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Shadow12345

Member Since 2014
Hello My cats name is Shadow. I have had her since she was 2 weeks old. She has always been healthy no previous medical issues or medications She is 17 year old Female.Currently 5 Pounds. She was just diagnosed with Diabetes Mellitus 2.5 weeks ago. Her BG levels were above 500. The vet prescribed Lantus. She has been getting 1 unit every 12 hours twice a day. Over the past 2 weeks, she got a UTI, and is not showing any positive symptoms No weight gain. She is on low carb wet food- fancy feast classic brand.

THe vet recommended a Glocuse curve Test. I researched it and decided to do it at home. I bought the Relion, at Walmart. And have tested her 3 times today. The first test when she ate at 8:30 AM, her level was so high it just said HI. At 11:30 they came down to 579. 1:30 they came down to 413

Any advice as to what to do.... I think i should increase the dosage and i know to start at .25 but advice or encouragement would be great.....

--- Worried momma
 
Welcome
Starting at 1 unt 2X is god.
I would increase the dose. I myself would increase it to 1 1/2 units. Others here will likely say only increase by 1/4 units (go to 1 1/4 twice daily).
Goo that you are testing the BG at home yourself and that you are feeding low-carb food.
Most of us here test before each shot before eating. Also, one should test between shots. especial when just starting and increasing the dose.
 
I agree with Larry about increasing to 1.5u. Per the Tight Regulation Protocol:

Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Click to expand...
 
Thank you for your advice. I will see how her curve looks by the end of the night and make the adjustment. The website link you gave me has a lot of great information for increasing insulin dosages. I am just worried about her HI levels, they are so HI...
 
As to the meter returning HI levels, there's a joke around here that says it's the meter's way of greeting you. :lol: Don't worry; you'll get there. :YMHUG: Shadow didn't become diabetic overnight so it's going to take some time for her to get into better numbers as well. You're already feeding a good, low carb food, you have an excellent insulin, and you're home-testing already. There's a lot of new information to learn in managing this disease and you've already got 3-for-3 in your favor. ;-)

In the meantime, if you would like to set it up, we use this fantastic spreadsheet for helping us track our BGs and spot patterns as well as to share with others when we're in need of assistance.
 
Hi and welcome.........

I was new here a month ago and learnt a ton here from everyone. I did my own curve here and continue to test on average 8 x day and my only suggestion from what I learnt from here is that to do a proper curve you need to do much more then 3 tests. If you look at my SS from Jan prior to Davidson being on insulin, you will see the amount of BG tests I did from the initial one my old vet did (before I fired him)............I switched to wet food only after the initial old vets DX, and Davidson dropped his numbers significantly............then we started insulin and all I can say is the more tests the better!

It gets easy...........especially with the help from everyone on here.
Shawna & Davidson
 
Okay so Saturday I am going to increase the unit. I have yet to decide on .25 or .50. I plan on reading more information on this tomorrow. However my question is-- I see other peoples spreadsheets (which I am working on mine), and I notice that they change the dosage often, obviously based on the cats BG level. How do you figure out what unit to give?
 
It goes back to the TR Protocol. Based on weight, for most cats the usual starting dose will be around 1u. Increases/decreases are done in .25u increments at a time (unless high, flat numbers and then it's .5u) and doses are held at minimum for three days. Any time a kitty drops below 50 during the cycle, that counts as an automatic dose decrease of .25u. The nadir/low point in the cycle occurs about halfway through (5-7 hours after a shot), although this may differ from cycle to cycle and there is also the possibility of bouncing to take into account. Ideally, this nadir number should be below 100, otherwise a dose increase might be warranted. You also want a dose that is safe to shoot twice a day so if you have to keep skipping shots because the pre-shot number is too low (below 200 for new members), then this might also be grounds for a dose decrease.

