Oreo: started on Prozinc, now on Lantus

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Justgin

Justgin

Member Since 2017
Hi I'm new. Here's my introduction thread: http://www.felinediabetes.com/FDMB/threads/oreo-and-justgin.177611/#post-1960993

So, after 2 weeks on Prozinc, Oreo is now on Lantus. Just started Wednesday night, May 10. The dose is 4 units every 12 hours. He weighs 17.5 on my scale as of last Monday, May 8.

This morning I'm only going to give 2 units at 9am and then test him at +7.

It won't be possible to check +7 on days I work because I do 12 hr shifts. So would you just recommend preshot tests only?
 
Good Morning Justgin and Oreo.
As we kind of discussed on the intro thread I think its a good idea to cut the dosage back from that 4 units based on the starting dosage formula for Lantus. I would also get some second opinions from a vet or others here. But I know that higher BG numbers are safer to deal with than hypo events and since you have done little testing and those tests may be skewed by Oreo's stress or the vet trip the BG numbers may not be as accurate or as high as you think. My vet emphasized to me if you are going to error, error on the lower dosage with higher BG numbers side and sneak up on it. As to why figure the Lantus dosage on the cats "ideal" weight vs actual weigh that struck me as odd also but it mentioned it both for overweight cats and underweight cats...so I figured they know more than I do.
Not sure what to say on your testing question but I'm sure someone here will have a good suggestion. I know preshot is always good but the +7 kind of depends on the cat. What I've done with Sketch was to pic a time I could repeat that was about 4 hrs after his last meal to get things started. Do keep in mind when you are testing Oreo's meal times.
On your previous thread you also mentioned your cats were overweight and outlined what you were feeding them after switching them to wet . It sounds like switching to wet that you are trying to feed the same amount of calories they were taking in while eating the dry but I may have read that wrong?. I would think if that is the case that if you want them to loose weight you might want to cut the calories back gradually.
 
@Jeff Davis I read that an adult normal weight cat should have one 5.5 ounce can per day which comes to 27.5 ounces for 5 cats. Is that wrong? They've been hungry and begging for more food since stopping the dry and going low carb. So yes I've been giving them more wet than before, which compared to the dry is still lower in calories. What amount should I be feeding them?

Also, Oreo is stressed out when I test him, but I don't think that can be helped at this point unless the vet decides to give him a med to help him calm down before a test.
 
Justgin and Oreo...there are other variables from the normal recommended feeding amount when diabetes is involved. You may have noticed besides Oreo drinking a lot more and using his litter box more he also probably has had an increase in appetite. (Sketch had a huge appetite constantly yet wasn't gaining weight just holding what he had 12.5lbs) Because Oreo is needing more calories then he normally would because of the disease you will probably need to feed him a higher amount of food then a similar sized cat w/o diabetes. Also keep in mind that ounces don't necessarily convert to calories...(as you know being a nurse you can have 12oz of salad or 12 oz of cake and there is a huge difference in calories!) So you may have to "guesstimate " since you are trying to get Oreo to drop some weight without starving him. I think I would look at the Dr. Pierson food chart on this site and look at the calories of the foods you are feeding him now and previously to get an idea of total caloric intake for him daily. Once you have a good idea of what his calorie intake was with dry and wet then see what you have to do to get an equal amount of calories from the wets you are feeding him currently. Assuming since he is heavier than ideal cat weight for his size but given that the diabetes is increasing his need for calories I think I would stick with the amount food / calories he was getting and see how he reacts for a couple weeks. Then as you start to get him more BG balanced with the insulin start cutting calories back slowly...maybe 3 to 5% less calories per day to see if you can start getting his weight down w/o starving him.

The stressing issue is tough..... I know from experience with Sketch. I guess as I did with Sketch when I first started testing him (he's somewhat better now) I would assume that any test for Oreo is going to be somewhat high and dose slightly lower than his BG may indicate.
 
OK!

