Starting Q 12 Lantus

[Cheryl & Missy]

I am the one not doing home testing due to my stress and really think it would stress her more. Been massaging and rubbing ears gently in prep and now she doesn't even like THAT nailbite_smile .

Brought to vet today to check CBC as today was last day of antibiotic, liver enzymes as still tapered 2.5 mg Prednisolone, and of course glucose that was better 237, Pred due today. Do think infections better as she's fighting the antibiotic which initially was tolerating it.

He's pleased with her glucose I asked about starting 1 unit BID insulin and he said ok, initially he wanted 0.5 unit am and 1 unit in eve, but I asked shouldn't both doses be same? He asked if I thought I could do 0.75 units bid as just wanted to increase it by 0.5 units/ day with what she was already on (1 unit a day)

My question for ears here is would it be better to try half unit bid as she's been on just one unit daily?
Sugar check was post BP which she absolutely hates though this time she growled just when they put cuff on her tail. Tech had me take her out of carrier and she was on towl on table, BP was higher, then he brought her in back for labs without carrier too, she seemed calm and to like him but who knows.

 

[BJM]

I can't read your spreadsheet because it isn't in google docs where everyone else has their spreadsheet.
If you create an account in Google Docs, you can upload the spreadsheet, you'll be able to edit it there, and we'll be able to see it.

It should be fine to do 0.5 units twice a day if the numbers were oK all day.

There are a host of secondary monitoring tactics in my signature link which don't require blood; use what you can and track them daily (ex water consumption) to weekly (ex weight). Because you aren't blood testing, checking for ketones in the urine is very important (high glucose can lead to diabetic ketoacidosis, an expensive and potentially fatal condition.) You also can check for glucose in the urine that way; finding it suggests you aren't yet at optimal control OR that the kidneys may have some damage.

 

[Blue]

Many people 'think' their cats will not like the ear tests, but they get used to it and my cats pretty much slept through getting their ears poked, so I would take it as meaning it sure did not hurt.
Often, the fear is in the owner, and not the animal.
I never heated their ears or did any fancy rubbing; maybe that stuff would have bothered my cats, but I don't know.
I just got the lancet device loaded, and had the meter with strip ready, then poked the ear and tested.
Treats after the poke go a long way in convincing the cat that poking has a reward!

I can't really comment on dose at all without seeing any numbers.
Lantus works with the SAME DOSE at am and pm, so futzing around with the amounts will not feel good to the cat.
If you are giving 1u BID now and want to increase, it might be an idea to go small.... go with 1.25u at am shot and 1.25u also at the pm shot. Whatever you decide to give, make both shots the same amount.

You can poke yourself with the lancet device, it's a really quick poke, and adjust the depth based on how well it gets your finger to bleed. Free hand is much slower and you can't regulate how deep you are poking, but with the device, it's fast and pokes to the depth you set.

keep trying.... it's new to both of you so if you are stressed, then so should she be in the start. You are settling with the whole thing now, and so is she. Before you know it, you will find it as easy as anything you do every day, and all you will get from her will be an annoyed look for disturbing her sleep, but certainly no stress!

 

[BJM]

OK, made myself a DropBox account so I could download your spreadsheet (I have too many !@#$ passwords to remember!)

As far as the constipation goes, some find that Laxatone may raise glucose levels. A product many use successfully is Miralax, 1/8 teaspoon daily, mixed in food, maybe with an extra tablespoon of water.

A reading of 237 at the vet's may have some vet stress elevating it. I would not increase the dose.

Dividing the insulin into 2 even doses is a very good idea, as there is no telling how low she is going during the day, nor how high during the night, plus she is clearing an infection, which may lower the glucose further.

Its time to start covert rehearsal in your mind of successfully wrapping her up in a towel, pricking her ear, testing the blood, giving her a treat, and recording the data. Mental rehearsal has been shown to help folks learn to do new things.

Without testing, there is a significant risk of giving her enough insulin that she goes into a hypoglycemic attack. That glucose level at the vets is low enough that it could happen any time now.

Here is a stress management technique that is easy to learn:

 

[BJM]

Here is Missy's Spreadsheet in Google Docs

If you make yourself an account, log in, and click on this link, I believe you can save a copy in your own account.

