? New, Overwhelmed, Trying to Figure Things Out

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Mr. Biggs & J

Member Since 2018
Hello everyone, Jennifer here.

I'm pretty new to this forum [started Friday] and I've already posted an introduction here [http://www.felinediabetes.com/FDMB/threads/new-and-at-wits-end.195778/] and have gotten multiple and wonderful responses.

Now I'm posting in here because of the encouragement of others so.. here goes. I apologize if this is super lengthy. I will try and break things up so they're easier to read.

The basics:
- Biggs, approximately 8 years old.
- Diagnosed 10/2017.
- Underweight at 11.75 lbs.
- Is currently at 9 units of Lantus/Glargine as of 05/19/2018.
- Was told he had a "gallop" rhythm heartbeat and that he's losing muscle mass on his hind legs/thighs on 05/19/2018.
- Doesn't have much energy/seems lethargic most the time now, doesn't even meow that much when it comes to feeding [used to be a siren].


The details:
- Biggs was diagnosed back in 10/2017 and was immediately put on Lantus/Glargine. I first had him on the Friskies Classic Pate but with the ever increasing dosage and Friskies having changed their formula [I didn't know exactly what the carb count was anymore] I ended up switching him a few times to different foods before landing on the Fancy Feast a couple months ago [https://www.fancyfeast.com/gourmet-...tes/classic-pate/poultry-beef-variety-pack-30].

- I finally got a hold of Friskies and they ended up mailing me their nutritional info and it turns out their formula would be fine.. PLUS Biggs has liked that a LOT more- it takes him a while to eat the FF whereas he almost wolfed down the Friskies. So I'm going to be switching him back in a few days because he needs to eat.

- On Saturday, 5/19 I picked up the ReliOn Confirm and called them to get the control solution. They said about 7-14 business days.. which tells me I can't start home testing him until I get that.

- I've made a spreadsheet [in my signature] and have enabled comments to be left. I have a basic understanding of it which is nice.

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I'm currently attempting to understand various things. To be completely honest I was never really able to wrap my head around things without someone helping and talking to me at the same time.

I'm trying to understand the different protocols for Lantus.. and I think I see that the SLGS would be best. So to help my poor brain out I'm trying to just not pay attention to the TR.

Human Glucometer Reference Numbers and Notes [https://docs.google.com/document/d/1Rt6BJ0BGgwx8eivIOoXM7NeHApMwzIw1W_BE-GOgj9o/edit]. I'm hoping I understand some of this. Basically the whole overall aspect is very low numbers = need sugar/carbs. Very high numbers = insulin. The mg/dL is what my meter will show me and I can proceed from there. [Also read as in referenced by the sticky on "How to Treat HYPOS"].

So I suppose my main questions are.. he's at 9 units.. what do I do about this? Do I suddenly drop him all the way back down and go from there?

For the SLGS I see "1u BID".. what does "BID" stand for?

How exactly, in the simplest terms, do I perform a "curve"? My understanding, which I don't trust, is that it's essentially taking readings every 2 or so hours for a set amount of time and then... seeing about adjusting the dosage on that?

I have ordered the Zobaline (for Diabetic Cats) for his losing muscle mass on his hind quarters. It says serving size as 1 tablet.. do I just give that to him all at once? Or should I crush it and break it up into his two meals? [I also read that I can just mix it into his wet food.]

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People may not want to come across as rude but honestly, try explaining things to me as though I'm 10 or have a learning disability [which in all honestly I probably do]. I promise I won't be offended. YOU are helping ME. I can only say thank you.

If I have missed anything or if people have ANY questions about anything, please feel free to drop them on this thread. I will get back to them ASAP.
 
