blood glucose has probably been high for a while. As the insulin starts to take effect and numbers start to come down, the liver has to learn to adjust to the lower numbers. We call this "liver training school". But before it relearns that low numbers are ok, when the BG drops to a number lower than the liver is accustomed, or if BGs drop low, or if the BG drops suddenly, the liver”panics” and reacts by releasing counterregulatory hormones and glucagon. This drives the BG back up. This is what we call a "bounce". Bounces can take up to 72 hours to clear so we are generally careful about increasing doses during the bounce. Once the bounce clears, then you can see the "real" numbers and determine if the dose needs to go up or down.
 
He could be dropping low at night and bouncing from it during the day. Many cats do go lower at night, a few night tests for the next few days may tell us a lot.

Tonite maybe we will only see a big bounce but if we can do these tests the next few nights..
 
Setting the alarm to wake you for the +6 may help you get some sleep tonight. Another option for you instead of trying to stay up until 1:30.
 
Isnt that interesting.. you can clearly see him clearing the bounce... and he is still dropping. Looking forward to that weekend curve. By tonite he will probably have gone back up.. he is determined to not let you see how low he goes ;)
 
Not sure if you looked at my ss but he was 278 preshot this morning.

I think that I may have been giving too much insulin..? Im doing .5 units, but I hadn't been using the syringes that are marked in half increments. I finally got some of them a few days ago and looked at one, and noticed that i wasn't lining it up quite right. Could this be a contributor?
 
I did see that which was why i was thinking the bounce is clearing.
Can you get syringes with 1/2unit increments? you are going to need them I think ie For U-100 syringes (Lantus, Levemir), get 3/10 cc, half-unit marked, short needle, 30-31 gauge ie Relion 3/10cc 30 & 31 gauge short, BD Ultra fine 3/10cc short, Terumo Thinpro Insulin Syringe 31G 3/10cc.

Wendy
 
I am using the .5 unit syringes now. Should I have the plunger right ON the line, or right BEFORE it. I've been doing it right on the line because I think thats correct.

So I did my curve today (click my link in my signature if you'd like to see). I was off by an hour in the morning because I was thinking I was doing it every 3 hours, but I wanted to do every 2 hours, so thats why the hours seem a bit off.

Thoughts?

Thank you
 
I posted on Lantus to get some more thoughts. I do know you are an hour over preshot time now so maybe get another test in to see what he is doing? That will help the decision... I assume you fed at shot time too?

BTw - great to see a blue!
 
Just took a shot at +2 after eating, and no shot given since he was 190.. and now he is 210. What a strange animal I have!
 
He is surfing on the Lantus that is still in his system. He will probably shoot up soon.. if you can adjust to this new time (your next shot would have to be 11.5-12 hours from this shot time) you could shoot now and move back by 30mins a day.

Wendy
 
With a skipped shot this morning, that 435 at +8 is not unexpected. There has been no insulin to keep his numbers down.

Maggy needs some insulin tonight for sure. Let me go look at the ss. Be right back.

ETA: No updates on the SS for today so not sure what to advise. Would you please update the SS?
 
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