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Ok, thank you for this. I was just outside checking on Tucker but will look this over and see if it makes sense to me. Thank you for taking the time to send it all through. I'm going through it now.
 
Ok, it appears I've logged into my Google Account and there are numerous Tucker Spreadsheets there. It is in the US version and I can't get them to change to my local version in Australia. Also, I don't need to have 6 versions sitting there.
 
Good! You found them! Glad I could help.

It's your account. And those spreadsheets are probably empty. You could delete all of them and make a single new one. You can get a new blank sheet from the link
Here are Instructions on getting the FDMB spreadsheet

This is my last post for tonight. It's 1am and time to sign off.
 
Ok! I'm not sure if I've got it right now.......so if anyone can look on my spreadsheet and give me feedback that would be great. I found the tab at the bottom that allowed me to change it to the metric measurement (duh, I know). I put in the date and I put in his morning insulin. Under +6 (because I did his BG 6 hours after his insulin dose) I put in '16' because that was his reading. Am I doing this right and is it showing up for you to see? Many thanks....especially for your patience.
 
Ok, just realised that "AMPS" doesn't mean amps of insulin but AM-PreShot. So I changed that number since I didn't get a reading this morning and put the 4 units over one column. I'm hoping if I keep posting his numbers you will be able to give some feedback on what to do dose wise from here.
 
Just had a look at your SS. The 4 units is showing up on both US and World pages but the 16 is only showing on the World page. It should automatically put the US number in for you when you put in the world number so something is not quite right with the SS.... I'm hopeless at helping with the SS sorry but someone will come along and help I am sure.

I see above that Chris has said if the preshot is under 11, do not shoot and do not feed but to post for help and retest in 20 or 30 minutes. Do you understand why we do that and the reason for it. I see you were struggling with the concept and want to make sure you understand why we do it. If you are still confused let me know and I will explain further. I will make sure I am online at your PMPS which I am guessing is 6 pm your time and 6.30pm my time. Can you confirm that please?

Have you allowed Tucker back inside?
Has he ever had accidents with his urine before this diagnosis?
Apart from a hypo causing him to lose control, he could have a UTI. Do you know if the vet tested his urine for bacteria.
Also unregulated cats drink a lot of water and wee a lot of urine, so poor boy may have been caught short.
Is his kitty litter box very accessible for him?

Re his food and eating. Most of us here give several smaller meals over the day and evening and not all in one large meal before the insulin shot. Glargine (Lantus) is a long acting insulin and the onset of the insulin after giving the shot is usually 2 to 3 hours. So you could give Tucker a third of his meal at preshot, then a third at + 3 and a third at +5 for example. Then the same with the evening meal/s. That way he is getting some food when the insulin is at its greatest influence...does that make sense? And he doesn't have to wait so long between meals.

Cats often lose weight when FD is diagnosed. He will regain the weight once he is more regulated.

Also do you have some honey in the house in case of low numbers when you need to bring the BSL up quickly?
Another thing we all have is some medium and high carb food (canned) which we can give if the numbers are dropping and we just need to stop them dropping too much.
If you look on the Weruva site, the cats in the kitchen pouches have carbs of between 12 and 18 carbs and would be suitable. Also some of the Fancy Feast cans with rice in them are high carb. I used to make sure I had a few of each and had the number of carbs written on thecan/ pouche. You may not need them for a while but good to be prepared.

That's good there are no ketones in his urine. Test a few times a week while his numbers are high as ketones can lead to ketoacidosis which is very serious in cats. Caught early is the way to go. Some cats are prone to ketones and others can have very high numbers and never get them. Just something to keep and eye on.

You can test the BSL whenever you want apart from preshot and at about +5. If you find it has dropped since the preshot, you might want to test it again in an hour or two depending on how big a drop has occurred.
The SS is like a puzzle and all the BSL readings are the pieces of the puzzle. Eventually you will get to know how Tucker will react to the insulin. The more you can fill in the spaces(times) the easier it is for us to see how he is going and whether his dose should be lowered, raised or stay the same. (Not filled in all in one day but over a period of time.)
If you can check out the syringes I mentioned above that will allow you to give smaller increases and decreases.

