new member - need advice/help/another set of eyes

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Deborah & Shasta

Deborah & Shasta

Member Since 2012
Hello from Florida,

My name is Deborah and my cat, Shasta, was diagnosed April 2011. I just transitioned Shasta off of dry food and transitioned her from Hill's m/d to Fancy Feast. Also, I just started home testing...today is day 3. Yesterday was a horrible day for home testing, but today was/is so much better. I am a bit concerned about her last BG test. Don't get me wrong, 168 (+3) is a nice number from what I understand, but I am worried for where she will be at 6+. Should I be concerned of her number dipping low? Here is our background story, if it helps...

She's not a particularly nice cat at the vet's office. So, at the time of diagnosis, my vet recommended that we start her at 1u (Lantus) and monitor. He suggested I start her on Hill's Prescription Diet m/d dry (1/3 cup a day - free feeding due to my schedule) & wet (a forkful at each insulin shot) and call if she seemed to be getting worse. Oh, and I forgot to mention that she has a heart condition which makes sedating her a bit troublesome (she's on Atenolol for saddle thrombosis).
She seemed to be doing fine...until I had to go out of town - March 2012. Another side note, she will not let anyone else touch her (they can feed her, just not touch her), but I promise she's a sweety to me! Anyways, when I got home, she was not well. I took her to my vet...but he had literally just retired! =( The new vet ran blood work, etc. We worked at getting her eating again (thank goodness for Friskies! She HATES the m/d taste!) The next time I took Shasta in to see the new vet, she was her usual grouchy-self. I was told that because of her disposition, they wouldn't be able to do much more for us other than yearly shots/check up. (meaning, if Shasta ever needed to be "hospitalized", they wouldn't be able to do anything for us...which I kind of understand...but didn't appreciate her lack of willingness).
Recently, I noticed some hind leg weakness with Shasta. I stopped by the clinic (mid-morning) to ask advice and was told the vet would be in touch. She called at 6:30pm...it was Friday. Anyways, she suggested I up Shasta's dose to 1.5u or 2u and call back after the weekend. (meanwhile, no one suggested I home test! Just blindly shoot my cat!) This vet has "tried" to be helpful (kind of), but I started feeling very anxious and irritated. So, I started researching online and finally got myself logged into this wonderful site!

I just started BG testing, but maybe someone will see something that I don't know to look for. Please check out her tiny SS. Any advice/help/calming that can be sent my way would be greatly appreciated.

Thank you, in advance, Deborah & Shasta
 
Hi Deborah....welcome to the FDMB. I'm sorry you've had so much trouble with the vet situation.

I popped over from the lantus group to help and I appreciate the spreadsheet. So I need to take just a minute to look at it. You are home testing now and you check before every shot? I'll be right back.
 
I can't see your SS. You need to go back into the "edit signature" and change the "ccc" to "pub". I'll be checking back in.

168 is a safe number but I'd sure like to see the SS. Thanks!
 
Marjorie and Gracie said:
I can't see your SS. You need to go back into the "edit signature" and change the "ccc" to "pub". I'll be checking back in.
168 is a safe number but I'd sure like to see the SS. Thanks!
Click to expand...

Me, too!
Hi Marjorie :-)
Hi Deborah, and welcome! Try to stay relaxed. Like Marjorie said, 168 is a fine number. Now let's get looking at your others, k?
Jane
 
Hello Deborah at probably 4 am in florida,
Your link to your spreadsheet is locked off as private so no one is able to see it. There is an option at the top to make it public.
But as the others said, 179 isn't a scary number.

From your posting, I can't tell what dosage you actually gave to Shasta you just mention what the vet recommended.
However, since you are still using dry food (and the one you have is still too high in carbs) you may be able to get into the normal glucose range just
by completely switching to canned. The target here is less than 10 % carbs. I am targeting less than 5%.
http://binkyspage.tripod.com/CanFoodNew.html
There are many choices including the easy to find most anywhere FancyFeast classic varieties shown on the older canned food list here.
http://binkyspage.tripod.com/CanFoodOld.html

If 179 was a pre-shot number than just changing to canned food is highly possible to bring the bg number down to the desired range.
If you work all day you have a couple of options. You could freeze a can and put it out as you are leaving after you feed a can ( fancy feast has smaller cans)
or you could even get one of the automated feeders ( many put frozen in it and set it to open at a later time)


I understand your problem of not having someone who Shasta will allow to help.
And the stress of strangers for her is likely raising her glucose level.
My cat doesn't fight the vet like yours but she fights me. She gets very submissive at the vet (learned helplessness) but it stresses her out so much
that I minimize it as much as I can.

