PLEASE HELP time sensetive new diabetic kitty questions !!!!

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mojokitty13

Member Since 2013
Hi all first off I really appreciate all the feedback in advance and apologize for my lack of knowledge :) so I have a 13 year old male orange long hair our Mojo boy he is my 6 year old daughters kitty he was diagnosed with diabetes on the 9th and we are heart broken as everyone is. Our situation is I am unemployed and have been searching for work for a year but finally got a job and start next week so when our kitty became sick we were lucky enough to find a low cost vet clinic that did his check up and blood work which I barely could afford so when I got the news my first worry was how I was going to afford the initial investment to get my kitty his insulin. After calling every pharmacy in a 30 mile area and getting the same $160 price to get him what he needed I was very discouraged because there is no way I could afford that until the end of the month after I get my first check which he could not wait that long his blood sugar was a 552 no vet or even the CSU vet hospital would just let me buy a sample or smaller vial at CSU they wanted to re-exam him and do another full panel of blood total $300 worth of work then they could fill their own prescription for 3ml vial of lantus for $80 again not an option I already had all that done and paid only $80 for the vet visit and blood work total on the 8th. I was told many mean nasty things from several of the vet clinics i called trying to get something I could afford. I was felling hopeless when I stumbled upon this AMAZING board and signed right up to find help. I found a thread from DCIN offering expiring lantus pens for the cost of shipping so I responded immediately this was at midnight on the 10th the day after diagnosis and got a response back 30 minutes later, DCIN Has saved my precious Mojo by sending us enough supplies to help get me started and until I can get the vial of lantus in a few weeks the package just arrived at noon and I gave him his first injection scarey but he did AWESOME however now that the stress of the medication is over with I have started to get a whole new set of worries about everything I need to do for him and am scared as I am not very knowledgeable about any of the blood testing or tracking or any of that So I ask for all of your help :)
Mojo has been prescribed Lantus (glargine) 1 unit every 24 hours. his blood sugar was 552 on the 8th when he got his panel done at the vet and the vet instructed me to give 1 unit as soon as possible (which I already did at noon today as soon as I received it) and then 1 unit every 24 hours and to come back in 3 to 4 weeks and have his blood sugar tested again. She said nothing about me being able to test him at home which I will be doing!
confused_cat
Question #1 (This is the time sensitive question)
How often and when should I check his blood sugar? How and when do I start testing so I can get a baseline for him and get some numbers? I think I read to do it 3 hours after injection again at 6 hours and at 9 hours but not sure if that applies to me because he is on i shot every 24 hours?

Question #2
Once I get his sugar regulated would be okay to put him on 1/2 unit every 12 hours to help him not experience the peak and valleys? have read about this a little but not sure how to know when it peaks? or even if this applies to 24 hour dosing?

Question #3
Do I adjust the amount of insulin given to him depending on his test prior to giving it to him or do I give him the same 1 unit that the vet prescribed him no matter what?

Question #4
I'm pretty sure I poke him in the ear to get the blood for the test just not 100% sure so want to check also is there any other place I can poke to get blood to test that is safe for him? and how long do I warm up the rice pack and let it set on his ear or where ever prior to poking?

Thank you in advance for all of your help and advise I really appreciate it also sorry for so many questions all at once just not sure where else to turn for the answers :)

Thanks so much
Cassie - Mojo's Mommy
 
Re: PLEASE HELP time sensetive new diabetic kitty questions

Welcome! Yep DCIN and this board are AMAZING places!!! I'm sure others are typing too but I'll answer a bit for you...I know this is all scary but 2 weeks from now you'll look back and wonder what all the fuss was about. Been there...done that...got TWO T-shirts!

mojokitty13 said:
....
Question #1 (This is the time sensitive question)
How often and when should I check his blood sugar?
According to his AMPS, I check KT's about 4 times in the cycle. When he's low, it is more often.

How and when do I start testing so I can get a baseline for him and get some numbers? I think I read to do it 3 hours after injection again at 6 hours and at 9 hours

Test BEFORE each shot to be sure he's high enough to safely shoot then 3, 6 and 9 are good. Test again 12 hours for the PM cycle.

but not sure if that applies to me because he is on i shot every 24 hours?

