Newly diagnosed kitty

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Thanks! So this morning the Vet initially said to bump him up to 2units twice a day. They just called and said his Pertosamine lab that test for the past two weeks, was 655 and should have been 400. So now they want him to take 3units twice a day. I'm scared this is really going to drop him down. Does anyone think I should start with the two units and just keep checking his BG? They also told me there is no point to check him unless you think he's low. I don't get the reasoning in this.
 
Did you mean Fructosamine test? I thought as of Thursday he was still on 1.0U twice a day... would not jump to 2.0U (which is a 100% increase) and definitely not jump to 3.0U. Let's get your Spreadsheet going with home testing first, we'll recommend you only increase by 0.25U at a time. Think you said you'll be picking up some half unit syringes from Walmart soon. :)

Think you're also working on food changes, we don't want to change too many things at once ;)
 
Hi, that's what I thought they meant, but I think she said Pertosamine (I might be wrong though). She said it is a lab that checks the BG for the past two weeks.
I picked him up from the Vet yesterday and they said he was too aggitated to do the Curve. They actually said he hated the Staff, which I thought was pretty insensitive. I'm sure he was very scared. But, this morning they advised 2 units twice a day. My husband gave him the units and checked in on him at noon. We're going to check him of course this evening before deciding what to give him.
The Vet also told me she didn't think it was worth the time to be checking his sugars unless we thought he was low. That I didn't understand.
And I think I got my Spreadsheet up!!! Not sure if anyone is able to see it. Do you know how I access it? And thank you! :cat: Oh I see the link now! I'll have to figure out how to access to chart it once I close it.
 
Also, the way my spreadsheet looks, it seems I can't chart AMPS unless it's under 299. Do you know how I can set this up to where it can be for any range?
 
Yeah that sounds like Fructosamine. I don't think he hated the staff, like you said, he was probably just very scared! Poor thing. When Vet's say things like, no need to check unless you think they're low, we'd think to ask them "Would you blindly give insulin to a small human child without testing BG before each shot?" Probably not ;). Our fur babies are no different. I do see your SS :). You'll just sign into Google, click on the 9 little square icon, then click on Drive and open the SS. Should automatically update. I still would've tried 1.5U first, at least for a couple days before going to 2.0U. When you check tonight just make sure he has not eaten anything 2 hours prior to PS test time so his BG is not food influenced.

Once you start collecting some data on his SS we'll be able to help more. Most of us do not consult our Vets for dosing advice because they have a tendency to increase by whole units. This works for most humans but not little kitties (even 20lb kitty is little compared to a human ;))
 
I showed the vet my SS and how well my boy is doing now. She didn't look impressed. Kept asking me if I'm giving him hill's prescribed food. Told her about YA and she dismissed it. I've given up talking to the vets. I've lost confidence in them. I thk cos it's so easy to euthanise cats that they don't bother to explore other ways.
 
That is terrible. One Vet I talked to who saw him for his appointment was grateful we're checking me at home so that made me feel good. I guess he has a cat that gets 6 units a day. But a different Vet from the same clinic called and advised I don't check him and put him on 3 units. I don't like they're not on the same page. What is YA? Is it a type of food?
 
Janel and Alabaster said:
That is terrible. One Vet I talked to who saw him for his appointment was grateful we're checking me at home so that made me feel good. I guess he has a cat that gets 6 units a day. But a different Vet from the same clinic called and advised I don't check him and put him on 3 units. I don't like they're not on the same page. What is YA? Is it a type of food?
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Honestly, I think a lot of vets are totally at sea when it comes to treating FD. I don't fault them necessarily - they don't get much instruction on it, they might see only one or 2 FD kitties in their practice, if any, and cats are very complex in their reactions to insulin. I even had my horse vet comment once about how very complicated cats are when it comes to diseases of the endocrine system like diabetes. That's why we as owners have to learn all we can and be willing to be more hands on, especially when the vet's treatment falls short.
 
I can see that from their perspective. It's just all very overwhelming. But thank God for this website or I would be totally lost! You all have been an amazing help and have given hope and comfort. We're going to start his Zobaline today so I hope we get good results with that.
 
