New here possible dosing advice?

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Glad you made it over to Lantus! Lots of real pros here. Hopefully one will weigh in soon, but in the meantime a couple questions.

1) The 7.1 was taken before the meal, correct? So it's not a food-influenced number.

2) Can you monitor all day today, and do you have lots of high-carb food (gravy from a "gravy lovers" cat food is really good for this), karo syrup /honey, and test strips?

That's a shootable number for Lantus in general, even on an AlphaTrak, but I worry because it's borderline, you haven't shot that low before, and of course we have the recent hypos to consider. On the other hand, the DKA dictates that skipping shots is to be avoided whenever possible.

I'm hoping one of the real pros can step in here with an opinion, but I'd be inclined to say shoot, especially looking at last night's spreadsheet when she was relatively low at pre-shot but zoomed to the moon quickly afterwards. It might have been partly the food from her evening meal, but that suggests that you should be able to keep her safe with food during the day. If you do shoot today and she doesn't do the same zoom, you will likely have to monitor closely all day.
 
Thank you for your opinion and reply! I didn't want to wait too long for the insulin, but my judgment call was to do exactly what you said. I was just hesitant because I agree it's borderline and she's kind of unpredictable right now. I plan to monitor her closely throughout the day and hopefully she'll be okay on the half unit.
 
Great!

Next time when you're in this situation, one thing you can do is to stall-- don't feed, wait 30mins, and test again. That way, you can see if she's on the way up (safe to shoot) or down (maybe not).

Hope she has a good day today!
 
Welcome to the best place you never wanted to be!

Looking back to your original post, I have a couple of thoughts/recommendations. Like you, when my kitty, Gabby, was diagnosed, she was quite ill and spent several days at the kitty ICU for diabetic ketoacidosis (DKA). If you're not already doing so, picking up Ketostix at the pharmacy is essential for a cat that has recently been through DKA. Ketones are typically caused by some infection or inflammation + not consuming enough calories + not enough insulin. As your vet probably told you, getting the electrolytes back where they should be is essential because it's those electrolyte imbalances that can make DKA a life threatening condition. It's also why testing for ketones at home is an exceptionally good form of prevention and a way to avoid a lot of very expensive treatment. (FWIW, treating less than a small number of ketones is different than DKA -- it's the latter that's dangerous but a kitty that's prone to having problems with ketones can go from a trace amount of ketones to very sick very quickly.) Also, be aware that some cats can still develop ketones even if they are not in high blood glucose numbers. It really depends on the cat. Part of why I'm mentioning this is not to scare you. I suspect that someone will comment that the "Recovery" food you're giving may be high in carbohydrates. Since I'm not exactly sure what you're feeding, it may be find to feed a post-DKA kitty a food that's higher in calories since getting a cat to eat is important in dealing with ketones.

I'd also encourage you to add a little more information to your signature line. Can you mention what type of meter you're using. Your spreadsheet (SS) indicates you're using a meter for pets. Can you also add the date Ballonee was diagnosed and that she had DKA at the time. We are very attentive to post-DKA kitties. Lastly, can you edit the title of your spreadsheet to include Ballonee's name? Many of us will be responding to people on the board and will have multiple SS open. It's helpful to have the SS reflect the kitty's name so we don't get confused (and I, for one, can be easily confused when jumping between SSs.)

When you mention that Ballonee's numbers went low, how low did they go? If you have those test data, can you add it to your spreadsheet? Just an an FYI, the initial dose of Lantus is typically based on a cat's weight (initial dose = Cat's ideal weight in kilograms x 0.25). So for an average cat that weights 10 lbs, this could calculate out to 1.0u. Since you mention that Ballonee is slender, her starting dose may have needed to be lower. However, given the DKA, you also need to juggle the amount of insulin and calories. Frankly, I've told members that if all their cat will eat is an ice cream sundae after a bout of DKA, then feed your kitty (vanilla) ice cream (and leave off the hot fudge sauce).

This is an incredibly supportive group and most of us have been terrified at the beginning of this journey. What you'll hear from many people is that our cats begin to understand that all of that poking with sharp objects ultimately results in their feeling better. Some kitties even purr through their tests. Until Ballonee gets accustomed to the drill, if you can give her a treat each and every time you test (preferably something low carb like freeze dried chicken or poached chicken), it will help to associate the testing with something she likes. For kitties that aren't all that food motivated, we've had people who will brush their cat if that's a "treat." (If you want a bit of hopeful reading, look at the link in my signature to Gabby's Legacy -- the 7th post is what I wrote after she passed.)

Please ask questions. There's an overwhelming amount of information in the sticky notes at the top of the board. Please don't feel like you need to memorize everything overnight. I've been hanging around here for over 9 years and I'm still learning. People are very generous with their knowledge and their time. We're here to help.

 
Thank you so much for your post! Ill make some changes to my signature and spreadsheet.

Sienne and Gabby (GA) said:
Since I'm not exactly sure what you're feeding, it may be find to feed a post-DKA kitty a food that's higher in calories since getting a cat to eat is important in dealing with ketones.
Click to expand...

