newbie intro and thanks for the help so far

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quilterkitty

Member Since 2013
Hi everyone, I'm Phyllis, and my sugarcat is Star. We live in the western suburbs of Des Moines, Iowa. Here's Star's story: A year ago before he had a dental procedure he had pre-anesthesia bloodwork done, which showed elevated blood glucose, but he totally freaks when he goes to the vet and wasn't showing any other diabetes symptoms so the vet just told me to try to slim him down a little (he weighs 15 pounds and is about 9 years old, stocky little guy) and keep an eye on him. Last week he was drinking a lot of water and flooding the litter box, symptoms my vet had warned me to look for, so I took him in Friday and, sure enough, he is diabetic. Now I'm kicking myself for not doing more research last year about diet and getting him completely off dry food. He was already eating canned food in the evenings but dry in the mornings and for a bedtime snack. If only I had known then about the perils of dry food I might have spared him this trouble, but that's water under the bridge, I suppose. Anyway, my vet prescribed Lantus, and we are using the SoloStar pen. She told me to give Star 3 units twice a day, which I did over the weekend. After researching foods (I found this site as well as the website with all the diet information and food charts) I took away all dry food, even the Purina DM the vet sold me, and am feeding Star and my civilian, Maggie (age 11.5) only canned Authority chicken, which they were both already eating and liked, so the transition was easy.

My vet called me Monday to check on Star, and I told her about the diet change. She recommended that I cut his Lantus dose in half because he was no longer getting a lot of carbs. The SoloStar pen only dispenses in whole units, so I gave him 2 units at 6:30 a.m. Tuesday and 1 unit at 6:30 p.m. Star seemed a little off last night (I hadn't tested his blood yet--had the Relion meter but was trying to get him used to my handling his ears, which he hates). This morning I gave him his breakfast and the 2 units of Lantus. Seemed like a good day. Tonight before his dinner, while he was lounging in the window, I bit the bullet and got a blood sample and tested it: 574. :o Yikes. That is higher than it was at the vet's office on Friday, before the diet change and the insulin (plus accounting for white coat anxiety). I was really shocked because he has seemed so much better. But that was only the first test, and it was at the end of the 12 hour cycle. I gave him 2 units of insulin. An hour after his dinner he was hungry again, so I gave him a little more food. An hour after that I tested him again, just to get a reading with food two hours after his shot: 581. :shock: Really? I know from reading this site that Lantus needs some time to build up a depot, so is that what's going on? He isn't drinking a lot, but he is still urinating more than average for him, although not nearly as much as he was last week. On 3 units he was barely peeing at all but also not drinking much, just getting liquid from his canned food.

The past couple of days he has seemed more like his old self, really affectionate and wanting to follow me to whatever room I'm in instead of just sleeping in front of the heating vent in my home office. But now I'm a little worried. Should I go back to the original insulin dose of 3 units twice a day? Or should I stick with 2 and just keep testing? My vet wanted me to bring Star back in at the two-week mark for a glucose curve, but I asked her if I could do it at home as long as I was comfortable with the process. She agreed. We both thought I could get a more accurate reading if he wasn't so stressed. I can only imagine what his levels would be while spending the day at the clinic. At least that was my original concern, but now that his levels are so high with the diet change and the insulin, I'm not so sure. And I don't know if it makes a difference, but Star also has a latent feline herpesvirus, which I treat with L-lysine when it flares up (but it hasn't in several years). I have learned so much already by reading pages and pages on this site over the last five days, but there's no substitute for just putting my questions out there to you and getting what I know will be good advice. I will work on creating his spreadsheet and profile (might need some help there), but what are your thoughts, oh great sugar cat gurus? (And please forgive me if I'm posting this in the wrong place, using the wrong format, or anything else I'm doing wrong. I promise I'll learn!) Thanks so much!
 
Hi QuilterKitty,

Well, until you hear from others here, I would think that I would not, myself, go over 2 units of the Lantus. Keep testing also.

