Update on Chloe

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Thanks everyone and good morning. I just checked her AMPS and she is at 363! Yikes, these extremes... last night almost 12 hours ago she got 3/4 unit. I'm going with the reduced dose and will see how she does. Thanks.
 
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I think I'd wait to test until sometime between +5 to +7 hours, when she is most likely to be lower.
 
She's stayed in the 200's all day. I administered 1 unit this evening, since she's been higher today. Hopefully that wasn't a bad thing to do. I'll test at +2.
 
that was a great pic. she looks content.

some of us have made foodcicles for longer periods.... some kitties will lick it when frozen... but it keeps the food fresher longer if you are in a
warm climate.
the other trick is to add water, make the food soupy, that will also keep the food from getting dried out and undesirable.

Great ideas, thanks!
 
She's bouncing from going low yesterday. It'll calm down in another day or two.
 
Yeah, this is now day 3 - she started low on Saturday. I've pretty much taken all dry food away. She's eating through the Purina DM faster than I can put it out. Truly, I just put out 1/3 of a can for dinner (she's had the other 2/3 already today) and it's nearly gone. She runs out of food in the middle of the night, so that is why I'm tempted. Ideally, her on the high carb food isn't good, so I know I need to just give her more of the canned. I keep updating her chart - glad I have that going now. I'm still too new to understand the trends, so do we just stay with the 3/4-1unit and wet food for now? I am probably driving all of you insane, and I don't mean to. I just want to double check myself and ensure she stays out of DKA (which I thought was from really low BG #'s, but now I realize it's from really high BG #'s. Oy!)
 
You need to decide what protocol you want to follow for the Lantus.
At a minimum (Tight Regulation), you hold the same dose for 3 full days, then assess during the nadir period.
For the Start Low, Go Slow protocol, you hold the same dose longer and run a curve to evaluate the dose.
 
Shoot - I gave her 3/4 unit yesterday and 1 today - although those syringes are so tiny, I guestimate on the dosing. I think I'll go wtih the Tight Regulation, but I feel like I might be walking into a dark hole alone. I'd love to get her OTJ!
 
That's OK - just pick one of the doses and try to stick with it for a few days. Personally, I'd go with the 3/4 unit as the 1 unit dropped her low yesterday. :)

You're not walking into a dark hole - you've already handled low numbers and got through it. And there's no guarantee that even on SLGS you wouldn't see a very low number like that now and then - even though that isn't the aim with SLGS, our kitties do like to surprise us sometimes!! ;) And you'll never be alone on here - there will always be someone around who can help you with any questions you've got and give you support on the days when Chloe drops low (or even just the days when you're finding it all difficult to deal with - those days happen to us all). :bighug:
 
Ok, I'll switch back to the 3/4 in the AM. I just checked her +2 and she's higher like she was last night. No low #s today though, so that's good.

I know, sorry - I know I have people here, I just think that trying to follow the protocol might be tough. Sounds like a need a few more things before starting it though. I don't have syringes that have the 1/2 unit markings. And I know I'll need Lantus again, and at nearly $250 last year, I'm sure it's gone up this year.

Manxcat do you have any experience with either protocol? Seems many go with the Tight Regulation, but I'm intrigued by your kitty's success! And just like in my business - you learn what has been successful and go with it!

:)
 
A really important note: we adjust the insulin dose based on the lowest glucose post-shot, aka the nadir. It is more of a time period, as the actual low may move around a bit.

Check our Supply Closet forum area.
 
She's definitely doing well today - no real lows and nothing too horribly high either. :) With her +2 being higher than her pre-shot number, it will most probably be another fairly quiet night for Chloe though, like yesterday, a before bed test is a good idea just to make sure - kitties do like to keep us on our toes some days with unexpected numbers! :rolleyes:

The Tight Regulation protocol can be tiring at times - I'm not going to lie to you about that. There are days when they look like they might head low when you might have to get a couple of tests in overnight. But it does give you the best possible chance of getting a cat OTJ - and remember, if Chloe doesn't head in the direction of OTJ and you want to switch to the Start Low Go Slow protocol sometime in the future, you can still do that too. :)

Walmart sell syringes with 1/2 unit markings - as far as I know, all their 3/10 cc syringes come with the 1/2 unit markings (though the pharmacy staff don't always know that). ;) And buying Lantus from Marks Marine in Canada is about 1/2 of the price of buying it in the USA - I believe they're somewhere around the $150 mark for a box of 5 pens at the moment, where those same 5 pens here will cost upwards of $400!!

