New to Lantus TR with a Juvenile Diabetic - a few questions

[KPassa]

Hi Everyone,

My 6 month old kitten, Mikey, was just "officially" diagnosed with diabetes last week. For the last few weeks prior, I've been giving him 1 unit of Lantus twice a day as the vet and I continued monitoring him in the hope that his elevated BG level might be a side-effect of something else going on (he initially presented with a UTI) and would clear up on its own.

Last week, my vet recommended I increase him from 1 u to 2 u, but since last week, I've switched him over from dry cat food to Fancy Feast Classics (they're the easiest to find, but I just discovered my local pet store carries Nature's Variety, so I'll probably be switching him to that), so I held off on increasing his dose to see how the food change played out on his BG levels. Yesterday, I was finally able to start monitoring his BG levels with a glucometer (when I first bought it last week, I didn't realize you had to purchase test strips and lancets, too). I'm still not very good at it and poor Mikey has been a real champ through all the numerous pricks, but I've been able to get a few readings so far.

On Saturday night, he began throwing up his food. I thought it might be related to the switch in diet, so I watched him carefully. He continued throwing up his food yesterday morning as well, so I skipped his morning insulin shot just in case low BG was the cause (this is before I figured out how to use the glucometer on him). The reason for this is that I've noticed over the last few weeks that his morning insulin dose seems to put his BG too low (lethargy, listless, lip-licking, etc...).

(I also think I've pinpointed the vomiting to the particular type of cat food (Fancy Feast's Classic Tender Beef) because when I switched him to a different one for his breakfast yesterday (FF's Chicken Feast), he had no problem holding it down; when I gave him the leftover beef for lunch, he threw it up again. I haven't given it to him since and he hasn't thrown up since.)

I finally was able to test him the first time yesterday around 5:30 pm and his BG tested at 222. Note that this is after not having received his morning insulin shot. I gave him his evening insulin around 6:15 pm and fed him and then was able to test him again around 8 pm, where it was around 185. This morning, I was running late for work so I didn't test his BG before I gave him his breakfast and insulin shot at around 7:30 am. When I tested it today at noon, it was at 57! I gave him some more food and tested him again around 1 pm and it's now at 180.

First question: since he's still a kitten, should I be feeding him two cans a day instead of 1? Or should I be finding other food that's kitten-specific for him? Should I be adjusting him to scheduled twice-daily feedings or just ration it out over the day as I see him looking for food (as I've been doing)?

Second question: how does the time-release on Lantus work? Would it be his evening shot or his morning shot that seems to overcompensate for his insulin causing him to seem mildly hypoglycemic? If what I suspect is true, is it possible to give a larger dose at night and a smaller one in the morning or do the doses have to be the same size?

Third question: I have two massive litter boxes, one smaller box, and he's given free reign of our backyard to do his business in. For the past month since all these troubles started, he seems to have "gone off" his litter box, meaning, if he pees in it once, he will not use it again until it's completely cleaned out, not just scooped. This is problematic because he's been consuming a lot more water (one of the reasons I took him into the vet in the first place) which makes him pee a lot more often. I work all day and can't be here to scoop after him each time he goes. He'll also hold it in till either the litter box meets his standards or he has an accident because he didn't make it outside in time. Has anyone else experienced this? Could it be the type of litter? Has the smell of his urine perhaps changed to the point where he can't even tolerate it? Another weird, possibly related bathroom thing is that I've caught him a few times licking his fresh poop.

Last question (for now :lol: Due to my work schedule and regular life events, I try to give his insulin shots between 6 and 9, separated by at least 12 hours, i.e. if I gave him his evening shot at 7, I won't give his morning shot till at least 6:30, preferably later. Even though my vet said an hour or so of overlap is fine, I've only felt comfortable with about a half-hour or so. Do I need to be even more rigid with this? Is this causing some of the problems I'm seeing?

He's got another vet appointment scheduled toward the end of this week (I want to do a curve on him first before I bring him in again) and I want to be able to explain to the vet what I think is going on so we can adjust his dosage appropriately, if need be, so any information is greatly appreciated. :smile:

 

[rhiannon and shadow (GA)]

Re: New to Lantus TR with a Juvenile Diabetic - a few questi

Hello.
Welcome to LantusLand.

