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Sepi

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How much does Gary have to eat in order to get the insulin? Vet said only two meals a day and total of 240 calories.
Does he have to eat 120 cals in order to get his shot?
Also he is really not eating much. So how much food do they need to eat in order to get insulin?
And is this only two meals a day apply if he isn't eating ?
Thx
 
How much does Gary have to eat in order to get the insulin? Vet said only two meals a day and total of 240 calories.
Does he have to eat 120 cals in order to get his shot?
Also he is really not eating much. So how much food do they need to eat in order to get insulin?
And is this only two meals a day apply if he isn't eating ?
Thx
I am on the ProZinc protocol, I do know they have to have some food in their stomach,, I feed Corky 4 meals a day 2 main at AMPS/PMPS and two snacks.
 
How much does Gary have to eat in order to get the insulin? Vet said only two meals a day and total of 240 calories.
Does he have to eat 120 cals in order to get his shot?
Also he is really not eating much. So how much food do they need to eat in order to get insulin?
And is this only two meals a day apply if he isn't eating ?
Thx
Please give some snacks as well as the two main meals. Just feeding the 2 main meals is old thinking. Do you think Gary could be nauseated? Is he normally a good eater?
Lantus will start to work about two hours after the shot so if he will eat a bit more during the 2 hours after the shot, that is ok too.
Do you have a hypo box set up in case of low numbers?
Would you like to set up a spreadsheet so we can help you with dosing?
What is KAD? Did you mean DKA? If so that changes a lot. Please let us know

What dose of Lantus are you giving?
 
How much does Gary have to eat in order to get the insulin? Vet said only two meals a day and total of 240 calories.
Does he have to eat 120 cals in order to get his shot?
Also he is really not eating much. So how much food do they need to eat in order to get insulin?
And is this only two meals a day apply if he isn't eating ?
Thx
Hi
I think @Sienne and Gabby (GA) mentioned she feeds her cat several small meals during the first few hours after a shot. I do that also but I’m new so don’t take my word on anything. Hopefully she will check in on you soon
 
Please give some snacks as well as the two main meals. Just feeding the 2 main meals is old thinking. Do you think Gary could be nauseated? Is he normally a good eater?
Lantus will start to work about two hours after the shot so if he will eat a bit more during the 2 hours after the shot, that is ok too.
Do you have a hypo box set up in case of low numbers?
Would you like to set up a spreadsheet so we can help you with dosing?
What is KAD? Did you mean DKA? If so that changes a lot. Please let us know

What dose of Lantus are you giving?
 
Thank you. What would be considered a snack?
He is getting 1 unit 2 x Day.
The vet gave him a shot for nausea this afternoon, and I have Maropitant .025 to give for the next few days to see if it was nausea.
Also have the transdermal appetite enhancer Mirataz that a member suggested.
Great news was tonight he ate almost a full meal, but that was aided by try TikiCat After Dark Velvet Mousse. He went wild.
So for a snack, could he have a few teaspoons if that?
I am working on the spreadsheet, I couldn't get it to work on my phone so have to dust off my laptop.
 
Thank you. What would be considered a snack?
He is getting 1 unit 2 x Day.
The vet gave him a shot for nausea this afternoon, and I have Maropitant .025 to give for the next few days to see if it was nausea.
Also have the transdermal appetite enhancer Mirataz that a member suggested.
Great news was tonight he ate almost a full meal, but that was aided by try TikiCat After Dark Velvet Mousse. He went wild.
So for a snack, could he have a few teaspoons if that?
I am working on the spreadsheet, I couldn't get it to work on my phone so have to dust off my laptop.
Again, just a beginner here but for my boy I sometimes use Tiki Mousse as his snack (it’s also his usual meal) just in a smaller amount. Other times he get tiki chicken breast in consommé or salmon in consommé (less carb than the mousse so that’s his standard but if he’s being picky or his numbers are lower I go with the mousse.

Methos has always been a picky eater who gets full easily—I suspect he may have been a really friendly feral since he doesn’t know how to meow—and is used to mouse sized meals. So even before insulin he was on a four meal and two snacks diet (luckily I’m retired and have no life).