General Guidelines
Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

Reducing the dose:
If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. See additional notes in the next paragraph about drops into the 20s and 30s. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.
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Hello,
Please grab some ketostix (purchase -- pharmacy) to check for ketones in your kitty's urine. Best wishes, Sophie
 
sophie said:
Hello,
Please grab some ketostix (purchase -- pharmacy) to check for ketones in your kitty's urine. Best wishes, Sophie
Click to expand...


Hi Yes, I have got some Ketone Test Strips. She has been in the Small, Negative & Moderate Area. I know this is not good. Will this get better when her levels come down
 
Lantus and Levemir are depot insulins and have an established protocol which change doses slowly and by small increments (0.25 - 0.5 units at a time)

ProZinc and PZI are in and out insulins. Some folks may use a sliding scale with these types of insulin.
 
KPassa said:
When did she have them in the moderate area?
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Last week she was moderate. Any ideas on how to collect her urine. Ive tried putting a bag to line her litter, but she gets irritated. Also, I can not find too much information on this Ketones. Help?!
 
See my signature link Secondary Monitoring Tools for some tips on urine ketone testing.

Ketones form as a by-product of fat breakdown for calories. Too many ketones may indicate diabetic ketoacidosis (DKA) which can be expensive to treat and fatal. Two of the 3 types of ketones cause distinctive breath odor like fruit or nail polish remover.
 
Welcome!! (would love to know your name other than worried mama...there are lots of those here...lol) You're in the best place you never wanted to be to help your extra sweet kitty, Shadow!

Is today the first day you've tested at home? Or have you been testing all along but just haven't got it set up on a worksheet yet?

I ask because the way I'm reading your post, it looks like today is the first time you've been testing at home to try to do a curve, and if that's the case, I don't think you should be increasing past the 1 unit twice a day yet.

It takes 10-14 cycles to "fill the depot", and if you haven't been testing until today, or haven't been getting mid-cycle tests, there's no way to know if 1 unit is too little, too much or just right.

For such a small kitty, I think we need to clarify that first

Here are some Urine testing tips with some ideas on how you can get those ketone tests in.

Good luck to you and extra sweet Shadow!
 
Chris & China said:
Welcome!! (would love to know your name other than worried mama...there are lots of those here...lol) You're in the best place you never wanted to be to help your extra sweet kitty, Shadow!

Is today the first day you've tested at home? Or have you been testing all along but just haven't got it set up on a worksheet yet?

I ask because the way I'm reading your post, it looks like today is the first time you've been testing at home to try to do a curve, and if that's the case, I don't think you should be increasing past the 1 unit twice a day yet.

It takes 10-14 cycles to "fill the depot", and if you haven't been testing until today, or haven't been getting mid-cycle tests, there's no way to know if 1 unit is too little, too much or just right.

For such a small kitty, I think we need to clarify that first

Here are some Urine testing tips with some ideas on how you can get those ketone tests in.

Good luck to you and extra sweet Shadow!
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hi my name is Andrea

thanks for replying to my questions!! Shadow has been on 1 unit 2 x a day for 2.5 weeks. she has gotten tested at the vet about 2 times. both reading over 400. yes today was my first day testing at home. I am now very worried about these ketones. I set up her liter with the bag over it. so next time she urinates I can get a better test. is it normal for her to have some small or moderate reading right now with her levels being so high? I mentioned this to the vet and I am now feeling worried and angry that she didn't mention it to be a big deal. I had tried to research this topic before along with everything else butt I couldn't seem to did solid information. now j am concerned :(
 
Hi Andrea!

is it normal for her to have some small or moderate reading right now with her levels being so high?
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Anytime we see high BG numbers like Shadow's, we want to make sure you're testing for ketones. If you get a reading of anything more than a trace, it's an emergency and you should know where an emergency vet is (or your main vet IF they'll come in at any time) because if you get a reading higher than a trace, Shadow will need to be under a vets care for awhile. DKA is expensive to treat and not always successful.

What I had been concerned with was the recommendations to increase to 1.5. I'm not sure that's a good idea because you just started testing at home. The numbers you got at the vet we can pretty much dismiss because the stress of being at the vet can cause the BG numbers to rise...up to 200 points!

