New Members Heidi & Cheddar

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Cheddar's Mom

Cheddar's Mom

Member Since 2023
Hi! Boy I wish I had found this group a few years ago! Cheddar was diagnosed around Thanksgiving 2020. He was 13 1/2 at the time, 16 years old now. We had just switched vets because of abuse from the last one, and the first thing he did was check blood and urine. If we had followed the previous vet's advice, Cheddar would have surely died. I was relieved to hear he was diabetic because that's something we can deal with! Unfortunately, I didn't get a lot of info on how to care for him, other than give him an injection of Novolin every 12 hours. Food didn't matter. He was on a grain-free canned food diet anyway, so I didn't change anything. Now I know better! I'm mixing low carb food in to gradually switch him over. I have learned soooo much from all of you here! I went out and bought a meter and started home testing. I wanted to wait to post my first message until I had something for you to look at in his SS.
One question I have is how often do you do glucose checks at the vet's when you're home testing on a regular basis? We have been going every 3 months. I never felt comfortable with checking that seldom, but from the beginning we were discouraged from home testing. Better late than never I guess!
Cheddar has difficulty walking and can't jump up onto the couch/bed anymore. My husband built a nice set of steps for him to get up onto the bed and he can manage that. We thought it was age-related, but now I'm betting on neuropathy. I started mixing B12 into his food. He also started drinking a ton of water a few months ago. About 24 ounces every 36 hours. Is that something that can get better as his glucose stabilizes?
If you have any suggestions for how I can better support his glucose fluctuations I would appreciate it. What kind of numbers are we shooting for throughout the day?
Thank you!
 
Cheddar's Mom said:
Hi! Boy I wish I had found this group a few years ago! Cheddar was diagnosed around Thanksgiving 2020. He was 13 1/2 at the time, 16 years old now. We had just switched vets because of abuse from the last one, and the first thing he did was check blood and urine. If we had followed the previous vet's advice, Cheddar would have surely died. I was relieved to hear he was diabetic because that's something we can deal with! Unfortunately, I didn't get a lot of info on how to care for him, other than give him an injection of Novolin every 12 hours. Food didn't matter. He was on a grain-free canned food diet anyway, so I didn't change anything. Now I know better! I'm mixing low carb food in to gradually switch him over. I have learned soooo much from all of you here! I went out and bought a meter and started home testing. I wanted to wait to post my first message until I had something for you to look at in his SS.
One question I have is how often do you do glucose checks at the vet's when you're home testing on a regular basis? We have been going every 3 months. I never felt comfortable with checking that seldom, but from the beginning we were discouraged from home testing. Better late than never I guess!
Cheddar has difficulty walking and can't jump up onto the couch/bed anymore. My husband built a nice set of steps for him to get up onto the bed and he can manage that. We thought it was age-related, but now I'm betting on neuropathy. I started mixing B12 into his food. He also started drinking a ton of water a few months ago. About 24 ounces every 36 hours. Is that something that can get better as his glucose stabilizes?
If you have any suggestions for how I can better support his glucose fluctuations I would appreciate it. What kind of numbers are we shooting for throughout the day?
Thank you!
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+
Hi My name is Mayte, I myself new to this web site, since a week ago, it has been a life changer, my kitty is 10 years old diagnosed 2nd of this July, I panicked, I've' never been sick nor my children, he was hospitalized for 5 days. If not for this forum I found about last week, I would have lost it.
You asked on checking the glucose, you kow I am using the FREESTYLE2 MONITOR AND SENSOR
The sensor it's placed in the middle of back,( you have to shave the area) the monitor tells all graph, low/high glucose, time in target, dose increase/decrease, I don't need to go to the vet or pinch him, Its the bomb look it up it's for humans but the emergency hospital I took him to, they recommended it, he left with it on, now, the sensor only last 14 days, but you can change it yourself, the cost at Walmart is $31.00 each you get a prescription from your vet for monitor ($87.00) one time cost, and a prescription for the sensor also PRN
make sure is a PRN prescription that means is good for 1 year you can buy them in two's I buy them in threes because sometimes they do stop working before the 14 days (the monitor tells you) and you have to call customer service and they send you a replacement at no cost within 48 hours, you'll love it, the monitor also sends alarms, for low glucose/high and time to check it's awesome. I hope this works and saves you money on Vet bill that they always invent something to charge more, if you go thru the forum here you will see that they explain everything even advancing glucose home check rather than the vet. Its' a great support system, wishing you the best with your furrr baby
 
Hi and welcome!