A learning disability? Do you mean like recently graduated techs that get their third year from us? Or vets that recommend you NOT test at home.
> 9 units seems like a lot but... never go for sudden drastic changes.
> the mysterious curve! What you're looking for is to see how the blood sugar levels change over the course of a 12 hour period. Nigel had textbook curves but Noah's look like a 4 year old took a crayon to your walls. You'll be at home while you do a curve so keep notes on when and how much you feed. I would say not to do a curve on a day when kitty is even mildly ill with anything else. You may or may not find no two curves are ever the same. Don't tear your hair out or sacrifice a goat in the back yard, it doesn't help. And always remember, N2C No two cats are ever the same.
Oh hi Jennifer! Now I remember you from Welcome to the Group. :rolleyes:
 
- On Saturday, 5/19 I picked up the ReliOn Confirm and called them to get the control solution. They said about 7-14 business days.. which tells me I can't start home testing him until I get that.
I would not wait on the control solution to start testing. It is not an absolute necessity; it is nice to have around to confirm your strips are working correctly should you question the numbers you are getting.

How exactly, in the simplest terms, do I perform a "curve"? My understanding, which I don't trust, is that it's essentially taking readings every 2 or so hours for a set amount of time and then... seeing about adjusting the dosage on that?
Your understanding is correct. To do a curve, you test prior to an insulin shot, making sure the cat has not had food for the two hours prior. Then, you test every two hours after that, feeding as you normally would. The last test of the 12-hour curve would be the one just prior to the next insulin shot. You always want to withhold food for two hours before your pre-shot tests just to make sure the number is not influenced by food, but you can feed as normal the rest of the day. (My cats are fed four times a day (every 6 hours), and I leave their leftovers out for them to graze on.)

For the SLGS I see "1u BID".. what does "BID" stand for?
BID means twice a day dosing. You give your insulin shots twice a day or once every twelve hours.

he's at 9 units.. what do I do about this? Do I suddenly drop him all the way back down and go from there?
That is a very large dose. Can you provide more information on how he ended up at that high of a dose? Was it based on curves at the vets office every two weeks or fructosamine tests or what? I have never used Lantus, so I would not be one to give you dosing advice, but there are many others who can help with that.
 
Hi and welcome!!

Don't worry about making questions there is no such a thing as too many or too dumb a question so keep on asking, we are not always very good at explaining things anyway

Congratulations on setting your spreadsheet you are all ready to go

9 units is a very large dose for Lantus but without knowing at least some of the test results he had is hard to say if it's the right one, as soon as you start getting some of your test results post them in here or at the Lantus forum ( I know first they say go to the main health now latus forum :rolleyes: but the truth is there are real experts on Lantus and a lot of activity in that forum and that's the insulin you are using).

Given the description of his behavior and symptoms you probably are not giving him the right dose but the dose you are giving him could be either to low or too high sometimes a higher than needed dose of lantus can have the same results as a too low one so we will have to see and adjust his dose according with the test results, but with a high dose like this is particularly important to have your hypokit ready just in case

Does he have any other health issues ? It's important to know since almost everything going on in his body influences his insulin needs
 
Welcome to FDMB! You have come to the right place for answers about FD!

Please don't wait for the control solution to arrive before you start testing. Mr. Biggs is on a very high dose of insulin, and the most prudent and safest path is to start testing as soon as possible. (I have been using the Relion Confirm for 3 years and have never used the control solution; I have requested it twice, and they have never sent it. I'm not sure it's necessary at all for this model of meter.)
 
Hello Jennifer & Mr. Biggs,
You've definitely come to the right spot to get answers! And ask lots of questions. It's how you'll learn so much good information to help your kitty.
Looking at some of the spread sheets can give you an idea of what other people are doing. It will take time but you'll be surprised how fast you'll get the hang of it.

I rely on the advice I get here not on my Vet.

Once you start filling in Mr. Biggs SpreadSheet it will be very helpful.

8 yrs is NOT old for a cat! I've had several live to be 20 & 23 yrs old. Your kitty hasn't even reached middle aged! HA!

Best of luck with Mr. Biggs.

I think you'll be going to the Lantus Forum. I'll check in with you in a day or two.
 
Hi Jennifer :cat:

I just wanted to welcome you, and to say you have come to the right place. Take a deep breath, you can do this :) I am new to this by a few months, and my Shmee is on Lantus as well. There are so many experienced people on here that will be willing to help you. I will be looking for you in the Lantus forum :smuggrin: PS - Love the name Mr. Biggs! Cute.
 