It sounds like you are off to a good start. It does take practice to get better at the testing. I hope you have found a treat that Mikey likes
to reward him for cooperating with testing. It helps when they get fed up with being poked. If you have any testing questions, be sure
and ask.

I thought I'd share with you a food list I created looking for some of those lower carb canned varieties that hardly has any beef on it.
( my cat doesn't like beef canned foods)
canned food list
The carb value is the % on the left.
I really like the Nature's Variety line since it's low carb and has good phosphorus ranges. It may become our dominant food at my house.
My personal belief is to give smaller meals more often.
Someone will come along and give you the proper amount for a kitten.

Lantus needs to be consistent in dosing amounts and it needs 12 hr intervals. If you can figure out a way to manage it, it's really
good for you to be able to monitor after the shot times and get a +2 test. That may mean giving up some sleep but it's really hard if
you shoot and run out the door to work to know how your cat is doing during the cycle. Your cat will have his own pattern and you will
learn it by testing and seeing how he reacts to the insulin.
Someone who can advise on dosing will come along later but it sounds like your dose could be a little high. They will tell you the proper
dose that you will be able to shoot twice a day.

The litterbox odd behaviour almost sounds like he's hungry. I'm sure there are other conditions I don't know about that could be at play..
but I have known a few hungry cats who had no food available to eat their own poop.
Diabetes starves their bodies even though they are eating, the nutrition isn't getting where it should so their body doesn't recognize
the quantity of food being taken in. Especially a kitten that would have a higher calorie need while he is growing.

 

[Sienne and Gabby (GA)]

Re: New to Lantus TR with a Juvenile Diabetic - a few questi

Welcome to Lantus Land!!

What a little guy to have to be dealing with all of this! A UTI could certainly have contributed to his developing diabetes. Do you know if your vet sent blood out for a spec fPLI -- this is a test for pancreatitis.

Beef and fish are two of the most common foods that cats are allergic to. I think Mikey has told you in no uncertain terms that beef and his tummy and not in agreement. (My kitty doesn't handle beef well, either!)

I would not increase a dose by an entire unit. When we adjust doses, it's in 0.25u increments. It is far too easy to miss what would be a good dose by increasing too much.

Food: I don't think it's necessary to feed a kitten variety. If you want to try it, the following are all within the acceptable carb range for a diabetic cat: Authority chicken & lamb (10% carb) or chicken & liver (6%), Eukenuba kitten entree with gourmet chicken (1%), EVO chicken & turkey for cats and kittens (3%), Fancy Feast Kitten in Tender Turkey Feast (4%) and Tender Ocean Whitefish Feast (5%), Felidae Cat & Kitten (9%), Iams Pate w/ Gourmet Chicken-Kitten (10%), Innova Cat & Kitten (8%), Max Cat Kitten Chicken & Liver (10%), Pro Plan Kitten in Chicken & Liver (2%), Whitefish & Tuna (6%), or Salmon & Ocean Fish (3%), Pro Plan Selects in Chicken & Brown Rice - Kitten (5%), Royal Canin Kitten (10%), and Wellness Kitten (5%).

When my cat was diagnosed, I had a kitten I put them both on the same adult cat food. It was fine. I also think it's fine to feed a kitten as much as he wants. I got no guidance from my vet regarding how much to feed a kitten but you may want to check the number of calories per day that your vet would recommend. I wouldn't go by the number of cans -- I'd go by calories.

Second question: how does the time-release on Lantus work? Would it be his evening shot or his morning shot that seems to overcompensate for his insulin causing him to seem mildly hypoglycemic? If what I suspect is true, is it possible to give a larger dose at night and a smaller one in the morning or do the doses have to be the same size?

Lantus is not "time released" in the way that you're thinking. Its a depot-type of medication. This is not the same as being time released. You want to shoot the same amount of insulin twice a day. Giving uneven doses is going to give you wonky numbers. Many cats do seem to experience lower numbers at night. Remember, many cats are nocturnal so they may be more active at night.

Litterbox: I would talk to your vet about the litterbox situation. Cats are far too fastidious to play with their poop. Mikey may have some nutrient deficiency. That may be more the cause for the poop situation. I suspect that Mikey likes being able to go outside and mark his territory. You may have created a monster by letting him outside. There is a litter called Dr. Elsey's Cat Attract Litter. You may want to try that.