Usually most times, the cats are started on 1 unit of Lantus twice a day, as far as I remember. My boy died 3 years ago, that was on Lantus, but I know that you do have to watch in the beginning, when starting out and you don't want to have Star suddenly crash on you by getting too much Lantus built up in his system.

I suppose you do have the Karo syrup or honey on hand, just in case his numbers would drop suddenly?

There will be others here soon that are up to par, and current on the best way to go, but I sure would be more cautious and keep testing, especially if he starts behaving like he is listless, etc.

Welcome to the site, and hope all works out for your kitty.

Jean and Charcoal (GA)
 
Hi Hon, sorry there's no one around, but they should be shortly.

I have no advice, I've only been doing this sugar dance myself for a couple months, but you will have plenty of help and support here.

While you have a chance, read as much as you can, starting with the stickies up top. There is a mountain of fantastic info and a lot of people with big hearts to help you.

Wishing you a healthy and happy kitty!

Big Hugz! :YMHUG:
 
Hi, I am a newbie, so I can't give you any advice on dosing Lantus. I know that the girls that have been helping me, and many others willing to help will be on here 1st thing in the morning to help you and you will be in the best hands. Please hang in there :smile:
 
Hi Phyllis, Welcome to FDMB!

I agree with Jean and wouldn't increase the dose until you can chat with some of the more experienced members here. We typically "hold" a dose for at least 3 days before increasing or decreasing unless the numbers are too low and you need to reduce the amount. If you change your cat's dose too often, it can cause some wonky and unpredictable numbers. You're absolutely right -- sometimes, it takes insulin awhile to build up in the depot, so it might take a few days for you to start seeing changes in Star's blood glucose (bg) readings. FYI, this board usually recommends a starting dose that is 0.25u/ kg of ideal body weight, but don't change anything until a dosing expert stops by to chat with you. Since you're new, we suggest that if your cat is under 200 at a pre-shot time, you should not shoot or feed --- come here and ask for advice first.

Make sure you keep testing, though, and recording all the data. Always test before shooting, and get spot checks and mid-cycle checks as often as you can.

As far as the SS, here are some directions to help you get started. Click here for the template and instructions on how to add it to your signature (so it appears at the bottom of all your posts.)

On the SS, AMPS refers to the morning test right before you shoot insulin (AM pre-shot), and PMPS is the evening pre-shot. Since we are all in different time zones and shoot at different times, we use + number system. For example, Let's say you shoot at 7am and 7pm:

AMPS = 7am test
U= units of insulin shot
+1= 1 hour after shot time (8am)
+2= 2 hours after shot time (9am)
+3= 3 hours after shot time...
etc...
PMPS = 7pm test

You may want to take a look at the starred sticky notes at the top of the Lantus board. There is a huge amount of information about Lantus and it's use.Below is a description and link to those notes:

Tight Regulation Protocol: This sticky contains the dosing protocol that we use here.
New to the Group: Everything you wanted to know about this forum and more.
Handling Lantus: how to get the maximum use from your insulin and what to not do with it.
Lantus depot: This is an important concept for understanding how Lantus works.
Lantus & Levemir: Shooting & Handling Low Numbers: What data you need in order to be able to work toward remission or tight regulation as well as information if you have a low pre-shot number or a drop into low numbers during the cycle.

Please read over the last link and print out the information on how to handle hypo. In addition to having extra test strips, syringes, low carb food, and other diabetic supplies, you should have an emergency kit put together in case Star drops too low. Get a few cans of medium carb canned food and high carb canned food (absolutely no dry, though.) You can also add honey or corn syrup to your kit. Are you testing for ketones at all? Ketostix are urine test strips you can buy from most pharmacies and walmart. If you don't have any ketostix, that's another item to add to the shopping list. ReliOn (Walmart brand) sells them for relatively cheap. I use the Bayer ones from Walgreens which are slightly more expensive at $15 a bottle.

This food chart was compiled by a DVM, Dr. Lisa Pierson, and lists the nutritional values for most commercial brand cat foods. For a diabetic cat, you'd want to feed under 10% carbs (the lower, the better, but not too much fish). You can also look over the chart to find foods that satisfy medium carb and high carb values to keep on hand in case of emergency. We use food to coax our cat's blood glucose up safely when they start dipping too low (you can read about this in the dealing with low numbers link.)