I would suggest you stay with 1 unit, every 12 hours, but get as many tests in as you can over the next 3-5 days. At LEAST pre-shot tests and one like at +5 to +7 on the AM cycle, and a "before bed" test on the PM cycle...If you can get MORE than those 4, that's great and will make it even easier for us to know how she's doing. Others may suggest increasing sooner but I'm not sure that everyone understands that you just started testing so we don't have anyway to know how Shadow has been doing on the 1 unit dose.

We really do need you to get our spreadsheet program up and working as soon as possible so we can see the test results as you get them. This will help us to help you on increases and decreases, KPassa had posted the link to our spreadsheet in one of her comments. You just have to get a Google account (If you don't already have one) and use the template we already have. After that, all you have to do is put the numbers into the cells they belong in.

If you can't figure it out, we have people here that can help get it set up for you.

Another thing that would be very helpful is to put some information in your signature line. (like mine says Chris & China White 12yr F/S, dx date 5/10/13, Lantus, etc,etc)

You'd go to the User Control Panel up on the left side of the page

Then go to Profile and Edit Signature

A new box will come up titled "Edit Signature"...this is where you'd put your name, Shadow, age, sex, diagnosis date, What insulin you're using, Which kind of meter are you using, What kind of food you're feeding, as well as any other health history for Shadow. When you have your spreadsheet up and running, the link for that would go here too.

Having all that done will keep us from having to ask the same questions all over again and again.

Let us know if you need help getting the spreadsheet up and going...I'm NOT a computer person, and I was able to figure it out, but it does look kind of daunting if you've never done something like that before!

Keep asking questions too, and read other's posts. You'll learn a lot by seeing what others are asking!

One last thing...Please go back to your first post and remove the 911 icon...choose "None" or the ? instead. We use the 911 for when one of our kitties is having a medical emergency, like a hypo. If you have questions, the ? icon will help get eyes on your posts. Of course you can always use the 911 if there's a medical emergency with Shadow!
 

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Understanding the spreadsheet:

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning pre-shot test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +5 column
and so on.

Halfway across the page is the column for PMPS (evening pre-shot)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

It is merely a grid for storing the info; no math required.
 
Shadow12345 said:
Last week she was moderate. Any ideas on how to collect her urine. Ive tried putting a bag to line her litter, but she gets irritated. Also, I can not find too much information on this Ketones. Help?!
Click to expand...
Here is some information on ketones and here are some more tips on collecting urine.

Chris & China said:
I ask because the way I'm reading your post, it looks like today is the first time you've been testing at home to try to do a curve, and if that's the case, I don't think you should be increasing past the 1 unit twice a day yet.
Click to expand...
Andrea was going to wait till Saturday to do the increase if needed. ;-)
Shadow12345 said:
Okay so Saturday I am going to increase the unit. I have yet to decide on .25 or .50.
Click to expand...
 
Hello All

The past few days have been stressful. I have learned alot about Ketones and am comfortable with the topic. I spoke with my vet about my results from shadows mini curve-- i am having a hard time setting up my spreadsheet, my husband is going to help me with it this weekend
On friday her AMPS read HI

From the conversation with my vet I decided to increase shadow to 2 units. Friday night was her first shot at 2 units
Saturday AMPS read 208. Shadow has never seen any numbers under 400 in 2.5 weeks. I know it was a big jump and i was very nervous I was up all night checking her. My husband is with her all day today checking her. We will check her tonight and see where her levels are. Her Ketones have been at a negative all day yesterday and all day today so far.... I know this is confusing without my spreadsheet :?: scared at this point. But keeping a careful eye.
 
Andrea, I'm very happy you're keeping a close eye on Shadow!

Dosing with Lantus is not based on pre-shot results...It's dose on the nadir (the lowest point in the cycle). It's important for you to get pre-shot tests so you know if it's safe to give insulin at all. We suggest a "no shot" number of 200 for new cats. This does NOT mean you don't shoot, it just means if you get a pre-shot under 200, you should stall, don't feed, and post for help.