It also sounds like you want to go shopping for a new vet. Call around and find one that supports glucose monitoring.
There are numerous articles you can take to help educate a different vet if you find one willing to learn.
The consensus around here is to go low and go slow.
Most of us would not start at that high a dosage so you are right to be concerned.
 
Hi! The best way to share your spreadsheet is to publish it to the web, so everyone can see but not change your data. With the spreadsheet open in Google Docs, click the File menu and then Publish to the Web. When that opens, check to Automatically Republish When Changes are Made, and click the Publish button. It'll give you a link to put in your profile here.

Meanwhile, you can look into getting some Methyl-B12 (Methylcobalamin) for Shasta. It sounds like she may be developing neuropathy, which is high blood glucose affecting the nerves in the limbs. Methyl B-12 is helpful in treating and maybe preventing this. If you can find the capsules, open them and mix the power in her food. If you get the tablets, break them up and mix them in her food. It's over the counter.

Your vet is unfortunately not unusual. A lot of vets don't mention home testing and a few actively discourage it - don't know if it's a control issue (vets not wanting clients to adjust dosage, etc. on their own) or just ignorance.
 
Is my spreadsheet working yet??? Still trying to figure this site out! I have updated Shasta's BG numbers. I guess I should have prefaced everything with: I'M A NERVOUS NELLIE when it comes to my cat (and my horse)! At the moment, Shasta is up to her favorite activity...napping next to me! :smile:

A clarification to her Lantus units for the past few days. On the advice from this site and Dr. Lisa Pierson (via catinfo.org), I dropped her back to 1u (removed dry food & transitioned to FF wet.) I am not opposed to going back to 1.5u, but I was concerned about keeping her at the higher dosage with so many big changes AND it being a weekend. Ok, I haven't read all of your posts yet...so I'll let me do that and I'll be back. Thank you!
 
HI Deborah, nice to "meet" you. I'm not surprised your vet isn't on board with testing - a lot of them aren't. Which is a bit suprising to me - if you wouldn't give a human diabetic insulin without testing their levels why would you do it to your furbaby? Anyway, glad your on board with the testing and the forum. As others have mentioned Lantus is an insulin that has a shed or depot that takes a few days to fill up so its better not to be changing doses constantly. Sometimes if you do increase insulin you'll see a bounce - where the blood sugar actually goes up for a couple of cycles before going down as the body gets accustomed to it. Probably your best tool is a curve - thats when you do your morning test & shot - then test at 3 hour intervals. So in my case I test/feed at 6am, at 9am (or +3 hours) test, then at 12pm (+6) test & give snack, then at 3pm (+9) test, and 6pm (+12) test and feed. This way you'll have a really good idea how your cat is reacting to the insulin and how low you can shoot. My personal comfort level is full dose to 150, between 150 & 100 a half dose, and if lower then 100 I don't shoot. So hang in there and get some numbers so you aren't worried all the time. This whole process really does get easier with time. I also give my cat Methyl B12 and its helped her out quite a bit. I buy Zoballine and just give her the tablet whole with her other pills in the morning. Jan
 
I just checked her BG (4+) and it's 110...and I still have 2 hours until nadir. I feel like I'm playing Russian roulette with her health. :sad: She has slept most all morning, except when I bug her with BG testing. I will check her BG again at 5+.

I forgot to mention that she is no longer showing signs of hind leg weakness.

Another question...and I know that every cat is different, but what is an appropriate amount of wet food to be feeding at each insulin shot and how often should I be allowing for snacks and how much? I read that on average, to feed 4-6 ounces (canned) per day. I seem to be thrown off (as much as Shasta is) with the dry food for free feeding. I have been rewarding her with a few pieces of Purebite freeze dried turkey after BG testing, but otherwise I'm lost for snacks and how much, etc. Thank you all for your help and advice.
 
