Thank you Carolyn and Latte!

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Sonya

Sonya

Member Since 2012
Thomas had 5 units of Lantus last night,ate 1/2 can of FF. I put out 1/4 cup dried M/d, but I think our other cat ate this. His blood sugar last night was 268 PMPS, this morning it was 60! I was so shocked I did it twice, the second time it was 62. He was probably just a little annoyed. So this morning, no shot!

This is so awesome! But scary too, I only checked because I had changed his food and wanted to see where he was at. I was prepared to give him his normal 5 units. Thanks to Carolyn and Latte's advice, I checked his BG this morning. Thank you so much! You probably saved his life!

Sonya and Thomas
 
WOW! I am SOOOOOOOOOO glad you tested before shooting! :shock: :shock: :shock: :shock:
And yes, under the circumstances I think it was very wise to not shoot this a.m.

If Thomas were my cat, and I was doing a food change to low carb/wet, I would probably start fresh with maybe 1u. You can work your way up or down in dose from there. And again, ALWAYS checking BG's before giving a shot. I would make sure to get as many 'nadir' (middle of the cycle) tests, a before bed test, and attempt a weekly curve on the weekends (or whatever day you have off).

One thing to note...when you test again, later today or tonight, you will probably find Thomas to be high again. Please do not let that discourage you, OR suggest you should give another 5 U. His liver will probably freak out from that 60 and dump a bunch of sugar in his system, causing high numbers. It is quite possible that is part of the reason you see high numbers when you test randomly, and possibly a sign he has been going low all this time due to too much insulin. Slow and steady, at a lower dose on a 12/12 schedule is going to be the safest way to go.

ETA: Yesterday's post http://www.felinediabetes.com/FDMB/viewtopic.php?f=32&t=68269
 
Sonya-
I noticed on your ss, you put OTJ next to this a.m.'s preshot number. confused_cat

It is possible with a food change Thomas may get there at some point. Unfortunately one number in the normal range is not enough for a cat to NOT need insulin. Usually you work your way down the dosing scale until the cat is basically given a small drop, and stays in normal BG's. Then you take away the insulin and monitor to make sure they continue to stay in normal BG's for about 2 weeks.

What time do you give insulin (and time zone)? Can you test again at your normal shot time and post on the board?
 
We do 6 and 6 for the shots. Thats what works with my work schedule. I will check and post tonight. Thanks again!
 
WHOA here is a perfect example of the effects of food changes and also the critical importance of testing before EVERY SHOT!

OK I don't even want to think what could have happened if the usual shot of 5u would have been given this morning.

Sonya, I am so so glad you tested. Now, we will see if Thomas will be OTJ or not. In order to say that he's OTJ, I think you test at his normal amps and pmps times and record the number. I don't know the range that's acceptable, but I think if you test tonite and it's under 120, then no shot, and you need to do the same for several days, testing at 6am and 6pm and getting a number under the 120,
After a couple weeks, you would be able to say Thomas is OTJ.... you'll still continue to test at shot times for awhile and then do some spot checks.

But now, let's see where he is tonite at 6pm! You may see him bounce quite HIGH from the shock of hitting that nice 60, and then you'll need to decide what dose to give, but it will NOT be 5u.

Another thing that many people do is to get a 2nd test.... say you are used to seeing all a bunch of 300s and some 200s and then BAM! you get a 60.. I would be like WHAT??? and I would test again just to be sure it is a legitimate number. If the 2nd test is closer to your usual numbers, that first one was likely a flukey wrong number, but if it's still pretty close and still under 100, I'd say yup, that a nice green and the insulin would go back into the frig!

I guess you'll see what number you get tonite! It should be interesting, so post when you know and you can get someone to help you with a new dose because the 5u is no good anymore.
 
Sonya said:
Thomas had 5 units of Lantus last night,ate 1/2 can of FF. I put out 1/4 cup dried M/d, but I think our other cat ate this. His blood sugar last night was 268 PMPS, this morning it was 60! I was so shocked I did it twice, the second time it was 62. He was probably just a little annoyed. So this morning, no shot!

This is so awesome! But scary too, I only checked because I had changed his food and wanted to see where he was at. I was prepared to give him his normal 5 units. Thanks to Carolyn and Latte's advice, I checked his BG this morning. Thank you so much! You probably saved his life!

Sonya and Thomas
Click to expand...

Just curious, who's giving you this dosing advice that got you up to this high dose as it looks like the increases have been happening way to fast. Is your vet giving you this fast track dosing?

