NEW, still have some questions

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Mindy & Max

Mindy & Max

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Alright...for those who weren't following my other thread,

Max was diagnosed last Friday. We've had vomiting issues for several months, he started losing some weight, and the vet put him on prednisone to stop the vomiting. That worked, but he lost 4.5lbs while he was on it, and then we got the diabetes diagnosis. I've changed his food, and he's no longer eating any dry food, and wolfing down the high-protein Friskies food as fast as I put it out. Finally got to talk with the vet about insulin on Wed. She wants to try Lantus, as it has a good rate of "reversing" diabetes back to a non-diabetic state in cats. I've called around, and will get an Rx in to a local pharmacy for a vial to get started...I'm hoping we won't need more. I do know the prices are cheapest in Canada, but they said it will take 10-14 days for an order to arrive, and I'm sure you all know that just isn't good enough. If he does need to be in insulin long term, I'll go the route of ordering cartridges from Canada.

Anyway, I also ordered a Maxima AST glucose meter and strips yesterday (thanks to suggestions from here)...hoping to have that early next week. In the meantime, is it safe to start giving him insulin without testing his sugar levels first, or do I really need to go to the pharmacy and buy a meter and strips to use ASAP? I think I can get in to the vet Saturday morning to learn how to give him his shots. I don't know what all the numbers mean yet anyway...still trying to read/research when I can, but I don't have internet at home, and this is probably the worst week in history at work to be trying to do this (I have a major exhibit opening, the biggest we've ever had, waaaaaay too much going on!).

Oh, and when I talked with the vet on Wednesday, she said to give him 2 units, 2x's a day, but someone else here said I should only start with 1 unit, BID. I have a call in to the vet to resolve this, and to get an Rx for the Lantus (she thought it didn't require an Rx). The pharmacy does have the Lantus in stock, so I can get it as soon as the Rx is in.

Anyway, with all I'm juggling right now, I think I'm hitting the wall of "overwhelmed" right now. Any help you can give would be great. Is there a "Feline Diabetes for Dummies" book I can buy somewhere? :smile:
 
LOL! The closest thing we have to a Feline for Dummies is our FAQs. Be sure you check those out. But be comforted by the fact that all of us have felt just like you - overwhelmed, scared with lots of questions. Everyone who answers is paying it forward for the help we received when we first started.

If I were you, I would start with a very small dose of insulin - .5 or 1 unit twice a day. If you start at 2 units as your vet suggests, you could be starting over the ideal dose and cause a rebound effect. You could wait until you get your meter before starting insulin or you can run down to Walmart and get a Relion meter and strips. They are very inexpensive, and it is always nice to have a spare on hand. It is always nice to be hometesting first as cats are unpredictable. We started Oliver on insulin, changed the food and the next morning, his numbers were 100 points lower than the day before. We would have overdosed him if we hadn't been testing.
 
I think you've come a long way baby (a 1970s cigarette commercial...) :-D

Do I think it is safe to start without testing? No, BUT...most of us started prior to testing. MOst of us managed ok, while some cats have hypo'd because of this. So you weigh your risks....complications from further delay vs possible overdose. Frankly, I think that the complications from delay are higher than if you start at a low dose like 0.5 units a day until you are testing. I was the one who said to do 1 unit twice a day, as 2 units may be wayyyy too much and you need to work up to that dose.

If you have a few minutes, please head to the lantus insulin support group and read some of their 'stickies' on lantus and how to use it, as this should help you with your questions. You can also post their for more personalized lantus help.

Jen
 
The FAQs here are the closest you will get to a "dummies" book. The Start Low Go Slow (SLGS) protocol has been used successfully for many years and for many years we have seen serious problems result from starting at too high a dose.

Your vet is on the right track with Lantus and home testing, and you're on the ball with food, so those are stresses you can cross off your list.

Your best bet is to consult with those on the Lantus forum. They have more experience than a hundred vets put together and they are successfully guiding most cats to regluation or remission. Let them help and calm you.

You are doing a wonderful job!
 
Like Jen said, most of started giving insulin before home testing.

If your cat is not well, drinking and peeing alot, I'd start giving the Lantus immediately. I'd probably start at 1/2U or 1U BID at most.

Do you know how to find the Lantus forum?
 
Thank you all!