I think the snack idea is just that you are breaking up his total calories and spacing them for when insulin kicks in (I think around +2 and peaks —usually between +4 and +6 but each cat is different.

edit: idk what they put in the Tuna and Chicken mousse but both of my cats would kill for it. It’s my go to if I absolutely need him to eat for his shot. The only thing he likes more is the bad-for-him medium carb food in my hypo kit. That he adores :rolleyes:
 
you. What would be considered a snack?
A snack is a teaspoon or 2 of normal low carb food.

The vet gave him a shot for nausea this afternoon, and I have Maropitant .025 to give for the next few days to see if it was nausea.
good. I would definitely give the maropitant (cerenia) daily for the next few days.
I see you have changed the KAD to DKA in your signature. I’m guessing the DKA was very recently…Is that correct?
Did Gary have an infection or inflammation with the DKA and did he have antibiotics?
Cats who are recovering from DKA need extra care. And with post DKA, a lot of cats are nauseated so I’m glad you have the cerenia. Here is what I would suggest you do to help Gary recover fully from the DKA.
  • you need to give one and a half times as many calories as he normally eats. Offer snacks every couple of hours during the day and evening as well as the 2 main meals. Food is like a medicine and helps keep ketones away. If Gary won’t eat the low carb food, feed him whatever he will eat as eating any food is better than not eating,
  • Don’t skip any doses of insulin as insulin helps keep ketones away. If the BG is not high enough to give the dose…stall, dont feed and test again in 20 minutes and post and ask for help.
  • Test daily for ketones. Put the results of the tests into the remarks column of the SS so we can see. Please report any trace ketones at all. To test for ketones you will need to get a bottle of Ketostix from a pharmacy and follow the directions on the bottle. There should be no ketones.
  • Give antinausea medication as needed
  • Give appetite stimulant if needed after the antinausea medication
  • Give extra fluids. If Gary will tolerate warm water in the food, put a teaspoon into each snack..
  • Ask the vet about subQ fluids
  • Set up a spreadsheet and test the BG frequently. I would strongly recommend you do this and learn to home test as it is really important that Gary is getting the correct dose of insulin. It is food and insulin. (And fluids) which will keep the ketones away. And it is ketones that form and then progress on to DKA. I am going to tag @Bandit's Mom to help you set up a spreadsheet. …I see you have a freestyle liver at the moment. So that is good. You might like to look at the relion meter long term.
  • A good glucose meter is the relion premier meter which you can buy from Walmart. You also need a box of 100 test strips and a box of 100 lancets size 26 or 28 and some cotton balls to hold behind the ear when Testing. We can help you learn how to test.
  • Post daily with updates and ask for help as often as needed.
 
Thank you. I'm trying to get my info into the spreadsheet.
But for right now here are Gary's numbers from today:
7am 199. fed him and shot 1unit Lantis
930 89
1130 88; 1:30 154; 3:30 180; 5:30 187; 638 148; He ate and shot 1 unit at 7:00pm
9:17 he is at 60;
10:15pm he is at 57

I'm thinking this is too low???
 
Gary is on Lantis 1ml. His number two hours after shot is 59. That seems too low.
* Now he is 65 at 10:50

First day doing a curve with FreebLibre.
He was 199 at 7am. Then are and I shot
89 at 930
88 at 1130
136 at 7 when he ate and I shot 1 unit.

And what does apms mean in the spreadsheet. I'm trying to get these numbers in. I think that is just the reading on the meter?
 
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Again, just a beginner here but for my boy I sometimes use Tiki Mousse as his snack (it’s also his usual meal) just in a smaller amount. Other times he get tiki chicken breast in consommé or salmon in consommé (less carb than the mousse so that’s his standard but if he’s being picky or his numbers are lower I go with the mousse.

Methos has always been a picky eater who gets full easily—I suspect he may have been a really friendly feral since he doesn’t know how to meow—and is used to mouse sized meals. So even before insulin he was on a four meal and two snacks diet (luckily I’m retired and have no life).