When you are ready, you might like to start posting on the Lantus and Levemir page. There is always someone there who is using Lantus and that is the best page to get dosing advice for Lantus.

See you at 6pm. Can you post his PMPS please?
Bron
 
Thank you! I'm reading through your post. I'm not sure about the "stall", and will do a BG in just under an hour.
 
Ok.
Are you able to test him a few times this evening to make sure he is in safe numbers.?
It might just be for 6 hours or it could be for longer if he stays low
I know Chris said to give 3 units but because it is close to 11, I think I would give 2 units.....justto be on the safe side as we don't know how he reacts to the insulin yet.
Once you have the syringesyou will be able to change to smaller increments.
 
Ok, so after getting the 11.3 BG and reading what you suggested to my husband we went out and gave Tucker 2 units of Lantus and his normal wet food dinner. It was gone within 10 minutes. He is bathing himself and looking pretty happy atm.
 
I will retest his BG at 9pm and at midnight. Can you give me an idea of what I will be looking for with each of these readings, please? Thank you!
 
Tucker said:
I will retest his BG at 9pm and at midnight. Can you give me an idea of what I will be looking for with each of these readings, please? Thank you!
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Often after some food the BSL will spike a bit....up a point or two..... This is normal.
By +3 you might hopefully see the insulin beginning its onset and the BSL dropping a bit. But don't be disappointed if it doesn't. Insulin is a hormone not a medication like an antibiotic which goes to work straight away fixing the problem. His body has to get used to the insulin and how he is going to react to it. ECID.
If the reading is lower than the preshot then I would test at +5 to see if it is going lower.
I will stay awake for the +3 and +5 and depending on that reading we can decide when to test next.
Are you happy with that?

Did you keep any food for him to have a bit later?
Pieces of cooked chicken has no carbs so can be given as an inbetween snack without affecting the BSL., but his normal low carb food is fine too.

Don't worry too much if his BSL are high at the moment. It is far better to have high BSL for a day than a low BSL for a minute.
Most cats take a while to get regulated.
 
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I've just seen where you said you have bought some syringes. Great!
Can you tell me what they are or maybe take a photo of the box. Only today we had someone who was given the wrong type of syringes for the insulin and was unwittingly giving too much insulin.
 
I am looking for the bag of needles the vet gave us. They are orange and I was told they are '100'. We have plenty of food here. Tonight Tucker ate a whole packet of Dr. B's Barf Turkey Pattie with a dollop of CORE mixed in because it's his favourite.
 
The Feline Diabetes Message Board FAQ[22] lists 60-120mg/dL (3.3 - 6.7 mmol/L) as "normalized" when not receiving insulin, and 60-150 (3.3-8.3) as "tightly regulated" when receiving insulin

Do these numbers seem right? I was just looking up 'what is normal' BG for cats and found this.
 
Do I need to take any action at this time or just wait until midnight to retest? Also, I do not feel right having you stay up late for this! Can you tell me what to do if say the next test is lower/higher/the same? If I know what to do for each estimate value I can let you go live your life and get some sleep tonight!
 
Tucker said:
The Feline Diabetes Message Board FAQ[22] lists 60-120mg/dL (3.3 - 6.7 mmol/L) as "normalized" when not receiving insulin, and 60-150 (3.3-8.3) as "tightly regulated" when receiving insulin

Do these numbers seem right? I was just looking up 'what is normal' BG for cats and found this.
Click to expand...
Yes, we usually look to try and keep kitty between 60-120 (3.3-6.7). That is the ideal range. Most cats without FD are around 3 to 5mmol. But getting FD cats under the renal threshold is what we try and do initially. That is when the cat does not spill glucose into the urine. Approx 11 to 15 (200 to 280) is the renal threshold depending on the individual cat.
Keeping them under the renal threshold reduces the excessive drinking and urinating and also the extreme hunger. It also is much better for the kidneys.
But getting the numbers down to ideal or even under the renal threshold takes time and it can't be rushed.
If there is one think we have all learnt from this journey is patience. In fact we recommmend caregivers buy patience pants as we all need them sooner or later:joyful:
 
So does that mean when Tucker is below 11 he is actually feeling better but also he is at less risk of having an accident? He's sitting on a cat perch right now looking at me and I'm thinking "14.3............are you about to pee everywhere??". My husband adores our babies, but he was less than happy that we had to literally throw our sofa away when Tucker was first diagnosed. My goal is to have him be able to sleep at our feet again, because then I KNOW he will be living a happy life.
 