The TR protocol has tiny changes in dose for safety as well as to try to find that "perfect" dose. We never suggest increasing a whole unit at a time, although we hear vets tell their clients this quite often...and so many times, we hear from people when their kitties are in a hypoglycemic crisis because of it. I know you trust your vet, but the truth is that most vets just don't understand the protocol and treat their cat patients as if they were dogs.(Diabetes is much more diagnosed in dogs) Most vets may have a handful of feline diabetics through their entire career. As good as your vet might be, there's just no way most vets can keep up to date on the latest treatments for every disease in every different kind of animal they treat. The people here deal with nothing other than feline diabetes, 24 hours/day, 7 days a week, so there's a LOT of experience in treating it at home here...and our number one rule is to be safe. PLEASE get tests from Shadow as often as you can today and if you get a result under 50, please ask for help. (and this is where you'd want to use the 911, but for us to see it quickly, it needs to be "attached" to your first post)

Do you have any test results other than pre-shot or numbers from the vet? We ask that you get at least 4 tests per day. 2 at pre-shot times, 1 at somewhere between +5 and +7 during the AM cycle (+5 is 5 hours after shot, +8 is 8 hours after shot) and 1 test "before bed" on the PM cycle. Of course the more tests you get, the sooner you'll be able to see how Shadow is really doing.

I do not mean to scare you, or in any way upset you, but for a 5lb kitty to get an increase like that can be very dangerous, and I know you only want the best for Shadow.
 
Hi All

We just got a test from Shadow. She hates to be tested we are trying to make it as painless as possible this was my husbands first day at home with her Testing alone.

7:30 amps 208
So 4:30 pm Test result HI

I am very confused. Not sure what happened. Not sure what to do this amps she was 208. I gave her 2 units. 9 hours later she is HI

She is due for a shot at 7:30 pm What do i do if it still HI. I imagine it will be?! Should i dropnit down to 1.5 because some of you said 1 whole unit is too much. Help please
 
What I'd guess happened was that the 2 units caused her to drop way low...possibly even into hypo territory, so her liver kicked in and you're now seeing what's called a bounce.

Bounces happen when the blood glucose numbers drop either too low, or lower than the cat is "used to" and the liver thinks it's an emergency and floods the bloodstream with hormones and sugars to bring it back up fast.

It's "survival mode" left over from when cats lived in the wild...if their blood glucose was too low, those hormones and sugars released by the liver kept the cat alive. With our diabetic cats, their body has become "used to" high numbers, so even bringing their glucose down into "Normal" seems wrong to their liver now. As they get better regulated, the liver will calm down some. It's a matter of getting them used to being in normal numbers again.

It's very important that you slow down. If I were you, I'd go back to no more than 1 unit. At 5lbs, that's already a hefty dose, and since you just started testing, there's no way to know how low that dose has been taking Shadow.

If her number is above 200 at 7:30pm (your PMPS =PM Pre-Shot), I'd go back to giving her 1 unit, and getting as many tests in as you can over the next few cycles. On the PM cycle, we like to at least get a "before bed" test so we know if it's important to set an alarm and get up later and recheck

Edited to Add:
She hates to be tested we are trying to make it as painless as possible
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Most cats just don't like having their ears played with. The actual testing doesn't hurt as there are few nerve endings in the edges of their ears. This will get better! Decide on where you want your "testing spot" to be and as many times a day as you can, take her there and just give her ears a little rub and then give her a small treat, like freeze dried chicken, boiled chicken or any low carb treat she really likes. Soon she'll associate that spot with the yummy treats, and won't pay any attention to what you're doing with her ears. Everyone has the same problem when they first start, and soon, their cats are jumping on the testing spot reminding them it's test time!
 
I LOVE your spreadsheet's name!! That is so great!!