I think the snack idea is just that you are breaking up his total calories and spacing them for when insulin kicks in (I think around +2 and peaks —usually between +4 and +6 but each cat is different.

edit: idk what they put in the Tuna and Chicken mousse but both of my cats would kill for it. It’s my go to if I absolutely need him to eat for his shot. The only thing he likes more is the bad-for-him medium carb food in my hypo kit. That he adores :rolleyes:


That Tiki After Dark Mousse (with organ meat)has made Gary an eater again!!! Thanks for the idea.
 
Thank you. I'm trying to get my info into the spreadsheet.
But for right now here are Gary's numbers from today:
7am 199. fed him and shot 1unit Lantis
930 89
1130 88; 1:30 154; 3:30 180; 5:30 187; 638 148; He ate and shot 1 unit at 7:00pm
9:17 he is at 60;
10:15pm he is at 57

I'm thinking this is too low???
I don’t know how to advise you but hopefully @Bron and Sheba (GA) or @Bandit's Mom or @Diane Tyler's Mom GA will be back by to help. I think @Wendy&Neko and @tiffmaxee also help with Lantus. How is Gary acting at those numbers?

when you have a chance: you are close with the spreadsheet but not quite there. You can click on mine and see: you put the date in the first column, then the amps (preshot blood test for morning) then the units in the light blue column. After that you fill in subsequent blood tests going across, not down.
 
Thank you for the help in the spreadsheet. I will correct that in the morning.
The latest reading is 68. Gary seems fine. I did give him some food when the 59 showed up.
I'm thinking that since his number right before he ate was 137, I should have only given 1/2 a dose and not the whole dose? This is the first full day monitoring so don't have any idea how this Lantis will work on Gary. Time will tell. And sadly, lots of errors on my part. I'm so thankful for the forum.
 
Thank you for the help in the spreadsheet. I will correct that in the morning.
The latest reading is 68. Gary seems fine. I did give him some food when the 59 showed up.
I'm thinking that since his number right before he ate was 137, I should have only given 1/2 a dose and not the whole dose? This is the first full day monitoring so don't have any idea how this Lantis will work on Gary. Time will tell. And sadly, lots of errors on my part. I'm so thankful for the forum.
My errors could fill a book. Luckily our cats are pretty resilient. Since he’s acting ok and his numbers came up with food it sounds to me (another beginner) that you’re managing things (do you have karo syrup or honey for emergency use, and some medium carb food?). I think you said he’d had DKA right? If so I think it’s extra important he get insulin so I really can’t say what a reduced dose would be…but I hope an experienced person hops on soon to advise you.

I do know that if you need a question answered it helps to use the drop down in the title and select the “?”

let me know if you don’t know how to do that
 
What time is is where you are? I’m wondering if you will be sleeping soon bc I don’t know about sleeping. If his numbers might go down again
 
My errors could fill a book. Luckily our cats are pretty resilient. Since he’s acting ok and his numbers came up with food it sounds to me (another beginner) that you’re managing things (do you have karo syrup or honey for emergency use, and some medium carb food?). I think you said he’d had DKA right? If so I think it’s extra important he get insulin so I really can’t say what a reduced dose would be…but I hope an experienced person hops on soon to advise you.

I do know that if you need a question answered it helps to use the drop down in the title and select the “?”

let me know if you don’t know how to do that
What time is is where you are? I’m wondering if you will be sleeping soon bc I don’t know about sleeping. If his numbers might go down again

It is midnight. I'm staying up to monitor him.
I do have the the Emergency Kit ready.
 
To get more attention maybe start a new thread in the lantus forum. In the title choose the “?” Prefix (or 911 if emergency). Put the date then cat name, and test results so “11/12 Gary 136 @PMPS 136, 59@ +2, 65@+3 after feeding need advice”
 
I’m finding it hard to read the SS? It looks as if the BG numbers are going up the page and not down. (Or across…but I see Colleen pointed that part out to you.) I think I’ll tag @Bandit's Mom to see if she can help you get the SS sorted out.
As you are doing SLGS ( because you are feeding dry food) you will need to reduce the dose because it dropped under 90 so your new dose is 0.75 units (3/4 of a unit). Have you managed to test for ketones at all?
I would keep offering low carb food for now.
 
