Roscoe! Advice please!

[KristinaK]

Hi!

Roscoe is my 11 year old kitty who was recently hospitalized for hepatic lipidosis, diabetes, and pancreatitis (it’s been rough). He was in the ICU for 5 days and came home with a feeding tube and a Libre. Feeding tube is out! And we are now doing paw pricks twice daily. We started with Basaglar 2 units BID and are down to 0.5 units BID with his BG being around 200 to 250 before the next dose is given. Is this how others are monitoring? Any advice or suggestions is warmly welcomed as we are new to this (week 6).
He also seems to be twitching more often. I tested him and his BG was 244 so i thought this was strange. Anyone see this before?
Thank you all!

 

[jt and trouble (GA)]

Welcome to FDMB the best place for you to get answers and help. Glad you found us! I cannot give dosing advice but I can welcome you! Hold on for a Veteran to answer these questions. Theres a few questions you will be asked Like do you keep a record of readings? Here we use a spread sheet you can find it here: http://www.felinediabetes.com/FDMB/forums/suggestions-tech-support-testing-area.6/

Thats a good starting point. I will let others chime in
again welcome to FDMB
jeanne

 

[Ale & Bobo & Minnie (GA)]

Hi!

Roscoe is my 11 year old kitty who was recently hospitalized for hepatic lipidosis, diabetes, and pancreatitis (it’s been rough). He was in the ICU for 5 days and came home with a feeding tube and a Libre. Feeding tube is out! And we are now doing paw pricks twice daily. We started with Basaglar 2 units BID and are down to 0.5 units BID with his BG being around 200 to 250 before the next dose is given. Is this how others are monitoring? Any advice or suggestions is warmly welcomed as we are new to this (week 6).
He also seems to be twitching more often. I tested him and his BG was 244 so i thought this was strange. Anyone see this before?
Thank you all!

Hi Kristina,

welcome to you and Roscoe!

what do you mean by twitching? A few questions the more experienced folks here are going to ask to be able to advise you better. What are you feeding Roscoe and how often. The meals should be at least 2 hours before the pre shot test and then after. I’m also going to include some helpful links below, like JT did, but hang in there as others will reply:

http://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

You’ve come to the right place

 

[Ale & Bobo & Minnie (GA)]

Hi!

Roscoe is my 11 year old kitty who was recently hospitalized for hepatic lipidosis, diabetes, and pancreatitis (it’s been rough). He was in the ICU for 5 days and came home with a feeding tube and a Libre. Feeding tube is out! And we are now doing paw pricks twice daily. We started with Basaglar 2 units BID and are down to 0.5 units BID with his BG being around 200 to 250 before the next dose is given. Is this how others are monitoring? Any advice or suggestions is warmly welcomed as we are new to this (week 6).
He also seems to be twitching more often. I tested him and his BG was 244 so i thought this was strange. Anyone see this before?
Thank you all!

Oh and if you click on the line to my spreadsheet in my signature, you’ll see I’ve been testing pre shots and also a mid day spot check to try to get an idea of her nadir, which is the lowest point in a 12 hour cycle. They may advise you to also do a +2 after the shots. We’ll see. Just keep in mind I use a different insulin which is Lantus. Also what meter do you use for testing human or pet meter? Most of us use human meters like ReliOn or Freestyle and it sounds like you do too...?

 

[KristinaK]

Welcome to FDMB the best place for you to get answers and help. Glad you found us! I cannot give dosing advice but I can welcome you! Hold on for a Veteran to answer these questions. Theres a few questions you will be asked Like do you keep a record of readings? Here we use a spread sheet you can find it here: http://www.felinediabetes.com/FDMB/forums/suggestions-tech-support-testing-area.6/

Thats a good starting point. I will let others chime in
again welcome to FDMB
jeanne

Thank you!

 

[KristinaK]

Oh and if you click on the line to my spreadsheet in my signature, you’ll see I’ve been testing pre shots and also a mid day spot check to try to get an idea of her nadir, which is the lowest point in a 12 hour cycle. They may advise you to also do a +2 after the shots. We’ll see. Just keep in mind I use a different insulin which is Lantus. Also what meter do you use for testing human or pet meter? Most of us use human meters like ReliOn or Freestyle and it sounds like you do too...?

