new to board - not sure whether or not to give shot-stalling

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BRRI

BRRI

Member Since 2014
Tikki is 12 years old and was diagnosed with diabetes on may 1st.
We've been struggling to get him regulated and his levels have finally come down from the 500's, 400's and 300's we were seeing.
He gets lantus every 12 hours and the vet has had him on 7 units for each shot since june 7th. The last two weeks we finally started to see levels in the low 200's and hi 100's
Today I was home all day and decided to do a curve
these were his numbers
7am pre meal and shot - 228
9:15 am -147
11:10 am- 38 - called the vet and discussed with him - I got him to eat a little more and the vet told me to test again in an hour to make sure he was going up - he suggested we back down to 6 units this evening
12:15 -66
2:05- 86
4:15 - 62
6:55 pre meal- 120


I should be giving him a shot now but am very hesitant to give it since he's been so low all day
 
Re: new to board - not sure whether or not to give shot-stal

I would skip this shot.
I'll try to get some more people from the Lantus forum over to help you.
 
Re: new to board - not sure whether or not to give shot-stal

I agree with Dyana...It's better for you to skip tonight

High numbers take time to do any damage...Low numbers kill quickly. Let's stay safe tonight while we can hopefully teach you more about how to treat your kitties diabetes

7 units is a HUGE dose....We usually recommend starting at .5 to 1 unit and monitoring to see what each dose does for several days before increasing...and then increasing only by .25 to .5 at a time
 
Re: new to board - not sure whether or not to give shot-stal

Welcome to the FDMB by the way!! Can we know your name too?

You're in the best place you never wanted to be here! There are hundreds of people here who are treating their diabetic kitty's successfully at home and we can help you learn all there is to know about it.

It's great that you're home testing! That's a huge piece of the puzzle! Can we ask what you're feeding?

Tell us some more about your extra sweet kitty, Tikki! Has he/she ever had ketones? Any other health problems?

The people here are great, and very generous with their time and their experiences. I hope you'll let us help you to help your kitty!
 
Re: new to board - not sure whether or not to give shot-stal

Hi! I agree with Chris and Dyana, I would skip the shot. Tikki's numbers will likely be higher tomorrow morning due to a bounce from that 38 and a skipped shot. Don't worry about that. It's normal.

7 units is quite a large dose. How did the vet arrive at that dose? What dose did you start at?

This is an awesome place to get the help Tikki needs!

~Suzanne
 
Re: new to board - not sure whether or not to give shot-stal

Tikki is a silver tabby cat we think he's about 12, he belonged to my neighbors until about 5 years ago when they kicked him out and he moved in with us. He is a very sweet cat and just wants people to pet him all the time.
he was a bit overweight , we have another cat and we used to just leave the dry food out all the time for them and they ate whenever they wanted, In february we took away the all you can eat food buffet and started meal feeding dry (generic) food , he started losing weight and we assumed it was because of the change in feeding .we took both cats to a vet run shot clinic for thier shots in April and I mentioned to the vet that he had lost weight and also had really bad breath, I was concerned that he may need his teeth cleaned . The vet checked him out and decided he was all ok. About two weeks later one night after work we found him in the yard barely moving and when he did get up he was staring off into space . We took him to the kitty ER and they ran some tests and he was diagnosed with diabetes, his sugar was so high they couldn't get a reading and the vet told us that the bad breath was a sign of the ketones. He spent 2 days in kitty ICU when he left the hospital he was on 1 unit twice a day, he was on that dose for about a week and the numbers were still in the 300's-500's. My husband and I both had to travel for work so we boarded him at the vet ( new vet) for a week , while he was there they tested and gradually increased him to 3 units twice a day. since then we have been testing and he has been back to the vet a few times and gradually increasing, the numbers weren't dropping. The week of june 7th they moved him to 7 units twice a day.The numbers finally started dropping over the last two weeks. He is eating D/M wet food meals with a little D/M dry in his dish overnight.
Our new vet reccomended this board. I would really appreciate any help or suggestions, it's been a crazy couple of months! Thanks Beth
 
Re: new to board - not sure whether or not to give shot-stal

Hello and welcome to you and sweet Tikki. There are many reasons that kitties can be more difficult to regulate. My Neko got up to 8.75 units of Lantus before she got her first low number. She has two high dose conditions, one called acromegaly and the other is insulin auto antibodies. Other things that can contribute to higher insulin needs or making it hard to regulate are feeding dry or other high carb food, needing a dental, or certain medical conditions such as pancreatitis and hyperthyroidism.

Since you are home testing (good for you!) we share results in a common spreadsheet format. If you are interesting sharing that data, the instructions to do so are here. We can help you with dosing if you create that spreadsheet. People who post on this forum suggest a no shot value of 200. As you get more data on how Tikki reacts, you can shoot at lower numbers.

There is lots of information on Lantus in our Tight Regulation Forum, including a description of the protocol that many of us here use to determine changes in dose. As Chris mentioned, we do start with a lower dose (based on kitties weight) and make smaller changes so we don't miss the good dose.