Last question (for now :lol: Due to my work schedule and regular life events, I try to give his insulin shots between 6 and 9, separated by at least 12 hours, i.e. if I gave him his evening shot at 7, I won't give his morning shot till at least 6:30, preferably later. Even though my vet said an hour or so of overlap is fine, I've only felt comfortable with about a half-hour or so. Do I need to be even more rigid with this? Is this causing some of the problems I'm seeing?

Lantus works best the more consistent you can be. Your vet is wrong when it comes to the timing of Lantus shots. An early shot acts like a dose increase; a late shot acts like a dose reduction. Up to 30 min. will not have that big of an effect. However, you do not yet have enough data on Mikey to know how he will respond to early or late shots. If you are giving a shot more than an hour early, it may be having an effect.

The bottom line is that until you have more test data, we'd just be guessing at what's going on. As soon as you're able, it will be very helpful if you can set up a spreadsheet. This will allow you to keep all of Mikey's test data in one place and it will allow us to provide you with more input.

 

[KPassa]

Re: New to Lantus TR with a Juvenile Diabetic - a few questi

I thought I'd share with you a food list I created looking for some of those lower carb canned varieties that hardly has any beef on it.

Thanks so much for the food links! Do you have any recommendations on treats? I was using Trader Joe's cat treats back before I learned all about cat food and carbs (was that really only last week??) I haven't used them since because I haven't been able to find out the carb content to know if it's okay.

Lantus needs to be consistent in dosing amounts and it needs 12 hr intervals. If you can figure out a way to manage it, it's really
good for you to be able to monitor after the shot times and get a +2 test.

What is a "+2 test?" If I'm understanding the terminology, does that mean test him 2 hours after I've given him insulin?

A UTI could certainly have contributed to his developing diabetes. Do you know if your vet sent blood out for a spec fPLI -- this is a test for pancreatitis.

Here are the tests Mikey has had in the last few weeks (some of them multiple times): X-Ray, Blood test, Urinalyisis-Major, Fructosamine level, Physical Exam, and a Total Body Function (includes superchem, CBC, T4). I'm not even sure what some of those tests are, so maybe he did? The vet didn't think it was pancreatitis or an under-developed pancreas due to the symptoms he was exhibiting and that all the tests he ran showed nothing else wrong with him besides the UTI and the elevated sugar levels. He ultimately thought the UTI was caused because the sugar levels were so elevated that it created a perfect environment to breed bacteria. I gave him Clavamox for a week and it seems to have cleared up and not returned since.

I would not increase a dose by an entire unit. When we adjust doses, it's in 0.25u increments. It is far too easy to miss what would be a good dose by increasing too much.

I'm glad to know my gut instinct was right in holding off on increasing his dose to 2u, especially since I was changing his food. My vet wasn't too happy about this and said, "well, since you're going to do what you want to do anyway, do you still even want to bring him in next week for his follow-up?" He also sold me Hill's Prescription dry M/D cat food. I have a feeling I've now become better educated about this stuff than my vet....

When my cat was diagnosed, I had a kitten I put them both on the same adult cat food. It was fine. I also think it's fine to feed a kitten as much as he wants. I got no guidance from my vet regarding how much to feed a kitten but you may want to check the number of calories per day that your vet would recommend. I wouldn't go by the number of cans -- I'd go by calories.

This is how I was estimating his calorie intake: for his food, each Fancy Feast can is approximately 90 calories. Mikey weighs about 4 and a half pounds right now. If he were an adult cat at a healthy weight, this means he should be consuming ~80 calories a meal, i.e. 1 can. Since he's a kitten, it seems he needs double the calories, so two cans. I'm not sure if my math is wrong or if the starting numbers are incorrect (I got those from googling calorie counts for cats and kittens), but that's why I wanted to check. :smile: Either way, he's been much happier with me these last couple of days since I've been giving him more than the "recommended amount" of food.**

Lantus is not "time released" in the way that you're thinking. Its a depot-type of medication. This is not the same as being time released. You want to shoot the same amount of insulin twice a day. Giving uneven doses is going to give you wonky numbers. Many cats do seem to experience lower numbers at night. Remember, many cats are nocturnal so they may be more active at night.

