New to diabetes and Lantus BG 100

Hi my kitty 9 year old Lucy spent 5 days in the Vet ER hosp and was diagnosed with diabetes and pancreatitis. She was put on1 unit of Lantus and came home 2 nights ago. (Sorry if I i don't get all the lingo right) I gave the insulin Wednesday am and then took to vet for testing. Her BG was only 49 on an AlphaTrak and vet said cut dose to .5. However I had the wrong syringes and couldn't do .5 that evening.

I called the ER and the vet there said don't give any insulin until I recheck BG in am. This morning BG was 421 at my vet at 830 am on the AlphaTrak. I gave .5 u at 930am. At 630 tonight I did home testing and got 100 on the ReliOn Micro.

She's not eating on Her own so I'm syringe feeding Her. She last ate at 7 am. People on the Facebook group told me I should check here for what to do. Im overwhelmed and confused! Testing went well anyway.

She was originally supposed to get insulin at 7am and 7pm but thats been hard due to her having to be syringe fed. Someone suggested i should check BG again at 930 and not give insulin unless BG is 200+. Is that what is best?

I've been so overwhelmed with learning everything! I understand that low is worse than high so is 200 a good number on the ReliOn? Any help is appreciated!

Spreadsheet coming tomorrow! Thanks!

 

What food are you feeding?

Glad you are home testing.

 

She is still on the urgent care a/d by syringe. I've tried every type to entice her. She's on an appetite stimulant and gets another one tomorrow am. Also requested anti nausea from vet and she had that at 930 am.

 

Hi and Welcome to Lantus and Levemir group. It will all get easier , I promise. We all arrived here confused and overwhelmed.

The problem at hand is to get her eating so that you can give her insulin. Did they send you home from the hospital with any medications to help stimulate the appetite or any pain meds for her. The pancreatitis can make her feel pretty crummy and have pain.

Once she is over 150 you could shoot if you think you can get her to eat and if your schedule can be off by the amount of time you went over 7 PM.

Have you tried all meat baby food ? Beechnut brand is the best as they do not put any cornstarch in their food. When Bubba goes off his feed, baby food either chicken, turkey or ham will get him to eat again.

I see you just answered some of my questions about meds. Any pain meds?

 

Good on the a/d. Depending on which table you look at it is 3-6% carb. High(er) in calories than some low carb foods.

Any mention of DKA (ketones or ketoacidosis)?

Did they treat with any steroids (prednisone or the like)?

Just trying to gather information, no right or wrong answers

 

No pain meds. I could ask for some tomorrow. I got some baby food but it was Gerber. I can try beechnut tomorrow.

So if I test at 930 and she's 150 or over, I should feed her and then shoot? Would it make a difference to feed her regular pate with broth in the syringe instead of the a/d?

 

Yes, she did have DKA. They didnt mention steroids to me.

When she first got sick, my old vet just thought she'd been scratched and gave antibiotics. He then told me to sit tight and wait for them to work but she got sicker so it was day 3 before I took her to the ER. After the ER visit I changed vets to one more expert in diabetes.

 

Ok, that puts it in a different light. Gizmo didn't ever have ketones but he has been hospitalized 3x's for pancreatitis. The 2nd time he was treated with steroids which pushed him into diabetes.

Need to get her eating. Right now feed her anything that she wants. If she won't eat on her own you need to continue syringe feeding.

Going to tag @tiffmaxee @Bobbie And Bubba @Wendy&Neko hopefully they will give dosing advice.

 

Do I just syringe feed twice a day before insulin? Since she isn't eating should it be more often?

 

How much does she weigh? How much food are you able to get into her at a time? Smaller, more frequent it better.

There is a link in my signature "Primer on Pancreatitis" it will give you some good info.

 

Thanks! She weighs 11 lbs right now. My instructions were to feed her twice a day then give insulin but that doest seem like enough right now.

Shes getting 15cc of the a/d twice a day.

 

Most of us feed multiple small meals instead of 2 big ones....One of the things about Lantus is they don't HAVE to eat a certain amount before giving it as long as they are willing to eat (or you're able to syringe feed)

Each shot doesn't usually start to "kick in" for 2-3 hours, so you have extra time to get food into them. Older, harsher insulins were different and they needed to have food on board first, but not necessarily with Lantus.

That's not nearly enough....30cc's in only 1 ounce! A can of Fancy Feast is 3 ounces and most cats need at least 2 cans per day.

Are you testing for ketones?

 

Looking forward to that spreadsheet. I don't feel comfortable giving suggestions on dose without it.

Please put something like DKA in your signature, plus the date that happened. That can impact what people suggest regarding dose.

If you are feeding A/D, you probably want to feed close to the entire can per day.

 

No im not doing ketones.

Should i be feeding her 4 meals of 15cc then? I think the ER vet was hoping she'd be eating on her own by now

 

Should i split into smaller feedings then? The Er vet just said make sure she gets at least 1/4 can before insulin.

 

Help! Now her B G is 62!

 

I posted snother thread with background but i tested my cats Bg at 630 and it was 100 and now its 62! Should i just feed her? I didnt feed her at 630 because her last insulin was at 930am so was going to test and feed at 930.

 

62 is still safe, but you could go ahead and give her a little food

I think you'd better plan on skipping tonight

 

Please take another test 20-30 min without feeding, and post it here please.

 

there is history of DKA per Sig line...

 

She needs more than she's getting....15cc is only 1/2 ounce.....she should probably be eating closer to 6 ounces per day

I'd try to get at least the whole 5.5 ounce can of A/D into her ….if you can syringe 30cc's every 4 hours, that'd be 6 ounces

The ER vet doesn't know Lantus very well....it's not necessary for them to eat before shooting....just that you can get them to eat before it starts to "kick in"

 

I'm now watching too. Agree with the advice. 62 is borderline and not critical yet.