Again, welcome to you and Star! If you have any more questions/need any more help about using and navigating the board, let us know. The more experienced members can help you with dose advice and other protocol related questions.

Courtney and Kismet
 
Good morning Phyllis ~O) and welcome to our family. We have a specific forum for Lantus ( http://www.felinediabetes.com/FDMB/viewforum.php?f=9 )users with some phenomenal experts to help out, but it is perfectly ok to post here on this board. I'm online most the day and can help in any way I can. If you decide to come over to our board, keep your posts to one forum only, however, should you need immediate assistance and there is no one on the our board, do post here. :-D My name is Kat (short for Kathleen) and my sweet sugar-boy is Gobbles. He'll be 11 on April Fools Day & is a neutered grey tabby shelter cat. He was dx'd 11/17/12 and was started on 1 U. Lantus bid.

I agree with everyone here who said DO NOT to give him the bigger dose. He just was diagnosed, and has just started on insulin, so those high numbers are not a surprise. The formula for initial dosing is 0.25 x ideal weight in kilograms. For example, If Star's ideal weight is 10 lbs, his starting dose on Lantus would be 1.0 U. How much should he weigh?

Also, don't feed him for at least 2 hours before you give him his shot: if you feed him less than 2 hours before you check his BG, you are not getting an accurate measure of his BG because eating (any kind of food) raises blood glucose levels.

What time zone are you located in and what time is his next shot due?
cat_pet_icon
Hang in there; Star is in good hands and you'll do great! We are here for you & Star
 
Thanks, everyone, for the encouragement and advice. Just now checking email. We are in the central time zone. Star had breakfast and his first shot at 6:30 a.m., about three hours ago. I did not test him (still getting the hang of all this, even changing my schedule as I am usually a night owl and have had to start going to bed early so I can get up early to take care of my fur child) but know I should get better about that. His next shot is at 6:30 p.m. I do have Karo syrup and some regular treats, which he loves and are higher carb, for emergencies but didn't get the Ketostix when I bought the Relion meter, strips, and lancets. On the forum somewhere I read that hypo is rare with Lantus, but I know it isn't impossible so I know what to look for and what to do if it happens. Guess I will pick up the Ketostix today. I suppose I'm still a little bit in the denial and guilt/anger stages even though I am following instructions for Star's care. It's a lot to deal with. As far as Star's ideal weight, I really don't know. He is short and stocky and I can't really see him below 12 or 13 pounds. He is obviously overweight at 15, but he's always been heavy. He was six months old when we adopted him (at least that's what was estimated), and once he was neutered he grew up (and out) fast. So if he gets down to 13 pounds I'll have to see what that looks like and re-evaluate. Oh, and his canned food is 3-4% carbs, according to Dr. Lisa's chart, depending on whether you look at the calorie percentage or dry matter percentage. I'll pick up some higher carb canned food today, also. Need to get some low-carb treats and will have to look at PetSmart for those.

If we go with 13 pounds, that means 1.48 units of Lantus. But my SoloStar pen won't do half units, only whole, so should I stick with the 2 units, or should I buy syringes and use them instead of the pen needles? I love the ease of the pen, and I'm going out of town for four days in early April and can train my cat sitter to use the pen, but a syringe might be more than she is comfortable with; I would have to ask her. This is all very complicated and somewhat overwhelming. :? My husband is sympathetic, but the cats are my responsibility. He is not happy about the expense of Star's treatment, but he is trying to be supportive. He won't test Star, feed him, or give him insulin, though. Not complaining, just feeling way out of my depth. But I love Star and want him to be healthy and happy, and I am responsible for him, so I'll do what it takes. Thanks for your help. And I'll work on the forum stuff (signature, profile, etc.) today, also.
 