Yes! This is the information I was looking for on how Lantus works. So, from what it sounds like you're saying, it seems like it's more of a cumulative effect depending on how much insulin Mikey's body is using. How specifically does that work? I remember reading somewhere that unused Lantus actually stays in the system up to 36 hours. The reason I've skipped his morning dose a couple of times is that his morning listlessness seems to progressively get worse till I skip one. Then, the next morning, he's almost as good as he is at night. The second morning after, he's a little worse, and so-on and so-forth till I skip another dose (seems to be almost a weekly occurrence).

The bottom line is that until you have more test data, we'd just be guessing at what's going on. As soon as you're able, it will be very helpful if you can set up a spreadsheet. This will allow you to keep all of Mikey's test data in one place and it will allow us to provide you with more input.

THANK YOU! THANK YOU! THANK YOU! I was seriously planning on creating my own spreadsheet today to track all his numbers (I've gotten a few more already) and to help me time out the curve test for him. This has just saved me so much time!

One last question: Ear pricking. I've definitely poked quite a few holes in Mikey's ears over the last couple of days as I've been getting the hang of drawing blood. (Only took me two pokes this morning!) Should I hold off on doing the curve testing till his ears have healed up a bit more from my incompetence or am I worrying for nothing?


**Edited because I meant per meal, not per day as I had earlier stated.

 

[Sienne and Gabby (GA)]

Re: New to Lantus TR with a Juvenile Diabetic - a few questi

Take a look at the sticky on the Lantus depot. You've already got a good feel for how the depot functions. Given that you've been skipping shots, in part, that effects the depot. At least in humans, children metabolize drugs differently than adults. That may also be a factor with Mikey. Finally, and I think this is likely, the listlessness you're describing may be a matter of his numbers dropping low. For example, on 10/28, at your PM +2 (we speak in +times because we're all in different time zones so the actual time on the clock is meaningless and yes, it means the number of hours after you've given a shot), Mikey had dropped from 222 to 185. Ideally, you needed to get a couple of more tests. This is especially the case because your next test, on 10/29 at AM +4 was a 57. I suspect that Mikey's numbers dropped lower than the 57. That may have contributed to his not being energetic. Likewise, he bounced into the 300s by his PM shot. Some cats who experience those kinds of swings in blood glucose (BG) don't feel so great.

Many of us use freeze dried chicken (or other protein) as a treat. I also use Wellness jerky style treats. Here's a post on low carb treats.

You need to test. It is the best way to keep Mikey safe. You don't need to do a curve. Spot checks are fine. I would get a +2 and always a before bed test every night. You can pick other, random times to test. Or, you can test every 3 hours to see where Mikey's onset and nadir fall. You might want to get some Neosporin with Pain Relief. A tiny bit on Mikey's ears will help the healing process. If you look at Gabby's SS you'll see that I test a good amount. Gabby doesn't object -- she gets treats!

 

[rhiannon and shadow (GA)]

Re: New to Lantus TR with a Juvenile Diabetic - a few questi

On the neosporin, make sure you get the ointment, not the cream. Some of us put a little tiny bit before the poke because it helps the blood
bead up and not get lost in hair if he has lots of hair on the ears.
If you haven't seen this yet, this is good for testing tips. If you aren't testing all that much yet and his ears are already getting sore, you
may be poking a little harder than you need to. It's definitely trial and error.
home monitoring tips

 

[KPassa]

Re: New to Lantus TR with a Juvenile Diabetic - a few questi

Thank you all for your suggestions and help as I navigate through these first few weeks. I've gotten a lot better at testing in the last couple of days and now almost always get his BG on the first try. We're both much happier for it. I also discovered something called Vetericyn from my neighborhood pet store that seems to work in place of the neosporin (and without the usually unnecessary antibiotics). That same pet store also trains their staff in nutrition, so when I showed up with my diabetic food and treat lists, they were so helpful and already knew everything I needed, including the best litters to try for his urine-aversion issue. They knew everything I wish my vet had known and everything I've just spent the last couple of weeks learning on my own. I'm very happy with them.

I'm still working on getting more consistent BG testing throughout the day, but there are some battles with Mikey I'm willing to let him win because he's been such a good sport through my learning curve. (He seems to really dislike me testing him in the mornings.)

I have noticed that whenever his BG is around 100-200, he is his rambunctious, jumping, hyperactive, kitten self. When it drops to the 50s range, he's a listless bump-on-a-log and when it creeps past the 250s, he's relatively "normal" if he were an adult cat (but he's not an adult so his energy level seems low for a kitten). He also seems to have a wide range he flows through still, with his numbers being more stable (if a bit high) at night vs. dropping almost dangerously low during the day.