A cat's metabolism is twice a humans, any type of insulin is given twice a day. Lantus is to be given 12 hours apart within 15 minute variance.

Question #2
Once I get his sugar regulated would be okay to put him on 1/2 unit every 12 hours to help him not experience the peak and valleys? have read about this a little but not sure how to know when it peaks? or even if this applies to 24 hour dosing?

This will become apparent as you learn your cat - every cat is different. Yours may be on insulin forever or may just need a little support to give his pancreas a rest.

Question #3
Do I adjust the amount of insulin given to him depending on his test prior to giving it to him or do I give him the same 1 unit that the vet prescribed him no matter what?

Others will post links and discuss this part - it's not a 'short' explanation altho' the 'short' answer is 'No', it will vary....

Question #4
I'm pretty sure I poke him in the ear to get the blood for the test just not 100% sure so want to check also is there any other place I can poke to get blood to test that is safe for him? and how long do I warm up the rice pack and let it set on his ear or where ever prior to poking?

Yes use the ear, there's a good pic out there, I just don't have the link at my fingertips.

Warm rice sock 15-30 seconds, not too hot, you're just warming the ear so no hotter than your skin can take.

BIG HUGS! This will get easy!
 
Re: PLEASE HELP time sensetive new diabetic kitty questions

Hello and welcome to the board! It's good that you are here and you have some great questions.

First of all, don't be heart broken, lots of cats and humans have diabetes. And once the cat is on a good dose, asides from testing and shooting, you won't even know he has it! And neither will he!

1. It's important to test before every shot. . However because Lantus has a 12 hour duration, 6 hours after the shot (+6) can be the cats lowest blood sugar point (the nadir as we call it) and you may want to test then too. At nighttime that can be a challenge so many people also test at +2 just to see how the cycle is going. We also recommend spot checks but that will become obvious once you get more experienced.

2. You should be shooting every 12 hours because lantus only lasts for 12 hours. I don't know why your vet said 24 hours. I will ask an expert to come over and advise dosing and when you should give your next shot based on this.

3. No, lantus likes consistency. The dose will usually be the same every shot and be held at that level for a while... But it may be increased or decreased if the dose is wrong. The expert will explain.

While I find an expert, can you tell me what you are feeding him?
 
Re: PLEASE HELP time sensetive new diabetic kitty questions

Oh THANK YOU BOTH SO VERY MUCH!!!!! ;-)
While I find an expert, can you tell me what you are feeding him?
I am feeding him fancy feast two big meals one morning one at night with a snack portion in between. Is that okay? He was on dry food free fed all day started making the switch to all wet scheduled feedings upon diagnosis. Also thank you for getting an expert as I already gave a full 1 unit dose at noon today so not sure what to do about next dose pretty sure the vet told me to do once a day for it to be easier but I don't care if its easy or not I just want what is best for my Mojo :)
Hope to hear from both you and the expert soon thank you again for you help

Hugs Cassie
 
Re: PLEASE HELP time sensetive new diabetic kitty questions

Welcome to FDMB, Cassie.

This is quite possibly the best place you never wanted to be.

Before answering your questions, I need to respectfully contradict the information you've been given by your vet. In cats, Lantus is dosed twice a day. A cat's metabolism is faster than a human's and, as a result, the insulin is used more quickly. All insulin that is prescribed for cats is given twice a day. The initial dose of Lantus can be based on a formula (initial dose = 0.25 x cat's ideal weight in kilograms). Usually this calculates out to around 1.0u.

You may want to set up a spreadsheet so you have a place to keep the test data you'll be collecting. This will help you to monitor Mojo's progress and it will allow us to see what's going on and to help you.

Question #1(This is the time sensitive question)
How often and when should I check his blood sugar? How and when do I start testing so I can get a baseline for him and get some numbers? I think I read to do it 3 hours after injection again at 6 hours and at 9 hours but not sure if that applies to me because he is on i shot every 24 hours?
The minimum number of tests you need with Lantus is 4. You need to test prior to your morning and evening shots and you need at least one test somewhere around the mid-point of the cycle. However, in the early stages, we encourage you to test every 3 hours. This will allow you to determine when Lantus onset begins and get an idea of when the low point of the cycle, the nadir, occurs. Lantus dosing is based on the nadir, not on the pre-shot value. Many of us test considerably more than 4 times a day. You can click on our spreadsheets to see the variation in how people test.