Thank you for all this helpful info! I use the pet meter that the vet recommended. It’s the AlphaTrak. I also am not able to test him that often because I work about 10 hour days this has been quite challenging so I truly appreciate all your help!

 

[KristinaK]

Thank you for all this helpful info! I use the pet meter that the vet recommended. It’s the AlphaTrak. I also am not able to test him that often because I work about 10 hour days this has been quite challenging so I truly appreciate all your help!

We have also been free feeding him until his liver enzyme count is back to normal. Hoping in the next few weeks he will be healed. I am free feeding him Royal Canin Glycobalance dry food. I have ordered the wet food but he doesn’t like it as much. Thinking about mixing the two. My other cat also makes it a challenge because he will try to eat all of Roscoes food! Cat drama!

 

[Ale & Bobo & Minnie (GA)]

Thank you for all this helpful info! I use the pet meter that the vet recommended. It’s the AlphaTrak. I also am not able to test him that often because I work about 10 hour days this has been quite challenging so I truly appreciate all your help!

We can only do the best we can. I wasn’t able to test midday before covid19 either

 

[Ale & Bobo & Minnie (GA)]

We can only do the best we can. I wasn’t able to test midday before covid19 either

also, can you explain the “twitching”?

We try to transition away from the dry food because it’s so high in carbs, but not before the diabetes is regulated because switching foods can affect the BG levels right @Deb & Wink? @jt and trouble (GA) who is the best person to help with basaglar?

thanks ladies!

 

[jt and trouble (GA)]

also, can you explain the “twitching”?

We try to transition away from the dry food because it’s so high in carbs, but not before the diabetes is regulated because switching foods can affect the BG levels right @Deb & Wink? @jt and trouble (GA) who is the best person to help with basaglar?

thanks ladies!

I have no idea what that is I will google it but Deb is is the person I would ask

OK i THINK its close to lantus. But I still wouldnt know. Sorry

 

[KristinaK]

I have no idea what that is I will google it but Deb is is the person I would ask

OK i THINK its close to lantus. But I still wouldnt know. Sorry

I am actually a pharmacist! Basaglar is just like Lantus.. just cheaper! Kind of like a generic.

 

[KristinaK]

also, can you explain the “twitching”?

We try to transition away from the dry food because it’s so high in carbs, but not before the diabetes is regulated because switching foods can affect the BG levels right @Deb & Wink? @jt and trouble (GA) who is the best person to help with basaglar?

thanks ladies!

So the twitching is where his body just does a little jerk every once in a while. Similar to where there’s something on his face or back and he twitches to get it off. Nothing prominent like a seizure though. And it’s typically just a twitch, not multiple in a row.
Thanks again!

 

[jt and trouble (GA)]

I am actually a pharmacist! Basaglar is just like Lantus.. just cheaper! Kind of like a generic.

thank you!

 

[Ale & Bobo & Minnie (GA)]

I am actually a pharmacist! Basaglar is just like Lantus.. just cheaper! Kind of like a generic.

Oh great then we speak the same language ha! Minnie is on Lantus and let me find the link to the info about BG levels for Lantus, but basically you want PS numbers to be above 200 and the nadir should never be below 90 when it is we take the dose down by .25. Hold on I’ll be back

 

[Ale & Bobo & Minnie (GA)]

Oh great then we speak the same language ha! Minnie is on Lantus and let me find the link to the info about BG levels for Lantus, but basically you want PS numbers to be above 200 and the nadir should never be below 90 when it is we take the dose down by .25. Hold on I’ll be back

http://www.felinediabetes.com/FDMB/...-low-go-slow-slgs-tight-regulation-tr.210110/
Assuming you’re using the SLGL method, scroll down to that section

 

[KristinaK]

http://www.felinediabetes.com/FDMB/...-low-go-slow-slgs-tight-regulation-tr.210110/
Assuming you’re using the SLGL method, scroll down to that section

This is awesome! And I actually just tested him since we give the insulin typically at 730. He was 147 so the vet told me under 150 and we should skip the dose. He has been getting 0.5 units BID. Thank you all so much! You are amazing!

 

[Ale & Bobo & Minnie (GA)]

This is awesome! And I actually just tested him since we give the insulin typically at 730. He was 147 so the vet told me under 150 and we should skip the dose. He has been getting 0.5 units BID. Thank you all so much! You are amazing!