Gary is quite safe in those numbers (59,65) and the freestyle libre is often unreliable in low numbers so I would suggest you buy a human meter such as the reliOn premier meter as well and learn to test the BGs manually, so you can check the BGs when the libre drops under 100
What are you feeding him during the cycle?
 
My errors could fill a book. Luckily our cats are pretty resilient. Since he’s acting ok and his numbers came up with food it sounds to me (another beginner) that you’re managing things (do you have karo syrup or honey for emergency use, and some medium carb food?). I think you said he’d had DKA right? If so I think it’s extra important he get insulin so I really can’t say what a reduced dose would be…but I hope an experienced person hops on soon to advise you.

I do know that if you need a question answered it helps to use the drop down in the title and select the “?”

let me know if you don’t know how to do that
I’m finding it hard to read the SS? It looks as if the BG numbers are going up the page and not down. (Or across…but I see Colleen pointed that part out to you.) I think I’ll tag @Bandit's Mom to see if she can help you get the SS sorted out.
As you are doing SLGS ( because you are feeding dry food) you will need to reduce the dose because it dropped under 90 so your new dose is 0.75 units (3/4 of a unit). Have you managed to test for ketones at all?
I would keep offering low carb food for now.
I’m finding it hard to read the SS? It looks as if the BG numbers are going up the page and not down. (Or across…but I see Colleen pointed that part out to you.) I think I’ll tag @Bandit's Mom to see if she can help you get the SS sorted out.
As you are doing SLGS ( because you are feeding dry food) you will need to reduce the dose because it dropped under 90 so your new dose is 0.75 units (3/4 of a unit). Have you managed to test for ketones at all?
I would keep offering low carb food for now.
Actually, I'm not feed him very much dry at all. And the Dr Elsey is low carb.
He was tested for keytones in Sunday at the Vet hospital. He didn't have any in urine or blood.
 
Gary is quite safe in those numbers (59,65) and the freestyle libre is often unreliable in low numbers so I would suggest you buy a human meter such as the reliOn premier meter as well and learn to test the BGs manually, so you can check the BGs when the libre drops under 100
What are you feeding him during the cycle?

I did buy the Relion yesterday. And then the Vet suggested the Libre so we could start monitoring Gary ASAp. So are you saying he could be lower based on the Libre defects? I can't set up the Relion tonight. He is acting fine.
 
Actually, I'm not feed him very much dry at all. And the Dr Elsey is low carb.
Even if the dry is low carb you need to be doing the SLGS.
But I am taking the recent DKA into consideration as well.
With the BG numbers quite low I think you need to reduce to 0.75 units at the next dose.
But I would really like it if you could buy some Ketostix from a pharmacy and test Gary’s urine daily at the moment for ketones as this will give us a good idea if he is getting enough food and enough insulin. Do you think you could do that?
 
Gary is quite safe in those numbers (59,65) and the freestyle libre is often unreliable in low numbers so I would suggest you buy a human meter such as the reliOn premier meter as well and learn to test the BGs manually, so you can check the BGs when the libre drops under 100
What are you feeding him during the cycle?

Does during the cycle mean since his dose at 7pm?
He had Wellness Turkey pate and almost 2.8 grams of Tike Cat after dark Mousse with organ meat.
Tonight when his number went below 60 I gave him some Instinct Limited Ingredient Turkey dry. He used to eat that and when he was diagnosed I checked and it has 27 percent carb so stopped immediately. I figured tonight I wanted him to have some carb when he dipped. And then about a half hour ago I gave him a teaspoon of the Tiki After Dark Mousse
 
So are you saying he could be lower based on the Libre defects?
The libre tends to give lower BG numbers under 100 than when it is checked against a hand held meter. When people check the BG with a human meter the BG numbers are usually higher. Does that make sense? So I think Gary is fine.
 
Even if the dry is low carb you need to be doing the SLGS.
But I am taking the recent DKA into consideration as well.
With the BG numbers quite low I think you need to reduce to 0.75 units at the next dose.
But I would really like it if you could buy some Ketostix from a pharmacy and test Gary’s urine daily at the moment for ketones as this will give us a good idea if he is getting enough food and enough insulin. Do you think you could do that?
Yes. I will get the strips tomorrow. And thank you.
 