I have a follow-up with the vet this week and I'm not sure what to tell him: does he perhaps need a lower/higher dose? Could these numbers be affected by the fact he's still growing so his weight is increasing on a weekly basis (skewing the weight-based insulin dose)?

 

[Sienne and Gabby (GA)]

Re: New to Lantus TR with a Juvenile Diabetic - a few questi

The tests you've gotten where Mikey is in the 40s are flags that his dose needs to be reduced. This is from the TR Protocol sticky:

Reducing the dose:
If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.

If you're comfortable doing so, you can reduce Mikey's dose to 0.75u.

It does take some cats longer to be comfortable in lower numbers. Numbers that are over 120 are outside of the normal BG range. Normal is 50 - 120. You want to do what you can to keep Mikey's number at least below the lower 200s. The threshold for potential kidney damage (aka "renal threshold) is around 220 but this varies for every cat.

 

[Wendy&Tiggy(GA)]

Re: New to Lantus TR with a Juvenile Diabetic - a few questi

Hi there

Are you posting here on a daily basis? Would be nice to see how he is doing regularly - if you look you can see everyone else is posting daily so we can really see what is going on. Also maybe you want to read through some of the stickies on the protocol. I agree with Sienne too - take him down to 0.75IU and see how he does for three days - and please post on the forum!

He may be dropping too low at points ( below 40 ) and you aren't catching it and that would cause him to be tired and lack energy. And as Sienne says you dont want him spending too much time over 200 as it can cause damage to his internal organs.

 

[Frosty]

Re: New to Lantus TR with a Juvenile Diabetic - a few questi

I just wanted to pop into your condo and say hello and welcome to Lantus Land (LL). Your and Mikey are so lucky to have found this forum.

Tomorrow you will need to start a new condo with Mikey's AMPS (morning pre-shot) test. When you create it you need to put a link (called a fancy link here) to this condo in the post. It's the last thing in the post. If you go to other condos you will see at the bottom of their post something in the order of "Candies Condo" or in your case "Mikey's Condo".

Here are the procedures for doing that. If you have problems with this tomorrow don't worry about it one of us will help you with it. If you have questions please don't hesitate to ask. Again welcome to LL.

The way to make a fancy link is as follows:
1. Pull up the previous day’s condo

2. Copy the address of the link from the top of your browser

3. Then return to the Tight Regulations Page and click on the NEW TOPIC button on the top left above the first posts

4. At the top you will see several icons such as 911, a candle, rainbow, OTJ etc. Below them is the subject line. Put your subject beginning with the date (mm/dd) and your cats name then enter the numbers as you have been doing

5 Below the subject line are some tabs such as Quote, Code & URL etc. Click on URL

6. [url] will appear in white box belo... and place the condo link below your message.

 

[KPassa]

Re: New to Lantus TR with a Juvenile Diabetic - a few questi

The tests you've gotten where Mikey is in the 40s are flags that his dose needs to be reduced. This is from the TR Protocol sticky:

As of Monday evening, I've reduced his dose to .75 units. I haven't gotten as much testing as I would like in these last few days due to being away at work, not to mention the still ongoing battle to make BG testing a routine (Mikey says he needs to eat first before he'll cooperate), but I have visibly noticed a difference in that he's not slipping into his lethargic (hypoglycemic) state as often or as severely any more. I'm working from home tomorrow so it'll be easier to more consistently test him throughout the day and I should be able to get some good numbers with the new dosage.

Are you posting here on a daily basis? Would be nice to see how he is doing regularly - if you look you can see everyone else is posting daily so we can really see what is going on. Also maybe you want to read through some of the stickies on the protocol.

My goal is to post daily, but I'm not doing a very good job of it yet. I'm still making my way through the stickies as it seems that every time I think I'm finished, someone points me to a new sticky or a new section to look at. :lol: It's also only been the last few days that I've finally gotten good enough at testing his BG that it only takes one or two pokes now. His ears are still quite a bit splotchy red from all of my previous attempts over the last couple of weeks so I'm also holding off on doing a full curve test until my current skill level is able to compensate for my previous ineptitude and his ears start looking a bit better.

Your and Mikey are so lucky to have found this forum.

