Recently diagnosed, need help with dosing

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newpain

Member Since 2024
Hey everyone! I am so happy that I found this forum!

One of my cats (a stray we rescued 6 months ago) was diagnosed with diabetes 2 weeks ago (tested 639 mg/dL). She is around 16yo and unbelievably skinny (5.2 lbs) and constantly hungry and thirsty. I only fed her canned wet food in the last 6 months and she actually lost weight (was 5.5lbs when we rescued her 6 months ago).
The vet prescribed Lantus glargine at 1 unit 2x a day (every 12 hours) and I've been giving her the doses while learning how to home test (wasn't able to get any blood from the ears or paws until today).

I just got a drop of blood from her ear and the meter showed 229 mg/dL (using a CONTOUR NEXT ONE meter I got from amazon - https://www.amazon.com/gp/product/B08FV1SVSW). She had 1 unit of insulin with her food around 6-6.5 hours ago.

It looks like the 1unit might not be enough and I might need to increase the dose, so, how do I do that and how much should I increase? Does anyone know on average how much is 1 unit decreasing so I can get a ballpark idea of how much I need to dose?

She usually eats around 5oz of canned pate food a day split in 2 meals 12 hours apart. She does seem hungry through the day though, but I don't know if I should feed her and how that is going to impact her blood glucose levels, any suggestions about that?

Thanks everyone, appreciate the support!
 
Hi and welcome to the forum.
You are using a great insulin for cats. Well done learning to home test the blood glucose.
What I would suggest you do is set up a spreadsheet and signature so that we can help you with dosing. You can find the links to these in this link HELP US HELP YOU
We will need to see some BG data before we can suggest any increases in dose. Always test before every dose to see it is safe to give the insulin and then if you can get a test in sometimes between +4 and +7, that will tell us how well the dose is working. The BGs can change each day so we need to see at least a weeks worth of data first.
Is the food you are feeding low carb? Have a look at the FOOD CHART to see
As well as the two main meals, offer her lots of snacks during the cycles, both am and pm cycles. A snack is a teaspoon or 2 of low carb food.
If she has lost a lot of weight, she needs more food and diabetic cats can’t absorb the nutrients in the food while they have high BGs. It is not going to impact her BGs much and she needs to eat. We need to see what is happening throughout the day while she is doing normal things.

Every cat is different so we can’t say 1 unit will do this or that. It is a matter of gathering data for your kitty. We do know that we need to start with about 1 unit of insulin and then follow what the BGs are telling us as to whether we should increase or decrease. We can teach you how to do that.
I have lots more to tell you but if you can start off with getting what I have suggested started and then we can go from there.
Keep asking questions and posting:)
Bron


 
Thank you for the info, I really appreciate it!

I had a lot of trouble with home testing, the cat is only 5.2 lbs and everywhere I poke her, she won't bleed. Finally I got a sample today, after 2 weeks. I feel sorry for her ears and paws, they suffered in the process.
I will set up the spreadsheet and start recording data.
So, you suggest that I keep giving her 1 unit of insulin every 12 hours and in the meantime keep taking measurements?

Regarding this sentence, "always test before every dose to see it is safe to give the insulin". What is safe and what is not safe? Do I keep giving her 1 unit anyways? In my case, she had 229 few hours ago, she is eating now, so her BG will go higher, do I still give her 1 unit regardless?

"Is the food you are feeding low carb?" I am only feeding her Fancy Feast Poultry and Beef Pate, this is the one: https://www.amazon.com/dp/B01ALT2IRM
I believe this food is low carb.

"As well as the two main meals, offer her lots of snacks during the cycles, both am and pm cycles."
I was worried about this increasing her BG so I kept her hungry between meals. Maybe I don't understand how the insulin works? Is it going to keep her BG low through the whole 12hr period?
She definitely needs to eat considering that she's only 5lbs. She came to me with 5.5lbs and lost some weight in the meantime, even though I was feeding her constantly through the day (I only started limiting her food once she was diagnosed with diabetes).

"We do know that we need to start with about 1 unit of insulin and then follow what the BGs are telling us as to whether we should increase or decrease. We can teach you how to do that."
I appreciate that and thank you for the help!
 
Gave her food, she ate maybe an ounce and 30 min later tested 288, so I gave her 1unit insulin. Will test again before going to bed in a few hours, so hopefully 3 readings today.
By the way, how often do you test? Do you alternate the ears?
 