The libre tends to give lower BG numbers under 100 than when it is checked against a hand held meter. When people check the BG with a human meter the BG numbers are usually higher. Does that make sense? So I think Gary is fine.
He is acting fine. I'm staying up until I see the number go up. This morning it looked like Lantis kicks off at the two hour mark and BG drops by quite a bit. Then 6 hours in the BG goes back up. So I'm hoping to see the rise around 130am.
 
Does during the cycle mean since his dose at 7pm?
During the cycle means after you have given the insulin until you give the next dose.
Tonight when his number went below 60 I gave him some Instinct Limited Ingredient Turkey dry. He used to eat that and when he was diagnosed I checked and it has 27 percent carb so stopped immediately. I figured tonight I wanted him to have some carb when he dipped
That is ok to do that. However, I would recommend for in the future you get some higher carb canned food for if Gary drops lower again. That is a better choice. And because you gave the high carb food, you need to test the BGs for 2 hours after the last time you fed high carb food (either dry or canned) to make sure he can stay up higher on his own. This applies to everyone each time they give high carb food when their kitty drops low.
This morning it looked like Lantis kicks off at the two hour mark and BG drops by quite a bit.
This is pretty normal. My Sheba always had her biggest drops between +2 and +4 or +5. But every cat is different.

If in future Gary drops under 90, you can just try feeding normal low carb food to see if that brings him back up higher. There is actually no need to feed high carb food unless the BG drops under 50.
 
During the cycle means after you have given the insulin until you give the next dose.

That is ok to do that. However, I would recommend for in the future you get some higher carb canned food for if Gary drops lower again. That is a better choice. And because you gave the high carb food, you need to test the BGs for 2 hours after the last time you fed high carb food (either dry or canned) to make sure he can stay up higher on his own. This applies to everyone each time they give high carb food when their kitty drops low.

This is pretty normal. My Sheba always had her biggest drops between +2 and +4 or +5. But every cat is different.

If in future Gary drops under 90, you can just try feeding normal low carb food to see if that brings him back up higher. There is actually no need to feed high carb food unless the BG drops under 50.
I'm in the process of doing a 24 hour curve, so I will see what happens with high carb. And I totally agree about the higher carb wet. I just did have any so I grabbed the Instinct Dry. I'm trying to get him off any dry, but the poor guy needs to gain weight and is getting picky. Thanks again. Its late and you all are a blessing. Get some rest!
 
I'm in the process of doing a 24 hour curve, so I will see what happens with high carb. And I totally agree about the higher carb wet. I just did have any so I grabbed the Instinct Dry. I'm trying to get him off any dry, but the poor guy needs to gain weight and is getting picky. Thanks again. Its late and you all are a blessing. Get some rest!
You are doing a great job looking after Gary!
I live in Australia and it is late afternoon for me:)
 
You are doing a great job looking after Gary!
I live in Australia and it is late afternoon for me:)
Lucky you! What a beautiful place to live.
I will ask one more question then ;) To determine the size of the daily dosage, what BG range should I use? Like if it is under 200 don't give 1 unit give 3/4m
 
Lucky you! What a beautiful place to live.
I will ask one more question then ;) To determine the size of the daily dosage, what BG range should I use? Like if it is under 200 don't give 1 unit give 3/4m
Yes I live in beautiful Sydney.:)
The dose of Lantus is based on the nadir (or lowest point) in the cycle, not the preshot BG. And the dose is not changed every day.
I will link the SLGS dosing method below for you to look at but you will see that if the BG drops under 90 at any point, you reduce the dose by 0.25 units. So as Gary has earned a reduction in dose to 0.75 unit he needs to stay at that dose unless he has a failed reduction, or he earns another reduction. And the way to find this out is to test the BGs and add them to the SS and the we can see what is happening.
If however he shows some ketones in his urine, we would need to look at the dose again…with DKA we follow dosing methods but sometimes have to be a bit more aggressive to get rid of the ketones.
Once Gary is no longer on any dry food he can move to the tight regulation dosing method if you like. That is a more aggressive dosing method than the SLGS one.
Here are the 2 dosing methods for Lantus
 