I'd suggest you hold the 1 unit for at least 5 more cycles..Since Shadow is "bouncing", we need to give her body at least 72 hours to clear the bounce. We don't want to increase when they've bouncing, so you just have to hang on and be patient. Now IF you get a test over these next cycles that's below 50, that's an automatic reduction in dose, and when they "break the bounce", they can come down fast.

Get as many tests as you can get. At the very least, a test before each shot, one somewhere mid-cycle during the AM cycle, and a "before bed" test during the PM cycle. We need to see how far down this dose is taking Shadow before we think about increasing, and when we increase, we do it in .25 increments. It really can make a big difference with just a drop or two more or less of insulin. It's very powerful stuff!

If you get a Pre-shot under 200, we suggest you stall, don't feed, and post for help. We just want to make sure someone who's been through it before is with you to advise you.(If you move to the TR Forum, soon that number will drop to 150..and eventually a lot lower)

Since you're testing and have your spreadsheet set up, I'd like to invite you over to the Tight Regulation Forum There you'll get the most experienced users of Lantus to advise you and help answer any questions you may have, and it's also a great way to learn by reading others posts (we call them condo's)

Each day, you start a new condo. You put the date, name, and your AMPS result in the Subject line. In the body of the post, you give the WCR (Whole Cat Report)..How Shadow is feeling, eating, etc....are the 5 P's in place? (peeing, pooping, preening, purring, playing?) Any questions? Any and all information you think would help us to help you. We also want you to put the link to the prior day's post in your first post of the day so people can quickly go back and see what was going on the day before. We're a big family there and watch out for each other pretty closely. Of course you may continue to post in the Health forum if you like. It's totally up to you.
 
hello and welcome to the FDMB, andrea and shadow! good job testing and getting your spreadsheet up already. :mrgreen:

everyone has offered the usual good advice. however, considering shadow has thrown small and moderate ketones recently and in such a short amount of time, i'd like to add a couple of comments.

please test for ketones often... as often as you possibly can since shadow has a recent history of ketones AND you've dropped the insulin dose back down. my own cat is prone to developing ketones. if she's having any problems i try to test her urine for ketones at least once (preferably twice) a day.

the recipe for developing ketones = an insufficient/inadequate supply of insulin + infection, inflammation, or other systemic stress + decreased appetite.

please post immediately if shadow throws as little as trace ketones OR if she appears to lose her appetite, starts vomiting, or anything out of the ordinary. we can share tips and tricks to get rid of ketones before they get worse... including recommendations to immediately increase the insulin dose while monitoring carefully (the usual dosing guidelines are thrown out the window if kitty is throwing ketones).

i don't want to overwhelm you any more than necessary, but getting as much data as your schedule allows will help you figure out if shadow's dose is too high or too low. think of data points as collecting pieces to a puzzle. the more pieces you have... the easier it is to see the whole picture. :mrgreen:


ask any questions you may have. we'll do our best to help you out...
 
just tested shadow +4 she read a 536 still high. her hind legs seem to be very wobbly tonight. Also, she seems always hungry throughout the day. She has been like this for a few weeks now. I have tried to increase her food intake about 1 ounce. But lately she doesn't seem to eat all of it. Probably over the past 2 days. Maybe because I tried to increase the unit too quickly? As to her being hungry throughout the day, what should I do. I don't want her to be starving, and I would like to see her gain some weight. Have yet to get a Ketone test tonight, she hasn't urinated. This AM it was Negative. What should I do when I do get a Trace or Small result, as I fear this is in the near future with her high levels over the past day.....

Thank you :)
 
Shadow12345 said:
just tested shadow +4 she read a 536 still high. her hind legs seem to be very wobbly tonight. Also, she seems always hungry throughout the day. She has been like this for a few weeks now. I have tried to increase her food intake about 1 ounce. But lately she doesn't seem to eat all of it. Probably over the past 2 days. Maybe because I tried to increase the unit too quickly? As to her being hungry throughout the day, what should I do. I don't want her to be starving, and I would like to see her gain some weight. Have yet to get a Ketone test tonight, she hasn't urinated. This AM it was Negative. What should I do when I do get a Trace or Small result, as I fear this is in the near future with her high levels over the past day.....