As for food, any low carb wet food will do, you don't have to buy the expensive veterinary food. There is a good explanation of kitty nutrition at http://www.catinfo.org and a chart listing most foods and their breakdowns. Anything with a carb% less than 10% is considered low carb. A lot of people here feed in the 3-6% carb range. I would eventually get rid of the dry food if you can, but gradually, as that can have a huge impact on the numbers. We had one member whose kitty went from 5.5 units to zero in 24 hours after removing all dry food from the house. It was a rather intense 24 hours!
 
Re: new to board - not sure whether or not to give shot-stal

Hi again Beth and extra sweet Tikki!

Most vets do what yours did, and increase in whole units, and too quickly. And many times, the first time we hear from people here is when their kitty is in a hypoglycemic crisis and their vet isn't available :sad:

We really can help you get Tikki better regulated, and do it very safely! Since she's had ketones, it's important that you're testing for them. You can get ketostix from any pharmacy to dip into her urine to make sure you stay on top of that. If they are caught early, sometimes they can be dealt with at home, but as you know, if they get out of hand, you have a very sick kitty, very quickly and it can take a lot of time and money at a vet....and it's not always successful
Here are some Urine Testing Tips that can help you.

It's really wonderful of you to have taken in your neighbors cat when it needed you! Sounds like you're a crazy cat lady like the rest of us, and also that you just understand that animals aren't something you just "throw away". It's really sad so many people think they are!

The people here have years of experience to share with you...and that experience is day in, day out...24/7/365. No vet can keep up with the latest treatments for every disease in every animal they see, and they get the vast majority of their nutritional education from salesmen that come into their practice to sell food. The people here do nothing except deal with feline diabetes and the diseases that come with it...and there's no better experience out there than real life!

Hope you'll let us help! Ask questions if you think of them too!
 
Re: new to board - not sure whether or not to give shot-stal

hi beth! and tikki!

feline diabetes is what we all do 24/7 - we can help you with Tikki. Cats feel better when their blood sugar is under control and not fluctuating all over the place. It also prevents organ damage.

The first step is a spreadsheet. Wendy gave you the link for that. Numbers don't lie - they tell us the story of exactly what's going on with the blood sugar and how well the dose is working. We can look at the past several days and teach you how to "read" what's going on so you can help Tikki get regulated. There are a few circumstances where high numbers don't mean the cat needs more insulin. When we see data on a spreadsheet, we can tell you when it means increasing, when it means the dose needs to be decreased, or when you should just wait for his blood sugar to come down on its own.

I'm glad your vet recommended FDMB. Everyone here is a volunteer who has experience with diabetic cats. It's not so scary when you learn enough to feel like you are in control of the blood sugar, knowing when to increase, when to decrease, how to handle low numbers, and the science behind how diabetic cats can go into remission.

Cats who get into Tight Regulation (meaning their blood sugar is kept between 50-120, which is normal numbers) as quickly as possible after diagnosis have the best chance of having their pancrease heal and becoming diet-controlled. The link that Wendy gave you to the Tight Regulation protocol has a PDF 5 paragraphs down that describes how this can happen. Not every cat gets there, but if that is your goal, the sooner you learn about Tight Reg, the better.

keep posting, keep asking questions.
 
Re: new to board - not sure whether or not to give shot-stal

You're already home testing and that's terrific. You might find it helpful to have some reference numbers to use for comparison to the tests you get.

Comparing a human glucometer to a pet-specific glucometer is like reading temperature in Celsius vs Fahrenheit. Both are correct. You just need to know the reference ranges to interpret what the numbers mean.

[Glucose reference ranges are unsubstantiated and have been removed by Moderator]


* * * * * * * * * * * * * * *​
Examples of using the chart:

Ex. You are a new insulin user and you test your cat before giving insulin. The test is 300. It probably is safe to give insulin.

Ex. You are an established user of Lantus, following the Tight Regulation protocol. You've tested around +5 to +7 to spot the nadir. It is 200 mg/dL. You probably need to increase the dose, following the instructions for the protocol.

Ex. Your cat is acting funny. The eyes are a bit dilated. You are concerned and test the glucose. The number is 35 mg/dL. ACK! The cat may be in a hypoglycemic state. You quickly follow the HYPO protocol linked in the glucose reference values chart. (which we really, really, suggest you print out and post on your refrigerator.)
 
Re: new to board - not sure whether or not to give shot-stal

He has earned a dose reduction of 0.25 units by going below 50 mg/dL if using a human glucometer or 80 mg/dL using a pet glucometer.

Also, please make sure you have a 'hypo' kit available - Karo syrup or other sugar syrup, high carb gravied food (ex Fancy Feast Gravy Lovers), oral syringe, and directions to nearest 24 emergency vets.
Short version of hypo protocol:
When the numbers go below 50 mg/dL on a human meter or 70 mg/dL on a pet meter, do the following;
Retest to confirm
If still low, feed 1-2 teaspoons of high carb food or regular food with a few drops of syrup on it.
Wait 20 min
Re-test.
Repeat until you've got 3 rising tests and are past nadir (lowest glucose between shots).
 
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