Janel and Alabaster said:
I can see that from their perspective. It's just all very overwhelming. But thank God for this website or I would be totally lost! You all have been an amazing help and have given hope and comfort. We're going to start his Zobaline today so I hope we get good results with that.
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We're always here to help. :)
 
Thank you so much! I can't imagine what I might be putting him through, or not treating him as good as I could without all the helpful info. :) We're going to adjust his dose on Saturday when we're home with him all day. Only by .5 so we'll see.
 
Janel and Alabaster said:
Thank you so much! I can't imagine what I might be putting him through, or not treating him as good as I could without all the helpful info. :) We're going to adjust his dose on Saturday when we're home with him all day. Only by .5 so we'll see.
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I see starting last night you jumped to 2.0U though, that's a 100% dose increase. Please try to get a before bed test if you are not home during the day :bighug:
 
Good Morning! We did do the increase. At 6:30 last night we checked him and he was at 380 so we gave him 2 units. We checked him again at 12:30am and he was at 322. We checked him this morning at 6:30 and he was at 305. We gave him 2 units which made me a little nervous, but we fed him a whole can of food instead of half. I hope this was okay to do. I am just so nervous. Do you think I should try to go home at noon and check him?
His energy level as of yesterday was a bit better. This morning he was really talkative which was great. He even sprinted for a second. We started his dose of Zobaline last night and today as well.
Thank You for checking in! :bighug:
 
Janel and Alabaster said:
Good Morning! We did do the increase. At 6:30 last night we checked him and he was at 380 so we gave him 2 units. We checked him again at 12:30am and he was at 322. We checked him this morning at 6:30 and he was at 305. We gave him 2 units which made me a little nervous, but we fed him a whole can of food instead of half. I hope this was okay to do. I am just so nervous. Do you think I should try to go home at noon and check him?
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Ok then you're 322 reading should go in +6. Meaning 6 hours after shot administered :). Was wondering how he might have dropped 58 points in an hour after eating more :smuggrin:. If you won't be penalized for stopping home and you are worried, you can try to stop home. He'll probably be OK since the little drop last night was over 6 hours. If the Vet tries to increase to 3.0U next, please don't jump to that. He is showing some response to 2.0U so you might've lucked out and his ideal dose (which can change ;)) was not between 1.0 and 2.0U. It might be between 2.0 and 3.0U, so if he hold similar numbers the next couple of days, think of trying 2.25U :)

If any of that was confusing, 1. My apologies! 2. Ask me to clarify :smuggrin:
Janel and Alabaster said:
His energy level as of yesterday was a bit better. This morning he was really talkative which was great. He even sprinted for a second. We started his dose of Zobaline last night and today as well.
Thank You for checking in! :bighug:
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That's very good to hear!
 
Hi and welcome. Around here we increase in .25 increments so as not to miss a good dose. My Max was 16 pounds and started at 1 unit and within a week had a 60 nadir. Every cat is different. The depot builds so it's too soon to know if he will need more or less insulin. Since dosing is based upon the nadir, lowest point in the 12 hour cycle I'd try to get a test st +5-7 whenever possible. If you can grab a +2-3 you will get an idea if more tests are needed for that cycle. There's a lot to learn so keep asking questions. I'd also suggest you start posting on the lantus/lev board so more eyes will be watching.
 
Oh I was so happy to see him have some sass back! Oh, so the +"numbers" mean hours? Like where to put it in the spreadsheet? I'm sorry, not computer savy over here. Thank you for clarifying! :) Thank you so much for getting back with me about the numbers! I am definitely not going to go to 3 units. I really don't feel safe doing that. Tonight we're finally picking up the titrating syringes. I think tomorrow were going to bump him up to 2.5 in the morning depending what his reading is tonight. The Vet wants us to bring him in two weeks for another Fructosamine lab, but I'm nervous because they're expecting the results to be from the 3 unit dose. :/
 
