New Member Izzy

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Janet and Izzy (GA)

Janet and Izzy (GA)

Member Since 2013
Wow..well I never thought I'd be here! I have been following DCIN for a few years now and donate when I can...now here I am being a member of the Diabetic Cat Club.

Izzy is a 17 year old Maine Coone. She was diagnosed with CKD about 3 years ago and we have been going along with that feeding high protein, los phosphorus foods as she is allergic to corn, wheat and soy and all the prescription foods made her itch. So we have been going along...most with Fancy Feast Classics and Sheba Pate and occassional Friskies pate....much to my dismay as I would prefer her eating better foods. She has other ideas and we just work with it. She spent 15 days at the vet hospital back then and bounced back well until last week.

Last week she was was Really wobbly and I originally attibuted it to arthritis...until she peed on my bed. I knew somethign was up. I took her in they gave her some fluids and drew blood. The next day they cam back and said...she is diabetic...her blood suger was 819! No ketones in the urine though....how far did I want to take this....

I said...hook her up. Lets see if we can get those numbers to drop and give her a few days. 7 days later she is now home and on Lantus 2x per day...and OMG I should have read the letter from the Sugar Cat first...I totoally tortured her the first night...testing her and bothering her when all she wanted to do was SLEEP! well neither of us slept!

She seems to tire out so fast. She has trouble walking. I am looking into where to find Methylcabalomine....or something like that :) They said I could try. She has trouble getting into the litter box and she is eatint a little bit...not as much as I would like to see. And she is now on 100ml of Sub Qs every other day.

Sometimes I wonder if I am doing the right thing...if I am just trying because I can't let go. Others time I see a glimmer of the cat who likes to play.

Just taking it day by day and looking to cost savings where I can.

Thanks for listening! Janet & Izzy.
 
Hello and welcome to the FDMB. The best place you never expected to be. If you've been a supporter of DCIN, you probably know some of the basics.

So you are already home testing, have Izzy on a low carb diet, giving her very good insulin with the Lantus. All sounds good so far. What meter are you using?

What are some of the numbers you are getting now?

The methylcobalamin is available on line as Zobaline. Non-sweetener version for cats. Here is one link http://www.ilifelink.com/zobaline-for_diabetic_cats-3_mg_x_60_tablets.html

Or you can have it compounded at a pharmacy. I give it as a liquid via injection once a week.

Now, my best advice to you is to learn deep breathing techniques. It will help relieve the stress with this new journey in this sugardance you have started with your dear Izzy.

Breathe in, hold, release, breathe in, hold, release, breathe in, hold, release.

Ask any questions you want and we will try to help you as much as we can. We have a lot of experience in the day to day management of feline diabetes. Some one said "We like and breathe diabetes 24/7" It's true.

It will be ok. We have all been where you are now. We will help get you through this.
 
Diabetes is a chronic disease which may be managed at home quite successfully.

You can do it!

And many of the cats here will actually come to be tested, because we give them low carb treats for putting up with the minor annoyances of ear pricks and subcutaneous insulin injections
 
Thanks everyone. She is really easy to test and sub Qs are easy as long as I use the Terumo 21s and warm the bag to 100 degrees. :)

She has been really good at letting psycho mom test her lol

She has only be home since 7/1 and I drove myself crazy yeterday lol

Her numbers yesterday (we got home about 6pm) were 92 @8:30m pm, 76 @11:31 pm, 76 @ 5:30 am and 176 at 12:10 pm. The Vet said...calm down and stop poking her hahahahaha

I didn't give her the Lantus that evening because she didn't eat. I thought I had to wait until she ate?

Of course I was sure she was going to go into coma and I had no Karo syrup so yup....ran to the store for syrup. Then my friend said, tube icing so I got that too.

Total freak show! Love this cat to death and I know I'm on borrowed time and have been since her dx of CKD.

Was not excited to see the !74 bottle of Lantus says to disguard it after 28 day!! But my friend who is diabetic and uses Lantus said...she doesn't toss hers that early...just keep it refidgerated. So that made my day lol
 
Hello and Welcome :)

I'm fairly new here myself, Poe is on Lantus too using a ReliOn Confirm, lots of the members here use the ReliOn meters, lancets, and syringes. It's quite a value, especially for the strips.

More experienced people will chim in as the day progresses and given its a holiday, it might be slower than usual. Lots of very good reading though in the stickys for this board and the Lantus board.



:-D
 
Hi and welcome to FDMB.