Your spreadsheet numbers look nice.... a lot like mine.
I am a pessimist by nature but today, I'm wearing an optimist hat.
I daresay that you and I have an excellent chance at getting OTJ (off the juice)
We might be in the category here in the next few weeks or month of remission due to the diet change. :-D

As or the food question... I am working on that very issue myself.
Since I have gone to the low carb cans exclusively and pure protein treats I have been pretty much giving her food whenever she asks and the treat everytime
I poke her.
My reasoning is I've done the southbeach diet and it's a similar approach (removing carbs and learning to live on less of them).
Those first weeks of going high protein and no carbs make you hungry at first until you adjust. And you adjust and the hunger lessens.

I think kitties who have been on carb overload react a lot the same.
To counter hunger, you have high protein snacks several times which take the hunger away.

So I give shadow 4 meals a day and her snacks and since I'm up checking her glucose at night, I give her a little then too. I'm using the canned foods
that are 5 % or less carbs right now. And I'm also picking the one's that aren't higher in fat or calories.

I tried the raw stuff and I'm still offering it but she doesn't want it. She's a canned food kitty. If she would take it , she would have no carbs.

What I haven't achieved yet is the timing of her feedings with her bg testing.
I am researching how much eating spikes their blood sugar and how long that spike lasts since Shadow has been getting fed usually the hour before
her pre-shots and that's made her numbers look a little higher on her pre-shots.
This morning I waited 2 1/2 hrs after her breakfast (1/3 of a small can) and her number was lower.
Someone had told me to wait at least 2 hrs and I would say the additional half hour wait today made the difference.
I will have to post my findings for all because I think it could make a nice difference for those of us getting the 300 or 200 readings at pre-shot times.


Fancy feast says 1 can / 3 1/2 lbs of body weight for an average size cat.
So my 12 lb cat is getting 3 cans a day plus her treats.
You can't really get fat from a high protein diet. It's our carbs that make us fat
so if your cat is a little underweight from the diabetes, feeding her the way I am will help her get back to a healthy weight.
A slightly overweight cat should stay with the fancy feast guideline.


Hope I've helped.

https://docs.google.com/spreadsheet/ccc ... xVmc#gid=0
 
Hi Deborah

Yay....I can see the SS!!! What a lovely curve last night and today :-D :-D :-D

We who follow a tight regulation protocol (which is the only science-based protocol and provides the best chance for a cat to go into remission) usually give dose reductions once the kitty falls below 50. I would encourage you to post
in the Lantus TR Insulin Support Group where there are more people round the clock. We can help you with low numbers during the cycle, low numbers at preshots, and dosing.

Please click on the links in my signature for "How to Handle Low Numbers" and "Dealing with Low Preshots". For a new member, we would not recommend you shooting below 150 without help.....which you can get in the ISG I referred to above. I"m certain you can also get help on the Health board but there are just many, many more lantus experienced users in the Lantus TR ISG so you would have a faster response time.
 
Wow! You guys are wonderful!!! Thank you so much for all of the advice...including any more you'd like to add! :smile:

Her curve today wasn't quite as good as I would like for it to be, but I know it could be worse. I will be posting in the Lantus group...as soon as I find it! (thank you Marje, Mike & Gracie for the suggestion!) Also, I will be researching automatic feeders...much needed for when the school year starts back. Rhiannon & Shadow - thanks for all the optimism and feeding advice! nwnews - I will try testing with that curve in mind tomorrow! Thank you!


Ok, just took her BG at 2+ and it's 151 (down from 267 at pmps). Is that a "normal" drop??

Here's my timing: BG test pmps @ 8:20pm, feed (1/2 can FF...she is eating well) @ 8:30pm, Lantus 1u @ 8:40pm, BG test 2+ 10:00pm. (don't worry, I'm going to figure out the Lantus group and post there, too!)
 
Yes. That drop is normal.
That shows the insulin is having an effect.

After time, there will be a pattern so you will know when the shot has reached it's peak performance ( the lowest number in the 12 hr cycle called nadir.)
And then the number will go back up, until the next shot cycle .
If you random test enough, that shows you what a bg curve would show you.
 
rhiannon and shadow said:
Yes. That drop is normal.
That shows the insulin is having an effect.
Click to expand...

Thanks! We had a bit of a scare last night... her +4 BG was 39. Got her numbers up, safely and have been monitoring today. (thank goodness I'm on summer break!) I dropped her dosage to .75u this morning on the advice of several members in the Lantus forum.

Live and learn, right?! :YMSIGH:

Ok, off to read more about Lantus Protocol!
 
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