? Unable to regulate

M

MB and Feen

Member
My cat has been on Basaglar for about two months increasing the dose per SLGS method. It seems that the insulin is doing absolutely nothing to regulate him.

Unfortunately I have been unable to update his spreadsheet because I do not have a computer at home right now and my phone doesn’t let me edit spreadsheets. I test before every shot and do curves and he has never dropped below 230 including his nadir, so I doubt he is “bouncing”. He is consistently between 240-280 every time I test.
 
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MB and Feen said:
My cat has been on Basaglar for about two months increasing the dose per SLGS method. It seems that the insulin is doing absolutely nothing to regulate him. He is currently on 5u BID exactly 12 hours apart. His main two meals are FF chicken pate with a few low carb snacks between meals. I worked for ten years as a vet assistant and so I am pretty confident giving SQ injections and I am also T1D myself, so the insulin is getting into him every dose.

Unfortunately I have been unable to update his spreadsheet because I do not have a computer at home right now and my phone doesn’t let me edit spreadsheets. I test before every shot and do curves and he has never dropped below 230 including his nadir, so I doubt he is “bouncing”. He is consistently between 240-280 every time I test.

I’m at a loss of what to do. If I tell my vet she will switch him to Novolin N. She will not prescribe Lantus, was very hesitant about Basaglar in the first place. It seems to me that 5u BID for a ten pound cat is a high dose to be doing nothing. He hardly has any fat on him but should I be trying a longer needle? Is it possible that this insulin just isn’t compatible with him? He is close to needing a new Basaglar pen-do I keep doing the same thing I’m doing? Any advice is appreciated. I understand that not having the spreadsheet up to date is problematic but I don’t have a solution for that right now.
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Tagging
@Bron and Sheba (GA) and @Wendy&Neko
Since I saw they helped you on your previous posts
posts
https://www.felinediabetes.com/FDMB/threads/5-29-amps-289-5-285.290561/
https://www.felinediabetes.com/FDMB/threads/5-8-feeney-300.289769/
 
Here is a suggestion for a human meter as a back up to test
Here is the link for the meter and test strips so you don't have to search for them
Relion Premier Classic Meter at Walmart for 9 dollars
https://www.walmart.com/ip/ReliOn-Premier-CLASSIC-Blood-Glucose-Monitoring-System/552134103

The tests strips are 17.88 for 100
https://www.walmart.com/ip/ReliOn-Premier-Blood-Glucose-Test-Strips-100-Count/575088197
At least if you need more test strips you can runintoWalmart and pick them up or if you're running low you can just order them from Walmart


Testing
Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up
c2b8079a-b471-4fa6-ac36-9ac1c8d6dcca-jpeg.57072
fec17d29-5ab4-44a8-912b-3a91944c3954-jpeg.57073

6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 10 or 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand not the lancing device
I find it better to see where I'm aiming
Look at the lancet under a light and you will see one side is curved upward, that's the side you want to poke with

Try putting a thin layer of Vaseline on theear so the blood will bead up

Here is a video that one of our members did ,ignore the coding because she is using a pet meter, with a human meter no coding needed
VIDEO: How to test your cat's blood sugar


More
Here is a link to Hometesting tips and links
 
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Great, thank you for the meter/strip suggestion. I’ve been sharing my Contour next supplies with Feen but I’m running low and my insurance doesn’t want to cover them anymore so I’ll need to make a meter change soon and it’s nice having one that’s compatible for him to use.
 
I added on to my last post
Do you have the U-100 syringes with the half unit markings?
We increase and decrease by 0.25 units at a time and these make it easier to do
Also on your spreadsheet where it asks what insulin can you get rid of the dose you have there and put Basaglar
I don't think anyone can give you advice on what's going on without current BG readings .
Maybe someone has a computer you can use to update the spreadsheet
 
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Diane Tyler's Mom said:
I added on to my last post
Do you have the U-100 syringes with the half unit markings?
We increase and decrease by 0.25 units at a time and these make it easier to do
Also on your spreadsheet where it asks what insulin can you get rid of the dose you have there and put Basaglar
Click to expand...
Diane Tyler's Mom said:
I added on to my last post
Do you have the U-100 syringes with the half unit markings?
We increase and decrease by 0.25 units at a time and these make it easier to do
Also on your spreadsheet where it asks what insulin can you get rid of the dose you have there and put Basaglar
Click to expand...

Yes, I use U-100 syringes with half unit markings. And yes, as soon as I have access to a computer that allows me to edit the spreadsheet I will update the dose as well as the testing I have done since I was last able to edit (hopefully this week, getting a new computer). I’ve been recording everything on paper in the meantime.

I guess I was hoping that until I had that updated I could maybe get guidance on more general questions like is 10u of Basaglar per day a lot for a cat? Especially with no apparent impact on BG and likelihood of the need for an even higher dose? Does it ever happen that a cat just doesn’t respond to certain types of insulin?
 