Tucker said:
Do I need to take any action at this time or just wait until midnight to retest? Also, I do not feel right having you stay up late for this! Can you tell me what to do if say the next test is lower/higher/the same? If I know what to do for each estimate value I can let you go live your life and get some sleep tonight!
Click to expand...
No need to do anything at this point.
I will set the alarm and see how you are going at +6.
Please don't feel bad? I like to stay with people when they are first managing/ learning to monitor or have shot a low number.
But with the next test, if it is higher or the same, you should be safe to leave it til AMPS because you should be near the nadir and after that the effect of the insulin starts wears off.
If it is lower it might be worth testing an hour later to see that it is not dropping further.
As we don't know yet when Tucker's onset is, we can't be sure if the 14.3 at +3 was because his onset hadn't started or because he was not going to have an active cycle.

Re the AMPS dose.......because you have given him 2 units tonight, it might be worth just staying with 2 units for at least three days to see where it takes him instead of jumping around doses again. Then you can go up in dose if this dose is not enough. What do you think about that?
 
I am a little bit confused (again). You said that Tucker shot low. I was thinking 11 was pretty average since he had not eaten in 12 hours and that 'low' was sort of the 5 range. Sorry, I guess I'm just not getting it. I'll re-test at midnight my time and let you know what it is. I'll also get up at 6am and do the AM blood test before we give him insulin. I think sticking with 2 units for a few days while his body adjusts to the dose is probably the way to go, but I'm all ears!
 
Tucker said:
So does that mean when Tucker is below 11 he is actually feeling better but also he is at less risk of having an accident? He's sitting on a cat perch right now looking at me and I'm thinking "14.3............are you about to pee everywhere??". My husband adores our babies, but he was less than happy that we had to literally throw our sofa away when Tucker was first diagnosed. My goal is to have him be able to sleep at our feet again, because then I KNOW he will be living a happy life.
Click to expand...

I'm sure you want to get him back on the bed again...there is nothing like sharing a bed with our feline friends:).
When he is under the renal threshold he is sure to be feeling better.
I am just wondering if he might have an infection in his bladder that is making him do random wees.
Did this start to happen when he was first diagnosed?
Did you tell the vet about the accidents and did she look at any other causes?
There are puppy pads that can be bought at pet shops that you might be able to put down in strategic places to keep things safe.
 
Tucker said:
I am a little bit confused (again). You said that Tucker shot low. I was thinking 11 was pretty average since he had not eaten in 12 hours and that 'low' was sort of the 5 range. Sorry, I guess I'm just not getting it. I'll re-test at midnight my time and let you know what it is. I'll also get up at 6am and do the AM blood test before we give him insulin. I think sticking with 2 units for a few days while his body adjusts to the dose is probably the way to go, but I'm all ears!
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11 is very "average" but when you are first starting out and don't know how kitty will react to the insulin, we advise not to shoot below 11 without stalling and asking for advice. Once you know how he is going to react, you can shoot at much lower numbers. But it is good to gradually get down to the lower numbers to shoot.
If Tucker were mine, I would give him something to eat at about +5 or around there. It is good for the pancreas to have several smaller meals instead of one large meal.

Keep asking questions. Knowledge is power.
You are doing a great job looking after Tucker! He's a lucky boy!
Bron
 
Thank you for all of this help! I will try to get a free catch of urine and have the vet do another check for bacteria. He has never had an accident inside-ever, until the week he was diagnosed. I walked into the lounge room and literally thought our roof had leaked-there was that huge of a puddle on the wood floor and on my leather sofa. It did not smell, it was just clear fluid. Then it happened again the next day and we didn't know what was going on. Then that afternoon I watched Tucker walk over to the lounge and basically explode more fluid than I have ever thought possible. I took him straight in and got the diagnosis. We were told then and have been told 3 other times that his urine tests have all been good apart from the glucose.
 