Thank you :)
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i think the best you can do is continue filling in the picture with data. at this point there's not enough data collected to see a clear picture, but that will change real soon. you're doing great getting more tests!

i don't usually recommend feeding a kitty as much as they want, but in shadow's case... that's exactly what i would do at the moment if she were mine. if she's eating enough it'll help keep ketones at bay. you could also mix as much water in her food as she'll tolerate to keep her well hydrated. is shadow currently eating less than usual?

has anyone suggested Zobaline (methylcobalamin) for weakness in the hind legs?

when shadow throws ketones you'll want to post for help. suggestions for treatment would depend on what symptoms kitty presents, but almost always includes increasing the intake of water and/or administering subcutaneous fluids. other suggestions may include assist feeding and/or adding a bolus insulin to treatment. it really depends on what is happening with kitty at the time. we suggest contacting your vet when kitty throws small, moderate, or large ketones. trace ketones can usually be treated at home if the caregiver's schedule allows.


EDITED TO ADD:
call your vet immediately if kitty becomes lethargic.
 
would zobaline be acceptable to start now even though shadow is not regulated?
as far as food intake we have been feeding her 2 times a day at the times of her shot. in the beginning she would want to eat the whole bowl. now she appears to want to eat half and come back later and finish the rest. I have been taking the good away because I didn't think it would be good for her to eat it during the day. while we are trying to regulate her. I keep a very small amount of dry food out for her.
 
most diabetic kitties do well with small frequent meals fed throughout the day. alex gets 4 meals per day (roughly every 6 hours), but there was a time when i fed her 6 - 8 mini-meals over a 24 hour period. some kitties do well grazing on food left out all day/night. it all depends on the kitty. you'll have to see what works best with shadow.
eventually, you'll want to phase out that dry food. it'll be easier to regulate her without dry food in the picture.
 
Hi Andrea!

You can feed Shadow several small meals instead of 2 big ones with shots. Smaller meals are actually easier on the pancreas than large meals are. The only time we suggest taking food away is for the 2 hours prior to shots so that the pre-shot test isn't influenced by food.

You could split her big meals into 2-3 small meals and spread them out more, which also gives you more opportunity to add water into the food. The more water you can get her to accept, the better. Some people try to feed all the food before +6 so when the insulin is starting to "wear off", you're not adding food, but others feed at shot times, and then 2 or 3 small meals through the entire cycle(like +4 and +8). As you test Shadow more, you'll see how she reacts to food as well as insulin, and then you'll have a better idea of which feeding program works best for her.

If at all possible, I'd go ahead and remove any dry food from the picture. Since it's so high in carbs, it's adding fuel to the fire when we're trying to control it.

If your schedule doesn't allow you to be home all day to feed, you could look into getting an auto-feeder which you can set to open when you want to feed, or you can make "food-sicles" by mixing food with water, putting it into an ice cube tray and freezing. Cats don't generally eat what they can't smell, so until it thaws, most cats won't be interested so that's another option for having food for Shadow when you can't be there to feed.
 
Chris & China said:
If at all possible, I'd go ahead and remove any dry food from the picture. Since it's so high in carbs, it's adding fuel to the fire when we're trying to control it.
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hmm... i dunno. shadow is only 5 pounds. the guidelines in the TR protocol (an aggressive method) suggest an initial starting dose of 0.25u per kg of ideal weight which in this case comes out to an initial starting dose of 0.575 lantus (round down to 0.5u). zeroing in on the right dose for shadow could be tricky because of her issue with ketones and further complicated by the possibility glucose toxicity has set in because the starting dose was too high as well as the effects of the dry food being at play.

if you take the dry food away abruptly and without more data in hand you might want to make sure you're able to monitor closely. my concern is the dry food may be what was keeping shadow from dropping too low on the 1u dose, but there's no way of anyone knowing for sure without the data to back it up. however, safety is always our #1 priority around here. i'd exercise caution if for no other reason than to be on the safe side.

fwiw, just my thoughts...
 