So far you are doing everything right: Low carb diet, good insulin and hometesting. I have been using Relion meters for years, for 3 diabetic cats, and have been very please with them.

For your insulin, you will be able to use the Lantus long after the 28 days. Many people can use a vial up to 3-4 months before it starts becoming ineffective. You will know when it is not working as well by a steady increase in the BG readings. However, I would recommend that when you do need to buy a new vial, ask your vet for a prescription for the pens instead. The initial cost is about twice of that of a vial, however you get 5 pens. Because a vial will stop working long before you use it all, you end up throwing away a lot of it. With the pens, because they are smaller containers, you should be able to use almost every drop. One box of 5 pens will be enough insulin to last almost a year. You will draw the insulin from a pen the same way as a vial. It is just a smaller version of it.

Just remember to test before every shot. The order is to test, feed then shoot. You want to wait until your cat has eaten before giving insulin.

You are doing a great job. We know this is all new and a little overwhelming. You will soon develop a routine that works best for you. And we are here to help you along.
 
We keep the Lantus for 4 to 6 months with proper handling and storage. Here is a post on that. http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=151

Be sure to give the insulin shots and sub-q fluids in widely separated areas of the body. That is because the fluids can affect the rate of absorption of the insulin.

Janet and Izzy (17, female) Maine Coon
Relion Micro w/ Lantus
CKD on sub-q fluids

Would you be willing to cut and paste that info about your cat into your signature?

Would you please provide us with some more information and put this in your user control panel? It helps us to help you better. This will take about 5 minutes of your time.
Think of this as having some very useful information at our finger tips for those that are replying to your posts. One reason we like to see this information in your signature is because if there is ever an emergency situation like a possible hypoglycemic episode, we don’t have to ask a lot of questions like what meter you are using to give you the best advice. Doing this signature update is totally optional, but it does help us to help you better.
If you are willing to do this, would you please do those updates when you get a chance? Thanks.
Go to the upper left corner of your screen and click on the words, User Control Panel
On the next screen, a row of tabs is presented. Select the Profile tab
On the next screen, there are a number of choices along the left hand side. Select Edit Profile.
Go down to the location field and enter your country, state/province, and city if you are willing to share that info.
Click on submit to save this change.

Still in the User Control Panel, Profile tab, this time select Edit Signature from the left hand list of options.
A free form text box appears.
We like to see information like your name, your cats name age and sex, the diagnosis date for the diabetes like this (DX 4/30/13), what meter you are using for testing, what insulin you are using , what you are feeding (wet or dry, what brands/style of food), any complicating health issues your cat may have, any additional medications your cat is receiving. If you are using a pet specific meter like an Alphatrak or Ipet, please change the font size on that text from Normal to Large (using the drop down arrow list in the middle of the editing commands)

Click on submit to save this information. Now, this will appear at the end of every post you make. You can update the info when you need to.

There is an additional document you can create to provide even more information about your cat. This is also optional to create this google document and link it into your signature. The profile is in addition to the synopsis info in your signature. See this link on the how to's of profile creation. http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=79123 You can leave this profile creation until later but I would really like to see the signature info.
Click to expand...
 
Hang a sec - can you tell me when these numbers were in relation to her shot time? Reason i ask is these are good numbers and i want to be sure there isnt the possibility she is dropping too low.... Especially as 2 IU is a high starting dose for any cat. What does she weigh? (Fyi normal cat is 40-130)

Her numbers yesterday (we got home about 6pm) were 92 @8:30m pm, 76 @11:31 pm, 76 @ 5:30 am and 176 at 12:10 pm.
Click to expand...


Lastly FYI we dont advise newbies shoot under 200, esp if the cat isnt eating. We need more data first, can you set up a spreadsheet? http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207
 
They told me I didn't need to test her :( So I did't test her this morning before feeding her. I was going to do her glucose curve test tomorrow.

They said nubmers between 70-200 were normal....and to coninue with the lantus, so that what I have been doing. She has only been on insulin I think since last Saturday.

Should I test her before giving a shot? Should I not give a shot if her numbers are normal? I don't know what caused her to spike to 819?

it's all so confusing.
 
Janet said:
Should I test her before giving a shot? Should I not give a shot if her numbers are normal?
Click to expand...

Definitely test before giving a shot, so you know it's safe to give the shot. If she was already low and you gave a shot, it could be dangerous.