Also, you are increasing the dose in full units... if you do not have syringes with 1/2 unit markings, you need to get some because if Thomas still needs insulin, he may need a small dose like 1/2unit or even less. You will need to use the syringes with 1/2 unit markings to give consistent doses.
 
Our advice on dosing has been coming from our vet. She has been very supportive, but maybe not experienced with this? She recommended the home glucose testing we've done.

Tonigth Thomas was very high, the meter just said "Hi"which according to the book is 600 or more. So my husband may have over reacted, Thomas got the 5 units again tonight with 1/2 can of FF. We will check again in a few hours to see where he's at. Thomas's behavior seems normal, very hungry.

Our syringes are whole units so I will check into getting the other kind.

Thanks again for the good advice. I read the documents you attached earlier. It seems hard to go back to 1 unit with him being so high tonight.

Sonya
 
Yes, I warned of the HI numbers. It is quite possible Thomas was even lower than what you caught this a.m., considering nadir is typically around +6 (midnight for you). As I mentioned, his liver will panic and try to protect the body by dumping every possible bit of sugar it has stored to keep him alive. Couple that with a missed shot, and it is no doubt he is this high. What we call this is a 'bounce'. The sugar released in a 'bounce' can last UP TO 72hrs, and then it is back to the lower numbers. Eventually the liver realizes it is ok to chill, and stops overreacting. This bouncing phenomenon does not just happen when a cat goes dangerously low (hypoglycemic). It can happen when the cat has BG's that are lower than it's body is used to. In your case, I think it is possible Thomas could have gone dangerously low last night. He is lucky to have a properly functioning liver!

One thing to remember, Lantus is not dosed on preshot numbers. It is dosed on nadirs (lowest point in the cycle/often, but not always +6). Seeing a high preshot does not always mean an increase is needed. It means it is time to investigate and find out where the cat goes lowest in the 12 hr cycle and HOW LOW did they go?

Is it possible for you to get some more tests during the week? What times would work?

Also, PLEASE (and I do beg ;-) ), please reconsider that dose of 5u....ESPECIALLY as you change him from the High Carb to the low carb wet.
 
Unfortunately our work schedules don't allow us to be home during the weekday. I can check and see if I can take Wednesday off. Or I might just make myself sick over this and stay home with Thomas that way!

If Thomas's BG is going to be high for a while, should I ignore this and just give him one unit and the low carb food?

Sonya
 
Sonya,
Most people do work and cannot test during the weekday. So, you are not alone there. What folks try to do is test before each shot, test before you leave the house for work, and test before you go to bed. Then, on the weekends, do a curve and maybe try to get an extra test at night. IMHO, I think testing randomly, like I suggested above, gives you a lot more information than doing a curve 1-2x/month. When testing infrequently, you could very well be catching him in the midst of a bounce. You think he is running high and you up the insulin.

Regarding the dose, I always play on the side of safety. The tests you have (as of right now) do not support OR dispute 5u as being too much. There is just not enough information. BUT, this a.m.'s preshot number AND the fact you are changing his diet would cause a bit of worry in my mind. I would much prefer to have my cat higher for a few days (while checking ketones) than go too low for a moment. Going too low can kill. If you start at a smaller dose, you can work your way back up based on information you collect with tests. Then you can find the right (and safe) dose.

I think it is awesome your vet suggested and is supportive of home testing. I wonder if he would be open to hearing about the protocol http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581, and ask his colleagues about it? You might teach him a thing or two! ;-) I would call and let him know that you tested before shooting and got the 60. See what kind of feedback he gives you.

I hope you check in tomorrow. I won't be up as early as you, but I will look at the board in the a.m. :mrgreen:

There is a bit more traffic on the TR LL board, if you ever need help and are not getting a response in here:
http://www.felinediabetes.com/FDMB/viewforum.php?f=9
 
I'm in Central Standard Time and I'm usually up at 6:30 am since Musette gets her shots at 7am. I will also keep an eye out for you as well. :-D

Mel, Maxwell, Musette & The Fur Gang
 
You guys are awesome! I did a check before bed and he had dropped to 408. This morning he is at 272. I went with 1 unit this morning. I'm hoping that is the safe thing to do with the diet change and this bounce. We will keep checking his levels before his shots and try for a random reading now and again. Definitely more this weekend.

Today I will check into the syringes with 1/2 units.

Thanks again!

Sonya
 
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