Jill & Alex said:
Chris & China said:
If at all possible, I'd go ahead and remove any dry food from the picture. Since it's so high in carbs, it's adding fuel to the fire when we're trying to control it.
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hmm... i dunno. shadow is only 5 pounds. the guidelines in the TR protocol (an aggressive method) suggest an initial starting dose of 0.25u per kg of ideal weight which in this case comes out to an initial starting dose of 0.575 lantus (round down to 0.5u). zeroing in on the right dose for shadow could be tricky because of her issue with ketones and further complicated by the possibility glucose toxicity has set in because the starting dose was too high as well as the effects of the dry food being at play.

if you take the dry food away abruptly and without more data in hand you might want to make sure you're able to monitor closely. my concern is the dry food may be what was keeping shadow from dropping too low on the 1u dose, but there's no way of anyone knowing for sure without the data to back it up. however, safety is always our #1 priority around here. i'd exercise caution if for no other reason than to be on the safe side.

fwiw, just my thoughts...
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Shadow dropped to 208 when we upped her dosage to 2 units per the VET. I'm not sure if you saw that on her SS
As far as the dry food goes, if everyone suggests to completely remove it, I will do that over the next 3 days. However, she barely nibbles on it, MAX amount of bits eaten AVG @ 10-13 a day. And I understand that every bit helps. That would be great if this did too!

Thank you to everyone that has taken the time to post on my questions and help Shadow & I.
 
Edited to Add:
Most cats just don't like having their ears played with. The actual testing doesn't hurt as there are few nerve endings in the edges of their ears. This will get better! Decide on where you want your "testing spot" to be and as many times a day as you can, take her there and just give her ears a little rub and then give her a small treat, like freeze dried chicken, boiled chicken or any low carb treat she really likes. Soon she'll associate that spot with the yummy treats, and won't pay any attention to what you're doing with her ears. Everyone has the same problem when they first start, and soon, their cats are jumping on the testing spot reminding them it's test time!
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Last night we boiled some chicken and put in a tupperware for Treats. We picked a Shooting Spot and are trying to associate that area with the treats! Thanks for the encouragement. Shadow loves to be cuddled and rubbed, the ears touching isn't the problem per se. Practice makes perfect :smile:
 
Chris & China said:
Hi Andrea!

You can feed Shadow several small meals instead of 2 big ones with shots. Smaller meals are actually easier on the pancreas than large meals are. The only time we suggest taking food away is for the 2 hours prior to shots so that the pre-shot test isn't influenced by food.

You could split her big meals into 2-3 small meals and spread them out more, which also gives you more opportunity to add water into the food. The more water you can get her to accept, the better. Some people try to feed all the food before +6 so when the insulin is starting to "wear off", you're not adding food, but others feed at shot times, and then 2 or 3 small meals through the entire cycle(like +4 and +8). As you test Shadow more, you'll see how she reacts to food as well as insulin, and then you'll have a better idea of which feeding program works best for her.

If at all possible, I'd go ahead and remove any dry food from the picture. Since it's so high in carbs, it's adding fuel to the fire when we're trying to control it.

If your schedule doesn't allow you to be home all day to feed, you could look into getting an auto-feeder which you can set to open when you want to feed, or you can make "food-sicles" by mixing food with water, putting it into an ice cube tray and freezing. Cats don't generally eat what they can't smell, so until it thaws, most cats won't be interested so that's another option for having food for Shadow when you can't be there to feed.
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Interested in trying Foodsicles! I know she would love smaller meals, beacuse she would feel like she is getting more food. About every 3-4 hours she is hungry and could eat appx 1 ounce. I just get nervous how the food will interact with her insulin. But I understand this too we have to monitor! Thanks
 
Chris & China said:
I LOVE your spreadsheet's name!! That is so great!!

