? New Member - URGENT DROPING FAST NEED TO SHOOT OR NOT

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Shawna & Davidson (GA)

Shawna & Davidson (GA)

Member Since 2014
Hi L&L members.....

My Vet referred a client to me last night, who was here this morning and needs HELP WITH DOSE, ETC. She does not have a computer, but her mom does and she has been given a quick 1 hr review from me on dosing, SS, food, and testing..........she has my extra Reli-On Prime meter, lancets and test strips for 5 days of testing. With her working full time I suggested SLGS method and not the TR due to not being able to test at all during the day.

BG TEST 6/24 at 08:40 am est - 493 / 27.3

Tonight she will test thru the night at PMPS each hour or so in order to get BG numbers to catch Nadir, and is aware of no food for 2 hrs prior to test/shot time.

What I know: Male, 11 yrs old, 14.7 Lbs, Vet Prescribed Caninsulin 2.5u twice daily

DX Feb/18, full blood work done and no known issues other then FD (she's getting records), no Ketones
Shot time is 07:00am _ 17:00pm
Drinking over 1 liter/quart water per day min. and peeing tons
Difficulty feeding (told to use HC with gravy - now LC FF from today) and uses a syringe when kittie doesn't eat
Has gone into HYPO (shivering, lethargic, almost coma) and she's not sure why (now knows symptoms)

She has the FDMB sites and will read up tonight.


QUESTIONS:
Should she change to Lantus or keep using Caninsulin
What dose is recommended with BG at 493

I've suggested she read up as much as possible, get lots of tests, make a profile and detail her cats records asap.............hopefully she will do this within a day or two so that those with experience can chime in and assist.

ANY FEEDBACK I CAN GIVE HER IS A HUGE STEP CONSIDERING HER VET DID NOTHING FOR HER.
 
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I use the One Touch Ultra 2. The strips are 100 for around $70.00. I have never received what I would call a false reading; the strips are very sensitive and if there isn't enough blood it gives you an error message instead of a false reading. I didn't do any research on meters/strips though...our vet actually picked everything up for us on the way to teach us how to test.

I have no experience with any insulin other than Lantus; Boomer has always done well on Lantus.
 
Hi Sienne;

What she needs is guidance as to the correct dose at this time, she's using my meter for now and I may get her one from USA when I'm there (weekly) and/or if she should switch to Lantus? Which format to follow based on her schedule........BG seems really high considering been DX since 2/18 - then again with vet telling her to just do 2.5u twice a day doesn't give opportunity to regulate.
 
Meters are free in Canadian pharmacies when you buy 100 strips. All test strips in Canada are expensive, generally around $70 - $80+ for 100 strips. Check a variety of pharmacies including Costco and Walmart. Shoppers Drug Mart is usually pricier but the Seniors' Day 20% off program helps a lot as well as cashing in points on test strips. I almost never pay much for strips because I shop there on Seniors' Day and use points to pay for them. If the new person is too young maybe an older friend or family member could shop for her. I use a Freestyle Lite meter but there are a variety to chose from. I like mine because it takes only a minute drop of blood to give a reading.

Caninsulin can drop BG hard and fast so going from a high PS to a hypo is quite possible if the dose is too high. The goal at nadir with Caninsulin is numbers in the 90 to 110 range to keep a margin of safety. The curve will almost always be very deep. Onset is fast so a user should wait at least 20-30 minutes after feeding kitty before injecting insulin. Nadir generally falls between +4 and +6 hours and it can wear off by +8 or +10 in some kitties. It's an economical insulin to use and that might be why vets prescribe it.

Lantus can be bought over the counter in Canada. Again, check prices at various pharmacies. A pack of 5 cartridges can be around $100, slightly more or slightly less depending on where you buy them.
 
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Thanks Kris.........I'll pass this info onto her (Rebecca) when she calls me tonight..........hopefully she can start her own thread and get replies directly related to her kitties needs. She can test with my 'stuff' until Thurs. when Shopper's has the 20% discount (her mom will go for her) and she can decide if she wants to stay on Caninsulin or make a swith to L or L............
 
Hi to all

Rebecca just called me again and apparently she doesn't have a computer, no access to one and works daily so she will not be able to post here (or in the Caninsulin area) so I've printed everything out the "Beginner's Guide to Caninsulin" and will get it to her.