Please don’t limit her food. She needs to eat.
I meant to tell you don’t feed her for the 2 hours before you test to give the insulin. We don’t want that test influenced by food.
Until you get more data I would not give the insulin if the Preshot test is below 200. If this hapoens you can stall, don’t feed and test again in 20 minutes to see if the BG is rising. You can also post and ask for advice
newpain said:
how often do you test? Do you alternate the ears?
Click to expand...
I would test before every dose and at least once during every cycle to see how low that dose is taking the BG. The lowest point is usually somewhere between +4 and +7
You can test alternate ears if you like.
newpain said:
I was worried about this increasing her BG so I kept her hungry between meals. Maybe I don't understand how the insulin works? Is it going to keep her BG low through the whole 12hr period?
Click to expand...
She needs to eat. We need to see how she is going when she is eating normally. Lantus onset is usually around +2 and that is when it will start to lower the BG. This continues for several hours and then it starts to go back up again by +12. Every cat is different. You will get to find out what your kitty does by testing and looking at the data
I will give you a link to hometesting
HOMETESTING HINTS AND LINKS
 
Thanks for the info!

I did a few more tests last night and this morning and started recording the data in a spreadsheet. It looks like her BG stayed in the 200s even after insulin yesterday. This morning, I tested before feeding her, it was 293.

Bron and Sheba (GA) said:
The lowest point is usually somewhere between +4 and +7
Click to expand...
Bron and Sheba (GA) said:
Lantus onset is usually around +2 and that is when it will start to lower the BG. This continues for several hours and then it starts to go back up again by +12.
Click to expand...
I don't understand what those numbers mean, can you please explain?
 
Can you please set up your signature and our spreadsheet
Tao on the blue link ,it will also tell you how to set up our spreadsheet and how to use it.
You can look at any members spreadsheet to get an idea what it looks like

Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help
 
newpain said:
I don't understand what those numbers mean, can you please explain?
Click to expand...
+4 is 4 hours after the dose of insulin is given. +7 is 7 hours after the dose of insulin is given. As we live all over the world this is the way we identify where we are up to in each cycle. Does that make sense?
 
Diane Tyler's Mom said:
Can you please set up your signature and our spreadsheet
Tao on the blue link ,it will also tell you how to set up our spreadsheet and how to use it.
You can look at any members spreadsheet to get an idea what it looks like

Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help
Click to expand...
Ah, I didn't realize you have a template. Will set that up along with the signature, thanks for pointing that out and sharing the link!

Bron and Sheba (GA) said:
+4 is 4 hours after the dose of insulin is given. +7 is 7 hours after the dose of insulin is given. As we live all over the world this is the way we identify where we are up to in each cycle. Does that make sense?
Click to expand...
Yes, that makes a lot of sense now, thanks for the explanation. I initially thought those numbers are BG numbers and got confused about it.
 
Bron and Sheba (GA) said:
Sorry if I confused you. I should have given a better explanation. Looking forward to seeing the SS
Click to expand...
Oh, no worries. It's just that there is a lot of terminology around here and I'm still pretty new. I spent some time reading the guides linked above and I have a much better understanding now.

I see there is some definition for dosing methods: SLGS or TR. I am sure they must be documented somewhere, but I wasn't able to find much using the forum search function. Any suggestion on what would be a good dosing method for me?

I don't have much data to go off of, but I set up the spreadsheet and updated my signature, hoping to get some advice as I collect more data.
 
DOSING METHODS SLGS AND TR
Check these out. I’d print them off so you can hilight things.
Basically TR you can increase every three days if needed and you reduce if the BG drops below50. And you need to be feeding a wet low carb food. And you need to test at least 4 times a day
SLGS you hold the dose for a week then do a curve and increase if needed. The dose is reduced if you drop below 90. And dry food can be fed (not encouraged)

Read through it and ask questions
 
How long after a meal should I test before giving insulin? How long does it take for the food to reach peak BG?
 
Diane Tyler's Mom said:
I don't know what you mean by this ?
@newpain
Click to expand...

Diane Tyler's Mom said:
With lantus the nadir or peak is usually around at +6 but can vary
Click to expand...

I was not talking about insulin, I was asking after a meal, the BG will start to go up, how long does it take to reach the peak? In other words, after a meal, do you test immediately or wait a little to test and inject insulin?

She had breakfast 30 min ago and I just tested, her BG is 178. I assume I shouldn't give insulin now? (I read yesterday that if BG is under 200 I shouldn't)
 
Diane Tyler's Mom said:
You need to withhold food 2 hours before testing first thing in the AM ( AMPS) same goes for the PMPS is that what you mean?
You don't want the BG to be influenced by food
@newpain
Click to expand...