Most of us use a syringe and then use that to draw the insulin out of the pen, because when we adjust the dose we do it in .25u increments. Where in the Central Time Zone are you?...I'm also in CST but I'm in Nebraska, if I'm close enough I could probably lend you a hand on learning to test. If not we can more than likely be able to round someone up that is local. Just need a city and state

Mel, Maxwell, Autumn & The Fur Gang
 
I'm in Clive, Iowa. Right on the edge of Waukee. Nebraska would be a bit of a commute for you. ;-) I *can* do the testing, just have to get in the habit. (My vet actually said that she or a tech would be happy to come over and help me if I need it. She's really impressed me.) Star does not like having his ears touched, and testing leaves marks on his white ears so I can see where I've poked him and try not to get him in the same place every time. Alternating ears, etc. Also, just to be sure the meter is working correctly, I tested myself. Got 86 before breakfast. So Star's high numbers aren't the meter's fault, darn it. :-x I'll call the vet and ask for a prescription for syringes with the correct markings. Thanks!
 
Yeah especially where I'm at in Nebraska...I'm almost to the Kansas border...so yeah little too much of a commute. :lol:

Not sure about Iowa but in Nebraska you don't need a script for insulin syringes at least not the U100 ones that are used for Lantus. I just go out to Walmart, ask for a box of 3/10cc (these are the smallest made) 31 gauge short needles, I learned long ago not to ask Walmart for ones with 1/2 unit marks because they will swear they don't carry them but all their 3/10 cc ones have the 1/2 unit marks.

Mel, Maxwell, Autumn & The Fur Gang
 
Thanks, Mel, I didn't know syringes might not require a prescription; I'll definitely ask about that. Did call my vet, and they have a bunch of the right size ones (when people's pets pass away they often donate their supplies to the vet) that they will give me to get them out of their supply cabinet, so I'm set for now. Hopefully Star's dose will decrease at some point to 1 unit, and I can go back to using the pen without syringes. I'm staying optimistic! My daughter, my only child, is studying in China this semester, and having her so far away has been difficult (she is a junior at Iowa State, and I don't see her that often during the school year but we can communicate better when she's nearby). Sort of OBE lately . . . but coping. :smile:
 
I usually test Gobbles on his back paw pads and rarelythe ears--he has always been touchy about his ears. It seems that he feels absolutely nothing when I test on the back paw pads and I usually get a big enough drop of blood each and every time (may take a little longer than an ear poke to come up). If you are going to try that, just be sure that each time, blood or not, put triple antibiotic ointment on it...I've never had a problem with him having an infection. All I do is sit on the floor, put him on my lap facing away from me, grab his cute little furry foot and jab. He's quite docile which also helps with the testing :mrgreen:
 
To calculate his initial starting dose,
take his LEAN weight in pounds, ie what he should weigh if overweight, what he does weigh if underweight: you mentioned 12 pounds
divide by 2.2 to get kilograms: 12 / 2.2 = 5.45
multiply by 0.25 to get an estimated starting dose 5.45 * 0.25 = 1.3625, round down to 1.25 units (safer to round down)

Use a U-100, 3 mL, 30 or 31 gauge syringe with half unit markings to withdraw the insulin and eyeball between the half unit markings for the quarter unit value.
 
Thank you both! I will try the back paw pad (already have antibiotic cream--is ointment better?), and I'll reduce the insulin dose to 1.25 units. Might have to mark the syringes until I get used to eyeballing. I'm a quilter and can eyeball a 1/4 of an inch seam allowance easily, but hitting 1.25 units on the nose will take some getting used to. :lol:
 
quilterkitty said:
Thank you both! I will try the back paw pad (already have antibiotic cream--is ointment better?), and I'll reduce the insulin dose to 1.25 units. Might have to mark the syringes until I get used to eyeballing. I'm a quilter and can eyeball a 1/4 of an inch seam allowance easily, but hitting 1.25 units on the nose will take some getting used to. :lol:
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Do you have a pair of reading (magnifying) glasses? They help immensely. I wear contacts or glasses to begin with, and I put the glasses on to measure doses (when I'm wearing my regular glasses, I put the reading glasses on top of my glasses...LOL!!!) When trying the paw pad, you can rub the paw pad vigorously or warm it up a few seconds before you poke. Once you poke hold & gently squeeze (with your fingers on sides of paw pad). What size lancet are you using?
 