*** Darcy had a BG of 36 this morning and is on 2.75 Caninsulin..........VERY LOW so I told her to go home and give HC food and decrease to 2.5u tonight. He's been that low several times and I'm not familiar with Caninsulin and can only suggest to her what I do for Lantus.

QUESTIONS:

Does the Caninsulin work the same way, so can she follow the TR with that insulin or at least follow what we do with the charts & BG numbers to reduce or increase accordingly? If someone can send me the links I will print it all out for her, keep in mind I don't know who she is and don't have the time to do all the work for her. If I can help by passing on some info then that would be great, as she already has received info and I showed her how to home test and she's dropping off those records tonight so I can at least see them.......

Do you think she should change to Lantus? She bought a meter (not sure the type) and is testing as often as she can and giving the shot twice daily - so that's good, and has 1 month left of Caninsulin

Should I print out the TR or Hypo Sheets?? Are these the same for all insulins or just Lantus?

Any help I can pass along will obviously benefit her cat Darcy.

Thanks and sorry for not knowing about this - it was hard enuf learning about TR and Lantus for Davidson
Shawna
 
Short answer, she should change to Lantus. More later. We have a dosing guide in another forum for Vetsulin/Caninsulin is she wants to use it for a while.
 
UPDATE: using "1 Touch" meter (Canadian) which I've never heard of......told her to switch to ReliOn cuz way cheaper for test strips

Today's BG tests:
07:00am test 201
+3.75 - 36
+4.5 - 36

Told her to feed and leave HC food out - she returns at 5pm (17:00) to check and PMPS is 7pm (19:00) and will test again...........I've printed out the Hypo sheets, Hypo Tool Box..........
 
FYI: the ReliOn meters aren't available in Canadian Walmart stores. If she's in Canada it's better to stick to a meter she can buy strips for on short notice. All strips are very $$ in Canada. It's the insulin we get a lot more cheaply.
 
Kris & Teasel said:
FYI: the ReliOn meters aren't available in Canadian Walmart stores. If she's in Canada it's better to stick to a meter she can buy strips for on short notice. All strips are very $$ in Canada. It's the insulin we get a lot more cheaply.
Click to expand...

yes, I know that but we live on the border and I'm in USA 3-4 times a week and she doesn't have $$ and is now paying $75CAD for 100 strips and I can pay $20CAD for 100 ReliOn...... Thanks for your concern and feedback
 
Shawna & Davidson said:
yes, I know that but we live on the border and I'm in USA 3-4 times a week and she doesn't have $$ and is now paying $75CAD for 100 strips and I can pay $20CAD for 100 ReliOn...... Thanks for your concern and feedback
Click to expand...
I saw that you're in Ontario. I didn't realize the person you're helping is close to you so you can shop in the US for her. :)
 
Morning to all....................I've got her to switch Darcy to Lantus starting tonight at 18:30 hrs

INFO: Darcy is 14.9 lbs, was on Caninsulin and huge bounces daily incl. going to Hypo numbers (tho no signs of any symptoms of effects of it) a recent as yesterday. Had her reduce dose daily and this morning gave him 2u Caninsulin

7/20 BG on Cansulin 396 @ +11:45 (05:45am today)
AMPS 430
+.5 - 403
no ketones present today

QUESTION for her:
-what should she start Darcy on for a dose with Lantus? Would 2u be a good start?
-as a newbie, should she still reduce if Darcy falls under 50

I'm helping her out on the phone since she has no computer or access to one or internet...........I've printed out everything and anything off this site and she's aware and feeding FF, no carb treats, she's reading and familiar with the Hypo, tool box, etc. and I've convinced her to take a day off work tomorrow so she can do a Lantus curve with testing at amps. +1 and then every 2 hrs until pmps. I have no idea which format she is following as she works all day and does not have a break to come home.

Please provide your comments or suggestions as she's calling me prior to pmps and I want to get her started in the right direction with a dose that works.

Thanks in advance,
Shawna
 
I think it is wonderful you are helping her! Sorry I don't know about starting dose with previous use of a different insulin. With a recent change to Lantus, she might need more time to build and stabilize the depot before a curve would be valuable. Also just wanted to double check to make sure there is no confusion re: U40 and U100. :bookworm:
 
Thanks Carol.........okay on the curve - ANYONE think it's early as she has to take a day off work and would rather it be when it's benefits the cat.