Yes, that is what I was asking. So, for example, you feed a meal in the AM, then wait for 2 hours, test and give insulin, is that right?
 
newpain said:
She had breakfast 30 min ago and I just tested, her BG is 178. I assume I shouldn't give insulin now? (I read yesterday that if BG is under 200 I shouldn't)
Click to expand...
I see Bron told you
Until you get more data I would not give the insulin if the Preshot test is below 200. If this hapoens you can stall, don’t feed and test again in 20 minutes to see if the BG is rising. You can also post and ask for advice
 
newpain said:
Yes, that is what I was asking. So, for example, you feed a meal in the AM, then wait for 2 hours, test and give insulin, is that right?
Click to expand...
No that's not right
Lets say If your testing time first thing in the morning is 8 AM don't feed after 6 A . Same goes for the PMPS
Then you test ,feed , and give insulin if the BG is high enough
Do you understand this now :cat:
@newpain
Also with lantus
With lantus you test, feed, shoot all within about 5-15 minutes. You don’t need to wait after feeding at all since it kicks in around +2

On your SS when you don't give insulin we usually put NS (No Shot) not 0
@newpain
 
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Diane Tyler's Mom said:
I see Bron told you
Until you get more data I would not give the insulin if the Preshot test is below 200. If this hapoens you can stall, don’t feed and test again in 20 minutes to see if the BG is rising. You can also post and ask for advice
Click to expand...
So, I waited an hour since the first test and her BG is 201 now, is it safe to give her insulin? She won't eat again, had 1/2 can of FF an hour ago.
 
Update: Her BG is slowly going up, measured 231 now at +4.5 with no insulin in the morning, so I'll measure again tonight and give her a shot of insulin after dinner.
 
Hi. I’m glad Diane was here to help you.
Maybe I didn’t explain properly.
As Diane said if you are giving the insulin at 8am and 8 pm don’t give food after 6 am and 6 pm.
At 8 am test the BG and if the BG is high enough feed Rose and give the insulin. Then test again anytime around 4 to 7 hours after the dose. Vary the times. Hope this makes sense
Keep asking questions
 
I didn't notice, but her BG dropped a lot, did a test at +5.5 and it showed 53, re-tested it to make sure and it showed 55. I gave her food immediately and 2.5h later her BG is at 138.
So, the question is, is 1unit too much? Yesterday AMPS she was under 200 and I skipped the morning shot. Today she got a morning shot, but her BG dropped to 53 (maybe even lower and I didn't notice before I tested).

Bron and Sheba (GA) said:
Hi. I’m glad Diane was here to help you.
Maybe I didn’t explain properly.
As Diane said if you are giving the insulin at 8am and 8 pm don’t give food after 6 am and 6 pm.
At 8 am test the BG and if the BG is high enough feed Rose and give the insulin. Then test again anytime around 4 to 7 hours after the dose. Vary the times. Hope this makes sense
Keep asking questions
Click to expand...
Thanks for the response.
I was not sure when I am supposed to test, so I was testing after breakfast/dinner to make sure I need to give insulin.
 
newpain said:
I didn't notice, but her BG dropped a lot, did a test at +5.5 and it showed 53, re-tested it to make sure and it showed 55. I gave her food immediately and 2.5h later her BG is at 138.
So, the question is, is 1unit too much? Yesterday AMPS she was under 200 and I skipped the morning shot. Today she got a morning shot, but her BG dropped to 53 (maybe even lower and I didn't notice before I tested).


Thanks for the response.
I was not sure when I am supposed to test, so I was testing after breakfast/dinner to make sure I need to give insulin.
Click to expand...
Going to tag
@Bron and Sheba (GA) and
@Wendy&Neko
@tiffmaxee
@Bandit's Mom
I see she gave you the 2 dosing methods to pick one
Basically TR you can increase every three days if needed and you reduce if the BG drops below50. And you need to be feeding a wet low carb food. And you need to test at least 4 times a day
SLGS you hold the dose for a week then do a curve and increase if needed. The dose is reduced if you drop below 90. And dry food can be fed (not encouraged)

I don't give dosing advice but with that BG of 53 and you plan on following SLGS you would need to reduce the next dose to 0.75 units ,
That's why I tagged those members

When you do decide on which dosing method you want to follow please add it to your signature and your spreadsheet up top
Please try and get a few more tests in at night
@newpain
 
Thanks for your answers!

I think I will start with SLGS and see how that works for her.

I do not have syringes with half unit marking, so I'll have to "eye it" for tonight's .75u dose, but will have new syringes with half unit marking in the morning.

I am only feeding her Fancy Feast Poultry and Beef Feast Pate. I do not see a carb content % anywhere on the box, but this is the only food she's eating: https://www.amazon.com/dp/B01ALT2IRM. She doesn't have access to any dry food. I am planning to prepare some raw food for her if I can find a good recipe.