I wear progressive lens glasses (tried to go back to contacts, multifocal, last summer but they didn't work for me unfortunately--couldn't get the reading portion clear enough, and I didn't want to wear reading glasses with contacts), but to read anything really small I have to take them off and find my eye's "sweet spot." Different for each eye, of course. :lol: My glucometer came with a sample of ultra thin lancets but I knew from reading this forum not to use them; I bought a box of the 26g and have been using those. Maybe they are too big for Star's ear? I do want to try poking his paw instead. Is this the right size lancet for that? And do I clean the paw pad with alcohol before poking it? After? At all? Just use the antibiotic ointment? What do you do?
 
quilterkitty said:
I wear progressive lens glasses (tried to go back to contacts, multifocal, last summer but they didn't work for me unfortunately--couldn't get the reading portion clear enough, and I didn't want to wear reading glasses with contacts), but to read anything really small I have to take them off and find my eye's "sweet spot." Different for each eye, of course. :lol: My glucometer came with a sample of ultra thin lancets but I knew from reading this forum not to use them; I bought a box of the 26g and have been using those. Maybe they are too big for Star's ear? I do want to try poking his paw instead. Is this the right size lancet for that? And do I clean the paw pad with alcohol before poking it? After? At all? Just use the antibiotic ointment? What do you do?
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26g. is a good beginner size; usually about 28 is recommended. For Gobbles' feet, I have both 28 and 30g., and I use either; there's no difference as far as if I get blood or not (and I also use either size for when I occasionally test him from his ear).
 
quilterkitty said:
...I didn't want to wear reading glasses with contacts...
Click to expand...

Try Carson Clip 'n' Flip clip on magnifier from our shopping Partner Amazon

They worked great, flip up out of the way when not needed, and back down again easily. They worked great for me.

Or perhaps a syringe magnifier
 
Welcome Phyllis and extra sweet Star! You've already got lots of good info but one thing I want to highlight - you should not be using the pen needles with the Solostar pen. Those are for dosing humans that take a LOT more insulin than cats. They aren't going to give the exact same dose each time, it may vary by as much as half a unit. We dose up and down by .25units. It's important to keep the doses as consistent as possible. We insert the syringe needle into the rubber seal that you see when you change pen needles. As I did see mentioned, you need U100 syringes (there's also U40's for some other insulins) preferably with half unit markings. Walmart carries them but you'll have to ask for them at the pharmacy counter - they don't keep them out on the shelves. Most of us use the 'short' needles, I think they're 5/16th's??

I know this is lots to absorb but you're catching on quickly! Don't let us 'overwhelm' you, we ALL want to help just like people helped US when we arrived.

Husband not helping - mine doesn't either but it's one of those "just adjust to the situation" things....if I just HAVE to go somewhere and KT is low, I leave medium or high carb food out and have DH feed him that when he notices KT wanting to eat. Is that something with 'Iowa' guys? Hubby is from small town outside Iowa City...we're in Oklahoma now where it's a LOT warmer!

BIG HUG! WELCOME TO THE SUGAR DANCE!
 
Thanks for the advice on the pen needles. My vet gave me a whole box of U100 short needle syringes, so I'm going to start using those. Is there anything I need to know that wouldn't be intuitive? For instance, when I injected with the pen, the vacuum system (or whatever magic those things use) kept air from entering the cylinder and, I assume, "pushed" the insulin farther into the chamber. When I remove insulin from the cylinder with a syringe instead, will the vacuum system automatically adjust for the decrease in insulin there, or do I need to do something? Does that make any sense at all? I'm probably using the wrong terminology, but that's the best way I can think to explain without going to get the instruction leaflet.

I don't know if it's an Iowa guy thing (maybe it's the cold, lol!)--my hubby is originally a Florida guy but became an Iowan via Texas, Georgia, back to Florida, North Carolina, and then Iowa (same here, but I started in SC instead of FL). He's just not a cat person. ;-) But if I absolutely had to rely on him, I could. He doesn't want either of our cats to be hurt or in danger. It would have to be an emergency, though!
 
quilterkitty said:
...When I remove insulin from the cylinder with a syringe instead, will the vacuum system automatically adjust for the decrease in insulin there, or do I need to do something?
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.