The test result for 5/12/17 @ 18:00 is = not enough blood.

I pet him, told him he was a good boy, offered a treat which he wanted NOTHING to do with, and let him go. Very frustrated and disappointed and I want to cry. Also I'm saying about a million cuss words to myself.

If there is a postive side it's this. I forced myself to be calm and relaxed. He knew I was faking it, but he DID let me work on his ear. I've watched a number of videos today showing the exact spot, or the sweet spot. I stuck twice at that exact spot, got a teeny bit, milked it, and he let me too. But it was not anywhere near enough. He would shake his head and smear that teensy bit of blood on my hand. I'm guessing the stress causes his vascular system to restrict, therefore, not enough blood. He has been hungrier today with only 2 units Lantus this morning. But tomorrow I work all day and I am scared to give him any more than that if I can't be home to monitor him.

At this point, all I can do is continue trying to test him, and plan to take him to the vet next Thursday morning to do his curve testing. They can deal with his nerves there.
 
Justgin said:
OK!

The test result for 5/12/17 @ 18:00 is = not enough blood.

I pet him, told him he was a good boy, offered a treat which he wanted NOTHING to do with, and let him go. Very frustrated and disappointed and I want to cry. Also I'm saying about a million cuss words to myself.

If there is a postive side it's this. I forced myself to be calm and relaxed. He knew I was faking it, but he DID let me work on his ear. I've watched a number of videos today showing the exact spot, or the sweet spot. I stuck twice at that exact spot, got a teeny bit, milked it, and he let me too. But it was not anywhere near enough. He would shake his head and smear that teensy bit of blood on my hand. I'm guessing the stress causes his vascular system to restrict, therefore, not enough blood. He has been hungrier today with only 2 units Lantus this morning. But tomorrow I work all day and I am scared to give him any more than that if I can't be home to monitor him.

At this point, all I can do is continue trying to test him, and plan to take him to the vet next Thursday morning to do his curve testing. They can deal with his nerves there.
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Deep breaths....go to your zen place!!!..Congrats! you've made some progress in that you were able to touch Oreo's ear and actually get some blood! Don't feel bad I've had several attempts that produced no blood. A while back after about the fifth unsuccessful stick Sketch looked at me almost daring me to try one more time...he was probably thinking "one of us will be drawing blood on the next attempt!" sure enough, MY BG was 110 and he slinked away looking pretty satisfied and never left me a treat! If Oreo will let you, rub or massage his ear prior to sticking it to increase circulation. Maybe try a few times of just rubbing his ear and leaving him a treat without attempting to test. He might surprise you and warm up to the ear rub and treat thing.
What BG meter are you using? Some take less to get a valid test but I figure you already know that. I've been pretty successful using the Bayer Contour meter. (recommended by my vet)....seems to take very little blood for a valid reading.
I would agree with your thoughts on keeping the Lantus dose at 2 units tomorrow since you won't be there to monitor him. Will give you a bit of piece of mind while at work so you won't have to worry.
 
Jeff Davis said:
Deep breaths....go to your zen place!!!..Congrats! you've made some progress in that you were able to touch Oreo's ear and actually get some blood! Don't feel bad I've had several attempts that produced no blood. A while back after about the fifth unsuccessful stick Sketch looked at me almost daring me to try one more time...he was probably thinking "one of us will be drawing blood on the next attempt!" sure enough, MY BG was 110 and he slinked away looking pretty satisfied and never left me a treat! If Oreo will let you, rub or massage his ear prior to sticking it to increase circulation. Maybe try a few times of just rubbing his ear and leaving him a treat without attempting to test. He might surprise you and warm up to the ear rub and treat thing.
What BG meter are you using? Some take less to get a valid test but I figure you already know that. I've been pretty successful using the Bayer Contour meter. (recommended by my vet)....seems to take very little blood for a valid reading.
I would agree with your thoughts on keeping the Lantus dose at 2 units tomorrow since you won't be there to monitor him. Will give you a bit of piece of mind while at work so you won't have to worry.
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Lol your story made me laugh! Although I BET it didn't make you laugh at the time. :banghead: It's so frustrating but I'm sure I will look back on my experience and laugh as well. I'm using the Contour Next glucometer, got it at Walgreens. Is that the same one you have? Their strips are $28 for 25 so pretty expensive. I remember someone else recommended the one Walmart sells because the strips are much less expensive. So I may just have to make another trip to Wally's (I don't like that place) and get it.
 