I'd suggest you hold the 1 unit for at least 5 more cycles..Since Shadow is "bouncing", we need to give her body at least 72 hours to clear the bounce. We don't want to increase when they've bouncing, so you just have to hang on and be patient. Now IF you get a test over these next cycles that's below 50, that's an automatic reduction in dose, and when they "break the bounce", they can come down fast.

Get as many tests as you can get. At the very least, a test before each shot, one somewhere mid-cycle during the AM cycle, and a "before bed" test during the PM cycle. We need to see how far down this dose is taking Shadow before we think about increasing, and when we increase, we do it in .25 increments. It really can make a big difference with just a drop or two more or less of insulin. It's very powerful stuff!

If you get a Pre-shot under 200, we suggest you stall, don't feed, and post for help. We just want to make sure someone who's been through it before is with you to advise you.(If you move to the TR Forum, soon that number will drop to 150..and eventually a lot lower)

Since you're testing and have your spreadsheet set up, I'd like to invite you over to the Tight Regulation Forum There you'll get the most experienced users of Lantus to advise you and help answer any questions you may have, and it's also a great way to learn by reading others posts (we call them condo's)

Each day, you start a new condo. You put the date, name, and your AMPS result in the Subject line. In the body of the post, you give the WCR (Whole Cat Report)..How Shadow is feeling, eating, etc....are the 5 P's in place? (peeing, pooping, preening, purring, playing?) Any questions? Any and all information you think would help us to help you. We also want you to put the link to the prior day's post in your first post of the day so people can quickly go back and see what was going on the day before. We're a big family there and watch out for each other pretty closely. Of course you may continue to post in the Health forum if you like. It's totally up to you.
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We will post under here today. Looking forward to it. Thank you for the direction! I tried to figure this out on my own but just wanted to be clear--- 1 cycle is 1 day with 2 shots in it? So 5 cycles would equal 10 shots?
 
Hi Andrea,

Thanks so much for getting your SS up and running and putting some data into your signature.

Since Shadow is such a tiny kitty, I think that would be important information to have in your signature, along with the fact she is prone to ketones. That information would alert us to these critical pieces of information and allow us to give you better suggestions on how to manage the diabetes for her.

We definitely want to help you keep her safe.

I'm not sure I'd remove the dry food unless you can get her to eat more of the wet food. I think she needs the extra food and calories to help her gain back some badly needed weight.

Do you think she would eat more of the wet, if you left it out for her to nibble on or free feed during the day?
 
good morning, andrea!

Shadow12345 said:
Shadow dropped to 208 when we upped her dosage to 2 units per the VET. I'm not sure if you saw that on her SS
As far as the dry food goes, if everyone suggests to completely remove it, I will do that over the next 3 days. However, she barely nibbles on it, MAX amount of bits eaten AVG @ 10-13 a day. And I understand that every bit helps. That would be great if this did too!
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yes, i did see that 208 and the increase to 2u suggested by your vet on shadow's spreadsheet. what a beautiful sight to see amongst the higher numbers! as the days go on data collected will offer more insight into shadow's numbers. it's possible she'll require 2u bid or more of insulin... or she may require less. time and your meter will tell. :-D

while gathering data initially, generally i like keeping things consistent before making too many changes. however, removing the dry gradually over the next few days while monitoring sounds fine. at this point, it's hard to tell how much of an impact 10 - 13 pieces of dry food has on her numbers. it all depends on if she's carb sensitive or not. a little bit of dry food may not affect some kitties much at all. otoh, all some kitties have to do is look at a few pieces of dry food and their numbers soar! :lol:

the stickies (posts marked with a star) at the top of the "Topics" section in the Tight Regulation group have a ton of information about lantus and levemir... much too much to absorb at once, but are well worth reading. when i put them together, i tried to include as much information and reference material you'll need on your journey with shadow. you'll probably find yourself referring back to them when needed.




for those following along, here's andrea's thread in the Tight Regulation group today: Shadow AMPS 575-- 1st post here!.
 
Oh good! Glad to see that Andrea is posting over in Lantus TR forum. I think it's the best place for her to be right now and she'll get wonderful help over there.
 
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