Newly diagnosed!

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Unfortunately I didn't have the time during the day to get his numbers or to even wait 1/2 hour to test again as I had a busy work day yesterday, and I'm the only one in the household that tests him (Plus the rest of my family was off at work the entire time I was yesterday).

I did test him preshot (PM) and post shot. Its hard to get readings during the day if I'm not home. Its also hard to get on the message board during the day for advice if I'm having a busy day at work. I would have liked to have advice, but I just didn't have the time to post.

I'm trying hard to make sure I follow all the rules...sometimes its just impossible.... Since this was the first time ever I hadn't shot (previous advice said not to shoot when he's lower than 200), I made the best decision I could at the time. Added in that my work schedule sometimes doesn't allow for the flexibility of having a little extra "cat time" first thing in the morning...

I'm trying.
Liz
 
Don't worry; many of us also have difficulties juggling work and life and diabetes. It takes some time to develop a routine and it's even harder when you're the only one able to test him. Even if you can't get on the board during the day, the board is "open" 24 hours a day, so feel free to post whenever you get the chance. ;-)

lizhazel29 said:
I'm trying hard to make sure I follow all the rules...sometimes its just impossible.... Since this was the first time ever I hadn't shot (previous advice said not to shoot when he's lower than 200), I made the best decision I could at the time. Added in that my work schedule sometimes doesn't allow for the flexibility of having a little extra "cat time" first thing in the morning...
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The bolded phrase is the only "rule" you need to follow. Think of the "rules" more like "guidelines." Not everyone is going to be able to do everything or even do everything perfectly. There are numerous things that it's just not possible for me to do. The only way I can get a PMPS +11 is if I stay up all night since there is no way I can wake up early enough to get it. So, I don't worry about that too much. If Mikey's too low at his AMPS, I'd rather just skip the shot while I'm gone at work all day than wait around for a half hour to see if it's rising and end up late for work. Yes, a skipped shot might set us back a little bit, but I'd rather have a skipped shot than worry about him all day while I'm at work. Every person on here has limitations of some sort, whether it's time, money, eyesight, sleep, work, kids, etc.... We work around those limitations to the best of our ability and that simply takes time till you find out the routine and the habits that best help you help Tigger. You're doing just fine. :-D
 
GOOD NEWS! I sent the vet our spreadsheet and she lowered Tigger's insulin to 2 units twice a day!

YAY!!!! :mrgreen:
 
Yay on the vet reducing the dose!

Tigger will probably bounce high with that skipped dose this morning. Just so you expect that and for the PMPS test.

Would you do one change for us? Looks like you put in a direct link to your SS. If you copy the link from google, the one that is in the "publish to the web" pop-up window, at the bottom instead of the link in the web address bar, then your post stays up and the SS will pop up in a separate window. It helps to be able to have the 2 up side by side. Thanks.
 
With 4 weeks of data, plus the relatively high mid-cycle numbers, it is probably safe to reduce your no shot number from 200 mg/dL to 175 mg/dL.
 
Thats good news but I see from the SS that the vet has proposed a sliding scale ( 2 units over 350 or 1 unit over 300-350). However Lantus works best on consistent dosing and a sliding scale really doesnt account for bounces so I would recommend you stick consistently to the 2 units and see how that works.

Give the 2 units 3-5 days to settle in (reduce if he drops under 50 immediately though). . If after 3-5 days we dont see enough green or blue you may need to increase again but lets see.

And as BJ said lower your no shot number to 175. Over time you will need to get used to shooting at lower numbers as he should come down - shoot low to stay low as they say!

Wendy
 
I was thinking of sticking with the 2 units at whatever number he tests at (except below 175!). I'm pretty much using this board as a guideline and my emailing my vet to keep her in the loop. She's very very pleased with the food change and number drops! Said she was going to start recommending it to all her DM cats. We're doing so well so far! I'm really excited about the drop in dosage!!
 
OK guys - got my first 96 - 5 hours post am insulin.....acting completely normal (actually had to wake him up to get his readings).

This is good, right?? :)
 
:-D

Probably not the lowest he's been though.. so keep getting those mid cycle tests.. night too.. cos a lot of cats go lower at night than day. Looks like he is heading for a high PMPS so maybe set the alarm for a PMPS +6 if you can?

Are you using an alphatrak?

Wendy
 
Some healing low numbers for Tigger! That is great news! Keep it up Tigger, you may earn a dose reduction soon.
 
I'll try for the +6 but since I just gave him his PM (321) shot it may not happen. Little bouncy today, isn't he..
 
Need some quick reassurance.

Just found out my hubby had been sneaking in some higher carb food "for a treat" for the past week. I yelled at him so loud my cats ran!!! How long does it take to get him back to normal? he's been doing 300's for about a week now....I'm getting concerned because the vet changed our regimen to 2 units.

Liz
 
OK thanks - that makes me feel better. I can't believe he was doing it, and says "Oh it was for Princess". Like Tigger doesn't eat. Sure its for Princess....I was so mad at him!
 
Hey there

Just checking in to see how you are doing. i checked out your SS and have some thoughts .. First I see you are trying to "level things out". That wont be easy for a few reasons and I dont think you should worry about it because:

1. if the cats pancreas is working intermittently - and healing - you will see periods of low numbers where its working, followed by high numbers
2. If the cat is going too low at any point during the day or night ( you can tell by more frequent mid cycle testing) he will bounce high as a result of the low. Many cats bounce low and go high and gradually spend more and more time low, until they are in remission
3. The lows are good because it allows his pancreas to heal (as long as they arent under 50)

Instead of trying to flatten him, I would concentrate on sticking to the protocol (http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581). I think 2 units was actually working well for him back in August but the thing was that you were having to skip due to low preshot numbers. Over time all newbies need to learn to shoot at these lower numbers in order to keep the kitty low (shoot low to stay low). But you cant do that without more data to make sure its safe to do so.