Yes I live in beautiful Sydney.:)
The dose of Lantus is based on the nadir (or lowest point) in the cycle, not the preshot BG. And the dose is not changed every day.
I will link the SLGS dosing method below for you to look at but you will see that if the BG drops under 90 at any point, you reduce the dose by 0.25 units. So as Gary has earned a reduction in dose to 0.75 unit he needs to stay at that dose unless he has a failed reduction, or he earns another reduction. And the way to find this out is to test the BGs and add them to the SS and the we can see what is happening.
If however he shows some ketones in his urine, we would need to look at the dose again…with DKA we follow dosing methods but sometimes have to be a bit more aggressive to get rid of the ketones.
Once Gary is no longer on any dry food he can move to the tight regulation dosing method if you like. That is a more aggressive dosing method than the SLGS one.
Here are the 2 dosing methods for Lantus
So he earns this reduction after just one day of monitoring? The other thing I noticed is my syringes only have whole and half step lines. I can do my best. So his next dose will be 3/4 ? And if he goes below 90 again, we take him down to 1/2?
I will fix my spreadsheet in morning. And thanks again.
 
he earns this reduction after just one day of monitoring?
Yes.
The other thing I noticed is my syringes only have whole and half step lines. I can do my best. So his next dose will be 3/4 ?
Yes To get the 3/4 unit dose try and get 1/2 way between the 1/2 unit mark and the 1 unit mark.
And if he goes below 90 again, we take him down to 1/2?
Yes that is correct. But first I would like to see how the ketones are going. Hopefully none. We would not reduce the dose if there were any ketones, but more about that later if it happens.
Keep posting every day and we can help you.
 
Yes.

Yes To get the 3/4 unit dose try and get 1/2 way between the 1/2 unit mark and the 1 unit mark.

Yes that is correct. But first I would like to see how the ketones are going. Hopefully none. We would not reduce the dose if there were any ketones, but more about that later if it happens.
Keep posting every day and we can help you.
I will get the strips to test his Ketones in morning.
So hopefully will be able to catch urine by his dinner shot. Also will fix my SS. Thanks again for everything.
 
Maybe this will make it easier to understand how to enter numbers on the spreadsheet
About the spreadsheet to make it easier for you to understand
AMPS - means AM Pre Shot the first test you take in the AM that number goes there ,you need to withhold food 2 hours before testing so it's not food influenced

Units is where you would put how much insulin you gave


+1 is one hour after giving insulin if you were to test then that's where you enter his _BG number
+2 two hours after giving insulin. ditto
+3 and so on until you get to PMPS - PM pre shot withhold food 2 hours before testing

+1 same as you do for AM cycle

We don't give times because we are all in different time zones that's why we use the + numbers



You can look at any members spreadsheet to see what it looks like, it's at the end of everyone's signature just tap on it

On the spreadsheet where you put the dates, you just put the dates
Like
11-12 next line under that
11-13 then
11-14 and so on
@Sepi
 
Maybe this will make it easier to understand how to enter numbers on the spreadsheet
About the spreadsheet to make it easier for you to understand
AMPS - means AM Pre Shot the first test you take in the AM that number goes there ,you need to withhold food 2 hours before testing so it's not food influenced

Units is where you would put how much insulin you gave


+1 is one hour after giving insulin if you were to test then that's where you enter his _BG number
+2 two hours after giving insulin. ditto
+3 and so on until you get to PMPS - PM pre shot withhold food 2 hours before testing

+1 same as you do for AM cycle

We don't give times because we are all in different time zones that's why we use the + numbers



You can look at any members spreadsheet to see what it looks like, it's at the end of everyone's signature just tap on it
Thank you . I'm trying to fix the spreadsheet now. It wont let me edit it. I got to it by clicking on the link in my Signature. Maybe I have to find the actual sheet and mke the change there
 
Sorry for delay. Family emergency yesterday. I found it and deleted the data and will reenter.
Thank you!
 
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