New to forum and could use help

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GregFurBall

GregFurBall

Member Since 2012
New this this forum and having a hard time navigating around it.

Here's our story. Fur Ball was dx'd with diabetes on 9/5/12 (he is about 8.5 years old). We have lost 3 of our other kitties (2 passed away and the other one we were fostering for 2 years went back home). I had hoped Fur Ball was relishing in being the single kitty of the home. However, he had been drinking a lot of water since May/June, urinating excessively and not eating as much. The cat we fostered was kind of a bully and Fur Ball was afraid to 'do his thing' having been trapped in the litter box before and since he was gone I thought Fur Ball may have been making up for lost time.

We took him to the vet and she did a blood test (BG at 401) as well as an urinalysis to confirm. He weighed 17.36 lbs (down from about 24 lbs a year ago...yes he is a big boy). She told us to give him Hills M/D dry (Fur Ball was used to IAMS) and we started him on 2U of Lantis twice daily. We have been fairly consistent at giving insulin at 7am and 7pm. She said to not worry about home testing (which we were a bit leary of). We returned to the vet on 9/11/12 and the tech tested his blood at 1:00pm (mid-cycle) with a BG reading of 116. Weight had increased to 17.96 lbs.

I have been doing a lot of research since getting the dx. Found catinfo.org and have really appreciated that information. We made the decision to get him off dry food and started him on Wellness Core (I found Binky's food charts. Wonderful resource!) until we could figure out which raw food diet would work best. We transitioned him to Natures Variety Chicken Medallions and he has been on a completely raw diet since 9/17/12. Given all the research, we are blessed that he transitioned so quickly. I think he is feeling better and has equated the food change with that.

While we like our vet, I suspect she is not as well-educated about diabetes and after discoverying this board, we decided to seek your assistance. We also made the decision to start home testing on 9/17/12. We purchased the Relion Confirm. With our work schedules we have not been able to do much testing during the day but have completed a curve on 9/22/12. However, we just learned that Lantis is a depot-type of insulin. My husband was using the old-school way and we dosed to Fur Ball's BG which is why our spreadsheet numbers look so crazy. Doing this curve, we decided to just start low and stay consistent at .5 for the next week and try another curve next weekend. Especially since he is on a low carb/high protein diet now. At least that is what makes sense to us so if there are any other suggestions, they woud be greatly appreciated.

Regardless, all of the changes we have made really do seem to be positive. Fur Ball is a much more playful and cuddly cat. We really want to make wise decisions for his care but have definitely felt overwhelmed by this sudden change in our life. Thank you for being available for us.
 
Welcome Greg, Karen, and Fur Ball :-D

You did a good job, finding this place, learning to test, setting up your spreadsheet, transitioning to raw, and I thing starting over at 0.50 is a good idea right now.

I would suggest that you open a new post in the Lantus TR forum, tomorrow morning. You're doing a great job.

We want to try to get Fur Ball on a dose that you can give consistantly every 12 hours.
 
Hello Greg, Karen and Furball, and welcome the the FDMB forum! :-)

Well, wow! You certainly have accomplished a great deal in a very short space of time. Furball is a very lucky cat. :-)

My cat was a similar age to Furball when he was diagnosed. That was five and a half years ago and he's doing just fine.

I can't advise on dosing. But I'm sure there are others here with that experience who can soon help with that.

I think we probably all felt overwhelmed when our cats were first diagnosed. There's the shock of the diagnosis, and then the challenge of trying to cope with giving shots and blood glucose tests. It's such a steep learning curve. But you will find a lot of support at FDMB. The forum is international (although mostly American) so there's pretty much always someone around if you need help.

One thing I would suggest you do (if you haven't already done so) is to print out the info page about the symptoms and treatment of hypoglycaemia (very low BG). It may be that your cat never has a hypo episode, but it is as well to be prepared. The link is here:http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=15887

Best wishes,

Elizabeth
 
Welcome, Greg, Karen and Furball!

You're doing great so far! Well done :mrgreen:

I agree with Dyana: The 0.5u is fine for now. As you've learned already, the 12-hourly rhythm is crucial for Lantus insulin to be able to work its magic.

A little clarification: The preshot-based dosing isn't so much "old-school" as it is a method used for different types of insulin like PZI. Lantus is a newer insulin, and you're right, some vets tend to treat it the same as the "older" insulins, which doesn't work well at all for Lantus. It's good that you're educating yourself - maybe your vet will be receptive to you sharing what you learn, in time!

You'll soon learn more and more about how Lantus and its "depot" (which we also refer to as the "shed" over in the Lantus ISG). A quick intro for you: Lantus is stored as a precipitate (i.e. it forms micro-crystals) in the fat under the skin and is released gradually. During the first few days (usually 5-7) on Lantus, the amounts you inject are partially building up the depot, which is then continuously re-filled/kept up through subsequent shots. As you collect more data on how Furball responds to Lantus, you'll start learning about how to actively use the depot, and how it works, to your advantage.

I'd like to second Dyana's invitation to the Lantus ISGs - we'd love to see you there. There are two groups: One is called "Relaxed Lantus," and the other (the one where Dyana and I post our own cats' threads) is called "Lantus (Glargine) Tight Regulation," where we follow a specific (and scientifically based) protocol on how to treat our cats' diabetes and how to approach issues like dosing. A good place to start reading is the list of "stickies" (the starred threads at the top of the page in the Lantus TR forum).

Welcome the greatest place you never wanted to be :smile:

One last note: If you have time, it would be wonderful if you could set up an FDMB Profile by following this link to the instructions. Your story, Furball's story, and the background information (diet, medical history, FD history, a little about you if you like, etc.) are very good to have all in one place, so that when we show up to give you feedback, advice or even just support, we can easily access the overview of the relevant info that profiles give us. If you click on the links to the profiles of those of us who've already posted here in your thread, you'll see some examples of what profiles can look like.

It's great to have you here!
Jane
 
thanks everyone. We really appreciate the feedback. We just tested him this morning and his BG is 110. Do we still give the .5 dose?
 
Greg. Why don't you post this question, over on the Lantus TR forum? I posted late last night that you might be coming over, and that post got 18 hits, so people know you may be coming over.

Usually with new people that don't have much data (test numbers) yet, we say to not give insulin if the BG is below 150.

I have to leave in 30 minutes, so can't be here, but there are a lot of people more than willing to help you and guide you and welcome you over on the other forum.
 
Greg, if BG is 110 then that is a normal (non-diabetic) number. At least I think it is. I'm in the UK, our BG numbering is different here so I need to divide your number by 18 to get a UK number. (She fiddles with calculator...) OK, that's 6.1 in UK numbers which is at the upper end of the NORMAL range...
 
Greg, I've pasted info below from the 'FAQ's'

- - - - - -
Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?


A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines. Below 150 mg/dl (8.3 mmol/L), don't give insulin. Between 150 and 200 (8.3-11.1 mmol/L), you have three options: a.) give nothing; b.) give a token dose (10-25% of the usual dose); c.) feed as usual, test in a couple of hours, and make a decision based on that value. Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise. In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine. Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.

Keep in mind that these are general guidelines, and they should be personalized to your own cat's reactions to insulin. If your experience is that your cat does not became hypoglycemic with a dose which is close to her usual, then your experience should be your guide.

Lantus and Levemir users: Because Lantus and Levemir are gentler insulins, you may find that these guidelines are stricter than you need. If you have some data on how your cat responds to insulin, please read Jojo and Jill (Team J)'s guidelines at FDMB (http://www.felinediabetes.com/phorum5/r ... 22,1017956).
 
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