Not sure I am making sense but my recommendation essentially is
- give 2 units twice a day (unless he drops under 50) for another couple of days.
- as well as preshot tests, get a mid cycle test midday (around +5 to +7) and one a couple of hours after the pm shot around +2 to +3.
- keep us updated so we can revaluate the dose at that point
- Shoot him if he is over 150 and get another test in 2 hours. If under 150, wait 30 minutes and test again (dont shoot or feed) and let us know and we can help you shoot low if need be.

With those recommendations we should be able to get him into better numbers.
Wendy
 
How is Tigger doing? Were you able to get Hubby on board to giving them some "proper" treats? ;-) :lol:
 
Hi guys have been having some problems lately because it broke my left arm. This just happened last Tuesday so it's only been a couple of days. Testing Tiggerand shooting insulin is very difficult right now . I'm averaging two tests per day And one insulin shot . I've noticed his numbers in the afternoon has been between 75 and 90 so I don't shoot. All in all it's been very difficult but once I get my arm at this cast we should be going back to normal. Unfortunately I don't have a lot of help with him at home. But we are trying !! Thanks for keeping an eye on us and truly appreciate the help!!
 
Maybe contact your local high school guidance counselor, church youth group, or scout troop and see if there are some responsible teens, maybe ones looking to become vet techs or vets, looking for experience in animal care to help you out.

Also, ideally, you want a dose which is safe to give twice a day. I would cut back on the 2 units, perhaps down to 1.5 units.
 
If he is too low to shoot in the PM you might want to reduce dose to say 1.5 units, to see if that will allow you to shoot twice a day. The key to Lantus is consistency.

Wendy
 
Great news - my arm isn't fractured! So I'm back to a normal schedule with Tigger and I'm sure he's THRILLED about that. :)
 
Interesting blood sugar today - he didnt drop that low. But the furshot means his depot is drained. when do you think you can get more tests like this? I would be interested to see how low he drops once the depot is full

Wendy
 
I generally have more time on the weekends....he's doing a lot better with my shooting technique - I'm sitting him on my desk, and i'm sitting next to him on the chair, and inject. He seems happier this way. Of course, he gets mom-approved treaties too! :) I'll probably do another curve on Sunday. Thanks for keeping up with us!
Liz
 
What time do you shoot and when do you leave the house? Given you quite often get blue AMPS numbers I wonder if hes dropping low at night and if you can get a test in the morning an hour or two before pre shot, you might see that. Or maybe occasionally set the alarm to get up middle of the night.

Any chance of a few more tests this weekend?

Wendy
 
My work schedule is early - I usually test and shoot about 530 to 600 am - then leave shortly after. I'm going to see if I have time tomorrow to curve him some more. If not, then definitely Sunday (as I'm home all day and have a major homework project to do).

We won't talk about lack of sleep... LOL
 
Hmm so can you get a test before bed say at 9 or 10pm? that would be 3-4 hours after your pm shot and would give some very useful data!

What time do you get home at night?
Wendy
 
I can try 2-3 hours post pm shot to see what's what. I usually get home between 3 and 4. Sometimes I remember to test him but mostly he's just happy to see me and snuggle that I don't want to.. :) Weekends tend to get a little off schedule since we don't get up at 5 am. but for the most part, he's doing really well.
 
2-3 hours post shot would be good) ie

5am test shoot
5pm test shoot
7/8pm test

It would give a lot more info so we can get a better picture of whats going on - and some more spot checks at weekends. we want to try and see if he is doing those 78s or lower and you are currently missing it.

Wendy
 
Im doing every two hour testing today since I"m home all day, and he likes to keep me company while I"m doing homework....I'm posting as I go.
Liz
 
Wendy - we are at 89 at +12 hours.....I'm not going to shoot, but wait another hour to see if he bounces back up.
Liz
 
He pretty much stayed in the 90s last night and this morning. so he didn't get any insulin last night or this morning.... talk about weird...
 
Not if you gave 2 units last night. Instead, it would suggest the dose last night may need to be reduced.

How much did you give last night?
 
2 units last night. I have a call into the vet to see if she wants to decrease to 1.5 units, or even 1 unit. She had him on a sliding scale, but that didn't work so well, since consistency with Lantus is important.
 
Lantus dose adjustments are typically made based on the lowest point between 2 shots, with some consideration given to the pre-shot tests.

Given that you've been skipping due to low pre-shots, I would drop to 1.5 units.
 
OK just got off the phone with the vet. (Incidentally she's a cat only vet with lots of experience with renal and DM cats). She told me if he is under 250 don't shoot. She says over give 1/2 unit. She wants me to track him twice a day (or more if I can do it) to see how he fares.

I am really really really not sure about this.....From 2 units to ZERO if under 250? She looked at my spreadsheet too...

I guess I just need reassurance.
 
Lantus is best dosed consistently. Its better to find a dose you can give twice a day. This is because Lantus is a depot insulin and any dose change takes days to have an effect on the cats blood sugar. If I were you, and based on my experience, I would try and shoot 1 unit , twice a day, for the next few days and see how that goes - but I would get mid cycle tests to make sure he isnt dropping below 50.

Wendy
 
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