Did another test at +8 and it was 138 and just tested she is at 205 PMPS.

I have noticed that she didn't poop, at least nothing for the last 2-4 days.
 
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newpain said:
I do not see a carb content % anywhere on the box, but this is the only food she's eating: https://www.amazon.com/dp/B01ALT2IRM.
Click to expand...
These are fine ,they are all low carb
The carbs are never listed on the box or cans
2 of them are 2% carbs and 1 is 3% carbs
Look st the food chart here and you will see
link:http://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

Can you please fill in how many units you gave tonight ,it's not filled in.
You should have given 0.75 units

Also please add SLGS to your signature also
Tap in your name up top then tap on signature add SLGS then tap save
Please try and get a few more tests in at night, you might miss if she is dropping to low

Also on 6-26 for the night cycle you don't have how many units you gave Rosie, please fill it in

Be sure you have a hypo kit in the house

For your hypo kit in case you ever need to bring up your cats BG up
Med and High Carb food and have honey in your house



Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

Good idea to mark the cans with magic marker how many carbs

Or any on the food chart. Doesn't have to be Fancy Feast just an example about the med and high carb foods



https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-

10% and under is low carb
11% -15 is medium carbs.

16- 24 is high carb.
 
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newpain said:
. I am planning to prepare some raw food for her if I can find a good recipe
Click to expand...
Found this posted by a few members

If you plan to actually make cat food then you must purchase a nutritionally complete additive such as EZ Complete to add to the meat.

Some members make their own food buying the protein of choice and adding Ez Complete which provides everything else needed.

Link for it
https://www.foodfurlife.com/store/p3/EZComplete_Fur_Cats_225g_-_Makes_12.1_lbs_of_food.html#/
Frequently asked questions
https://www.foodfurlife.com/faq--contact.html#/


Here's the link to Dr. Lisa's recipe and a lot of tips, suggestions and information she has regarding home cooking cat food
https://catinfo.org/making-cat-food/
 
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newpain said:
I have noticed that she didn't poop, at least nothing for the last 2-4 days.
Click to expand...
If you think Rosie is constipated
a lot of us use Miralax , get the generic it's cheaper and it's the same thing
Such as clearlax or any other brand
(polyethylene glycol 3350)
You can start off with an 1/8 of a teaspoon everyday mixed in with the wet food and add water
to it, it's tasteless. See how that dose works for a couple of days, you might have to increase it to twice a day.
@newpain
 
So, even with 0.75 units that she got this morning, her BG dropped too low. From 221 AMPS to 49 now at +5. I gave her food immediately and will re-test in 30 min to an hour.

Edit. An hour later tested 73.
 
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newpain said:
So, even with 0.75 units that she got this morning, her BG dropped too low. From 221 AMPS to 49 now at +5. I gave her food immediately and will re-test in 30 min to an hour.

Edit. An hour later tested 73.
Click to expand...
Can I ask what did you feed her when she dropped down to 49? Was it low carb or medium carb?
So if you are following SLGS method any time Rosie drops below 90 you would reduce . Tonights dose would be 0.5 units

Going to tag
@Wendy&Neko
@Bron and Sheba (GA)
@tiffmaxee
Also to confirm that
@newpain

By the way I gave you another link about making your own food for Rosie post #35 above so take a look
 
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Diane Tyler's Mom said:
Can I ask what did you feed her when she dropped down to 49? Was it low carb or medium carb?
So if you are following SLGS method any time Rosie drops below 90 you would reduce . Tonights dose would be 0.5 units

Going to tag
@Bron and Sheba (GA)
@tiffmaxee
Also to confirm that
@newpain

By the way I gave you another link about making your own food for Rosie post #35 above so take a look
Click to expand...
She always eats the same Fancy Feast Pate, I do not have any other food at home. I tested AMPS and she was 221, fed her and gave 0.75 units insulin, then she ate one more teaspoon 2-3 hours later and when I tested at +5 she was at 49. I will test PMPS and decrease dose to 0.5.
 
I need some advice/opinions on maintaining schedule for the shots.
It's been difficult maintaining consistent schedule for the shots because of my job and other responsibilities. Most mornings I try to give her a shot before 10AM, but sometimes I have meetings and I can't step away until 12 PM. Is there any advantage of getting a shot early in the morning or is it ok if the AM shot is at noon and PM shot at midnight? I think if I do the shots at noon and midnight I can keep a more consistent schedule, but I wouldn't be able to do any tests after the midnight shot. Any thoughts/advice on this?
 
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