To withdraw insulin using the syringe,
1. Slide the plunger up and down a few times; this makes it easier to move for some syringes and may reduce air bubbles.
2. Push the plunger in all the way, hold firmly, and pierce the end of the pen
3. Withdraw the desired amount. If you draw too much, REMOVE the syringe from the pen and squirt out the excess. There are lubricants in the syringe that will contaminate the insulin if you try to put it back in
4. The pen will automatically adjust for the insulin withdrawal; nothing for you to do but put the pen back in the fridge on a shelf.
 
Thank you! Sounds simple enough. I will also test Star before feeding tonight and try to test several times tomorrow. Still need to get his profile and spreadsheet done. Where does the day get to? Maybe I need a personal assistant. :smile:
 
Hi Phyllis. I buy the following syringes from ADW (American Diabetes Wholesale) and shop through the link at the top of the page; thereby FDMB gets a percentage. Also note that there are other shopping links, including Walmart, in which the site gets a percentage. These are the 5/16th short needle 31 gauge (very fine) U100 needles with half-unit markings at a great price=$13.99 for 100:

http://www.americandiabeteswholesal...e-insulin-syringes_1316.htm?source=SiteSearch

They also carry the cheapest lancets (that I've ever purchased) which are 30 gauge (100 for $1.25): http://www.americandiabeteswholesal...afety-seal-lancets_1221.htm?source=SiteSearch

as well as cheap glucometers and strips (the Arkray Vital is a good choice and is the same as the ReliOn Ultima) which includes the glucomter, 200 strips, case and lancing device for $44.42: http://www.americandiabeteswholesal...onitoring-kit-pink_4035.htm?source=SiteSearch If you can afford it, is a good idea to have a back up glucometer, especially if you get low numbers and your glucometer doesn't work.
 
quilterkitty said:
...His next shot is at 6:30 p.m...I suppose I'm still a little bit in the denial and guilt/anger stages even though I am following instructions for Star's care.
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Can you get a test before you give him his 6:30 p.m. shot please? I know it can be a challenge at first--it took me about a week to master (after many unsuccessful pokes)--but it is for Star's best interests; believe me, you do not want to have to deal with a hypo situation--that would costs numerous tests, hair pulling-out and is very dangerous. You can and will do this; and you will do a great job :mrgreen: I hope I'm not being pushy; it is for the safety of Star, really. How much insulin are you planning on giving him? As far as the denial/guilt/anger: all normal--took me about a month to get through it. I cried on and off for a few months. He'll be fine and this will be a learning experience for you as well as bring you closer to Star. One of the best things I've learned so far is to get to really know my baby. You have so many people here who care about you & Star, have great advice, support and knowledge. Someone is always "around" should you need help. I don't know what I would of done and where Gobbles would be right now, if it wasn't for FDMB. And being in the Lantus support forum (I joined the "Lantus Tight Regulation) has given me some insulin-specific help, understanding and comrades!

Very Important: In case no one has told you yet: We strongly advise newbies:DO NOT give your cat his insulin shot if you get a BG reading (before you give the shot) of 200 or less!! If you do get a reading of 200 or less, please post the number and wait for a reply.
 
I don't foresee a BG level below 200 in our immediate future (major whoopee when that happens!), but I will keep that in mind. :cool: Turns out that Star tolerates someone messing with his paws even less than with his ears, so back to the ear I went. Tonight's BG--drumroll, please: 385. Much better than the upper 500's I got yesterday. Maybe the Lantus is finally developing a "shed" or "depot" or whatever we're calling the subcutaneous storage facility. Now he is giving me the stinkeye and refusing to eat, so I'm holding onto his 1.25 units of insulin for a few more minutes, since he had his morning dose at about 6:40. I'm using the syringe, not the pen needle. I think I've done everything right (so far) tonight. Pat on the head for me (Star got extra lovin')? :-D
 
Hello there and welcome to the board!