Tomorrow you will need to start a new condo with Mikey's AMPS (morning pre-shot) test. When you create it you need to put a link (called a fancy link here) to this condo in the post. It's the last thing in the post. If you go to other condos you will see at the bottom of their post something in the order of "Candies Condo" or in your case "Mikey's Condo".

Yes, we are indeed lucky to have found all of you! Thanks for showing me how to create a "condo" (I'm assuming this is another word for post?). I will try to set this up ASAP.

I do have a few more questions. I've seen a few places now where people mention the "meatloaf" or "catloaf" position. I've noticed since the beginning that Mikey was doing this, but I wasn't sure what it's related to. Can someone please explain this for me?

Second, when it comes to BG testing, I've noticed that he sometimes gives a lot more blood than normal. nailbite_smile It doesn't continue bleeding or anything, but it produces an amount about three times the size of his regular amount (which is about the size in diameter of an "o"). I've turned the lancet pen down to the lowest setting and I even tried it with a different lancing pen, but it still seems to happen about once or twice a day. Am I being overly anxious? Is this caused from all of the holes I've previously created in his ears?

Also related to BG testing, as I mentioned above, Mikey is not cooperative first thing in the morning until he's had his breakfast (I guess he takes after me and my need for coffee). I've tried treats and feeding him just a little bit, but the only thing that seems to work is a full meal. I discovered early on that the best and easiest way to to give him his insulin is while he's eating, so if I feed him breakfast and give him his morning shot before I get his AMPS, will this screw up the BG results significantly if it's only about 10 minutes? Will this cause problems with trying to get him regulated? Otherwise, about half my AMPS attempts end in failure for both of us.

Finally, last night, a problem arose that I hadn't ever considered: I was going to be physically unable to give his evening insulin shot and had no one around to do it for me (besides the fact that so far I haven't found someone I can train as my backup). Since I haven't read (or found) a sticky about this yet, I was just going to skip his evening dose rather than giving it to him a few hours too early or too late. Ultimately, I ended up being able to give it to him at the right time, but what do you do in times like this? Do you just skip it, give him a lower dose earlier/later? Am I the only person in this forum that can't seem to find anyone willing to give a cat an insulin shot? (Honestly, I've been told by three different people that I should just put him to sleep and get a new cat.)

 

[kathpj]

Re: New to Lantus TR with a Juvenile Diabetic - a few questi

Hi, I am a fairly new member of lantus land and certainly recognise some of the questions you are asking.
Taking blood from a warm ear is sooooo much easier than a cold one. Put rice in a small sock, tie a knot in it and microwave for a few seconds (we use 12 on full power) , not too hot and hold in on his ear till nice and warm. It will bleed beautifully. I always found one ear easier than the other. See REds spreadsheet link to how many times he has been poked in one ear and his ear is as good as new. Just clamp a tissue around the site for 20secs, good as new!
I changed my vet as he wanted me to do some very expensive protocols which you are quite capable of doing yourself. Lantus is increadibly powerful stuff and small amounts make one hell of a difference,
These fabulous people will give you endless support that is priceless. Keep posting, ask questions and you will be amazed at the combined wealth of knowledge. Trick is to keep your vet happy, they are not good at realising their limitations of knowledge!!
Good luck -remember the warm sock!
Kath

 

[Wendy&Tiggy(GA)]

Re: New to Lantus TR with a Juvenile Diabetic - a few questi

Hi there!

As of Monday evening, I've reduced his dose to .75 units. I haven't gotten as much testing as I would like in these last few days due to being away at work, not to mention the still ongoing battle to make BG testing a routine (Mikey says he needs to eat first before he'll cooperate), but I have visibly noticed a difference in that he's not slipping into his lethargic (hypoglycemic) state as often or as severely any more.

This is good! You could try giving him a low carb treat afterward as a reward - I like freeze dried chicken I get in walmart in a big bag ( dog size bag but its the same stuff as cat but cheaper and I break it into smaller bits)

My goal is to post daily, but I'm not doing a very good job of it yet. I'm still making my way through the stickies as it seems that every time I think I'm finished, someone points me to a new sticky or a new section to look at. It's also only been the last few days that I've finally gotten good enough at testing his BG that it only takes one or two pokes now. His ears are still quite a bit splotchy red from all of my previous attempts over the last couple of weeks so I'm also holding off on doing a full curve test until my current skill level is able to compensate for my previous ineptitude and his ears start looking a bit better.

Dont worry - its a lot to take in, you can only do your best. Have you tried Neosporin ointment on his ears beforehand? It makes the blood pool up easier and stops any pain. Also give the ear a nice massage first to warm it up and the blood comes easier. I also bought a mini flashlight on ebay from China ( want the link let me know) that i use to shine through the ear so I can see the vein and sweet spot area.. plus it gives me something other than my finger to push against.

Second, when it comes to BG testing, I've noticed that he sometimes gives a lot more blood than normal. It doesn't continue bleeding or anything, but it produces an amount about three times the size of his regular amount (which is about the size in diameter of an "o"). I've turned the lancet pen down to the lowest setting and I even tried it with a different lancing pen, but it still seems to happen about once or twice a day. Am I being overly anxious? Is this caused from all of the holes I've previously created in his ears?

Tiggy varies too - depends on how warm his ears are, how stressed he is, how much he ate.. who knows!. I dont worry about it. I dont use a lancing pen, I just use the lancet manually as I find it gives me more control over the prick. I also find if I poke the same area too much it bleeds easier but may eventually cause a lump and a little pain so I move to a new spot.(not so good). Make sure you apply a little pressure on the wound for a few seconds afterward.. will help stop these little bruises you are seeing.

Also related to BG testing, as I mentioned above, Mikey is not cooperative first thing in the morning until he's had his breakfast (I guess he takes after me and my need for coffee). I've tried treats and feeding him just a little bit, but the only thing that seems to work is a full meal. I discovered early on that the best and easiest way to to give him his insulin is while he's eating, so if I feed him breakfast and give him his morning shot before I get his AMPS, will this screw up the BG results significantly if it's only about 10 minutes? Will this cause problems with trying to get him regulated? Otherwise, about half my AMPS attempts end in failure for both of us.

You have to work with whats best for you. I free feed my cats so there is always food out and they dont have big food spikes. Some people here feed a number of mini meals. You could try transitioning to one of those strategies and then maybe he will be more chilled.

Finally, last night, a problem arose that I hadn't ever considered: I was going to be physically unable to give his evening insulin shot and had no one around to do it for me (besides the fact that so far I haven't found someone I can train as my backup). Since I haven't read (or found) a sticky about this yet, I was just going to skip his evening dose rather than giving it to him a few hours too early or too late. Ultimately, I ended up being able to give it to him at the right time, but what do you do in times like this? Do you just skip it, give him a lower dose earlier/later? Am I the only person in this forum that can't seem to find anyone willing to give a cat an insulin shot? (Honestly, I've been told by three different people that I should just put him to sleep and get a new cat.)

Oh no! You should smack those people that tell you this - we may be able to get him OTJ and then it wont be a worry. Missing the occasional shot isnt the end of the world. If you can plan for it then you can gradually move the schedule to accomodate ie move it by 15-30 mins each day so that its at a different time eventually ie normal am shot is 8am, pm is 8pm. Next day am shot is 8.15am, Pm is 8.30pm and so on till you reach a time that works. You need advance notice you wont be around though for this to work. You need to be careful about shooting early or late because of when you give the next shot and overlap in the doses. I will try and find that sticky on it.

 

[Carl & Polly & Bob (GA)]

Re: New to Lantus TR with a Juvenile Diabetic - a few questi

I do have a few more questions. I've seen a few places now where people mention the "meatloaf" or "catloaf" position. I've noticed since the beginning that Mikey was doing this, but I wasn't sure what it's related to. Can someone please explain this for me?

Usually when people are talking about the "meatloaf" position, they are describing a kitty who doesn't feel well. There is a big difference, however, between the "meatloaf" position, and the "sphynx" position. This link to Tanya's CRF page does a good job of describing the difference:
http://www.felinecrf.org/symptoms.htm If you scroll down to the pic of her kitty you can see what she says about the two positions.

Carl

 

[Wendy&Tiggy(GA)]

Re: New to Lantus TR with a Juvenile Diabetic - a few questi

as regards this

glad to know my gut instinct was right in holding off on increasing his dose to 2u, especially since I was changing his food. My vet wasn't too happy about this and said, "well, since you're going to do what you want to do anyway, do you still even want to bring him in next week for his follow-up?" He also sold me Hill's Prescription dry M/D cat food. I have a feeling I've now become better educated about this stuff than my vet….

You might want to find a new vet at some point, seems like this one has an attitude and you need someone supportive. I found very quickly that this forum taught me WAY more than my vet knows and so I listen to the vet, but consider the forum too and make the best decision for my cats considering both (I have two diabetic boys). Usually I do what the forum experts recommend! lol.

 

[KPassa]

Re: New to Lantus TR with a Juvenile Diabetic - a few questi

I tried the warm water in a pill bottle for the first few days of BG testing but switched to the rice-in-a-sock trick (15 seconds in the microwave and it's perfect temperature vs. waiting for water to heat up). I also cajole him into my lap by giving him his choice between freeze-dried chicken treat or freeze-dried whitefish treat. I switched to Vetericyn on on his ears after trying neosporin the first few days and watching him rubbing at his ears and licking his paws after (I didn't like him ingesting the antibiotics or chemicals in it and I didn't like him rubbing at his freshly pricked ears). After I'm done testing, I give him either another treat or his meal. I also just recently bought the illumavein (but it hasn't arrived yet). Usually, he's completely docile while I'm taking his blood and sometimes even purrs. I think my biggest issue is that I'm terrified I'm hurting him or will disable him in some way. Each time I look at his ears, it's getting harder to find a spot where his marginal ear vein doesn't have these little patches of red bruising(?) all across it.

When it comes time for his AMPS, however, he'll cry for food while completely ignoring the proffered treat so I always end up having to pick him up and physically hold him still on my lap. I have to hold him in place with one hand the entire time because each time I let my guard down, he takes his opportunity to get away, usually with a perfectly good blood sample, making me have to re-prick him. This only happens with his AMPS! All other times, including his +1 and his PMPS, he may flick his ears about and growl a bit to show me his dissatisfaction, but usually another treat placates him for further cooperation.

The only thing I can think that causes this is that he's fasted through the night for too long, but my vet (who sold me the Hills prescription dry m/d) stressed the importance of not overfeeding with the insulin. He said that since Mikey weighs less than 5 pounds, he should have the lowest dose on the bag of dried food, but doubled since he's still a kitten. I never even cracked that bag of food open and I'm fairly certain I'll be finding out whether or not I need a new vet when I try to return it tomorrow when our next follow-up appointment is scheduled. Even still, since I haven't been able to find anything on feeding diabetic kittens, I've been using the vet's "double it for kittens" as a general guideline for the wet food. Since I used to free feed him, it's been impossible for me to convert to a structured, twice-daily eating schedule (as recommended by my vet) without feeling guilty or that I'm harming his development in some way (I guess I don't trust my vet's dietary recommendations for good reason).

Here's a breakdown of a typical day, using Fancy Feast for simplicity (I also feed him EVO and Nature's Variety): Serving size suggests a single 3 oz can for every 3.5 pounds body weight and twice that for kittens. Since Mikey's only 4.5 pounds, I'm supposed to feed him less than 3 cans a day. In reality, I feed him 3/4 a can for breakfast, 1/2 for mid-morning snack, 3/4 for lunch, 1/2 for afternoon snack, 3/4 for dinner, 1/2 for evening snack, and then 1/2-3/4 for bedtime. So, he's eating anywhere around 3.5 to 5 cans a day. He's still not gained any more weight in the last month and often seems ravenous.

Then, doing further research today, I've encountered a few posts and articles about letting unregulated diabetic cats free-feed, which has me wondering if I've been doing more harm than good. Does anyone know if I can just throw that last bit of advice from my vet (and Fancy Feast) out the window and just feed poor Mikey however much he needs to eat to satiate his hunger?

Usually when people are talking about the "meatloaf" position, they are describing a kitty who doesn't feel well.

Thanks for the link, Carl. The only reason I asked about it is because he seems to do that when his numbers are particularly high, along with lip-licking. After looking at that page, I think he's doing this because he's either nauseated or has high stomach acidity. At least now I'm not panicking that he might have CKD or something worse.

 

[Wendy&Tiggy(GA)]

Re: New to Lantus TR with a Juvenile Diabetic - a few questi

I think Sienne said

I also think it's fine to feed a kitten as much as he wants. I got no guidance from my vet regarding how much to feed a kitten but you may want to check the number of calories per day that your vet would recommend. I wouldn't go by the number of cans -- I'd go by calories

I agree with her - I would feed as much as he wants to eat.