Thank you for setting up your signature and spreadsheet, it’s super helpful!

I never went back for vet checks once I started home testing and following the advice here. So that’s totally up to you.

I do want to point out that novolin is not the best insulin for cats. It’s a harsh and short lasting insulin and you need to make sure your cat has eaten at least an hour before the shots. I would suggest asking your vet about switching to a better insulin like Lantus or prozinc. You may want to share the guidelines from the American Animal Hospital Assn for the treatment of diabetes in both dogs and cats. the AAHA no longer recommends it for treating feline diabetes.

as for the neuropathy, Minnie had it too and it’s common for unregulated cats to develop. It does get better once your cat gets regulated and the methyl b12 helps but only once the diabetes is under control. Is that the b12 you’re using? The drinking and the peeing will get better too.

how often are you feeding him right now?

We are happy to help you with setting up the spreadsheet, sorting out what food to buy, how to transition safely to a low carb diet, how to learn to home test and much more. This is an excellent site for diabetic cats…it has been around for more than 25 years and has very experienced people to help you.

Keep asking lots of questions!
 
Just looked at your spreadsheet, I would stick with the .75 dose and not increase to 1 after that 66. I would go back to .75 in the am if I were you, especially with that lower than 200 pmps you got. Can you get a +2 tonight to make sure he doesn’t go too low? @Bron and Sheba (GA) agree?

It would be good to get a +2 every night if you can especially with novolin
 
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Here’s the link to the novolin sticky note. Make sure you read it all especially the part about dosing:

https://felinediabetes.com/FDMB/threads/beginners-guide-to-humulin-n-novolin-n-nph.231593/


“Increasing the Dose
  • If, after at least a week and having gotten a curve, the dose doesn’t seem sufficient, a dose increase should be considered. Doses are increased by no more than 0.25u.
  • Increasing doses of N/NPH needs to be done with great care. If you are new to using N/NPH, post on the board for advice if you are considering dose increases for your cat. If in doubt, consult your vet.
Decreasing the Dose
  • If your cat’s BG drops to 90 or below, it’s time to reduce the dose,
  • Reduce the dose by 0.25u.
  • There are some situations which signal that a larger than usual dose reduction is needed. If you are unsure, please post on this forum or the Health forum and ask for input about your dose.”
Cheddar is a great name btw :)
 
Thank you for all the advice!
I've read all the info on Novolin and researched the other brands. Unfortunately they are all at least 4x more expensive! I'm hoping to be able to get better control of the curve while we finish the current vial. If not, then I'll have to figure out a way to afford the other one.
What is the range that would be considered good for a diabetic cat? I was thinking (according to the color code on the SS) upper half of green to lower half of blue? He had a pretty good run the last couple of days on .75 or 1 unit, but this morning he was 335. My thought is to give him 1.25 units when it's over 300. I just fed him, and his dose will be in about an hour. Is it ok to fluctuate his dose within that range (.75-1.25) depending on the BG reading? I'm trying to gauge it by looking at the pattern emerging in the SS.
Thanks again!!!
 
To answer your other questions:
Yes, methyl B12 is what I am giving him. He's working up to 2000mcg, and then will increase to 3000mcg. Hopefully he'll be more regulated soon and we'll see some improvement. Per information I found on this site.
I feed him his main meals twice a day, an hour before insulin shot. He doesn't usually eat it all at once... he's more of a grazer. He has a few bites of deli turkey when I'm testing his blood, and I give him small snacks throughout the day whenever he tells me he's hungry. Luckily I work from home and am usually around all day to cater to him. I'm still mixing a little of his previous food with the new low-carb food. He was on a canned grain-free diet before, but now I know they are higher in carbs than I thought!
I'll try to start doing a +2 reading in the evenings now too.
 
Welcome to FDMB!

