Newbie with recently diagnosed cat – starting insulin

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Dutchess

Member Since 2012
Hello,
My foster kitty was diagnosed through a vet to be diabetic after obvious signs to me that there was something wrong !
She has been on low-carb canned food for 1 month now, but has NOT started insulin yet.
I have received support from a very nice organization who understood the financial constraints I am under, and being a single mom with a full time job and a house full of other foster animals, I was a complete stressed out mess, and they have helped me with support.
I am ready to start insulin and they suggested I get initial dosing advice from this board.
YES I have been home testing her blood just to see what the BG levels were.
Her levels have been consistent between 200-280 for the past week, with even 2 readings being in the 99 and 110 range!

How much insulin do I start her on ?

FACTS: I work out of the home from 8:30am – 6pm.
My children CANNOT test her BG when I am not there. They are not comfy with this.
I try to test her blood 2x/day
She is on low-carb canned food only, 3-4 meals/snacks a day.
She weighs 10lbs
I CANNOT test her blood 3 hours after her breakfast or lunch meals, because no one is home.
I have LANTUS insulin and 31gauge syringes.
I can give her insulin 2x/day 12 hours apart.
She is presenting well; she's happy, talkative; drinking from her food bowl.

Please help…and email me privately too, because I can’t always get onto this board: clanharwood@ rogers.com (remove space)

Dutchess’ Foster Momma
 
To start, because those aren't extremely high glucose levels, you might consider 0.5 units every 12 hours.

Try to start on a day (or night) when you are able to monitor and test during that first dose, especially around 5-6 hours after the shot. Set an alarm clock if it is during the night.

Read How to treat HYPOS - THEY CAN KILL! Print this Out!! and have the necessary supplies ready.

And go to either LANTUS (GLARGINE) - Tight Regulation or to http://www.felinediabetes.com/FDMB/viewforum.php?f=32and read over the stickies on using, storing, and handling Lantus.
 
Hi! We typically don't email dosing information or recommendations, as this is a public forum and everyone has their thoughts, opinions and to keep this as an open forum sharing information, all information is provided via posting.

If you go back and edit your original post, you can check a box "Notify me when a reply is posted" and you will receive an email to the address you signed up with, alerting you when someone replies.

Our recommendation for starting insulin is to Start Low and Go Slow. MEaning start at a low dose, such as 1 unit or 1/2 unit and with home testing, and guidance, adjust the dose in small increments as needed. A small increment is typically 1/4 (.25) to 1/2 (.50) units.

Also, when starting out, the typical recommendation, until you have enough tests to know how your cat will react, is to skip a dose if under 200.

That being said, we do suggest testing more than just twice a day, as lantus dosing is not based on the pre-shot number and rather the nadir (lowest point in the cycle). When you are home (nights, weekends) you ought to be able to get in a few more tests. We're not saying testing hourly or anything, but when you are home, if you can get the pre-shot test in, and then 2-3 hours after the shot, and again 6-8 hours after the shot. This will help form the pattern of how the cat will react to insulin.

Please be sure to visit the lantus forum and read the starred information there, so you better understand how to use Lantus, testing, etc.

Also, you can post on the lantus forum to get more specific guidance.
 
It is not good to provide help via email since that prevent peer review of comments/suggestion. I will sent you a private message. That send an email to your that you can click on a link to see the post/message board.

I am concerned about the need for giving insulin since you said you have had reading of "with even 2 readings being in the 99 and 110 range!"
Can you provide the blood glucose reading you have obtained so far together with when the readings were taken with respect to eating.
Depending upon the reading I would do no more than 1/2 unit twice daily but I would like to see the reading first.
 
BLOOD GLUCOSE READINGS SO FAR (1 month in)
I will make this as simple as possible :) Please keep in mind I am not home all day, and am trying my best with this foster cat, on top of 3 children, other foster animals, a fulltime job, and a household to run:) I have just come off of the most stressful 2 1/2 months of my life of trying to juggle selling a house with foster animals, and I need this to be the least stressful for me, or I will be no good to any of the animals or my children.
I'm just asking don't crucify me! :lol:
Thank you for understanding, and thank you for trying to help with the limited amount of info I can give you !