Looks like you got some good advice and have made a good start.

Have you read anything so far about "bounces"? When a cat is first diagnosed, the blood glucose has probably been high for a while. As the insulin starts to take effect and numbers start to come down, the liver has to learn to adjust to the lower numbers. We call this "liver training school". But before it relearns that low numbers are ok, when the BG drops to a number lower than the liver is accustomed, or if BGs drop low, or if the BG drops suddenly, the liver”panics” and reacts by releasing counterregulatory hormones and glucagon. This drives the BG back up. This is what we call a "bounce". Bounces can take up to 72 hours to clear so we are generally careful about increasing doses during the bounce. Once the bounce clears, then you can see the "real" numbers and determine if the dose needs to go up or down.

Anyway I am wondering if he is bouncing so lets set up a spreadsheet and get a few midcycle tests in over the next few days to see how he does. I am thinking morning preshot, 5-7hours after his morning shot, pm preshot and before bed.Or whatever works for you - we want to see trends and how low he goes during the day when Lantus hits is max action.!

heres how to set up a spreadsheet http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

Wendy
 
quilterkitty said:
I don't foresee a BG level below 200 in our immediate future (major whoopee when that happens!), but I will keep that in mind. :cool:
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For your cat's safety, please don't be complacent. There was a gal very recently on the FDMB facebook page whose cat, diagnosed on or about 2/10, hypo'd just 10 days later on 2/20--it could of been for a variety of reasons, but bottom line: she almost lost him; he ended up in ER, so.....a 200 or lower BG CAN happen early in the game! She was not testing, but if she had been, she probably would of caught it.
 
Tested Star this morning before breakfast: 393. Took three attempts (three strips--gah!) because he was so squirmy. Will test again in 4-6 hours, when I am home. Need to do more research on bounces. Thanks so much for all the advice, everyone!
 
Great job testing this morning! Three attempts is pretty good for a new HT-er :-D The darn strips do get expensive; what meter are you using? Have a wonderful day dancing_cat
 
Thanks! That's actually the first time it's taken more than one attempt, so I guess my beginner's luck has run out. :YMSIGH: Sometimes I think "there's no way this is enough blood" but it is; this time I thought "surely that's as much as I usually get," but no dice. Hmph. I'm using the ReliOn Confirm. Is it normal for the strips to be so hard to get out of the container? They stick together like crazy. I'm afraid I'll damage them just by getting one separated from the others. Is that possible?
 
I use Relion confirm also and yep, the strips can be tricky to get out.

Sometimes I put a clean tissue down and just shake them out and then carefully put the excess back in the box.
Its not so bad as the box empties a bit.
 
I tested Star just after 1:00 when I got home, and is BG was 324. Holding steady so far, but I'm watching for any changes. I'm totally fine with a gradual decrease. He is acting more like his old self (sleeping most of the time, lazy bones, but paying attention to whatever I'm doing and being very affectionate when he's up and about). Picked up Ketostix, kitten food in case of hypo (I checked Dr. Lisa's chart; already have Karo syrup), low carb all meat treats (Petsmart had some on sale!) and a sharps container. My niece is a diabetic and can use the pen needles that I won't be needing. Things are moving along. :mrgreen:
 
interesting.. looks like he may be coming down from a bounce. Be interesting to see his PMPS reading.

Great job on the spreadsheet by the way.! Now that you are all set up, can i invite you over to the Tight Regulation forum? There the experienced dosing members can keep an eye on Star and help advise. Plus there is a strong and fun sense of community there. Its a very active board! http://felinediabetes.com/FDMB/viewforum.php?f=9
 
Thanks, Wendy. Sounds great! What's the difference, practically speaking, between the tight regulation Lantus forum and the "relaxed" one? And are you thinking that Star bounced early on, when I first tested him and his levels were higher than at the vet's office? That would explain it, I guess, but I was so new I didn't know what a bounce was then. I'm glad I found this board! :smile:
 
Its two different protocols. You can follow either one although I am a personal advocate of the tight regulation since its faster and seems to me tohave a better chance of remission.