Depending on where you were pricing insulin, glargine (the generic/biosimilar for Lantus) was released not all that long ago. The price for Lantus (not the generic) is astronomical. Members would frequently purchase their Lantus from Canada at about 1/3 of the price here in the US. If you price out the cost for glargine on a site like GoodRx, a box of 5 pens runs anywhere from $80 - $200. The prices vary from city to city. My cat was initially prescribed Novolin (many years ago) when she was hospitalized. My regular vet commented that it was a very good insulin for dogs. Novolin does not offer the kind of duration that a cat needs because their metabolism is much faster than a dogs. It can also drop numbers very hard and fast.

I also want to strongly encourage you to get at least one test every night in addition to your PMPS test. Dosing is based on how low the dose brings your cat's numbers. Without the PM tests, you're missing half of your data. You have no way to know if Chedder is dropping into numbers that would warrant a dose reduction.
 
Sienne and Gabby (GA) said:
Welcome to FDMB!

Depending on where you were pricing insulin, glargine (the generic/biosimilar for Lantus) was released not all that long ago. The price for Lantus (not the generic) is astronomical. Members would frequently purchase their Lantus from Canada at about 1/3 of the price here in the US. If you price out the cost for glargine on a site like GoodRx, a box of 5 pens runs anywhere from $80 - $200. The prices vary from city to city. My cat was initially prescribed Novolin (many years ago) when she was hospitalized. My regular vet commented that it was a very good insulin for dogs. Novolin does not offer the kind of duration that a cat needs because their metabolism is much faster than a dogs. It can also drop numbers very hard and fast.

I also want to strongly encourage you to get at least one test every night in addition to your PMPS test. Dosing is based on how low the dose brings your cat's numbers. Without the PM tests, you're missing half of your data. You have no way to know if Chedder is dropping into numbers that would warrant a dose reduction.
Click to expand...

Thank you! I'll check GoodRx. I'll get a post PM shot BG starting tonight.

When you switch from Novolin to glargine, is there a particular way to do that? If I give the final 1 unit dose of Novolin at 8pm, would I just start right in with 1 unit of glargine at 8am? Or is there some type of transition protocol? I'll search this site also. I'm so happy to have found this group!
 
I made a direct switch. When switching between Lantus and Levemir, reducing the dose by 30% is recommended. Some members will do the same with any switch in insulin but there is no specific rationale other than some cats have a marked response to a new insulin.
 
Sienne and Gabby (GA) said:
I made a direct switch. When switching between Lantus and Levemir, reducing the dose by 30% is recommended. Some members will do the same with any switch in insulin but there is no specific rationale other than some cats have a marked response to a new insulin.
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Thank you. One more question...
Am I trying to get all his BG readings to fall within the blue (100-199) range? Would that be considered stable? I've been trying to adjust his dose based on the PS number and using what I have so far in the SS as a guide. Cheddar has been on Novolin for almost 3 years and started out at 6 units/day. I shudder to think what his curves looked like when he was only tested once every 3 months! Now his dose is 1 - 1.25 units every 12 hours. I've started lowering that to .75 if his AMPS is below 150 based on what happened on 8/17. Does that sound right?
 
This guide to Novolin may help.

I can't believe your vet started Chedder at 6.0u. That's a HUGE dose. We usually look at how low the dose is taking numbers. Given that Novolin wears off well before the next shot, it's more important to know what the low point (nadir) in the cycle is. The nadir with Novolin is early. There's a section in the link that discusses onset, nadir and duration.

Ideally, you want Cheddar to be in normal range numbers -- 50 - 120. There's no way to know if that's possible given that he's a long term diabetic. I'd aim for numbers that are below renal threshold which is roughly 250. If he can level out lower than that, it would be great but if not, aiming to stay below renal threshold will make it easier on his kidneys.

I would be cautious if you get a lower than expected pre-shot number given how quickly onset can occur with Novolin. You have 3 options:
  • Don't feed Chedder and then re-test in about 20 min. If numbers are rising, you're good (unless they are really low). Remember, with Novolin, you're testing, feeding, and waiting an hour and then injecting. The food will also influence the numbers.
  • Give a reduced dose.
  • Skip the shot.
Given you've been managing Cheddar's diabetes for 3 years, you know how to test and importantly, you know your cat. If you're unsure how to manage lower numbers, please let us know or post and ask for help.
 