You could also give a token dose between 150-200 but not sure with .5 if that would be worth it. Better to be high than risk low as everyone here reminds me. Also, I’ve been told that as you get used to his numbers and gather more data you’ll be able to deviate a bit from these ranges because every cat is different, but no rush with that!

 

[Deb & Wink]

Yes, Basaglar is similar to Lantus, but it is not a "generic" version of lantus. It's what is called a biosimilar. Meaning it works the same way in the body. We treat it here in our dosing protocols as if it was Lantus.

Kristina, if you could set up your User Id "signature" that would help us help you better.
How to's are here: Editing your Signature, Profile, and Preferences

Then a spreadsheet. We have a standardized, color coded one with a template that you copy.
Directions for that in this link here: FDMB Spreadsheet Instructions

What it means is here in this link. Understanding the Spreadsheet/Grid

The SS is a great tool, and you can even share the SS (spreadsheet) with your vet. Simple grid, to record the BG (blood glucose) data and the insulin dose each cycle. Plus, there is the Remarks column on the far right to track other information, plus a tab on the SS to record lab results.

 

[KristinaK]

Yes, Basaglar is similar to Lantus, but it is not a "generic" version of lantus. It's what is called a biosimilar. Meaning it works the same way in the body. We treat it here in our dosing protocols as if it was Lantus.

Kristina, if you could set up your User Id "signature" that would help us help you better.
How to's are here: Editing your Signature, Profile, and Preferences

Then a spreadsheet. We have a standardized, color coded one with a template that you copy.
Directions for that in this link here: FDMB Spreadsheet Instructions

What it means is here in this link. Understanding the Spreadsheet/Grid

The SS is a great tool, and you can even share the SS (spreadsheet) with your vet. Simple grid, to record the BG (blood glucose) data and the insulin dose each cycle. Plus, there is the Remarks column on the far right to track other information, plus a tab on the SS to record lab results.

Thank you for all your help! I will do that! I only used the term “similar to a generic” as I thought more would be familiar with that terminology than a biosimilar.
Again, I appreciate all the help!

 

[KristinaK]

You could also give a token dose between 150-200 but not sure with .5 of that would be worth it. Better to be high than risk low as everyone here reminds me. Also, I’ve been told that as you get used to his numbers and gather more data you’ll be able to deviate a bit from these ranges because every cat is different, but no rush with that!

This is great information! It is definitely difficult to measure out anything less than 0.5 units lol!
Thanks! I will start a SS.

 

[Chris & China (GA)]

He was 147 so the vet told me under 150 and we should skip the dose.

What we usually suggest is to stall, don't feed and test again in 20-30 minutes to see if the number comes up without the influence of food. If it does, it's usually a pretty good sign that the last shot is starting to wear off and it's OK to go ahead and shoot.

 

[Ale & Bobo & Minnie (GA)]

What we usually suggest is to stall, don't feed and test again in 20-30 minutes to see if the number comes up without the influence of food. If it does, it's usually a pretty good sign that the last shot is starting to wear off and it's OK to go ahead and shoot.

Any thoughts on the twitching you guys? Could it be nothing or super early neuropathy? Although I thought that starts with back legs only and Minnie did use to twitch them sometimes, but never her entire body

 

[KristinaK]

When he came back from the ICU, he could barely walk and he definitely couldn’t jump up on the couch or even in the taller litter box. His legs would literally collapse from under him. He’s now able to jump and run and walk on hardwood. Not sure if this has anything to do with it?

 

[Chris & China (GA)]

Any thoughts on the twitching you guys? Could it be nothing or super early neuropathy?

I'm voting for probably nothing. I think that after we get this diagnosis and start interacting more with our cats, we tend to notice things we never noticed before. Not because anything changed, but because we're hyper-focused on every little thing.

ETA..I can't count the number of dirty looks I got by poking China to see if she was just sleeping

 

[Ale & Bobo & Minnie (GA)]

When he came back from the ICU, he could barely walk and he definitely couldn’t jump up on the couch or even in the taller litter box. His legs would literally collapse from under him. He’s now able to jump and run and walk on hardwood. Not sure if this has anything to do with it?

That does sound like neuropathy but it’s odd that it would go away so quickly by itself. I’d just keep an eye on him to see if it goes away and if it doesn’t get worse it may just go away by itself too. For neuropathy, we suggest b12 methyl but if he’s walking jumping and all I wouldn’t worry about it