Bronx's dad said:
and most kitties are stressed at the vet causing higher blood sugar #'s, another reason home testing is key to see where he really is at in his normal setting
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Well, so far Oreo is stressed when I try to test him too because it's fairly new for us both. Last week when it took 15 minutes to get a sample, his result was 478, which is higher than it was at the vet or the ER. I've heard some vets give a little sedative to help with stress. I'll call the vet on Monday and see if he will do that.
 
Justgin said:
Lol your story made me laugh! Although I BET it didn't make you laugh at the time. :banghead: It's so frustrating but I'm sure I will look back on my experience and laugh as well. I'm using the Contour Next glucometer, got it at Walgreens. Is that the same one you have? Their strips are $28 for 25 so pretty expensive. I remember someone else recommended the one Walmart sells because the strips are much less expensive. So I may just have to make another trip to Wally's (I don't like that place) and get it.
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I think your meter is the newest Contour meter but I think it uses the same strips as mine which as you mentioned are pretty expensive. But my feelings are you get what you pay for and in this case we are looking for accuracy. I'm not a huge Walmart fan either and if the price diff is so drastic it makes me wonder about quality and accuracy. I guess the only way to know for sure would be to test them side by side and see if the readings are the same.
You noted that Oreo's BG tested at 478...have you noticed any improvement in his symptoms at all since giving him insulin?
 
Just an add-on to Jeff's post. If you test your Contour meter side by side with a ReliOn, or even another Contour meter, changes are you will not get the same reading. Human glucometers are allowed a 20% variation, so if you do get a ReliOn (which many members use here but I understand the dislike for Walmart) and do a side by side reading, check if they're within 20% of each other :)

I'm also going to push getting your Signature setup again :p: http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/
And hopefully you'll start your Spreadsheet, if you need help just ask: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
 
Yong is absolutely correct that there will 99% of the time be some variation between meters....I didn't mean to imply that two meters will / should have an identical reading but I kind of did.....even if you tested with two of the same Contour meters with sample taken at the same time there would most likely be some variance. But as he points out it should be reasonably close. :)
 
I'm fuming right now. Not at Oreo for being a bad patient because he was very good. He stood pretty still while I pricked his ear and got what I thought was a good amount of blood after milking it a little. However the meter was not impressed: not enough blood!!!! Meanwhile Oreo gets away and hides from me. So I still do not know what his sugar is but I am still trying! He was as calm as I'd ever seen him and seemed to understand that he was only up there on the counter (he doesn't do counters at all, nor climb at all - the most he will do is get on my bed on occasion) for a short time and then gets rewarded with food.

So I'm going to have to ask which meter requires the smallest amount of blood?
 
Justgin said:
I'm fuming right now. Not at Oreo for being a bad patient because he was very good. He stood pretty still while I pricked his ear and got what I thought was a good amount of blood after milking it a little. However the meter was not impressed: not enough blood!!!! Meanwhile Oreo gets away and hides from me. So I still do not know what his sugar is but I am still trying! He was as calm as I'd ever seen him and seemed to understand that he was only up there on the counter (he doesn't do counters at all, nor climb at all - the most he will do is get on my bed on occasion) for a short time and then gets rewarded with food.

So I'm going to have to ask which meter requires the smallest amount of blood?
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The relion micro and confirm both need 0.3 blood sample which is the smallest. Does yours need 0.5?