It’s important to get that +2 test in the pm. As I said on my earlier post #4, especially the other day when you got a lower than 200 pmps. I think if you start doing that it will help you get a better idea of what’s happening overnight. He may be going lower then bouncing the next day.

Another thing, you’re not holding the dose long enough. When he earned a reduction on 8/17, you didn’t hold it. You increased the dose that night and again the next day. We don’t dose by the pmps number here, we dose by how low the dose is taking your cat so I still think he should be on the .75 dose but you’ve upped it twice since 8/17 @Sienne and Gabby (GA) what are your thoughts on that?

Both Sienne and I have given you the link to the novolin guide so I hope you read through it as there is a lot of very useful info like the fact you need to wait an hour after feeding to give the shot.

as Siennne said, Lantus or the generic can be purchased at lower discounted prices. Since it’s a human insulin, there are a lot of online coupons folks here use and I hear the Costco pharmacy sells a pen for $50 which is about the price I was paying ordering from Canada.
 
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Sienne and Gabby (GA) said:
This guide to Novolin may help.

I can't believe your vet started Chedder at 6.0u. That's a HUGE dose. We usually look at how low the dose is taking numbers. Given that Novolin wears off well before the next shot, it's more important to know what the low point (nadir) in the cycle is. The nadir with Novolin is early. There's a section in the link that discusses onset, nadir and duration.

Ideally, you want Cheddar to be in normal range numbers -- 50 - 120. There's no way to know if that's possible given that he's a long term diabetic. I'd aim for numbers that are below renal threshold which is roughly 250. If he can level out lower than that, it would be great but if not, aiming to stay below renal threshold will make it easier on his kidneys.

I would be cautious if you get a lower than expected pre-shot number given how quickly onset can occur with Novolin. You have 3 options:
  • Don't feed Chedder and then re-test in about 20 min. If numbers are rising, you're good (unless they are really low). Remember, with Novolin, you're testing, feeding, and waiting an hour and then injecting. The food will also influence the numbers.
  • Give a reduced dose.
  • Skip the shot.
Given you've been managing Cheddar's diabetes for 3 years, you know how to test and importantly, you know your cat. If you're unsure how to manage lower numbers, please let us know or post and ask for help.
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To be clear, the original vet-prescribed dose of 6 units was per day. 3u every 12 hours. That changed every 3 months when he got his BG checked at the clinic. And the AM & PM doses were not always the same. Also, even though I've been managing the diabetes for almost 3 years, I only started home testing a couple weeks ago when I found this forum! I'm a newbie when it comes to monitoring and adjusting myself. I'm celebrating every time we get a reading in the blue zone on the SS. Thanks to all of you for such valuable information!
 
Ale & Bobo & Minnie (GA) said:
It’s important to get that +2 test in the pm. As I said on my earlier post #4, especially the other day when you got a lower than 200 pmps. I think if you start doing that it will help you get a better idea of what’s happening overnight. He may be going lower then bouncing the next day.

Another thing, you’re not holding the dose long enough. When he earned a reduction on 8/17, you didn’t hold it. You increased the dose that night and again the next day. We don’t dose by the pmps number here, we dose by how low the dose is taking your cat so I still think he should be on the .75 dose but you’ve upped it twice since 8/17 @Sienne and Gabby (GA) what are your thoughts on that?

Both Sienne and I have given you the link to the novolin guide so I hope you read through it as there is a lot of very useful info like the fact you need to wait an hour after feeding to give the shot.

as Siennne said, Lantus or the generic can be purchased at lower discounted prices. Since it’s a human insulin, there are a lot of online coupons folks here use and I hear the Costco pharmacy sells a pen for $50 which is about the price I was paying ordering from Canada.
Click to expand...
Ahhh, ok. I didn't understand about holding the dose. I've read sooo much new info here over the past couple of weeks it's been like drinking from a firehose! I will return to .75u and continue with it instead of basing it on the PS number. Or does 1u look better based on the last couple of days? Yes, I have read through the Novolin guide a couple of times now. I'm planning on switching to glargine as soon as we finish the current vial of Novolin. (It's about 2/3rds gone) Or maybe sooner!
 