Also, an important side note: At the moment I am Tucker's stay-at-home-mommy and I will do anything for him. I can easily feed him during the day at set times etc and can do testing around the clock. From the end of Sept through October I will not be available for 6 weeks at all, and my daughter will have to be in charge of Tucker's care. She lives with us but has a stressful job that has her leaving for work at 7:30 am and she is rarely home before 7:30pm. We are already trying to get our head's around how we are going to be able to get help for her and Tucker and it would be extremely helpful if we were to have some sort of a routine or pattern in place by then. Help? It's upsetting to even think about.
 
Well it certainly sounds like it is FD related. Poor boy it must be awful for him.
When the bladder has a lot of glucose in the urine , it makes it much more susceptible to infection. It might be worth asking if she would do a culture and sensitivity of the urine or failing that put him on a course of antibiotics.
Is he drinking a lot of water?
Maybe he is not taking himself to the toilet often enough to cope with the increased amount of urine. He is probably only used to going once or twice a day. I know Sheba used to hang on and then do enormous wees.
Maybe you could try carrying him into the litter box every couple of hours and hopefully he would do a wee.
 
Tucker said:
Also, an important side note: At the moment I am Tucker's stay-at-home-mommy and I will do anything for him. I can easily feed him during the day at set times etc and can do testing around the clock. From the end of Sept through October I will not be available for 6 weeks at all, and my daughter will have to be in charge of Tucker's care. She lives with us but has a stressful job that has her leaving for work at 7:30 am and she is rarely home before 7:30pm. We are already trying to get our head's around how we are going to be able to get help for her and Tucker and it would be extremely helpful if we were to have some sort of a routine or pattern in place by then. Help? It's upsetting to even think about.
Click to expand...

It is always hard to leave our kitties, especially our FD ones. At least you have a few months to sort out some support for your daughter.
Do you have a neighbour who you could train up to test and shoot who could be there when your daughter can’t?

Some of us get a vet nurse to come in and test and give the insulin.
Then there are some boarding places which take diabetic cats or maybe boarding at the vets.
Another thing would be to buy an automatic feeder which opens at set times so you can leave food out for Tucker when you are away for the 6 weeks.
Do you have other cats?
 
Bron and Sheba said:
Well it certainly sounds like it is FD related. Poor boy it must be awful for him.
When the bladder has a lot of glucose in the urine , it makes it much more susceptible to infection. It might be worth asking if she would do a culture and sensitivity of the urine or failing that put him on a course of antibiotics.
Is he drinking a lot of water?
Maybe he is not taking himself to the toilet often enough to cope with the increased amount of urine. He is probably only used to going once or twice a day. I know Sheba used to hang on and then do enormous wees.
Maybe you could try carrying him into the litter box every couple of hours and hopefully he would do a wee.
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I keep bringing him to the litter tray but he hops right out. I'm taking notes of all of your suggestions though, i feel so sad for him.
 
Bron and Sheba said:
It is always hard to leave our kitties, especially our FD ones. At least you have a few months to sort out some support for your daughter.
Do you have a neighbour who you could train up to test and shoot who could be there when your daughter can’t?

Some of us get a vet nurse to come in and test and give the insulin.
Then there are some boarding places which take diabetic cats or maybe boarding at the vets.
Another thing would be to buy an automatic feeder which opens at set times so you can leave food out for Tucker when you are away for the 6 weeks.
Do you have other cats?
Click to expand...
I'm working on options but at the moment we are up in the air. We have 2 ragdoll babies (Teddy and Daisy) who are simply irresistible and adorable.
 
