Please Help!!

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Emily

Emily

Member Since 2014
I can't get in touch with my vet as she is not in till this afternoon. Prince's BG level is at 198 right now (he ate most of his wet food about 45 minutes ago) and was due for his insulin (2.5 u of lantus) at 8am. However, I tested him right before and saw that he is at the lowest he has ever been, even after eating. What should i do??? I dont know how much insulin to give him??? I am really scared and dont want to do the wrong thing. This is so overwhelming!! It is currently 8:30am and he is a 1/2 hour late for his insulin.

I also realized i have 5 test strips left from the alphatrack 2 meter. where is the fastest place to get them? I can do 1 day shipping from the american diabetes wholesale store. do you think that is ok?? no vet seems to be willing to sell them.
 
I just realized I only have 5 strips left for my alphatrak. should i go to the pharmacy and get a human meter? they have contour, 1 touch, and then like a cvs brand. i also dont know how to use the human meter on my cat. i am brand new to this and just recently started using hte pet specific one. is the human one very different? i can try to overnight the strips for the alpatrak.
 
And do you have any midcycle numbers? lantus is dosed on nadir numbers.

We generally tell new diabetics not to shoot under 200 but to wait 20 minutes and retest, without feeding (which raises bg levels) he's very close to 200 so a shot should be okay, but I don't use Lantus, so I am not sure if you should reduce.
 
A human meter is just the same but easier. It uses less blood and is of course less expensive. The strips can be expensive though, unless you use the ReliOn which has the cheapest strips. But it is only available from Walmart. Of the ones you mention, I think people like the Contour or One Touch best. Then you can buy cheaper strips on Ebay.
 
I'm a Levemir user but have used Lantus in the past plus both insulins work similar. I would error on the side of caution since your low on strips and give a token dose of 1.5u or even 1u.

Then go get a human meter and strips to go with it. All 3 of my diabetics are tested with a human meter. The only difference is the human meter reads about 30 points lower. So normal range on a human meter is between 40 and 120 as opposed to your meter where normal is between 70 and 150

If you have a Walmart near you I highly recommend their Relion Micro or Confirm. I use the Micro and love it

Mel and The Fur Gang
 
Also going forward you want to test with Lantus BEFORE feeding for your preshot readings. He was probably much lower before he ate. With Lantus the order is test, feed, shot all within 15 minutes.

Especially for preshots you want a fasting (non-food influenced) reading to make sure its safe to shoot.

Mel and The Fur Gang
 
Thanks Mel!

Emily, moving forward, can we set you up with a spreadsheet so when you have questions, people will have a quick view of his dosing history and numbers?
 
Yes, please send me a spreadsheet. I have looked at others but i have no idea how to read them or create them. right now im going on a roadtrip to walmart to buy the relion micro/confirm and testing strips.
 
Welcome Emily and Prince,

I agree with Mel on giving the token dose for now. Looking forward to seeing more data to find out how low Prince is going.

I had to go look up the food to see what it's carb value was.... 8%... I 'll have to go try that one. I missed it on the chart.

I have the contour next ez and I really like it although the strips aren't cheap. I buy them in bulk on ebay too.
 
Also, I could not find info on how to use the human meter and read the numbers, so if someone could point me in the right direction, that woudl be great. i also have to report the numbers to the vet, so what should i say? i know this is all written in a crazy rambling-i am panicked right now. i really appreciate all of hte help
 
Check your private messages when things settle down later this am. (on the top of the page, "1 new message" I can help you with the spreadsheet.

The human meter should be similar. Read through the instructions, then try it on yourself to make sure you know how it works. The numbers will be in a little lower range than AlphaTrak, but that's fine. The vast majority of people here use human meters, so we had to "convert" yours before.
 
Hi Emily and welcome to FDMB.

Sue posted a note on the Lantus board asking a few of us to stop by. I've got a few questions for you...

When was your kitty diagnosed and is the 2.5u the dose your vet started Prince out at? If not, what was your starting dose and in what increment were you increasing the dose? What are you feeding Prince? Are there any health issues? Does Prince have any history of ketones?
 