Cheddar's Mom said:
Ahhh, ok. I didn't understand about holding the dose. I've read sooo much new info here over the past couple of weeks it's been like drinking from a firehose! I will return to .75u and continue with it instead of basing it on the PS number. Or does 1u look better based on the last couple of days? Yes, I have read through the Novolin guide a couple of times now. I'm planning on switching to glargine as soon as we finish the current vial of Novolin. (It's about 2/3rds gone) Or maybe sooner!
Click to expand...

trust me, we’ve all been there and that’s why I wanted to call attention to it again. We’re very good at repeating ourselves here ;) I would err on the side of caution and stick with the .75. I like to think of a cat going under 90 as their way or saying to us that the dose is too high. You may need to increase again, but I’d really like to see what numbers you get being with the .75 for a few days and those pm +2 tests will help a lot. As Sienne said, when you don’t have those it’s like you’re missing 1/2 of the data because you have no idea what’s happening overnight. I’d like @Sienne and Gabby (GA) to confirm for us how many days you should hold the dose for since I’m not familiar with novolin. I think 7 days but let’s see what she says. You’d only change the dose then if Cheddar drops below 90 again. Anytime he drops below 90, he gets a reduction even if it happens in back to back cycles

Here you go again:

Increasing the Dose
  • If, after at least a week and having gotten a curve, the dose doesn’t seem sufficient, a dose increase should be considered. Doses are increased by no more than 0.25u.
  • Increasing doses of N/NPH needs to be done with great care. If you are new to using N/NPH, post on the board for advice if you are considering dose increases for your cat. If in doubt, consult your vet.
Decreasing the Dose
  • If your cat’s BG drops to 90 or below, it’s time to reduce the dose,
  • Reduce the dose by 0.25u.
  • There are some situations which signal that a larger than usual dose reduction is needed. If you are unsure, please post on this forum or the Health forum and ask for input about your dose.”
 
Thanks for the clarification. (3.0u is per shot is still a large starting dose unless Cheddar is part mountain lion.)

@Ale & Bobo & Minnie (GA) - There's never been a definitive amount of time to hold a dose of Novolin. (I had to go back and read the sticky to see if anything had changed.) I would hold for a week and do a curve since the dosing is loosely based on SLGS. I know you know this but for others who may be reading, just remember to reduce the dose when the numbers drop below 90.
 
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I see you went back to .75 so try to hold it for a week unless he goes under 90 so we can see what happens.

I wanted to ask again how often are you feeding him?
 
Sienne and Gabby (GA) said:
Thanks for the clarification. (3.0u is per shot is still a large starting dose unless Cheddar is part mountain lion.)

@Ale & Bobo & Minnie (GA) - There's never been a definitive amount of time to hold a dose of Novolin. (I had to go back and read the sticky to see if anything had changed.) I would hold for a week and do a curve since the dosing is loosely based on SLGS. I know you know this but for others who may be reading, just remember to reduce the dose when the numbers drop below 90.
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Cheddar is probably not part mountain lion... but in his younger days he identified as a tiger.
I have him on 0.75u now. He started out a bit on the low side this morning so I'm monitoring to make sure it doesn't drop too low over the course of the day. So far so good.
 
Ale & Bobo & Minnie (GA) said:
I see you went back to .75 so try to hold it for a week unless he goes under 90 so we can see what happens.

I wanted to ask again how often are you feeding him?
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Sorry, I thought I answered that, but it may have gotten buried between all the other stuff. I feed him his main meals twice a day, an hour before insulin shot. He doesn't usually eat it all at once... he's more of a grazer, but he gets enough in to qualify. He has a few bites of deli turkey or ham (his favorites) when I'm testing his blood to make it more enjoyable, and I give him small snacks throughout the day whenever he tells me he's hungry. Usually an ounce, give or take, of a low carb canned food. We're experimenting with some different ones that are <10% carbs to find out what he loves.
 
Ale & Bobo & Minnie (GA) said:
That’s perfect. Smaller meals or treats throughout the day are easier on their pancreas and help avoid big sugar spikes :)

have you tried freeze dry treats?
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Haven't tried freeze dried treats yet. Both of my cats love Stella & Chewy's freeze dried raw food dinner morsels. Instead of a meal, now I'm giving a couple bites as a treat. Do you know much about that brand? It wasn't in the database, and I might need to contact the company to find out carb % if I can.
 