I apologize in advance if it wasn't appropriate to group my replies. I figured it would be the easiest thing to do instead of replying to each one individually. Figured I'd colour each reply differently so people can easily see the beginning and end, that way they don't have to skim through a lot. c:

@Noah & me (GA) Hahah, definitely the latter. It really is a lot but, as I put as a note in my spreadsheet, Biggs seemed a lot more animated this morning which really surprised me! It feels like it's been so long since he's been like that, I almost cried. And that's something I'll definitely keep in mind. Thank you Dickson (I hope that's your name)!



@FurBabiesMama After reading from responses I started this morning. I completely forgot to do so this evening.. shuttled parents to the airport then got back when it was storming, but it's something I'm most definitely going to be doing from now on. His first number to date that I've done is 276.

Ok, perfect. He only gets two meals a day as that works best with my schedule. I did read on the SLGS sticky that multiple meals a day would be best. I'll see what I'm able to do about that. Possibly invest in a timed feeder.

I just phoned the vet and I asked for a copy of pretty much everything that's happened since back in October. I figure even if I don't upload everything onto here I still need to keep it for my records. But to answer your question, yes, I do believe it is/was based on curves.



@Veronica & Babu-chiri Thank you! I'm very happy I found this forum. Y'all have been amazing to me and it's highly appreciated. I will most definitely be doing that once I get my copies from the vet (I'll be getting them tomorrow) so I'll try and upload some of them the same day.

Most definitely. I already have both the hypo treatment and hypokit sheets printed out. I hope no one will be offended when I say I did do some tweaking and editing. I don't know about others but when it comes to a first time crisis my head is going in all directions so I simplified a lot of the directions and just made it easier to read for myself.

Other than what's just recently occurred- his losing muscle mass in the back- he's been quite the healthy cat. I always found myself lucky that he never had anything going on with him that he had to deal with. He did have this little fluid sac on one of his shoulders before but the vet said it was completely benign. She drained it a couple of times and now it hasn't come back.


@Squalliesmom Thank you! In replying to FurBabiesMama I am definitely doing so from now on. I just hadn't been sure if I did actually need to wait for the control solution (in my chipmunk brain it seemed like it was something I should wait for) but I know otherwise now. ☺

@JoyBee&Ravan Hello! Haha, that's one thing I'm good at- asking a looot of questions. Thank you for the vote of confidence though. It's sorely needed right now. ♥


@Amanda & Shmee Thank you, you're very sweet. In fact, everyone has been thus far. I keep trying to do so- breathe, and just sit down for a moment to watch a funny video... or five. Kinda takes my mind off things for a little bit. I'll be in the Lantus forum in a day or two- as stated in above replies I want to get my documents in order and see which ones would be best to upload. (Also your fluff's name is adorable as well! Reminds me of Shmee from Peter Pan- one of my favourite childhood movies. c:)
 
Hi there,
Welcome to this group. My cat was diagnosed 1.5 years ago and this site has been a lifesaver.
I have to ask, did the vet start Biggs on 9 units? Why did they start him at this number? Like most users here have said, that is an extremely high dose for a diabetic cat. Most are on one to four units.
The best way to understand what is happening with your cat is to test at home as often as you can. Finding your cats Nadir (how LOW they drop in a cycle) is also important.
Definitely read about and understand "bouncing" as well. There is a possibility that you might be giving him too much.
Now on the flipside, if you keep going up in dose and cannot get him regulated (normal numbers), you might want to have an IAA (insulin resistant) AND IGF-1 test done (Acromegaly).
I started my cat on one unit. He eventually went to 1.25, 1.5, 1.75, 2.5, 2.75, 3..... all the way up to 8. At that point, I decided to have him tested. While he tested negative for insulin resistant, he tested positive for Acromegaly.
There is information on Acromegaly and IAA on the site as well. Please read that tab as well.
Good luck! Feel free to reach out with any questions! You're in good hands on the FDMB

Deena
 
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