Prince was diagnosed on 2/13/14. He started at 1.0 unit 2x a day. I am currently feeding Prince Innova Cat/Kitten wet food. At the same time he was diagnosed with diabetes, he was diagnosed with hepatic lipidosis and an inflamed liver. The vet was not sure what caused the inflamed liver...suspected hepatitis but also said that if it didn't clear up it could be IBD. He has yet to have another ultrasound. He was put on clavamox, b12 injections, tumil-k, and a liver supplement. He had ketones at the hospital. Should I be testing for those now? He just doesn't look as well as of yesterday and I am really worried that he is dehydrated. Still waiting to hear back from vet.

I am working on the spreadsheet.
 
Hi.......

yes test for ketones since you know he had them and regularly test his BG........try to get him to drink some water if you think he's dehydrated and if he won't try to give him some in a syringe by putting it in his mouth.
 
Great job on getting the spreadsheet up. Yay!!

First think that jumps out at me is his dose was raised far to quickly and by too much each time.

Lantus is a depot insulin an initially it takes 3 to 5days for it to build up that depot or shed. While the shed is establishing most of the insulin you're giving is going to build up that depot and not to Prince to help lower his blood sugar.

You want to hold a dose for several days before raising to let it "settle" then you need to know his nadir or lowest point he goes on a dose because dose changes are based on that number not the preshot values. And then the dose is raised by .25u to .5u. and each change is again held for at least 3 days.

Mel and The Fur Gang
 
Thank you so much you guys. Just to be safe, I gave him some water via a syringe and he had no problem drinking it. The vet got back in touch with me and told me to stick with 2 units of Lantus for now. He also has a new antibiotic for his diarrhea called IC Metronidazole.

I went out and bought the ketone strips from CVS so now I just have to wait for him to use his litterbox, sneak down there, and try to get him to pee on the stick!

I also got the new human ReliOn Confirm meter so I have to figure out how to use that. Is it much different than the AlphaTrak? I am going to use up the rest of the strips from my AlphaTrak and then switch over.

I just feel worried for my Prince. He just seems "off", not his usual happy-go-lucky self. I feel bad testing him so many times but I am going to aim for before his morning shot, around 6 hours after, and then before his evening shot. Do you think that is a good start or should I be testing other times, too? His poor little ears :(

Thank you again so much everyone. Thank you Sue and Oliver for all your help setting me up with the spreadsheet and telling me what to do! This board has been amazing and such a resource. I'm so anxious I'm about to start losing hair; I don't know what I'd do w/o this help!!
 
Try out the new glucometer on yourself first to see how it works. That's how I've always learned. :lol: Here are some tips for catching urine you might find helpful.

Emily said:
I just feel worried for my Prince. He just seems "off", not his usual happy-go-lucky self. I feel bad testing him so many times but I am going to aim for before his morning shot, around 6 hours after, and then before his evening shot. Do you think that is a good start or should I be testing other times, too? His poor little ears :(
Click to expand...

I'd also recommend grabbing a "before bed" test as well. Otherwise, if you want to give his ears a little break for the time-being, those 4 tests should be fine. Don't worry; his ears will soon get used to it and you won't have to feel so bad any more. ;-)
 
We suggest using an inexpensive human glucometer with pet-specific reference numbers. One many of us use is the WallMart Relion Confirm, or Confirm Micro, which is also sold at American Diabetes Wholesale as as the Arkray USA Glucocard 01 or 01 Mini (same manufacturer - Arkray USA). It uses a tiny blood droplet and the cost is significantly lower for test strips (like $0.36 each).

[Glucose reference ranges are unsubstantiated and have been removed by Moderator]


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Examples of using the chart:

Ex. You are a new insulin user and you test your cat before giving insulin. The test is 300. It probably is safe to give insulin.

Ex. You are an established user of Lantus, following the Tight Regulation protocol. You've tested around +5 to +7 to spot the nadir. It is 200 mg/dL. You probably need to increase the dose, following the instructions for the protocol.

Ex. Your cat is acting funny. The eyes are a bit dilated. You are concerned and test the glucose. The number is 35 mg/dL. ACK! The cat may be in a hypoglycemic state. You quickly follow the HYPO protocol linked in the glucose reference values chart. (which we really, really, suggest you print out and post on your refrigerator.)
 
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