Cheddar's Mom said:
Haven't tried freeze dried treats yet. Both of my cats love Stella & Chewy's freeze dried raw food dinner morsels. Instead of a meal, now I'm giving a couple bites as a treat. Do you know much about that brand? It wasn't in the database, and I might need to contact the company to find out carb % if I can.
Click to expand...

Hi @Cheddar's Mom welcome to the group.

Stella and Chewy's freeze-dried morsels are very low-carb, because they are almost entirely just meat. Officially they say "Stella & Chewy's dinners for cats contain so few carbohydrate-laden ingredients, the as-fed carbohydrate levels in these products is less than 1% as-fed"

On a side note....my god my cats LOVE the Tummy Ticklin' Turkey!!! I really only feed it as treats these days though due to the high phosphorus.

They are VERY high in phosphorus so you may want to limit the amount you give an older cat.

Pretty much any freeze-dried cat food is high in phos unfortunately, as far as I know. When I give the morsels as treats, I usually break up a morsel into several small little nuggets. We also use several freeze-dried turkey or chicken treat varieties that the cats just go NUTS for.

Whole Life turkey or chicken:

https://www.chewy.com/whole-life-just-one-ingredient-pure/dp/255798

https://www.chewy.com/whole-life-just-one-ingredient-turkey/dp/782966
 
Hendrick Cuddleclaw said:
Hi @Cheddar's Mom welcome to the group.

Stella and Chewy's freeze-dried morsels are very low-carb, because they are almost entirely just meat. Officially they say "Stella & Chewy's dinners for cats contain so few carbohydrate-laden ingredients, the as-fed carbohydrate levels in these products is less than 1% as-fed"

On a side note....my god my cats LOVE the Tummy Ticklin' Turkey!!! I really only feed it as treats these days though due to the high phosphorus.

They are VERY high in phosphorus so you may want to limit the amount you give an older cat.

Pretty much any freeze-dried cat food is high in phos unfortunately, as far as I know. When I give the morsels as treats, I usually break up a morsel into several small little nuggets. We also use several freeze-dried turkey or chicken treat varieties that the cats just go NUTS for.

Whole Life turkey or chicken:

https://www.chewy.com/whole-life-just-one-ingredient-pure/dp/255798

https://www.chewy.com/whole-life-just-one-ingredient-turkey/dp/782966
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Wow, great info! Thank you! I have been doing just what you said and breaking up a couple morsels to use as a treat. We alternate between Tummy Ticklin' Turkey and Yummy Lickin' Salmon & Chicken. (They're just fun to say!) I'll make sure not to use them too much, considering the high phos. and I'll check out the others you mentioned too. Thanks again!
Oh, one other thing. I watched your video and see that you prick the inside of the ear. I've been doing it from the outside. Is there a reason to do one way over the other, or is it just what's more comfortable for both of you?
 
It’s whatever works really. I always did the inside of the year too because of less fur.

Some freeze dried brands are PureBites and Vital Essential. I started getting this one from chewy because it seemed more economical. You can also try those lickable pouches like the ones from Inaba Churu. I think FF makes them too now

Cat-Man-Doo Life Essentials Chicken Littles Freeze-Dried Cat & Dog Treats, 5-oz bag:
https://www.chewy.com/dp/152851?utm_source=app-share&utm_campaign=152851
 
Cheddar's Mom said:
Wow, great info! Thank you! I have been doing just what you said and breaking up a couple morsels to use as a treat. We alternate between Tummy Ticklin' Turkey and Yummy Lickin' Salmon & Chicken. (They're just fun to say!) I'll make sure not to use them too much, considering the high phos. and I'll check out the others you mentioned too. Thanks again!
Oh, one other thing. I watched your video and see that you prick the inside of the ear. I've been doing it from the outside. Is there a reason to do one way over the other, or is it just what's more comfortable for both of you?
Click to expand...

That's just how we learned to do it, as far as I know either way is fine. As you put it, whatever is most comfortable and successful for you and the kittah, I think is the best way.
 