Tucker said:
I keep bringing him to the litter tray but he hops right out. I'm taking notes of all of your suggestions though, i feel so sad for him.
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It will all work out. At the moment you must feel overwhelmed with it all. It is hard in the beginning to even think it will all be sorted out but it will.
He is eating well and he is letting you test him and give him his insulin and you are managing to test him .... these are all huge positives believe me!
You have taken steps to sort out his BSLs, which will take time.
Your main problem seems to be the urine issue.
When you post in the Lantus and levemir forum mention the issue. You will be surprised how many may have suggestions to help.
Your other kitties sound gorgeous.
 
Bron and Sheba said:
It will all work out. At the moment you must feel overwhelmed with it all. It is hard in the beginning to even think it will all be sorted out but it will.
He is eating well and he is letting you test him and give him his insulin and you are managing to test him .... these are all huge positives believe me!
You have taken steps to sort out his BSLs, which will take time.
Your main problem seems to be the urine issue.
When you post in the Lantus and levemir forum mention the issue. You will be surprised how many may have suggestions to help.
Your other kitties sound gorgeous.
Click to expand...
You are too kind, seriously.
16394423-DF27-44C6-A9BB-D323867FA86A.jpeg
 
Also, for the morning? Tucker usually eats at 6am. So I am going to test his glucose before he eats anything, do I adjust the amount of insulin or do we stick to the 2 units for 3 days? Thank you!
 
Those siamese kitties are so cute. Our Chinus is a siamese is a tortie mix and she follows me around.

You are off to a good start. And Bron is providing great help, also regional. If you have more questions just tag me.

Chinus - getting sun 02-14-2017b.jpg
 
Answer 1: Do not change the dose at this point. We stay on 6 doses before adjusting because of the depot effect.

Answer 2: For first a.m. feeding, test before the food. That way the food does not influence the reading. I do the same for PM. So for AMPS and PMPS, it is best if they have no food for 2 hours prior to the test.
 
Beautiful girl! I think Bron has gone off to bed and I'm not quite sure what to do in the morning for Tucker. She had suggested backing him off to a 2 unit dose for several days to give him some stability while we gather data to see how he is responding. But 19.7 seems pretty high for 6 hours after his 2 units. Should I be concerned/thinking about giving him 3 units at 6am feeding.
 
Ok. So I will stick to the 2 units. What are we going to do if the BG test comes back 25 or something though???
 
We want to stick to the 2.0 units for the 6 dose period. Then we'll adjust. Your kitteh can go high for many days and still be alive. However, a single hypo can cause permanent effects or death. So we need to get a pattern before raising the dose.
 
Ok, I wasn't sure. We had been doing 4 units, then 3 units, then dropped down to 2 units last night so I wasn't thinking 4 was that much of a dose. I'll stick to the 2 and see what happens. At what point is it a real worry? When he was first diagnosed his initial blood test was 24. So after 2 months of insulin to have him at 19.7 tonight feels like a failure.
 
I will restate that I am more conservative than most people here. I keep Leo in the 120-180 (light blue) range during nadir. So he goes high at AMPS and PMPS. In his case, if I give just a little more insulin, it tends to drop him to the 45-80 (light green) range (hypo range).
 
We are trying to get the BG pattern. It will take 6 doses to really see it. The high numbers will not damage him for a few days. This is not a failure, but it is the start of a journey. Once we have the pattern and we get the proper dose, he will probably be stable for weeks at a time.
 
Also 19.7 is not horrible. We want to get him into the yellows for awhile, then we'll adjust his dose to get some blues and greens.
 
Ok, I think I understand. We'll see what happens with his numbers after the 6 doses of 2 units. So to be clear, tomorrow morning I need to do his BG before his breakfast at 6am, then at noon and then before his evening meal and plot it on the graph (that I think I have working now)? But don't adjust the dose at all.
 
Yes, that is all correct. The noon reading can be done after eating. I usually try to get the noon reading right before Leo's lunch to reduce the food influence on the blood sugars.

You are off to a great start. The spreadsheet looks good. I actually plotted Leo's numbers after his radiation treatment for the pituitary tumor in fall 2016. That is the "graph" tab in Leo's spreadsheet. Most kittehs don't need to be graphed though.
 
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