One thing you can do is put a small amount of neosporin ointment on his ear so the blood will not absorb into the fur. You could also try flicking the drop onto the back of your nail and test from there.
 
I use the relion micro meter from walmart. I order the strips and lancets once a month at walmart.com (2oo at a time). What size lancet are you using? I have had luck with 28g and not using the lancing device but by free handing it. Try testing him while he eats a little bit of wet food mixed with water. I give mine freeze dried chicken mixed with water for every test. He's so occupied eating that he doesn't notice that I am poking him. If he's a cuddler check out his ear veins using the flashlight on your phone to get a feel for where his are. Aim for the area just beside the vein. It's not optimal to hit the vein, you'll have to apply some pressure to it. I'm a nurse too and having a diabetic cat is so much harder than taking care of a human diabetic.
 
I just looked at a number of different booklets and information sheets and on the packaging as well, and cannot find where it says how much blood is required. I've already done the Neo. That helped but not enough. I'll try to get the blood on my fingernail.
 
Justgin said:
I just looked at a number of different booklets and information sheets and on the packaging as well, and cannot find where it says how much blood is required. I've already done the Neo. That helped but not enough. I'll try to get the blood on my fingernail.
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Also check what gauge lancet it is. If it's 31, then go to the store and pick up 28 gauge.... They are thicker.
 
I am using the lancets that came with the Contour Next. I have given him his insulin shot while eating and he does hardly seem to notice, but he doesn't mind his back being rubbed. He hates having his head touched, except for the sides of his chin scratched. Yes I'm glad you understand that a cat makes a bad diabetic patient, even though he has been pretty good I'll have to say. But once I've tested him, he hides from me, if I don't get enough blood I can just forget testing until the next time he's hungry.
 
Justgin said:
I am using the lancets that came with the Contour Next. I have given him his insulin shot while eating and he does hardly seem to notice, but he doesn't mind his back being rubbed. He hates having his head touched, except for the sides of his chin scratched. Yes I'm glad you understand that a cat makes a bad diabetic patient, even though he has been pretty good I'll have to say. But once I've tested him, he hides from me, if I don't get enough blood I can just forget testing until the next time he's hungry.
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Ok so they are probably 31 gauge... A bigger lancet may help. Also give him a low carb snack as a reward for testing. Something he loves but only gets at test time. For my cat it was cold cuts. When you are not testing but just petting, get some ear strokes in to desensitize him to having them touched.
 
I don't know what size the lancets are. I think they are about the same as his syringe needles which are 29 gauge. I tested myself when I first opened the kit using the penlet on the deepest setting - it hurt!

Also, I just found the info about the size of the blood sample on the side of the box which says "requires 0.6..".
 
Justgin said:
I don't know what size the lancets are. I think they are about the same as his syringe needles which are 29 gauge. I tested myself when I first opened the kit using the penlet on the deepest setting - it hurt!

Also, I just found the info about the size of the blood sample on the side of the box which says "requires 0.6..".
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0.6 is larger than average! There's your problem. Mine needs 0.3.... Half the size of yours.
 
Were did you get your ReliOn? Jeepers you might know I'd get the wrong one. And here I was impressed that the Contour needs less than the ones I've used at work!
 
Justgin said:
Were did you get your ReliOn? Jeepers you might know I'd get the wrong one. And here I was impressed that the Contour needs less than the ones I've used at work!
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Three relion micro or confirm are from Walmart. (Not the relion prime because it needs a bigger sample of 0.5) I use a pet meter called Alphatrak 2. (You can get it on amazon). Pet meters are configured for feline blood so they are the same numbers your vet would get, but the strips are expensive. Most on here use the relion which are much less expensive.
 
JanetNJ said:
Three relion micro or confirm are from Walmart. (Not the relion prime because it needs a bigger sample of 0.5) I use a pet meter called Alphatrak 2. (You can get it on amazon). Pet meters are configured for feline blood so they are the same numbers your vet would get, but the strips are expensive. Most on here use the relion which are much less expensive.
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Hey Janet when you say the Alphatrak is configured for feline blood what does that actually mean and what is the diff in the numbers???
 