As to the numbers at which you don't give a shot, it varies with your experience and your cat's reaction to insulin. As Wendy mentioned, new users are told not to shoot if BG is below 200, but as you get more data on your cat you will likely be comfortable (and safe) to shoot at lower numbers. If you are following Lantus Tight Regulation Protocol, there is information hereabout Shooting and Handling Low Numbers. The most important thing is "being data ready" - the more you test, you will know how quickly the insulin kicks in and how much it brings down her numbers. This doesn't mean doing a whole curve every day, but getting spot checks at different times on different days to help fill in the whole picture. Then you will be able to see a pattern and decide what you should do if you see lower numbers at preshot. You'll find setting up the spreadsheet Wendy mentioned to be really helpful so you can collect and make sense of all the numbers. Plus then others can help you by looking at the numbers in one easy-to-understand format.

My cat is quite weak in the legs too, but I've been giving her the methyl-B12 and I am starting to see some improvement. At one point she was almost falling on her face when she stepped out of the litter, but now she's walking around on her own more confidently although still awkwardly. It does take time but don't despair!
 
You really need to test before every single shot to keep her safe. If she is below 200 dont shoot, dont feed and come here and ask for advice.

Dont feed two hours before the shot so we know the preshot number isnt influenced by food.

How long has it been since her shot? Can we get a test now?
 
I ordered the b12 last night from the link this board gave me.

She is eating now...she didn't eat the first night. But she is back to eating. She is a snacker so I keep wet food out for her 24/7. I need to find a dry food she can eat...not because she eats it, but because my other cat is a "kibble crack head". So I keep kibble out for him but he is going to have to eat whatever is safe for her..

I have been feeding him Now Grain Free which is high protein, lower phosphorus....though it appears perhaps high in carbs due to potoates? At any rate...a dry food search is on my to do list.

When do I use the pee sticks to test for ketones. Is this something I should do routinely or just occassionally? I will make it through all the topics...I promise :)
 
There are a few low carb dry foods you can feed but it would be best for both their healths if they only get wet. ie Innova Evo Cat & Kitten 8% (Currently on a recall), Wellness Core Grain-Free Original Formula (tan gold bag)11%, Nature's Variety Raw Instinct chicken 7%, and Young Again zero Carb 0%.

Can you get a blood test now please? I am a little concerned. Also you test for ketones twice a week, or when the blood sugar is over 360.

Wendy
 
As far as CRF goes - have you been to Tanya's Feline CRF site? Lots of excellent information on managing a CRF cat. In addition to low carb foods for the diabetes, you want to keep the phosphorus low too. Cat Info has a PDF nutrition chart with many common US foods and their nutritional breakdown, including the phosphorus levels.


When you have a chance, you might want to edit your signature link for the spreadsheet. It looks a bit funky ;-)
The link should be
[color=#BF0000][b]link[/b][/color]
or
[url=link]text to display[/url]
 
ok so the 110 was 6? 7? hours after the shot.?

Reason i ask is that we need to know how low she goes - if she goes too low (under 50) then the dose is too much and she could drop dangerously low. The way lantus works is it acts as a curve - it reaches maximum action 5-7 hours after the shot...sometimes later.
 
ok so can you get a test at 5-7 hours after the shot? That 110 is pretty low and she could have dropped further after that..

Thats why we need a preshot test - if he preshot test was 120 then we know her curve is pretty flat and no need to worry to much but if her preshot was 300 and she dropped 200 points in 3 hours then we worry because she still has 3 hours to go before the insulin hits its peak - and how much more will she drop? below 50 and she could have a hypo.. make sense?
 
ok so we can assume she dropped lower than 110 since the way lantus works. see below example of a curve. Would have been good to know how low she went as I am still concerned she might be getting too high a dose. We base dose changes on her lowest point of the day - we dont want to go under 50 remember..

Example of a typical Lantus curve:
+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.

A few things.. tonite if she is under 200 I wouldnt shoot. You dont have the data to know if you can keep her safe if you shoot and she is under 200.

Tomorrow or even tonite (if you shoot) can we get a test 5-7 hours after her shot?

Wendy
 
if I don't shoot her tonight and I do her curve tomorrow....will that be an issue?

Should I feed her, wait 30 minutes....test and then decided whether to shoot or hold off until the morning?

Does neuopathy cause them pain? She seems a little growly when I try and comb her by the base of her tail. She has always had some issue there...would start licking the air when you scritch her...but now she seems like it might be tad painful too.
 
Lantus works best on consistency, it takes a few days to build up in their systems. So if you skip tonite then your results for a curve tomorrow will not be quite representation of how that dose Is working.

Let's see how the test is at preshot time and we can go from there...