 

[Cheryl & Missy]

OK, made myself a DropBox account so I could download your spreadsheet (I have too many !@#$ passwords to remember!)
BJM thanks for doing that, i can so relate to the too many $%#@ passwords lol. I do have a gmail but keep forgetting the password there so doing things where I can get in. My email has google set up and did do a SS on that, was trying to link it to my drop box but no go so have to maintain 2 or use the pc more. Currently on pc and updated the spreadsheet via google and link on here.
As far as the constipation goes, some find that Laxatone may raise glucose levels. A product many use successfully is Miralax, 1/8 teaspoon daily, mixed in food, maybe with an extra tablespoon of water.

I think regular Laxatone was contributory toward the sugar for sure, ingredients of Laxatone natural however seem ok to me, posted several places, but

Laxatone Natural Flavor
Ingredients: Soybean Oil, Hydrolyzed Vegetable Oil, Cod Liver Oil, Flaxseed Oil, Chicken Flavor, Vitamin E, Lecithin, Soy Protein, Sorbitol, Beeswax, Maple Flavor, Methylcellulose, and Chamomile.

A reading of 237 at the vet's may have some vet stress elevating it. I would not increase the dose.

Dividing the insulin into 2 even doses is a very good idea, as there is no telling how low she is going during the day, nor how high during the night, plus she is clearing an infection, which may lower the glucose further.

Its time to start covert rehearsal in your mind of successfully wrapping her up in a towel, pricking her ear, testing the blood, giving her a treat, and recording the data. Mental rehearsal has been shown to help folks learn to do new things.

Without testing, there is a significant risk of giving her enough insulin that she goes into a hypoglycemic attack. That glucose level at the vets is low enough that it could happen any time now.

Appreciate that which is why didnt want to do too much, was thinking of doing 0.5 units q 12 hours to see shes ok with that, didnt discuss with vet but think he suspects ;-) she had not eaten much this am prior to sugar

Here is a stress management technique that is easy to learn:

I am curently waiting forr pending long term disability through work and Soc Security disability. I worked for years in a hospital on oncology floor doing among other things accuchecks so its not unfamiliar to me just have limited to what I can deal with, if I end up pushing myself past function I cant help her or my Mom whos suffering from Progressive Dementia, another factor of my panic attacks.

The fact that my initial panic of Missy's diagnosis was thinking would have to feed science diet says much. :sad: I havent ever felt like this in my years of working since '79. Even if do reach a point for testing, what I have been doing with my 18 year old pred induced sugar kitty was giving insulin several hours after feeding her, like putting food down 4 pm, sometimes she doesnt eat much til 7, so aiming insulin at 7;30 pm, now doing BID thinking 9-9 to allow time to ensure eating before I give insulin. her lower sugar today was when Prednisolone was due, shes on that because of IBD which has been managed for years, Pred was initially every other day, then 3x/week, now twice a week.
I know stress and infection or end of infections factor in the sugar.

Most of her foods were those on binkys ok list, Fancy feast canned, just stopped all but classic, Instinct canned, Stella & Chewy's Freeze dried raw. I did fix the link to my spread sheet, now if I could only figure how to edit a form that was sent in PDF that I need to fill out, now that I am running low ink wise. :cry:

 

[BJM]

Some kitties scarf 'n' barf; some don't. When insulin starts taking hold, many kitties appetitites perk up and they'll graze a bit more often.

In the absence of blood glucose testing, you should rely on whatever indirect daily monitoring you can do.

You might adjust the spreadsheet to include weekly weight and the amount of water put down vs left am and pm and so on, so that you have data to go by. While indirect and not always reflecting immediate glucose levels, these data may be used to guide dosing. Once of Dr Rand's earlier files explains how to do that and is posted on the University of Queensland Center for Companion Animal Health website.

 

[Cheryl & Missy]

thank you BJM that I can include in comment section, cant wait for all this paperwork (not missy and from here) to be over as its pushing me far.think going for some rescue remedy and isolation....seriously...Missy has good appetite just eats over time, think arthritis is compounding it not wanting to walk room to room. we are very aware of watching water and food intake.
She did well with the one unit a day, beleive me I have watched her like a hawk. That was why I was thinking, with influence from reading here, to do 1/2 unit BID. Gave her half unit at 11 when we came home, she ate 2/3 her food maybe little more.going to carry her in and see if she will eat a little more. Her gait and stance is a bit better I think and no more carpet peeing when sitting on carpet, last few days poops been in box and not as much on her, so think doing better standing in there, meaning no baths every day for her.
right now my healing hands sore used to ipad not typing with both hands, fractured wrist in a fall 14 weeks ago or so to add to all my fun. NOT :cry: