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Ok. Vet says she's going to look into Lantus and get back to me. She was surprised and intrigued that such a low dose worked so well. She also said the prescribe Novolin because it's cheaper for their clients. She said it's easier to get people to treat their cats/animals if the price point is better. I'm really hoping she does more research into lower dosages so our babies will be able to live longer!! ;) I'm sure she'll call me back and give me the go ahead. I was pretty firm that I wanted to switch...mostly because the Lantus lasts longer in her system. I expressed my concern with that. She applauded me for my at home testing and my glucose curve!! :) Thanks again everyone! :-D
 
Your vet sounds great. :) Any vet who is prepared to work with you like that and research where necessary to help you is well worth keeping! :D I actually can see why she prescribes Novolin so she doesn't meet resistance from clients over the price - a lot of people don't know there's a difference between the different insulin types and the price of Lantus can certainly come as a shock!! It sounds as though the information you've given her may well help other kitties she treats as well - now she knows that a lower dose can work better, she might be more prepared to try lower doses with her other patients. :)
 
Her Co-Vet is awesome too!!! I was excited that she received my info so well. I was pretty firm...didn't give her much of a chance though!! :) Idk if I'll start the Lantus tonight...probably tomorrow. I wanna watch her all day tomorrow on it! :) I also told her that the fact that I have multiple cats probably saved her life cuz I had food out constantly... Can't wait to get Kloever feeling more like herself!!! :-D
 
OK! That is terrific.
Back up a page to where the formula for a starting dose of Lantus was calculated based on her weight and where the 2 protocols are described and let us know what protocol you'd like to follow and what you calculate should be her starting dose (math quiz!)
 
She's a little under 20lb - is that right? Sorry, you might already have mentioned her weight earlier on but I couldn't see it scanning back quickly. If so then, yes, your calculation is perfect. :)
 
You got the exact same thins I got when I checked it yesterday.
There are 2 protocols we have for using Lantus:
Tight Regulation
Start Low, Go Slow
You'll want to read those over and decide which makes the most sense for you and Lkoever.
Also, there are are a bunch of sticky posts you'll want to review at the top of the Lantus forum explaining how to use and store Lantus, and more.
 
Tight Regulation has some research demonstrating its ability to get cats off insulin when diagnosed early and following the intensive protocol (at least 4 tests a day - pre-shots, mid-cycle, and a before bed so you can be sure he's safe)
If you've got a lot of chaos in the house - kids - you might find Start Low, Go Slow easier to follow, but slower to get an optimal dose adjustment.
 
Yes on the 2 units. It does work differently than NPH - not as sudden a drop, nor wear off. Think gentle waves of effect over every 12 hours.
 
It takes 5-7 days to build up to a steady depot initially, then any dose change takes 3-5 days to stabilize.
Lantus requires you to be patient, so here are some patience pants!

Patience pants rainbow jeans.png
 
Oops - for some reason I haven't been getting notifications on this post today even though it's definitely on my watched list! I'm happy to see Kloever doing well on her first day on Lantus. :) That's a late nadir, but that happens sometimes with the longer-lasting insulins. Hopefully over the next few days those cycles will start to flatten out even more as her depot builds. :)
 
manxcat419 said:
Oops - for some reason I haven't been getting notifications on this post today even though it's definitely on my watched list! I'm happy to see Kloever doing well on her first day on Lantus. :) That's a late nadir, but that happens sometimes with the longer-lasting insulins. Hopefully over the next few days those cycles will start to flatten out even more as her depot builds. :)
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She just seems so much better....still drinking a lot of water though...
 
Everything takes time - her water consumption will decrease the close she gets to being regulated. How she's feeling in herself is very important - if she seems happier and better, then she's definitely on the way to being better. :)
 
See my signature link Secondary Monitoring Tools for other assessments which help you evaluate your cat. It isn't always about the glucose test.
 
Ok...you guys are gonna laugh at me. Getting Kloever's dose ready and noticed that I've been giving her 1 unit!!!!! I had been giving 5+ units from the beginning. So the "starting" line I thought was 1....that's pretty interesting to me. The Novolin was barely .5????? This time...I counted back from 5 and got to 2...TOTAL DORK!!!! I bet she does WAY better today!! I can't curve her though....need more strips!! She was 227 this morning on 1 unit!!! Not too shabby! :)
 
These things happen Kate - and better too little insulin than too much! Now you know, you can get her on the right starting dose and I'm sure she'll start showing you some green numbers in no time. :) Not that there's anything at all wrong with that 227 this morning - that's a good pre-shot number especially as her depot is still filling. :)

As long as you have enough strips to get a reading or two from her mid-cycle, you shouldn't need to do a full curve today - maybe give that a few days until her depot is full and you can see what the insulin is actually doing. I would recommend buying more strips sooner rather than later though - if you do get a low reading at some point, it's very easy to go through a lot of strips in just a few hours.
 
manxcat419 said:
These things happen Kate - and better too little insulin than too much! Now you know, you can get her on the right starting dose and I'm sure she'll start showing you some green numbers in no time. :) Not that there's anything at all wrong with that 227 this morning - that's a good pre-shot number especially as her depot is still filling. :)

As long as you have enough strips to get a reading or two from her mid-cycle, you shouldn't need to do a full curve today - maybe give that a few days until her depot is full and you can see what the insulin is actually doing. I would recommend buying more strips sooner rather than later though - if you do get a low reading at some point, it's very easy to go through a lot of strips in just a few hours.
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Buying some today!! :) I'm pumped she's doing so well! She seems so much calmer. Her urine output has decreased too...not perfect...but definitely an improvement! I might just give her 1.5 units tonight though...since 1 unit overnight had her at 227 this morning. Don't want her too low overnight whIle I'm sleeping. :)
 
That's great - I know I always worried if I got low on strips in case Rosa decided to dive! ;) It's great that Kloever's doing well - all those secondary signs are really good news. :) When you can see an improvement day by day, it really does show very clearly how much better they're feeling! You might well be right on the PM dose - you definitely don't want her dropping too far while you're asleep - but let's see where she gets to by her pre-shot tonight. There's always an option to reduce or skip if you're faced with a fairly low pre-shot and you can't monitor the whole cycle, but you might also find that her numbers stay fairly flat throughout a lot of the day...there's no guarantee of that as we don't really know what the 2 units of Lantus can do for her yet, but it is a possibility with some cats as Lantus is better at keeping lower numbers down and level than it is at reducing high numbers quickly. :)
 
manxcat419 said:
That's great - I know I always worried if I got low on strips in case Rosa decided to dive! ;) It's great that Kloever's doing well - all those secondary signs are really good news. :) When you can see an improvement day by day, it really does show very clearly how much better they're feeling! You might well be right on the PM dose - you definitely don't want her dropping too far while you're asleep - but let's see where she gets to by her pre-shot tonight. There's always an option to reduce or skip if you're faced with a fairly low pre-shot and you can't monitor the whole cycle, but you might also find that her numbers stay fairly flat throughout a lot of the day...there's no guarantee of that as we don't really know what the 2 units of Lantus can do for her yet, but it is a possibility with some cats as Lantus is better at keeping lower numbers down and level than it is at reducing high numbers quickly. :)
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Thank you thank you!!! :)
 
If you can get a test around +7 or close to that, that would be good - that way you'll be able to see if that 138 is close to her nadir or if she's still dropping by +7. Once you find out when she usually nadirs, it will get easier to get mid-cycle tests because you'll know when is the best time to take them. :) And I agree, that 138 is great - the Lantus is definitely working as she's come down nicely from this morning. :)
 
That's fine - we all have lives as well as diabetic cats. :) She's at a good number to be safe while you're out - though as you say, I never left Rosa without some low carb food to help her numbers stay level if I had to be out of the house for any length of time. She'll be fine while you're out - she's not showing signs of dropping very low and you'll have plenty of other chances to do more testing and find out when her nadir usually is. :) I hope you have a lovely time at your MIL's birthday. :) :bighug:
 
manxcat419 said:
That's fine - we all have lives as well as diabetic cats. :) She's at a good number to be safe while you're out - though as you say, I never left Rosa without some low carb food to help her numbers stay level if I had to be out of the house for any length of time. She'll be fine while you're out - she's not showing signs of dropping very low and you'll have plenty of other chances to do more testing and find out when her nadir usually is. :) I hope you have a lovely time at your MIL's birthday. :) :bighug:
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Thanks!! :)
 
+11 174...still haven't given her 2 units at night. Thinking 1.5? Haven't nailed down her nadir yet...so I'm kinda freaked out about overnight. Thoughts my friends??
 
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If she's still under 200, you could go with 1.5. :) Though at some point, we will need to get you shooting the full dose into lower numbers but it will have to be at a time when you can monitor her, so picking a night when you're tired or have plans for early the next day probably won't work so well for you.
 
manxcat419 said:
If she's still under 200, you could go with 1.5. :) Though at some point, we will need to get you shooting the full dose into lower numbers but it will have to be at a time when you can monitor her, so picking a night when you're tired or have plans for early the next day probably won't work so well for you.
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Thanks!! I could not for the life of me access any of this last night. It said the server wasn't loading any data...I was freaking out. She was 122 at not even +2
...checked her again at +3.25 and she was 136. I kept my eye on her...she seemed to be doing well. I went to bed. I had completely changed over 2 litter boxes that I had moved to a location specifically for her. This morning there was two spots of pee right outside of them...I just don't get it. And her AMPS is 194. She's acting great! Just don't know where to go from here...luckily I put her and Lucie in a room together at night where there isn't any carpet. I'm just at a loss...she hasn't done that in weeks!! :-(
And as far as the full dose at night...how can I watch her when the lowest number is probably +6 or even later? That puts me at 2:30 am at the earliest....?
 
The site was down overnight Kate. From what I can make out, it was routine maintenance but something didn't come back up. It sounds as though you did a GREAT job with Kloever last night monitoring though! :)

I never know what to advise with pee problems - all of ours have issues from time to time with missing the box or just choosing not to use it. We have all the litter boxes here either on vinyl floor or with plastic sheet under them to make clean up easier, but that's the best we've been able to do. It doesn't sound as though it's her levels that are causing it - those numbers all look fine, though if she's had any degree of neuropathy that can take time to resolve and can affect whether or not she's even aware in time that she needs to pee.

I completely agree, the night doses and monitoring can be tough. Rosa was one who would nadir early when she was going for a reduction, so if she was going to drop low she'd almost always do it by +4 which helped, though I finished up having to move her shot times to 6am and 6pm as we'd started off with her shots at around 10am and 10pm and there were a few nights when I had to stay up with her until 4am to make sure she was staying back up in good numbers on her own. You might find that moving her shot times to earlier in the day might help - that way her +6 would be earlier too.
 
manxcat419 said:
The site was down overnight Kate. From what I can make out, it was routine maintenance but something didn't come back up. It sounds as though you did a GREAT job with Kloever last night monitoring though! :)

I never know what to advise with pee problems - all of ours have issues from time to time with missing the box or just choosing not to use it. We have all the litter boxes here either on vinyl floor or with plastic sheet under them to make clean up easier, but that's the best we've been able to do. It doesn't sound as though it's her levels that are causing it - those numbers all look fine, though if she's had any degree of neuropathy that can take time to resolve and can affect whether or not she's even aware in time that she needs to pee.

I completely agree, the night doses and monitoring can be tough. Rosa was one who would nadir early when she was going for a reduction, so if she was going to drop low she'd almost always do it by +4 which helped, though I finished up having to move her shot times to 6am and 6pm as we'd started off with her shots at around 10am and 10pm and there were a few nights when I had to stay up with her until 4am to make sure she was staying back up in good numbers on her own. You might find that moving her shot times to earlier in the day might help - that way her +6 would be earlier too.
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Oh man!!! Thanks so much for you kind words and help. When the site wouldn't pull up I was devastated! I was like...where are all of my friends???!!! I was truly frightened for her. I took comfort in that I was giving her way more insulin before and she was adjusting herself...I just didn't want to put her through any unnecessary stress. Then I thought about checking my email and saw your post and felt a lot better about going to bed...but boy am I paying the price today!! Haha! I'm about to get a +7 reading from her today. Hoping for some great numbers!! :) Thanks again for ALL your help and support!!! :) :) :)
 