Jeff Davis said:
Hey Janet when you say the Alphatrak is configured for feline blood what does that actually mean and what is the diff in the numbers???
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. Cats blood is a different make up than ours. When testing a cat human meters run lower then pet meters. The higher the number the greater the difference. The lower the closer the numbers. There is no direct comparison.... Both types of meters will still be able to tell you if your cat is high or low.
For example...
The numbers to remember for a human meter: normal is 50-120. Below 50 is the time to act to treat for hypoglycemia. Above 120 is high.
For a pet meter normal is 68-150, and the time to act is under 68.

As you can see there isn't a huge difference in those numbers. Now take a cat whose bg is 400 on a pet meter, it might only read 300-350 on a human meter. Bigger difference than the lower end of the scale. Either way you know they are too high. See what I mean? I personally like having the same numbers my vet would get, so it's worth the cost to me, but the cost of strips are almost a dollar each as opposed to human meters which are about a third the cost.
 
Others use human meters for every day testing, and alphatrak for curves for their vet.

Before my cat went into remission I was spending $150/month on test strips. If she hadn't gone into remission after 4 months I may have eventually picked up a human meter to cut costs. Now I only test her a few times a month so the cost isn't really an issue.

I figured by testing at home I was saving myself about $150 in curves a month at the vet so I called it a wash.
 
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Janet. Thank you for the info. My vet had explained the limits diff between human and feline limits and advised me that 90 would be the lowest she would want to see it go given poss meter error....Sketch has been nowhere near those numbers. She feels with Sketch if we can get him in the range of 150 to 250 with regularity then we could look at fine tuning down below 150. I am testing at home due to his nature of stressing out big time going to the vet. Hoping to get a curve going. Sketch and I are both still relatively new to this whole process and he's only been on insulin for about 4 weeks. So we are on the start low go slow protocol.
So glad to hear that your Kitty is in remission! that's an awesome result.
 
Jeff Davis said:
Janet. Thank you for the info. My vet had explained the limits diff between human and feline limits and advised me that 90 would be the lowest she would want to see it go given poss meter error....Sketch has been nowhere near those numbers. She feels with Sketch if we can get him in the range of 150 to 250 with regularity then we could look at fine tuning down below 150. I am testing at home due to his nature of stressing out big time going to the vet. Hoping to get a curve going. Sketch and I are both still relatively new to this whole process and he's only been on insulin for about 4 weeks. So we are on the start low go slow protocol.
So glad to hear that your Kitty is in remission! that's an awesome result.
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Well we can definitely help with advice on home testing when you're ready to do that. Once I started testing my cat didnt need to go back to the vet. I just sent her a link to my spreadsheet every two weeks or so.
 
JanetNJ said:
Well we can definitely help with advice on home testing when you're ready to do that. Once I started testing my cat didnt need to go back to the vet. I just sent her a link to my spreadsheet every two weeks or so.
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Actually Janet I am already home testing although Sketch being an outdoor indoor cat and difficult to handle makes it hard to develop a curve. I usually try to test him mid cycle about 4 hrs after his meal and some randoms when he is avail...practice for me!. The vet had recommended the home testing due to his stress going to the vet and how that could drive the numbers up. She felt and I agreed that we would see more accurate #s home testing. And since Im the only one he will allow to touch him it seemed the best way to go. That being said I have had a few issues with getting successful draws early ( went to lower gauge lance 28) on but seem to be hitting the sweet spot now. I am hoping he will settle a bit so I can start more effective testing and zero in on getting him regulated. I appreciate everyone's input. This is an interesting adventure. Thanks!
 
Update:

Oreo had his first curve test at the vet's office on Thursday, June 8. He was very upset while there, poor baby, and so I though this won't go well. But it did as far as his results are concerned.