Neuropathy can feel like pins and needles but its more in their legs, not so much base of the tail..
 
So I take it...I need to test her again? I just fed her it's 5:43 and she did eat. She isn't a big eater but she did pretty well.

do I test her right after she eats? before she eats.

I normally try and give her a shot around 6:15 ish. I try to feed her around 5:30-5:45 and give it 30 minutes.
 
Really we want you to test before she eats. No food for two hours before the shot. Because that way when you do the test, the number isn't inflated by food. Anyway you know for tomorrow. Test, then feed/shoot.

Anyway get a test before you shoot and let us know what it is. Don't shoot if under 200.

Also what weight is she? I still think two units is too much to start.
 
She is around 11 lbs. I'm going to test her in the next few minutes. If she is under 200....don't shoot her? hold off until the morning?

Then retest her at 4:30 am if I plan on feeding her at 5:30 and giving a shot by 6:15?

Then monitor her every hour for 12 hours?

Is that a good plan staring now for tomorrow?
 
Yes, if under 200 don't shoot. If over 200 I would only give 1 unit.

Tomorrow test, then shoot/feed.i shoot mine while they are eating. You want to test just before you shoot ie within 15minutes or so.. So that the number really is a preshot test.

Wendy
 
Also you want to test before every shot, mid cycle (5-7hours after the morning shot if your schedule permits) and a before bed test (2-3hours after PM shot) to ensure she isn't doing anything weird overnight.

You don't need to test every hour.
 
its 6:22 and she tested at 140.

I just re-listed to my Vet's message. They want to see her next week and they want the glucose curve test do be done..test before shot, feed her, shoot her and then test her every hours until 6pm (since I start at 6am).

So at 140, I should forgot her evening shot and do the curve test in the morning?

in looking at my excel sheet..which only has 4 days of various information, this is what it looks like so far:
7/1/2013 8:30 PM 92
7/1/2013 11:31 PM 76
7/2/2013 5:30 AM 76
7/2/2013 12:10 PM 176
7/2/2013 5:00 PM 1unit
7/2/2013 5:50 PM 61
I quit testing because the vet said it wasn't necessary and numbers between 70-200 were normal.
7/3/2013 6:15 AM 1unit
7/3/2013 6:30 PM 1 unit
7/3/2013 6:30 PM 100ml Sub Q
7/4/2013 6:15 AM 1 unit
7/4/2013 10:50 AM 110
7/4/2013 3:25 PM 135
7/4/2013 6:23 PM 140

updated to delete the duplicate 7/2 pm shoot.
 
Sounds fine to me, just trying to save your cats ears.

Ok so as a newbie I would advise you not to shoot with these numbers being so low, or shoot a reduced dose like 0.5.. This means tomorrow she will be high likely, and you should let the vet know that you did this the night before your curve.

Let me know

Wendy

Ps if you do shoot (because u dont know me from adam) you should be ready with syrup in case of a hypo and you will need to test at least at +2, and then through the night especially if she is dropping.
 
ugh. So stressful!! What to do! I don't want her to have high numbers on her curve test that give them a false reading, but I dont' want to give her insulin if she doesn't need it! ACK!
 
Well, you could call the vet and tell them Izzy dropped to 61 today on the 1U of Lantus that you gave. Because of that, you don't feel comfortable giving her that much insulin again.

Most vets freak out when they hear of numbers under 100. We know that cats can go down to 50's and still be safe. Down to 40's and be safe with food support. We worry when the numbers go under 40. That get's our adrenaline pumping.

You could tell them you don't think the curve would get any good numbers. You have these tests from the last few days. You could send them a link to your SS (spreadsheet). Especially since you can't even keep Izzy on the dose they prescribed for you, you think you need to make some changes.
 
They were not concerned at all with the 76s. They assured me those numbers were fine. I don't know if they would be concerned with the 61.

Does anyone use Lantus 1x a day or is it strictly a 2x a day insulin. I sure hate sticking her so much :(
 
It only lasts twelve hours so its best twice a day. They don't even feel the shot , especially if they are eating when you do it. The needle is so short and fine its painless.

Try not to stress.. Everything you are doing will give her the best chance for remission.

Did you shoot tonite or no?
 
Janet said:
7/5 6 am: pre food and no insulin shot the night before 246
fed at 6:40 am
next test 7:40
Click to expand...

A token dose on insulin would be reasonable - 0.25 to 0.5 units. - if you can monitor. No disposable syringes have quarter unit markings, so you have to eyeball it. Some folks find calipers help standardize when giving low doses.