But no matter which one you choose I would still post on the tight regulation forum as there are more conversations and eyes there. If you do choose relaxed just note it in your signature

Tight http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581
Relaxed http://binkyspage.tripod.com/SLGS.html

Wendy
 
I am thinking he may have had too much insulin at first and dropped too low and then bounced off it. But thats just a suspicion. with more testing we will get a better idea of whats going on.. he is on a better dose now. He may end up back on a higher dose but this way we can ensure you dont skip an ideal dose.
 
You're doing great! hang with the Lantus dose for a total of 5 days, aka 10 cycles, with spot checks as you can get them, optimally around +4 to +7, or before bedtime on the off chance he is diving.

After the 5 days, a nadir check in that +5 to +7 time frame will guide any doseage adjustment.

After the 1st 5 days, adjustments may be made as often as evey 3 days if you have test data.

And always know, when it comes to glucose levels, better a day too high than a moment too low.

Have we given you the link to How To Treat Hypos? As soon as you get a chance, pick up the supplies (Karo syrup, high carb gravied foods, 50 extra test strips on hand, oral syringe) you'd need if you ever have scary low numbers. That way, folks here can coach you through helping him and you may be able to save his life and avoid a really expenxive emergency vet trip.
 
I do have Karo syrup and higher carb food plus an oral syringe. Need to pick up an extra meter and more strips to keep on hand. I have read the info on hypos and really hope I don't need it, but I'll print it out and keep it on the fridge. Will test Star before bedtime tonight and post his number then. One question: Star has a latent herpesvirus, which I treat with L-lysine when it flares up (it hasn't in several years), typically when he is under stress. I'm really surprised he hasn't had a flare-up this week, with everything going on. But if he does start showing symptoms of a respiratory problem or conjunctivitis, is it safe for me to give him the lysine? It's just an amino acid, but I know everything is connected.
 
Shame about the red PMPS. Are you coming over to the tight regulation board tomorrow?

Also see if you can get a before bed test

Wendy
 
Yes, I'll come over to the Lantus board tomorrow. Need to figure out how and what to post there, and I'm tired tonight (I rarely get a cold, but the stress of this week must have weakened my immunity and I'm now in that spot). In the grand scheme of things, 402 is still better than 500, and it will get better. Two steps forward, one back, right? I will test Star before bed and post his number. And tomorrow is another day. :smile:
 
Just tested Star and he is at 446. I'm not convinced I got his injection done correctly at dinner time; should I give him a micro-dose now? He is about to eat some food before bed, and his BG will surely go up. What do you advise?
 
quilterkitty said:
Just tested Star and he is at 446. I'm not convinced I got his injection done correctly at dinner time; should I give him a micro-dose now? He is about to eat some food before bed, and his BG will surely go up. What do you advise?
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Hi. You may have given him what we call a "fur shot"; basically it means we may have not given the shot, but cannot tell for sure. No, don't micro-dose or ever give any size of additional insulin; I almost did that once (I was flipping because his BG was somewhere in the high 400s), but posted a ? first, and was told to never, ever do that. I assume that's because if we are wrong, and we did give the shot, any increase in insulin would be a bad idea because it would lower the BG and can make the number a dangerous one...And I know it is tempting due to the high numbers. But Star will come down. Since Gobbles' last fur shot, I give him his shot in a room with good lighting and do so with my glasses or contacts in :mrgreen:
 
Moving over to the Lantus board now. Thanks so very much, everyone, for all your help here! And thank you for being so welcoming. :-D
 
The lantus tight regulation board can be a little confusing at first - heres how you post - we call posts "condos"

subject : 3/9 Star AMPS 400 + 6 200 ( date -catname- readings through the day) You can update it as you get readings or at the end of the day. Add a? icon if you have a question

Content: a brief update on how Star is doing ie Star was all happy this morning but is peeing a lot - how his 5 Ps are ie peeing pooing purring playing and preening. Any questions. Link to the prior days post/condo.

Wendy
 
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