Yes, I do know how to find the Lantus forum...but even with the stickies there I'm still not sure what the heck I'm doing, or what almost anything means. If I had time (haha, as if anyone really does!) to read at a slower pace, that might help.

I am definitely worried about overdosing him, especially because we've already changed his food. I'd like to be able to start the insulin this weekend so a) I don't have to miss work to do it (I just had a baby last fall and my paid leave bank is next to nil), and b) so I can try to keep an eye on him and make sure he doesn't get hypoglycemic. I'm just not sure the meter will be here by then, and I don't have time to get to a Walmart to buy a different one before then. And of course, I hate it that he has to wait that long, let alone making him wait until Monday before he can get some meds.
 
Trust me, I get the juggling act that you are doing. I am so grateful that Squeak was diagnosed before I started having babies, and that (knock on wood) he continues to be healthy and off of insulin.

I can't tell you what to do, only what I would do in your circumstances looking from my perspective...and that would be to give a very low dose of insulin and monitor his symptoms until you get a monitor. Others may disagree. Hence the shades of gray when it comes to treating feline diabetes.

Either way, we are here to provide support.

Jen
 
If you ordered from Hocks yesterday, you MIGHT get it Saturday -- maybe even Friday. My Hocks orders come from Indiana -- so not too far for us Michiganders.

And yes - most of us started insulin without home testing -- having found FDMB months after the original diagnosis.

I WOULD agree with starting at 1 unit twice per day or even 0.5 unit twice per day.

My 2nd diabetic cat, El Tigre started Levemir last April -- we started at 1 unit BID, and ended up reducing to 0.75 units BID within the first few weeks. Nearly a year later, he is now getting 0.5 units BID. I think he is playing more now, so he is burning some sugar naturally with exercise.

phoebe
 
Thank you all for the suggestions. I guess if I don't have a meter yet, we'll go with a .5 dose to start with, and increase if needed once I get a monitor and get things figured out. At this point I think I'm concerned that my own ignorance and scattered-mommy-brain are going to kill him. My vet said she has two other clients with diabetic kitties, but she didn't say if they were home monitoring or not. My impression is that they are not, since she wanted me to bring him back in two weeks to do a curve. I'm going to try to push to do the curve at home...and hopefully I'll have things ironed out by then with testing and the monitor to actually do it right!
 
I don't think you mentioned what his BG#'s are running like? Also, do you know how to hometest? Depending on what his BG levels are running it might be safe for wait for the glucometer and learn how to hometest. Sometimes the testing is the hardest part at first. Also, usually the starting dose is based off of the cats "ideal weight". What is his ideal weight? However, most on Lantus start iwth 0.5Units bid. And YES you do want to test before every shot if you can.

Here is the link for dosing protocol we all follow over in Lantus Land: Dosing Protocol for Cats on Lantus/glargine or Levemir/detemir Using Daily Home Monitoring of Blood Glucose

Also, when you pick up the Lantus from the pharmacy make sure they give you U100 syringes.
 
Thank you so much Paige.

His BG at the vet Friday afternoon was 500-something, but I've changed his food since then. He hasn't been tested since then. I don't know how to home test yet...that'll be my project to read/watch/research tomorrow. I'm going to the vet on Saturday to learn how to give him the shots, and I will push for a .5 dose at that time. I hope to have the meter by then and maybe they can help me figure that out too.
 
Do watch the videos online first -- MOST vets are not familiar with the technique we use of pricking the edge of the ear for a tiny blood sample.

I had to show my vet how i do it...
 
500 is quite up there and I would worry about ketones, but we also have to keep in mind that kitties get very stressed at the vet and their glucose numbers are almost never that high when they are at home. I can't remember if you mentioned that you were testing for ketones? If not, it wouldn't hurt to get some ketostix from the drugstore. You can buy them over the counter and they are little dipsticks that you place the cats urine on to test for ketones. They don't cost much, and it is something that all diabetic owners should get anyway. That way you can monitor for ketones if you do not start the Lantus right away.

You are doing a great job trying to learn as much as you can. It is quite overwhelming and totally stressful in the beginning trying to learn all the lingo and what to look for etc. But you have found the best message board in the whole world. There are users from all over and are here to help at all hours of the day and night.

Good luck at the vet on Saturday. You might want to take a copy of the stickies that I showed you. Especially the one on dosing guidelines
 
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