tiffmaxee said:
Hi and welcome. Around here we increase in .25 increments so as not to miss a good dose. My Max was 16 pounds and started at 1 unit and within a week had a 60 nadir. Every cat is different. The depot builds so it's too soon to know if he will need more or less insulin. Since dosing is based upon the nadir, lowest point in the 12 hour cycle I'd try to get a test st +5-7 whenever possible. If you can grab a +2-3 you will get an idea if more tests are needed for that cycle. There's a lot to learn so keep asking questions. I'd also suggest you start posting on the lantus/lev board so more eyes will be watching.
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Hello, and thank you. You all have been an amazing help. We're both incredibly blessed we found this site!
What does nadir mean? .. I have a pen I am using for his lantus so I will be drawing from that for the first time. Not sure how to do this but watched a video so I hope I can do this correctly. I've been wondering if I have been injecting into the muscle instead of the fat as well. It has been so hard to tell.
 
Janel and Alabaster said:
Oh I was so happy to see him have some sass back! Oh, so the +"numbers" mean hours? Like where to put it in the spreadsheet? I'm sorry, not computer savy over here. Thank you for clarifying! :)
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Yup, we do it this way to accommodate the multiple time zones members live in :)
This might help too: http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/
Janel and Alabaster said:
I think tomorrow were going to bump him up to 2.5 in the morning depending what his reading is tonight.
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I wouldn't bump him up so soon, like tiffmaxee said, the depot takes some time to adjust/stabilize. Have you read the Lantus protocols stickies? They're on the Lantus forum: http://www.felinediabetes.com/FDMB/forums/lantus-glargine-levemir-detemir.9/
Start Low, Go Slow Method (SLGS)
Tight Regulation Protocol (TR)

I believe collecting data on your SS is way more beneficial than a Fructosamine test and probably less expensive ;)
 
Yong said:
Yup, we do it this way to accommodate the multiple time zones members live in :)
This might help too: http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

I wouldn't bump him up so soon, like tiffmaxee said, the depot takes some time to adjust/stabilize. Have you read the Lantus protocols stickies? They're on the Lantus forum: http://www.felinediabetes.com/FDMB/forums/lantus-glargine-levemir-detemir.9/
Start Low, Go Slow Method (SLGS)
Tight Regulation Protocol (TR)

I believe collecting data on your SS is way more beneficial than a Fructosamine test and probably less expensive ;)
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What does the depot mean? And is it best to just keep him at 2 units with checking for maybe a week?
 
Janel and Alabaster said:
What does the depot mean? And is it best to just keep him at 2 units with checking for maybe a week?
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Click the Lantus link, it answers these questions better than I can :).
Walmart does carry U-100 syringes with half unit markings but I got frustrated after like 3 pharmacy staff's compiled of people who aren't the brightest bulbs :facepalm:. If I try again, I'm taking a picture of the one's I want as other's suggested. Good luck with yours! :)
 
@Yong @Kris & Teasel Today has been a rough one. :(. Not sure what happened, but I gave Ally his morning dose and he was at 400. Rechecked him at noon and he was at 417. We didn't want to give him more because we were unsure if the morning dose may be in his system still. Just rechecked him and he is at 466!!! We gave him 3 units. We went to Walmart and they did not sell any syringes with half doses, only full units. I am just beside myself. I'm afraid to feed him, but he has to eat. I'm only going to give him a half a can and retest around 8pm when it's two hours after he eats. Please advise if there is something more I should do. :(
 
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Hi Janel, I just responded to another post where you mentioned this:
"I would not have increased the dose by a whole unit again. 2.0U was starting to show something. Too much insulin can cause higher numbers too ;). You could post on the Lantus forum to see if they think you should go back and then increase by 0.25U. I see you might've had a fur shot this morning too, please NEVER re-shoot. There's no way to know how much or how little insulin actually went in."