Sienne and Gabby (GA) said:
This guide to Novolin may help.

I can't believe your vet started Chedder at 6.0u. That's a HUGE dose. We usually look at how low the dose is taking numbers. Given that Novolin wears off well before the next shot, it's more important to know what the low point (nadir) in the cycle is. The nadir with Novolin is early. There's a section in the link that discusses onset, nadir and duration.

Ideally, you want Cheddar to be in normal range numbers -- 50 - 120. There's no way to know if that's possible given that he's a long term diabetic. I'd aim for numbers that are below renal threshold which is roughly 250. If he can level out lower than that, it would be great but if not, aiming to stay below renal threshold will make it easier on his kidneys.

I would be cautious if you get a lower than expected pre-shot number given how quickly onset can occur with Novolin. You have 3 options:
  • Don't feed Chedder and then re-test in about 20 min. If numbers are rising, you're good (unless they are really low). Remember, with Novolin, you're testing, feeding, and waiting an hour and then injecting. The food will also influence the numbers.
  • Give a reduced dose.
  • Skip the shot.
Given you've been managing Cheddar's diabetes for 3 years, you know how to test and importantly, you know your cat. If you're unsure how to manage lower numbers, please let us know or post and ask for help.
Click to expand...
Update and new questions about Cheddar:
I just switched him over to glargine/Lantus yesterday. (Was on Novolin) His BG pre-shot numbers had been in the 400s lately...hoping to better control this now with glargine. Yesterday went fine, but this morning he had a low AMPS. (174) I waited 20 minutes and retested. It was even lower, (163) and I chose not to shoot. What next? I'm planning on testing every 2-3 hours today. If his +2 is higher should I give a small dose, or totally skip until PM? Any thoughts? Should I reduce the dose by .25 compared to his Novolin dose? Thank you!
 
@Cheddar's Mom
Hi Heidi ,next time you need Lantus
Lantus is the major brand name glargine the USA you can get generic/biosimilar glargine at very reasonable prices using GoodRx coupon. Most members use the generic because Lantus is to expensive.
https://www.goodrx.com/lantus?label...d-pens-of-100-units-ml&quantity=1&slug=lantus
Make sure that the Match your prescription pull down menue says generic glargine 1carton of 5 3ml pens.
There is no wait time test, feed, give insulin
Lantus usually doesn't kick in until 2 hours after the shot

We buy the pens but use the syringes to draw out the insulin because if you use the pen you can only adjust by full units ,we adjust the doses by 0.25 units


Also
The 5 pens will last about a year, we use the pens just like a vial, you would just insert the syringe it the gray rubber stopper on the pen and draw out your insulin
Its generic lantus



Or this one also

I see some members will call CVS, Rite Aid, Costco, Walgreen's, to get the price for 5 pens
Posted by another member
One members posted this
. I paid $175 for a box of 5 pens at Walmart pharmacy, but GoodRX coupon says you can get it for around $90 if you have a Rite Aid pharmacy near you.

Just call around for the best price

A member just posted this
Allie was using the Lantus and I just switched to the generic and using the GoodRX I got 5 pens for $81.30 at Walgreens.

GoodRX has a 1-800 number to assist you in using their services to get your pets prescriptions filled if the pharmacy gives you any issues.

I think I found it for you
GoodRx / Customer service

1 (855) 268-2822
 
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@Cheddar's Mom
Are you using the U-100 syringes with the half unit markings?
They make it much easier when you have to adjust thebdose by 0.25 units
If not I can tell you where to get them
In your signature can you add after where you have Novolin /Lantus and the date started. I do see you put a line on your spreadsheet so that's great
On the top of the spreadsheet can you also put Lantus and the date started
Have you looked at the 2 dosing methods yet for Lantus/Generic
Take a look and see which one you want to follow
They will explain when a increase or decrease is needed
We don't adjust the dose by the Pre Shots ( AMPS or PMPS) We adjust the dose by how low they drop (nadir)
Part of that process is getting a feel for basic concepts:
  • Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
  • Peak/Nadir - the lowest point in the cycle
  • Duration - the length of time insulin continues to lower blood glucose
Here is the link so you can read all about Lantus, read all the yellow stickys
When you decide what method you want to follow you can add that to your signature and your spreadsheet up top