If the next reading is low, then feed her and get the BG up.

 

There is another thread going
http://www.felinediabetes.com/FDMB/threads/new-to-diabetes-and-lantus-bg-100.196647/

 

Yes, I know but it's 9:30 now and the cat is at 62 and has only been testing for 12 hours.....If she's only been giving .5 and also only feeding 15cc's twice a day, I think it's more important that she get more food in first and get some ketone test strips if at all possible

We have no BG history on this cat and I'd like to make sure she's really only giving .5 (not 5U.....had another sugarcat mom doing that earlier this week)

 

Ok thanks. This thread should be ignored. The other one is active.

 

@Joanj ….can you take a picture of your syringe with what you think is .5 and post it here?

 

I went over the dosage and did a trial shot with the vet. Its definitely .5

 

I just gave her 2 syringes full so 20cc. Should i give her more in 4 hours or so? Im willing to stay up tonight

Should i do Bg again tonight in a few hours or wait til morning?

 

can you take another test now?

 

I did a BG about 45 min ago and fed her. Is now a good time to repeat then?

 

Where the plunger is in that picture, it looks more like 2U to me (kind of hard to tell though)

 

The last picture here is where .5 is on a syringe with half unit markings. It's the first "little" line following the Zero line (the long line nearest the needle)

 

Looks close to 2 units to me.

 

no, it can wait until the dose is cleared - it is very important to verify that you are indeed are giving no more than half a unit...
ETA: it does look more than the 0.5U on the pic you've attached.
When to test next and what type of food to feed depends a lot on what dose was given in te PM cycle.
Any chance you can retake the pic at the angle where it clearly visible that only half a unit was drawn?
@Joanj

 

If she keeps it down, I'd try to get another 20cc's in 4-5 hours. To combat ketones, they need more calories than usual, so as long as she'll tolerate it, I'd really push the food.

As soon as you can, I'd get some urine ketone test strips too. It's very important to keep monitoring her so if they start to increase, you can get her treated early instead of risking another DKA.

They're available at any pharmacy...I know our WalMart has them for a couple bucks

 

Ok ill do that and get the ketone strips tomorrow. Here is the photo maybe clearer

 

Half unit i gave was the very first half line

 

OK great.....Thanks for clearing that up!!

We had another member within the last week who thought she was giving 1U.....the pharmacist had told "shown" where 1U was....she was actually shooting 10U!!

 

OMG! I went over it thoroughly with the ER vet and my own vet as i was paranoid of doing it wrong.

I actually have some ketone strips from when i was on the keto diet. Theyre for urine. This may sound dumb but how do you do that on a cat?

 

Ok, thank you!

I wait for my cat to go into the litter box and hold long handled table spoon underneath the stream - you 'll need to collect very little of urine.
Some use plastic wrap to cover the LB and than take a sample from there.
Some hold the testing strip in urine stream.

 

First of all, there are no dumb questions here!!

Here are some Urine Testing Tips

It's important to make sure to get your reading 15 seconds after the "dipping" and in a good light

Anything over "trace" is a medical emergency

 

So to be clear - she ate about an hour ago and you did not give her insulin?
Can you take test now to check her BG level an hour after meal?

 

Yes she ate about 90 min ago. Her BG is now 68. It was 62 before. No insulin

 

Thank you!

You did not give insulin this evening yet, correct?

 

No none since 930 am. Her BG was 412 with alpha trak at the vet this sm.

 

Good choice!

If Lucy is high enough by 7am (and that's the time that works best for you to shoot every 12 hours), you can shoot then

 

Thanks do very much for everyones help! You are lifesavers- mine and Lucy's!

 

That's what we're all here for!!!

When you get a minute, would you go ahead and add more information to your signature? We like to have stuff like:

Your name/cat's name, age, sex, date of diagnosis, type of insulin, type of meter, type of food, any other health issues? and a general location.

When you get your spreadsheet set up, the link would go into your signature too.

 

Ok working on signature now.

 

When I have had to syringe feed, I fed fairly frequently but smaller meals, about six feeds per day.

 

See if the vet will give a Cerenia shot and also give Cerenia pills. The pills are a bit expensive but worth it if it can get her eating. More than likely she is nauseated from the pancreatitis. Another nausea med is Ondansteron (Zofram), it is a human med and if you can get a scrip it may be less expensive to get it at Walmart (or similar). See if you can get both. They can be given together and work a bit different on the nausea.

Most common appy enhancers are Mirtazapine and Cyproheptadine - Gizmo doesn't tolerate the Cypro but does well on the Mirtz - but ECID (every cat is different) so you will just need to experiment - see if the vet will give you both. They cannot be given together and should wait to give the other by a day or so after the first one tried (unless it works and then stick with what works).

Pain meds usually prescribed is Bupe (buprenorphine), I give Gizmo Torbogisic only because he seems to tolerate it better than the bupe. Be careful as the pain meds can kill the appy (double edge sword )

I am sure that they did labs while she was in the hospital - could you post those? Any concern from the vet about kidney or liver issues?

How is she doing with the force feeding? You might try to put a bit of the a/d down in front of where she is laying and maybe drizzle a bit of tuna water (make sure it is water not oil) on top. Warming the food a bit in the microwave can help - it will release the odor and sometimes that will entice then to eat.

Please start a new condo (with today's date) and new BG numbers when you get a chance and get the spreadsheet set up as soon as you can (we are a bit data obsessed here ).

To tag a user if you have a specific question for someone just add the @ symbol in front of the user's name - like @LizzieInTexas

Keep posting and keep asking questions - this is the best place you never wanted to be

Oh, and welcome to another Texas kitty and bean (human).

 

For the sake of continuity, the threads have been merged.