She's buying the 3ml ultra thin needles, exactly what I have...........plus Lantus pens
 
I’ll go out on a limb and suggest the usual starting dose for newly diagnosed cats - 1 u. It’s a good starting point and given the frequent hypo numbers recently should be safe. It’s a whole new world with Lantus.
 
Shawna & Davidson said:
what should she start Darcy on for a dose with Lantus? Would 2u be a good start?
Click to expand...

At 14.9lbs, the starting dose would be 1.6U so I'd probably recommend 1.5 to start with.

Shawna & Davidson said:
as a newbie, should she still reduce if Darcy falls under 50
Click to expand...

Depends on which dosing method she uses.....on Tight Regulation, reductions are earned if they drop below 50 on a human meter.....On Start Low, Go Slow, reductions are earned when they drop below 90

Question.....what food(s) is she feeding? Is there ANY dry in the picture?
 
Tnx Chris

No dry at all, I got her onto FF all Pate, with some MC and HC FF for when Darcy went low hypo numbers on the Caninsulin.

She gave him 1u at 18:30 tonight and will call me with the BG test tonight and tomorrow and I told her how to increase from the SLGS method which is best for her due to 2 jobs and crazy hours.

Also, told her to do the curve Wed. and not tomorrow as that was the Caninsulin will be out of Darcy's system and the Lantus will have a few days to get into the system and form a depot. Then she can get some good tests and see where the Nadir is.

The good thing, is she's reading the zillion pages I printed for her, she's asking lots of questions and seems to understand much of it, which as we all know is over whelming at first.

She can give an increase in the morning if the numbers are still very high and get up to the 1.5u by tomorrow night
 
HI Everyone

Thought I’d update you on how Garfie, the new member I’m helping offline is doing. Well started the Lantus and at 1U and he earned a reduce alreadyand today had a 52. Since DH is not home during the day and only gets 2 tests in at amps time, I suggested she reduce again tonight instead of not shooting since she is there and I am on the phone with her. Garfie is no longer in the reds or yellows and into the blues and greens and safe.

The full 12 hr curve is being done Wednesday when DH took the day off.........so we’ll see when the nadir is. Garfie is doing great, and responding very well to the Lantus compared to the Caninsulin - not sure why vets give it, as it does not produce the results. Im getting the BG tests daily and watching over to insure no danger zones, and I’m a phone call away for urgent or frantic situations, haha that we all experienced. I’ve convinced her to come home for a quick test during the day and she’s doing that if at all possible, so at least can see what’s happening.

Unless Garfie drops below 50, I’ll keep this does for 10 cycles.......or more, and if I need help I’ll start a separate post. Unfortunately she doesn’t have a computer or internet and I don’t have the time to maintain her SS, it’s a lot of time helping her as I am, but I too was in her shoes and got the help over the phone at the beginning and don’t mind as I’m around or at least my phone is always attached to me, lol.

Thanks for the suggestions, she’s so happy her kittie is getting better and hopefully can get him into remission...

Shawna
 
Okay, so all going well and I guess the Caninuslin is out of the system and now on Lantus since July 20th afternoon ..............Garfie was put on 1u and then had some scary low BG's and earned reductions or at least I dropped the dose to keep him safe and now at .25 units since he was very low several times and didn't want to risk a hypo while DH went to work............

FOLLOWING SLGS method starting today and she's doing a 12 hr curve today too. Here are the BG tests from the past couple of days

NEED TO FIND THE CORRECT DOSE AT THIS POINT TO START IN THE RIGHT DIRECTON.......weight today 14.6lbs today


July 23th
amps 135
+2 - 171
+5.5 - 124.2
+11 - 52.2
pmps 63
+1 - 52.2
+2 - 61.2
+3.5 - 66.6
+5 - 81
+9 - 91.8

July 24th
amps 102.6
+2-153
+3-129.6
+6.5-147.6
+11.5-421.2
pmps 419.4
+1- 426.6
+3-367.2
+4-354.6
+6-363.6

July 25th - curve day
amps 370.8
+1 - 408.6
+2 - 347.4
+4 - 279

Looking at the above, I understand the bounces are due to change in insulin and also reducies each day...........and I believe she should keep the same dose of .25 for a few days while the depot fills............HOWEVER, if you think he should be increased based on the BG numbers above please let me know. She is aware of the SLGS method and will follow it as per the decreases/increases and days on that dose.........she now has a computer with internet but not sure if she will post here, although I told her too as I don't have the time to do all this for her when I have Davidson to look after and my own life (as we all do). She's learning and I'll help her, but can't do all the work for her as she is aware.