Question #2
Once I get his sugar regulated would be okay to put him on 1/2 unit every 12 hours to help him not experience the peak and valleys? have read about this a little but not sure how to know when it peaks? or even if this applies to 24 hour dosing?
The amount that you dose is based on what Mojo's numbers tell you. Doses are raised and lowered in small amounts (usually 0.25u) and in a systematic manner. (The peak is another term for the nadir.) Most of the people here who use Lantus follow what's called the Tight Regulation Protocol. Lantus is given twice a day and the protocol will provide the guidelines for dose changes.

Question #3
Do I adjust the amount of insulin given to him depending on his test prior to giving it to him or do I give him the same 1 unit that the vet prescribed him no matter what?
See my response to question #2.

I would strongly encourage you to stop over to the Lantus board and read the starred sticky notes at the top of the Board. I've linked the notes, along with a brief description below.
  • Tight Regulation Protocol: This sticky contains the dosing protocol that we use here. There are also links to the more formal version -- the “Tilly” Protocol developed by the counterpart of this group in Germany, which was also published by Kirsten Roomp & Jacqui Rand, DVM in one of the top vet journals.
  • New to the Group: Everything you wanted to know about this forum and more. Info on our slang, FAQs, links to sites on feline nutrition and to food charts containing carb counts, how to do a curve and the components to look for, important aspects of diabetes such as ketones, DKA, and neuropathy, and most important, info on hypoglycemia.
  • Handling Lantus: how to get the maximum use from your insulin and what to not do with it!
  • Lantus depot: This is an important concept for understanding how Lantus works.
  • Lantus & Levemir: Shooting & Handling Low Numbers: What data you need in order to be able to work toward remission or tight regulation as well as information if you have a low pre-shot number or a drop into low numbers during the cycle.
 
Re: PLEASE HELP time sensetive new diabetic kitty questions

Hello,
I put together a list of site for someone like yourself just starting out. These are links for testing, food advise and lantus:

http://www.amazon.com/gp/product/B00165 ... 02_s00_i01 (fortiFlora-probiotic) Helps digestion&can help with appetite and switching to wet from dry food))

http://felinediabetes.com/diet.htm (Food Info)

http://catinfo.org/docs/Tips%20for%20Tr ... -14-11.pdf (Food Info)

http://www.catinfo.org/docs/Food%20Char ... -22-12.pdf (wet food carb list)

viewtopic.php?f=28&t=86436&p=925576&hilit=testing+ear#p925576 (testing tips)

http://www.youtube.com/watch?v=_zE12-4fVn8 (ear)
http://www.youtube.com/watch?v=q_3TLtN8XYo (shot)

viewtopic.php?f=6&t=18207 (spread sheet)

http://www.felinediabetes.com/FDMB/view ... =9&t=85113 (BS testing tips)

viewtopic.php?f=9&t=1581 (lantus protocol)
 
Re: PLEASE HELP time sensetive new diabetic kitty questions

Thank you to everyone for ALL the helpful advise I truly appreciate the help!! sorry i opened a new thread was unsure if I should keep posting different questions in this one or not? :( Was not trying to offend anyone or make you think I didn't value your advise I did look over all the links and information you all have provided me I am just a bit overwhelmed and it is taking my brain a while to process all the wonderful information I've been given, which is why opened a new thread being more specific with my questions. Again thank you all for your support I am so relieved that I have found such a wonderful place for help and support!

(((HUGS)))
Cassie
 
Re: PLEASE HELP time sensetive new diabetic kitty questions

Hi Cassie

You've been given some great info. It is overwhelming at first but we Erne here to help you and MoJo. He has a great mom and I hope he know it. Please let us know how we can help.