I assume that's a picture of Cheddar when he was a kitten, he's so adorable
 
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Cheddar's Mom said:
Update and new questions about Cheddar:
I just switched him over to glargine/Lantus yesterday. (Was on Novolin) His BG pre-shot numbers had been in the 400s lately...hoping to better control this now with glargine. Yesterday went fine, but this morning he had a low AMPS. (174) I waited 20 minutes and retested. It was even lower, (163) and I chose not to shoot. What next? I'm planning on testing every 2-3 hours today. If his +2 is higher should I give a small dose, or totally skip until PM? Any thoughts? Should I reduce the dose by .25 compared to his Novolin dose? Thank you!
Click to expand...

I see you asked about this in the AM sorry no one got back to you
I can try tagging Sienne again for you and Wendy to see what they think
@Sienne and Gabby (GA)
@Wendy&Neko
She also posted this in her post #28
His +2 is up to 287. I gave him a small dose of 0.5u. Will monitor with a few more readings throughout the day. Is this common when switching types of insulin?
Thank you ladies
 
Diane Tyler's Mom said:
@Cheddar's Mom
Are you using the U-100 syringes with the half unit markings?
They make it much easier when you have to adjust thebdose by 0.25 units
If not I can tell you where to get them
In your signature can you add after where you have Novolin /Lantus and the date started. I do see you put a line on your spreadsheet so that's great
On the top of the spreadsheet can you also put Lantus and the date started
Have you looked at the 2 dosing methods yet for Lantus/Generic
Take a look and see which one you want to follow
They will explain when a increase or decrease is needed
We don't adjust the dose by the Pre Shots ( AMPS or PMPS) We adjust the dose by how low they drop (nadir)
Part of that process is getting a feel for basic concepts:
  • Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
  • Peak/Nadir - the lowest point in the cycle
  • Duration - the length of time insulin continues to lower blood glucose
Here is the link so you can read all about Lantus, read all the yellow stickys
When you decide what method you want to follow you can add that to your signature and your spreadsheet up top

I assume that's a picture of Cheddar when he was a kitten, he's so adorable
Click to expand...
Thank you for the reply, and yes, that's baby Cheddar! I read a page all about Lantus and other glargine insulins. I did not see anything about when to change dose up or down, so maybe there's another page I didn't see. (Did you mean to include a link?) I did learn more about how to properly handle it though.
I will continue to monitor at the current dose for a while. I wasn't sure about giving him the shot this morning with a BG much lower than it has been recently.
Yes, I'm using U-100 syringes with 1/2 marks.
 
Cheddar's Mom said:
Thank you for the reply, and yes, that's baby Cheddar! I read a page all about Lantus and other glargine insulins. I did not see anything about when to change dose up or down, so maybe there's another page I didn't see. (Did you mean to include a link?) I did learn more about how to properly handle it though.
I will continue to monitor at the current dose for a while. I wasn't sure about giving him the shot this morning with a BG much lower than it has been recently.
Yes, I'm using U-100 syringes with 1/2 marks.
Click to expand...


Here's the link about the 2 dosing methods
Thanks for fixing your signature and SS :cat:

https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/
 
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Hello and welcome. It was Ok to skip today, as long as he's not prone to ketones, as you were new to the insulin. Above Sienne mentioned how some cats have a strong reaction to an insulin change, that may be what you saw.

A couple things about our dosing methods. It is essential that you always get what we call the preshot test, or the test before shooting. With Lantus/glargine, we test, then feed, then shoot, all in the space of about 10-15 minutes. Testing first tells you if it's safe to shoot. Also, the preshot numbers plus a test around +2 or +3 with glargine will tell you what sort of cycle he's going to have, and whether you need to test more of leave out food to keep him safe. It is also very important to try to get at least a before bed test in at night. Many cats go lower at night. We decide how to change the dose based on how low it takes the cat, hence the need for at least some night time data.

Going forward, why don't you try a 0.75 unit dose. It's always easier to start a little lower in dose and work your way up, than to fight lows when you are still relatively new to testing and definitely new to how Cheddar works the glargine.
 
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