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While you are at work you can get an auto feeder you can set them to open at different times
some info on auto feeders always add a little water to the wet food
Here is an auto feeder that hold 5 slots and comes with 2 ice packs for wet food
https://www.amazon.com/Cat-Mate-C500-Digital-Automatic/dp/B01AUYLVU8/ref=sr_1_6?gclid=EAIaIQobChMIuM_y2p79_AIVDvrICh1_xAy6EAAYASAAEgJBDfD_BwE&hvadid=178540036693&hvdev=t&hvlocphy=9003521&hvnetw=g&hvqmt=e&hvrand=6990619631848479728&hvtargid=kwd-12652445711&hydadcr=10635_9894649&keywords=petsafe 5-meal automatic pet feeder&qid=1675560889&sr=8-6

Extra ice packs so you can keep them in the freezer ready to go
https://www.amazon.com/Cat-Mate-Rep...5c-bd5c-e23f6094563c&pd_rd_i=B091HTXNHR&psc=1

This one has 3 slots with one ice pack
https://www.amazon.com/Cat-Mate-Automatic-Feeder-Digital/dp/B01MXDFB28

Extra ice pack
https://www.amazon.com/Mate-Replace...cb-974a-deec2fb8a80c&pd_rd_i=B07KFP7PRG&psc=1

You can even order the stainless steel inserts for the 5 slot if you don't like your kitty eating out of plastic, from what I have heard plastic could cause acne on some cats
https://www.amazon.com/Cat-Mate-Sta...36-830d-6cc20f385409&pd_rd_i=B0B3MS1MWR&psc=1
 
Welcome to the LBL forum. :)

What type of phone are you using? I know I can edit spreadsheets from my iPhone. Do you have the Google Sheets app installed?

Without current data, it's going to be very difficult to help you. My first question is how you got to the 5 units dose? SLGS says to increase by 0.25 units after holding the dose for 1 week with a curve sometime in there. You were at 1.5 units May 29th which is about 4 weeks ago. The highest dose you should be at now is 2.5 units given 4 times 0.25 units would mean 1 unit higher than 1.5 units. It's possible you've increased too fast and bypassed a good dose?

On the other hand, I've seen cats around your kitty's weight on much higher doses. Size of cat doesn't have anything to do with what dose will move them. There can be other secondary reasons a cat needs a higher dose. Please don't go to Novolin N, it's a bad insulin for cats, not even recommended by the AAHA anymore. They recommend Prozinc and Lantus (or biosimilar). The majority of kitties on FDMB are on Lantus - for a reason.
 
Wendy&Neko said:
Welcome to the LBL forum. :)

What type of phone are you using? I know I can edit spreadsheets from my iPhone. Do you have the Google Sheets app installed?

Without current data, it's going to be very difficult to help you. My first question is how you got to the 5 units dose? SLGS says to increase by 0.25 units after holding the dose for 1 week with a curve sometime in there. You were at 1.5 units May 29th which is about 4 weeks ago. The highest dose you should be at now is 2.5 units given 4 times 0.25 units would mean 1 unit higher than 1.5 units. It's possible you've increased too fast and bypassed a good dose?

On the other hand, I've seen cats around your kitty's weight on much higher doses. Size of cat doesn't have anything to do with what dose will move them. There can be other secondary reasons a cat needs a higher dose. Please don't go to Novolin N, it's a bad insulin for cats, not even recommended by the AAHA anymore. They recommend Prozinc and Lantus (or biosimilar). The majority of kitties on FDMB are on Lantus - for a reason.
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I have an iPhone but it’s extremely old and won’t let me update the iOS or add more apps because it’s out of storage. Luckily got word today that I can get a new work laptop by the end of the week.

On May 30 I talked to my friend who is finishing her residency from vet school and she advised that if I’m doing curves multiple times per week and his BG is never falling below 200 then I shouldn’t be waiting a full week to increase his dose and to increase by 0.5u at a time not 0.25. She said that since the markings are at 0.5, and with the likelihood of air bubbles and user error in drawing up, trying to increase by 0.25 isn’t very accurate anyway. I have been increasing every 3-4 days and maybe that’s been too fast.
 
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MB and Feen said:
I have been increasing every 3-4 days and maybe that’s been too fast.
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You aren't following SLGS then, and yes could be going too fast. Once we see the data we'll be able to tell you. With the bouncing behaviour common in newly diagnosed cats (and even some less new), it's possible you are only catching the higher times for tests. Or he could just need more insulin. The data will guide us.

Stick with Lantus/Basaglar for now. We have a lot more people switching from Prozinc to Lantus than the other way around.
MB and Feen said:
I guess I’m just looking for whether anyone else had ever experienced this lack of insulin response this long after diagnosis and/or if I should tell my vet what’s going on or if I should just stay the course with what I’m doing? I could try backing down his dose and then climbing back up more slowly.
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Don't back down the dose for now. If does need a higher dose (my cat got to 8.75 units), then going backwards is the wrong direction. As you can see, I did the 0.25 units changes, my girl was sensitive to small changes in insulin.

Your cat has barely started insulin, just over a month. I'd hardly call this "long after diagnosis". Feline diabetes require patience. We call this a marathon, not a sprint.

Once you have data in the spreadsheet, we'll be able to give more help.
 
Basaglar is the same as Lantus and is one of the best insulin for cats. Also going up by 0.25 units at a time is safer than by 0.5U. You are less likely to go past the best dose and it’s safer for the cat.
I would not go back in dose and start again.

I would also recommend a dosing method such as SLGS.
I’ve just looked at Fennys SS. Is there any way you can update the SS using someone else’s computer? I can see you love your kitty and want to find a solution.
Keep asking questions. :)
 
Thank you all for your replies and your patience while I got Feen’s spreadsheet updated. I was finally able to get a new computer and input all of his data. Looking at all of it as a whole I’m not seeing any patterns, but please let me know if you see anything I am missing.
 
Would it be possible for you to get a second test every cycle for a couple days? Say sometime during the day and a test just before you go to bed at night? With that data, we'll be able to figure out if he's going lower and bouncing or whether he just needs more insulin.

He does seem to like pink and yellow!
 
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