If you have any trouble getting the Spreadsheet done, please PM me and I'll help you. :-D
 
Re: PLEASE HELP time sensetive new diabetic kitty questions

More questions please help! Thank you so much for all the wonderful advise so far it is GREATLY appreciated! I am going to join the tight regulation Lantus forum as soon as I get the hang of everything I am doing! I have gone and read a bunch of the posts and it seems like everyone on there is very knowledgeable and will be very helpful too I just already have a ton of things to worry about ie my 14 month old son and 6 yr old daughter, Mojo and his testing and shots and I start a my new job on Tuesday so I wouldn't want to join the forum and not be able to post everyday and keep up with it so for now I am tracking his sugar levels on his SS which I added to my signature and reading all the information you all have sent me links to, my brain is finally not in freak out mode for now so I can not only read it but understand and put it to use :) Today the process has gotten easier however still very puzzled by his crazy numbers just can't wait to get a week or two under our belt and I really hope by then his body will be used to the insulin and stop confusing me so much with all the crazy ups and downs. Is it realistic to think they shouldn't be so all over the place or is that how it is for quite sometime? I have looked at other kitties spread sheets and they seem to vary throughout the day but not as drastic as my poor Mojo. For example today this morning AMPS 1st test 524, at +3 it was 324, at +6 (he ate a snack 30 minutes prior to test) it was 277, at +9 it was 352 and PMPS at +12 was 544 which is almost as high as he was on diagnosis day?????????????? I know it shouldn't be stable by any means or consistent but I just thought with him having the insulin it would at least not go up so so high but I'm probably just too anxious to have it low!
The initial dose of Lantus can be based on a formula (initial dose = 0.25 x cat's ideal weight in kilograms)
I used the formula given to figure out correct dosing and Mojo's CURRENT weight 8.6 lbs = 3.9 kg, however that is about half of his IDEAL weight, his IDEAL weight should be about 15 lbs or so he is a big big boy normally and that is when he is not over weight or way under weight like now. His frame is BIG he is tall, long and has big bone structure I think he is 1/2 maine coon crossed with domestic long hair. So my question is please define ideal because to me that is the weight he is normally consistently at before he got sick? Based on the formula given (.25 x 3.9 kg his current weight = 0.975) so 1u, but is the formula to calculate a dose per 12 hours or 24 hours?

I did take everyone's advice and today started BDI so this morning I at 9:30 am I gave him .5u and then at +12 9:30 pm I gave him another .5u breaking his prescribed dose of 1u into two injections. Sorry I'm asking the same basic thing again just very confused :( confused_cat Also please see his SS for all the numbers from yesterday and today so far! THANK YOU IN ADVANCE for answering my silly redundant questions
 
Re: PLEASE HELP time sensetive new diabetic kitty questions

I am sure an expert will get back to you soon but this SS looks good to me .. he has a nice curve going on.. you can see the insulin brings him down and then it wears off.

The formula gives the dose per every 12 hours so he should be on 1 unit twice a day looking at your math. Now saying that you have already started him on 1/2 unit so the experts may advise you increase slowly from there since you have already started. Lets hope an expert chips in soon before you do anything or maybe PM Marje and see what she says.
 
Re: PLEASE HELP time sensetive new diabetic kitty questions

Since you started at 0.5 unit, which is a very safe starting dose. If you read the information that Sienne & Gaby provided (by the way she is one of the most knowledgeable people here about using lantus), you will see that you need to hold this dose for about one week.

Why, because you need to let the insulin get into the cat's system and start to build up what we call a shed, which is like a storage depot of insulin - think of it like the gas tank in your car - right now the car is out of gas on empty, as you fill it with gas it goes to half full and full, well it is the same with insulin. However, unlike filling the gas tank and doing it quickly in seconds, we fill up the insulin tank slowly over the course of a week, even two weeks.

So, calm down, relax, continue with the 0.5 unit every 12 hours and get the tests in - pre-shot and during the course of day/night when you can. The more data you can collect - ie tests, the more useful it will be, when it does come time to adjust the dose.

The rule of thumb is to not feed prior to testing in order to get a test that does not contain a possible food spike. However, as Maui was a grazer, I did not always know when she ate and did not always not feed her prior to the AMPS/PMPS test. I would not get too concerned just now if your cat eats just before testing.

As I said you are getting the hang of this and gathering data. Later on, it may be necessary to remove food, it may not. Each situation and cat is different and you will figure out what makes sense for you.

Hope this helps - and it is OKAY to move to the Lantus forum and ask questions there - just remember on that forum, you only start and keep one posting thread going each day. Don't have multiple posts going, as it will get confusing and it is best to keep everything in one place. Also, if you don't post daily, that is ok too.
 
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