OCT 11
pre-b/f - 262
pre-dinner - 343

OCT 12
pre-dinner - 247
post-dinner (2hrs later)319

OCT 13-
pre-b/f - 302
pre-dinner - 260

OCT 14
pre-b/f - 364
pre-dinner - 307

OCT 15
pre-dinner - 331

OCT 17
pre-dinner - 437
post-dinner (2hrs later) - 452

OCT 18
pre-bf - 355
pre-dinner - 371

SAT OCT 20
pre-bf - 238
post lunch (348) I KNOW I need to be more regulated in my bg checking

SUN OCT 21
pre-bf - 314

OCT 22
pre-bf - 285

OCT 23
pre-bf - 259

OCT 24
pre-bf - 306

OCT 25
pre-bf - 205
pre-dinner - 374

OCT 26
pre-bf - 270

OCT 27
pre-lunch - 225

OCT 31
post-lunch - 99 (I performed this test twice)
post-dinner - 110 (I performed this test twice)

NOV 1
pre-bf - 205
pre-dinner - 219
post-dinner - 231 (2 1/2 hrs after)

NOV 2
pre-bf - 232
post-lunch (3 hrs after lunch) - 210

TODAY - NOV 3
pre-bf- 113


WHAT DO I DO NOW !!???
 
Is there anything different that would lead to the low BG that you posted? Such as not eating much? Getting into dry food for the high BGs? Eating different food?
With those low numbers insulin may not be required.
 
Hello everyone.
Dutchess is only given the same low-carb wet food, and I change between 2 brands for variety.

She is not allowed any dry food at all.

Yes, there are times that she does not eat much.

My son and I plotted her figures over this month on a graph, and there is definitely a trend downwards, with no help from insulin yet ! But according to my post above, she's not quite low enough yet, is she ? SHOULD SHE BE ON INSULIN WITH THESE FIGURES ?

She registered 188 this morning before breakfast. Is this a high enough number that I should have given her a shot ?

I have been practicing putting the insulin in the needle. At 1/2 unit, there is hardly anything in the needle (maybe 1 drop of insulin?) and it is almost indistinguishable between 1/2 unit and 1 unit that I'm not exactly sure if it's 1/2 or 1 unit, based on the readings on the needle.
 
Welcome!

Dutchess said:
She registered 188 this morning before breakfast. Is this a high enough number that I should have given her a shot ?

I have been practicing putting the insulin in the needle. At 1/2 unit, there is hardly anything in the needle (maybe 1 drop of insulin?) and it is almost indistinguishable between 1/2 unit and 1 unit that I'm not exactly sure if it's 1/2 or 1 unit, based on the readings on the needle.
Click to expand...

Even with her downward trend she might need a few weeks or months with insulin to ease her pancreas back into doing it's thing :-D . Those numbers certainly aren't high so the food is helping but maybe a 1/4 to 1/5 u to start with will make all the difference. While it is almost high enough the 188 is what we would tell new people to not shoot unless they have data and know what she does with the insulin through the day. You have a great start-up going on seeing how she is with no insulin so transitioning over will be okay. I, too, am one who is gone all day at work so I get most of my testing done at night. I shoot at 5am (b/c when I get home at 5 pm she wants FOOD!!! so that makes it 12/12. I get an out the door test (most days- not always) in the morning and a bed test at night. I get up at least once during the night so I test then as well and it usually hits around her nadir- which is later than +6 :lol: .

Okay- when you say you've been practicing drawing insulin have you been sticking the needle in the vial or pen (which do you have), drawing it up, taking the syringe out and shooting it into the sink? Or have you just shot it back into the vial/pen? Doing this can contaminate the vial/pen and make it ineffective as the lubricant in the syringe to help the stopper go up and down smoothly could be a contaminate. If you have done the second you will need to keep an eye on the rest of the liquid- look for flecks of stuff or if the fluid isn't clear or if the insulin doesn't seem to be working on Dutchess at all.

Here is a link on how to get up an SS for Dutchess and link it to your account:
viewtopic.php?f=6&t=18207

heather
 
LOL I knew that saying I was practicing would raise questions !

I test it and spit it into the sink....why do I do this? Because with the needles I am using - 10-50 unit are marked on it, I can barely even see the 1/2unit mark and I wasn't sure if anything was being drawn up into the needle at all at the 1/2unit mark.

I couldn't go lower than 1/2unit because the needle doesn't draw any up into it if the unit is smaller than 1/2unit.


As it is, 1/2unit is like putting NOTHING into her, because the stopper is right at the top.. I poke her....but it feels like the insulin doesn't go in because the stopper is 1mm from the top of the needle.

thank you ! I will look at the link to understand what it is :) All this jargon is new to me! :lol:
 
What size syringes are you using?

It is possible to get 0.3ml syringes with 0.5 unit markings. This may make things easier for you to dose such small amounts. BD produce them, I'm sure other companies do also. Here's a link to the BD UltraFine product, which is also a 31G gauge needle, so it has a very fine/thin needle (higher the number, thinner the needle):

http://catalog.bd.com/bdCat/viewProduct.doCustomer?productNumber=328440

(EDIT: that link shows the short 8mm needle length syringes, but they are available in the longer 12.7mm needle length as well.)

This googled image shows the difference:

syringes3sizesSmr.jpg


Additionally, I'm pretty sure there's some good info around on micro-dosing, the LantusLand crew will no doubt be able to help you out with this.

H
 
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