He ate from 08:05 to 08:35 (off and on) and I have him Lantus 4 units at 08:15. Took him to the vet's office at 09:30. Below are the test results using both the office's AlphTRAK and my ReliOn glucometers.

Time......Alpha.....ReliOn....+time

10:15........163........115..........+2

11:15.........135.........66..........+3

12:15.........125.........83.........+4

14:15.........101.........79..........+6


I called right after the first test and the tech said he was not happy being there. He was hoarse from meowing when I picked him up poor baby! But being stressed didn't seem to affect his results although maybe his numbers would have been even lower if he hadn't been. I was disappointed how my ReliOn performed beside the AlphaTRAK. VERY disappointed! Overall I'm pleased that at least he is in the 100 range now.
 
Justgin said:
Update:

Oreo had his first curve test at the vet's office on Thursday, June 8. He was very upset while there, poor baby, and so I though this won't go well. But it did as far as his results are concerned.

He ate from 08:05 to 08:35 (off and on) and I have him Lantus 4 units at 08:15. Took him to the vet's office at 09:30. Below are the test results using both the office's AlphTRAK and my ReliOn glucometers.

Time......Alpha.....ReliOn....+time

10:15........163........115..........+2

11:15.........135.........66..........+3

12:15.........125.........83.........+4

14:15.........101.........79..........+6


I called right after the first test and the tech said he was not happy being there. He was hoarse from meowing when I picked him up poor baby! But being stressed didn't seem to affect his results although maybe his numbers would have been even lower if he hadn't been. I was disappointed how my ReliOn performed beside the AlphaTRAK. VERY disappointed! Overall I'm pleased that at least he is in the 100 range now.
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Why are you disappointed in the relion? It is just what I would have expected from a human meter. They run lower. That's why the normal scale on a human meter is 50-120, and on an Alphatrak its 68-150. The higher the number, the greater the difference between the two meters.
 
The difference in those numbers when comparing meters is what we'd expect. People here understand human meter numbers and the dosing protocols for Lantus are written in human meter terms. Have a look at the TR and SLGS stickies on the Lantus forum. Some people use the AlphaTrak meter when they're doing a curve for their vet and use the human meter day-to-day. It's a lot more economical that way.
 
JanetNJ said:
Why are you disappointed in the relion? It is just what I would have expected from a human meter. They run lower. That's why the normal scale on a human meter is 50-120, and on an Alphatrak its 68-150. The higher the number, the greater the difference between the two meters.
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Ok I get that human meters run lower. So, according to the differences in meters, there would only be a difference of 18 to 30 points right?
But with my numbers, in the order above, there's a difference of 48, 69, 42, and then 22. Is it possible that I could inappropriately treat Oreo for a hypo when his real number was fine? Or, if doing TR, maybe not give him enough insulin based on the low result?
 
Kris & Teasel said:
The difference in those numbers when comparing meters is what we'd expect. People here understand human meter numbers and the dosing protocols for Lantus are written in human meter terms. Have a look at the TR and SLGS stickies on the Lantus forum. Some people use the AlphaTrak meter when they're doing a curve for their vet and use the human meter day-to-day. It's a lot more economical that way.
Click to expand...


Thanks!
 
Justgin said:
Ok I get that human meters run lower. So, according to the differences in meters, there would only be a difference of 18 to 30 points right?
But with my numbers, in the order above, there's a difference of 48, 69, 42, and then 22. Is it possible that I could inappropriately treat Oreo for a hypo when his real number was fine? Or, if doing TR, maybe not give him enough insulin based on the low result?
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At lower numbers there might be only a 16 point difference but the difference is greater the higher the number. So a 350 on a human meter might be 450 on a pet meter. Either meter will still tell you if you are too high or too low.


Of course if you are like me and like the numbers to be the same as the vet would get you could invest in an Alphatrak meter... For me the cost is worth it, but before my cat went into remission I was spending about $150 per month on strips.
 
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