Yes this was recommended by the vet for her for the time being :) I have picked up Urine sticks for both ketones and Glucose and hope to monitor that.

I don't have the data from the vet anymore unfortunately, but on 2 and 1 units it dropped to approx 2.3 mmol always in the evening :( on the pet meter. Ballonee weighed 1.98 kg when she was initially admitted to the vet. Very tiny. She had always been a little cat but definitely not that small.

Right now I'm a bit worried because she keeps dropping. She's at 5.7 now +3. She at 1/2 can of food so far today (1/4 recovery, 1/4 diabetes formula).. she had about 2/3rds of this before her Lantus and the rest after. I tried offering her some more food, but shes just not interested and quite frankly she is getting pretty sick of me stocking her around the house :/ It's ridiculous how much lower her numbers are at home in comparison to the vet. She was running high all day yesterday at the vet and now I can't keep her up :(

Thank you very much for being so helpful and open to questions

PS: Oh Geeze I don't think I was emotionally stable enough right now to read your post on Gabby <3 Beautifully written. I'm so sorry for your loss. Right now I feel like my kitten hates me so it's helpful to hear about the special bond formed.
 
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She's holding pretty steady, which is very good. Hear that, Ballonee? No need to go down any further! Right here is just fine...
 
Awwww.... It does get easier, I promise! The most helpful is if you can find a reward that she really likes. My kitty has been OTJ for a year and a half, and still, every time I go anywhere near the corner we used for the testing spot, she gets very excited and runs over to wait, just in case it's time for a test and a treat! But she definitely wasn't happy with the whole testing and poking thing in the beginning.

We talked about neosporin/polysporin before, but another thing that can help cut down on any discomfort is to apply a little bit of pressure on the poke site afterwards. It not only stops the bleeding, but prevents bruising of the area.
 
Well just now I finished her Gluc and sat with her and gave her tummy rubs (she loves them) usually sitting with her is more for me than her after because I just want to love her instead of hurt her :( I'm also having trouble differentiating between a relaxed sleepy kitty and a "low glucose kitty." She seems low energy right now but she might just be tired she was purring with me and reacting well to sounds around the house (becoming quite alert when she heard something).. that's a good sign right? That's so cute to hear about your kitty!! I'll have to find something she looks forward to. Thank you for the tip on preventing discomfort Ill make sure to do that next time.
 
5.7 = 102 (Most of us are in the US and don't use mmol/L -- we're hopelessly non-metric). It looks like her numbers were heading up.

You may want to read the sticky on Shooting & Handling Low Numbers. The general idea is that if numbers are getting into dangerous territory, you feed your kitty a small amount of high carb food. This may be the "gravy" that is in some of the higher carb foods or add s small amount of corn syrup, maple syrup, etc. to the food. Wait 15 - 20 min, and re-test and repeat the process until your cat's numbers are in a safer range.

Given Ballonee's initial weight, your dose should have been 0.5u. When a cat has lost weight and is well below ideal weight, the initial dose formula is based on actual weight vs ideal weight.

Many cats have to acclimate to being back in better numbers. Their bodies get used to the higher ranges and being back in closer to normal numbers feels "weird." The more time Ballonee spends in lower numbers, the better she will feel.
 
Thank you so much for your reply!

I will try to post in non-metric! Sorry! :(

Yes her numbers were heading up. I think I'm figuring out her low point (her 'nadir' is it called?). I did try and feed her some high carb food I got from the vet when she was getting below 106 but she just wasn't having it. Is dangerous territory considered below 106 (6mmol) or below 72 (4mmol)? Both vets said not to use corn syrup until under 72 but to definitely try the high carb food under 106.. Is that accurate?

Yes, my vet started her way too high on the two units :( I think the hypos that occurred from the high dose set her back a little bit. Thank you so much for mentioning that she might have to acclimate to being back in better numbers because although she didn't go super low today she seemed a bit more tired than usual and just a bit "off." I think that's probably why. At the vet she seems to go way higher than she does at home.
 
Hey there! Welcome and as Sienne said, keep asking questions as that is how we all learned. We are here to help you and Ballonee! Cute name! What time zone are you in? That will help us.

Her numbers today are nice! So glad you found this forum as there is a wealth of information here.

You are using a meter geared to cat blood glucose so your take action number would be anything 68 and under.
 
Thank you for your reply! So her PM gluc was 94.. the vet said to hold the insulin. Does that sound correct. I didn't really feel great about giving it at the number but Im still wrapping my head around the numbers.

I'm in Mountain time zone :)
 
With an AT2 meter, the no shoot number would be 68. You don't have a lot of data as to how she responds to the insulin yet. However, she has had DKA and that is tricky as the perfect storm to have another event is : in appetence + a systemic stress or infection + not enough insulin. Is she eating well for you?
 
Thank you, yes I'm still really figuring out her patterns. She is prone to hypoglycemia and drops really quickly (usually) after her Lantus. Last night was the first night she didn't go hypoglycemic (usually drops to 45-40) about 2-3 hours after her dose. I'll just monitor her tonight. Cross my fingers. Tonight the vet was talking about decreasing her dose to 0.25 units bid :/ Are some cats dosed that low?
 
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