THANKS FOR YOUR HELP IN GETTING HER GOING...............Garfie seems to be doing well with the changes, now just to get the dose correct and I believe the rest is easy since she's doing the testing as much as possible.

Shawna
 
BUMP............anyone with a suggestion on the dose if needed to be changed at tonight's pmps - or leave it for a few days for the kittie to stabilize a bit more since new to Lantus.
 
Need help with the memeber - does she shoot the .25u or stall and wait 30 min, as this is his 6th day on Lantus and I know it says not to shoot when this low.

Shot time is at 18:00 and I wonder if she should shave the dose as he's bouncing and therefore continues to drop.


july 25th - curve day
amps 370.8
+1 - 408.6
+2 - 347.4
+4 - 279
+6-221.4
+8-129.6
+9-120.6
+10-108
+11-99

What do you suggest this new member does?
Rgds
Shawna
 
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Wendy, pls see above have a typo and corrected it

Maybe stall 30 min and then see if he drops still, if he drops don’t shoot? She is home all night, but tomorrow works all day
 
I am reading go slow and it reads to me like he drops under 90 then drop 0.25 unit. But he is only on 0.25 and it hasn’t been a week on Lantau yet
 
Correct, I saw that and that’s why I posted....perhaps shave the dose in half? Or don’t shoot and see what he does in the morning. I don’t even think he build the depot as he started on 1 unit a week ago, then has dropped 3 times Inc dose due to really low numbers.
 
I'm making an assumption that this is a human meter. Is that correct?

Keep in mind that there's a 20% variance in any test. So there's really no difference between the 108 and the PMPS of 91.8. That said, for someone who's kitty is new to Lantus, this is anxiety worthy territory.

Does the new person have the flexibility to be off schedule? I'm guessing from the earlier posts that she has high carb food/syrup and extra strips. If you didn't check on this, please make sure there are supplies on hand.

The options are:
  • stall (don't feed) and retest in 15 - 20 min and repeat until the numbers are rising spontaneously;
  • shoot a reduced dose -- probably a 0.1u dose. Remember, though, that the depot may come into play and there's no guarantee that the dose reduction will have an effect this cycle;
  • skip
If numbers have been dropping over several days and the CG is exhausted, skipping may have the effect of depleting the depot a bit so she can get back on track without panicking (as much) over low numbers. I'd lean toward skipping because this is a bounce breaking and there's a lot of momentum behind the dropping numbers. Shooting a dropping number is not something I would recommend, especially not to someone who is new to this process.

Shawna -- did the CG make a big shift in what she's feeding her kitty? This can happen when someone makes the complete shift to a low carb diet.

 
Hi Sienna/Wendy

Thanks for you reply....yes a human meter and she does not have the flexibility in her schedule as works and leaves 07:30 each day and returns at 17:00 with a possible fast trip mid day to test.

When I met her 3 weeks ago she was on Caninsulin and kittie was close to hypo numerous times, so she was taught about a Hypo kit and all the symptoms....no hypo and kittie handles low numbers very well. She has everything for hypo and is aware of the vets in the area, and I’m here and 2 minutes away.

Did another test now and it was 97.2, no real change but slightly up. No food yet tonight and still stalling

3 weeks ago she changed to FF from dry food and or wet with high carbs.....so I think food change has already taken effect and has had no other food in that time, plus freeze dried chicken treats only.

I think skipping would be best option, although she is aware of the testing and making great notes which she sends me twice a day, or when I ask,,,,,,I taught her what to do in event of a hypo, yet it may be better to start tomorrow and let the depot build again.

?? If kittie keeps rising tonight and gets back into the 200 and more what dose should she do for the morning - .25? I’m communicating with her in the early morning since I’m shooting Davidson at that time, she knows to call me if urgent otherwise i get texts all the time of the BG tests.

Thanks...
 
Ok, sounds good....I will tell her to skip tonight totally and test as usual as he just went up a bit to 100.8 at +.5
BTW, she isn’t panicking just isn’t sure what to do and I haven’t seen this before where give a shot in the AM and kittie drops over 12 hrs consecutively. I see it now thought, lol........I’ll advise her to shoot .25 as long as it’s in the realm of the SLGS
 
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