You can order syringes online if your Walmart did not carry the one's with half unit markings. Many of us use ADWdiabetes.com. Glad you did not re-shoot :). Did you pick up ketone test strips? I think part of it is bouncing form those yellows last night and maybe a little from getting a fur shot. Here's a link for the syringes I bought: https://www.adwdiabetes.com/product/1289/monoject-ultra-comfort-insulin-syringes
 
Janel and Alabaster said:
@Yong @Kris & Teasel Today has been a rough one. :(. Not sure what happened, but I gave Ally his morning dose and he was at 400. Rechecked him at noon and he was at 417. We didn't want to give him more because we were unsure if the morning dose may be in his system still. Just rechecked him and he is at 466!!! We gave him 3 units. We went to Walmart and they did not sell any syringes with half doses, only full units. I am just beside myself. I'm afraid to feed him, but he has to eat. I'm only going to give him a half a can and retest around 8pm when it's two hours after he eats. Please advise if there is something more I should do. :(
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Please don't worry. What he's doing is a very common reaction to some slightly lower yellow numbers - he's bouncing. There's a lot to learn in treating FD and I recommend that you post on the Lantus forum to get help with dosing from the experts there. Read the info stickies about the two sets of dosing guidelines, TR and SLGS. It's best if you choose one to follow so you have a system in place to help you with dosing decisions.

Two things for now:
  1. A dose isn't raised in response to bounce numbers. Rather, it's the lowest a dose takes your kitty (the nadir) that you look at to evaluate the effectiveness of a dose and decide whether to keep it, raise it or lower it. That's why you need data from the +4 to +8 part of as many cycles as you can manage.
  2. When a dose is changed the recommendation here is that it's done in 0.25 u increments. You could potentially zoom right past the good dose by increasing by a whole unit.
All of this and more is in the info stickies on the Lantus forum. :)
 
Janel and Alabaster said:
Shoot. Ugh. Okay, we will definitely go back to the 2 unit dose. I guess seeing the 403 number this morning after his good numbers last night we thought we should. I wonder why too much Insulin would make him go higher? That is good to know.
If I do have a fur shot.. which I think your right that I did.. is it okay to give him his dose 12hrs later? We didn't give him any throughout the day or after that in fear he would drop to low. I hope we can find those syringes tomorrow. If not I'll start my search online.
Thank you SO incredibly much for responding! Today has been a tough one for us here.
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Going to reply here to keep it on your thread :). I think I gave you the link to the Lantus forum to find those stickies, Kris mentioned :bookworm:, Yes post #73!
We all have at least one fur shot in our longer sugar dances, it happens. Correct in do not give it later in the day, just wait until next scheduled time :bighug:. It's a steep learning curve, you'll get there ;)
 
Thank you both so much!!! I am beyond worried. Ugh. I just want him to be okay. I need to learn the process I guess. I will post dosage questions in the Lantus forum. Again, thank you!
 
Yong said:
Going to reply here to keep it on your thread :). I think I gave you the link to the Lantus forum to find those stickies, Kris mentioned :bookworm:, Yes post #73!
We all have at least one fur shot in our longer sugar dances, it happens. Correct in do not give it later in the day, just wait until next scheduled time :bighug:. It's a steep learning curve, you'll get there ;)
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Thank you! Its hard to not be sad about this, but it's all about learning and adapting now. Just need those syringes! :bighug:
 
Don't worry if he spikes even if it's a black number. Please go read those Lantus stickies I mentioned above and make a note of anything you want to ask about.

Here's the general mind set:
  • choose a reasonable dose
  • give it consistently AM and PM for minimum 3 days (TR dosing guide) or 5 to 7 days (SLGS dosing guide)
  • test BG AM/PM and mid cycle every day and/or do a weekly curve
  • evaluate the data using the guidelines described in TR or SLGS and keep or change the dose
  • don't react to spikes in BG.
 
Yong said:
Hi Janel, I just responded to another post where you mentioned this:
"I would not have increased the dose by a whole unit again. 2.0U was starting to show something. Too much insulin can cause higher numbers too ;). You could post on the Lantus forum to see if they think you should go back and then increase by 0.25U. I see you might've had a fur shot this morning too, please NEVER re-shoot. There's no way to know how much or how little insulin actually went in."

You can order syringes online if your Walmart did not carry the one's with half unit markings. Many of us use ADWdiabetes.com. Glad you did not re-shoot :). Did you pick up ketone test strips? I think part of it is bouncing form those yellows last night and maybe a little from getting a fur shot. Here's a link for the syringes I bought: https://www.adwdiabetes.com/product/1289/monoject-ultra-comfort-insulin-syringes
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Found this again! Just purchased the syringes! Ally and I thank you! :bighug:
 
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