Not a bad number to start the day, though :smile:
 
We use a different standardized spreadsheet for keeping track.

For those people home testing, we have a wonderful way to keep track of the test data and shots. There is a google spreadsheet template you can use so you don’t have to start from scratch and figure out what you want it to look like.

We have instructions on how to set one up. how to set up SS and link in your signatureThe color coding is helpful to see trends over time in how the insulin is working. We even help set them up for people that may be technology challenged. Please ask if you need help.

Having a SS set up and linked to your signature is a great way to get some suggestions from the experienced people on FDMB. You can even share the spreadsheet with your vet, by email. It's totally optional but it can get you some great advice on how to manage your cat with his BG numbers.

What do you think? You can look at Wink's SS in my signature to see what one looks like. I found it invaluable.
Click to expand...
 
Do you want help putting it into our format? Our format will really help us keep track of what's going on in relation to time and trends. It's colour coded so anyone here can come in quickly and advise.
 
Wow...now that's a detailed ss!

Yes that would be awesome....what do the color coding within the sheet mean? and what are AMPS?
I do give Izzy Miralax too usually in food in the am..which sometimes she eats and sometimes not. I usually use FF appetizers for her miralax.
 
AMPS = am pre-shot test
PMPS = pm pre-shot test
U = Units of insulin given
+1, +2, +3 are the hours since you give the shot.

Remarks column for notes like when you gave the sub-q fluids, foods fed when, etc.

Color coding is for the different BG ranges. There is a key, colored coded at the top of the SS.

I'll send you a PM, Upper left hand corner of your screen. I need some information to set this up for you.
 
To: Deb & Wink

after today's glucose curve...which I know my vet will take into consideration we started without the prior evenings shot....what does it all mean? How do you decided whether 1unit or 1/2 unit is the "right dose".
Click to expand...
Janet asked me this in a PM.

You decide by looking at the patterns and trends over time. I would not base any dose adjustments on that curve you did today, for the simple reason that you needed to skip a shot last night. The numbers this morning were undoubtably higher than they would have been. A bit of a 'bounce'.

After that glucose curve you did today, I would stay at 1U for now and monitor closely. You will probably need to learn to shoot low numbers sooner than later. I would suggest that you print out this article. shooting and handling low numbers

You want to be able to hold a dose for a minimum of 3-5 days or 6-10 consecutive cycles to see what effects the Lantus is having. The Lantus builds up slowly in the body before it starts to have it's full effect. If your cat drops below 50, then it is an immediate reduction, down 0.25U.

Because of that skipped shot on 7/4 PM, the counting of the cycles starts over.

We can guide you in shooting low numbers, but you need to have plenty of test strips on hand, some high carb (HC) food, karo syrup or honey or another simple sugar and the ability to stay around to monitor for several hours.

If you need to skip another shot because Izzy is low again, we would probably suggest that you lower the dose to 0.5U. We want to find a dose that you can give Izzy 2 x a day, without dropping her too low, or having her be too high.

Right now, you are in the data gathering phase of this sugardance. It took time for Izzy to become diabetic, it will take time to regulate her.

If you can, we strongly suggest getting a final test before you go to bed. Many cats drop lower at night so it is a good habit to get this before bed test in nightly.
 
This morning she is at 98 AMPS, fed her, and then I decided to shorten her dose to .5. I can be here all day to watch her and yet I am struggling with the glucose curve since the one I did yesterday apparantly isnt truly indicative of her numbers since I did not give her the PM shot the evening before.

I didn't want to totally skip this morning too! But I was afraid of giving her a full unit.

All so confusing on what is the right thing to do....and scary!
 
Nice numbers and good idea to reduce the dose. Can you get a +2? That should tell you roughly what the curve will be like today ie

If the +2 is higher you probably will be fine and the cycle will be inactive
If the +2 is the same or lower you will be doing more testing as its an active cycle

I am thinking the 1 unit is too much. You might want to stick with the 0.5 for a while to see how that does. Any activity today is a result of the "depot" from the 1 unit so we wont know how the 0.5 unit does for a few days.

Wendy
 
yes I will be able to test her at 2+, an hour after that I will be leaving for work (9:30am) and won't be home until 7:30 pm, so her PM dose will be outside of 12 hours. It's my weekend job which pays for her extroidinary vet bills....but I may have to cut my shift to 1 4 hours shift if this long day is going to interfere with her insulin. Monday through Friday I work 7-3:30...which is why I have her on a 6-6:30 am shoot.
 
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