Oh Kate :bighug: :bighug: :bighug:. I'm so sorry you had such a difficult evening with Kloever. You might want to join the FB group as well - just in case anything similar ever happens again. This is the link https://www.facebook.com/groups/felinediabetes/10153278911875202/

The Facebook group doesn't give dosing advice etc, but there is support there if you need it, especially for times like this site not being available. I'm really glad you found my post through your email notifications even if it did take longer than getting to see it on here.
 
manxcat419 said:
Oh Kate :bighug: :bighug: :bighug:. I'm so sorry you had such a difficult evening with Kloever. You might want to join the FB group as well - just in case anything similar ever happens again. This is the link https://www.facebook.com/groups/felinediabetes/10153278911875202/

The Facebook group doesn't give dosing advice etc, but there is support there if you need it, especially for times like this site not being available. I'm really glad you found my post through your email notifications even if it did take longer than getting to see it on here.
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Her +7 was 230... :(
Sent a request to join the FB group!! Thanks for the link!! :)
 
That's fine - it's really not all that different from her AMPS once you allow for the up to 20% meter variance. And that's good news - it means that although she's a little bit higher than you might like, the Lantus is keeping her numbers pretty level throughout the day. Though it looks as though she might be ready for her full dose tonight as she's over 200. :)

I'm sure you'll be approved onto the FB group later today - it doesn't seem to take long to be added after sending a request. :) Although there isn't the same sort of dosing advice given there, there definitely IS support available - and when this site is down, that's very important to have. :)
 
manxcat419 said:
That's fine - it's really not all that different from her AMPS once you allow for the up to 20% meter variance. And that's good news - it means that although she's a little bit higher than you might like, the Lantus is keeping her numbers pretty level throughout the day. Though it looks as though she might be ready for her full dose tonight as she's over 200. :)

I'm sure you'll be approved onto the FB group later today - it doesn't seem to take long to be added after sending a request. :) Although there isn't the same sort of dosing advice given there, there definitely IS support available - and when this site is down, that's very important to have. :)
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Her PMPS is 181....still 2 units tonight?? Yesterday it was 178...and she dipped to 122...?
Added: I gave her the 2 units. I think she'll do well!! :)
 
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I think she will do just fine Kate - and so will you. She didn't go below 122 last night and you've still got a fair amount of safety margin there before she gets into the sort of numbers where you need to intervene. You might find she'll make it into green tonight, but as long as you can get that +2 test on her, you'll be able to get a reasonable idea of what's likely to happen with tonight's cycle. :)

And congrats on shooting the full dose tonight. :) :bighug:
 
manxcat419 said:
I think she will do just fine Kate - and so will you. She didn't go below 122 last night and you've still got a fair amount of safety margin there before she gets into the sort of numbers where you need to intervene. You might find she'll make it into green tonight, but as long as you can get that +2 test on her, you'll be able to get a reasonable idea of what's likely to happen with tonight's cycle. :)

And congrats on shooting the full dose tonight. :) :bighug:
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So she probably won't go down over 131 points tonight you're saying? I will def get a +2 on her. What number for that would you consider safe for me to go to bed? I really believe overall she feels a lot better!! She's just pretty facing it on the couch right now. :) I was really nervous giving her the full dose!! I prayed when I gave it to her! :)
 
There's no way of being 100% sure - especially if she's close to ready for a reduction. But that extra 70 points is quite a long way further for her to drop. Lantus works best at keeping normal numbers in or close to the normal range - often when people shoot a low number, the number won't vary much at all over the whole cycle. It isn't so much about having a particular number where you'd say she's safe to be left, it's about how quickly she's dropping and whether or not she levels out and is around the same number for 2-3 hours. Once you get your +2 test, we'll have a better idea of whether or not it's likely to be an active cycle. Then we can work out when you'll need to test her again. If she's surfing happily by about +4, then she'll probably not go much lower but it's too early to tell that for sure just yet. I'll check back in with you for her +2 test anyway and once you've got that number, it'll be easier to work out when you should test her next. :)

I remember the nerves at shooting lower numbers only too well! I was terrified the first few times, especially when Rosa was earning reductions quickly - I could almost guarantee for a few weeks that shooting a low number would take her under 50 at that point!! You did really well though and even if she does drop low, you'll be able to get her back up quickly. :bighug:
 
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