I had Rosa on Tight Regulation (with more testing than is strictly necessary as she did like to dive on occasion, so I could never be sure that she wouldn't pull a sneaky fast drop on me if I wasn't paying attention). She did respond better to the protocol than I could ever have hoped for given her dreadful numbers for the first couple of weeks and, although I did have days where it was tough going and days where I doubted what I was doing, it did definitely work for her in the end. :) I have to say, much of the credit for that goes to the people here who welcomed me when I first joined, answered all my questions no matter how small they were, and were there for me on the days when Rosa was dropping low and I needed support or when I wasn't sure what to do next with her dose - I really don't think I could have kept up with the protocol without this board! :)
 
When you feed there is very often a food spike by about 2 hours later. That is why a drop by +2 suggests an "exciting" cycle. It is also a reason for spreading out the food into mini-meals - it keeps the food spikes from being too high.
 
When you feed there is very often a food spike by about 2 hours later. That is why a drop by +2 suggests an "exciting" cycle. It is also a reason for spreading out the food into mini-meals - it keeps the food spikes from being too high.

I keep the food out all day, she's a grazer, but she just eats through it so fast that I now have to replenish so regularly. She will eat for a few minutes, sleep for a while, eat some more, walk away and head right back. (The life of a cat, eh!?!) :rolleyes: LOL - Eat, sleep, and eat some more, lol. I am giving her just the Purina DM wet and adding some water like @rhiannon and shadow suggested. That seems to be helping it stay nicer longer!
 
She's definitely doing well today - no real lows and nothing too horribly high either. :) With her +2 being higher than her pre-shot number, it will most probably be another fairly quiet night for Chloe though, like yesterday, a before bed test is a good idea just to make sure - kitties do like to keep us on our toes some days with unexpected numbers! :rolleyes:

The Tight Regulation protocol can be tiring at times - I'm not going to lie to you about that. There are days when they look like they might head low when you might have to get a couple of tests in overnight. But it does give you the best possible chance of getting a cat OTJ - and remember, if Chloe doesn't head in the direction of OTJ and you want to switch to the Start Low Go Slow protocol sometime in the future, you can still do that too. :)

Walmart sell syringes with 1/2 unit markings - as far as I know, all their 3/10 cc syringes come with the 1/2 unit markings (though the pharmacy staff don't always know that). ;) And buying Lantus from Marks Marine in Canada is about 1/2 of the price of buying it in the USA - I believe they're somewhere around the $150 mark for a box of 5 pens at the moment, where those same 5 pens here will cost upwards of $400!!

I had Rosa on Tight Regulation (with more testing than is strictly necessary as she did like to dive on occasion, so I could never be sure that she wouldn't pull a sneaky fast drop on me if I wasn't paying attention). She did respond better to the protocol than I could ever have hoped for given her dreadful numbers for the first couple of weeks and, although I did have days where it was tough going and days where I doubted what I was doing, it did definitely work for her in the end. :) I have to say, much of the credit for that goes to the people here who welcomed me when I first joined, answered all my questions no matter how small they were, and were there for me on the days when Rosa was dropping low and I needed support or when I wasn't sure what to do next with her dose - I really don't think I could have kept up with the protocol without this board! :)

Thanks @manxcat419 ! Are you guys able to see the chart ok? (Just wondering if it is populating the updates ok. :) )

I'm about to head to bed now since it's almost 11pm, but feel ok that she's not too low. Thank you for the tips on the syringes at Walmart! And I had NO idea we could buy medicine from Canada?! I'm not familiar with the pens you mentioned, but her Lantus is in a vial. If that is cheaper and if I can order it from there, that would be amazing.

Tomorrow I hope to have time to read through the Tight Regulation after work so I can get her going on that soon. I'll work on getting the new syringes and the Friskies (the Purina DM is going out of style over here, lol!!!) and hopefully she eats it as well (she liked the salmon pate the best before) and I might find some low-carb dry food for when we're out of the house for hours at a time.

Yes, I agree, if it were not for this forum, I do believe that a month ago today, I would've lost my Chloe. Our new vet and the ER vet wanted me to put her down when I took her home on 5/14. It was really awkward, but I told them I needed to try everything. I'm thankful I found this forum and the people here got us through it. Our new vet (we had relocated) is so amazed that she's improved. When I call for the syringes, he will be even more impressed! ;) I can't thank you all enough!
 
If your state does not require an Rx for syringes, you can just get them from a pharmacy, probably less expensively. A box of 100 U-100, 3/10, 30 gauge, short needle syringes was under $14.00 the last time I bought some.
 
Yes, I can see her spreadsheet - it's all working fine. :)

I think Chloe's going to be fine tonight - her numbers have been fairly steady all day which should give you a chance to get a good night's sleep. :) The Lantus pens are a direct alternative to the vial - it just means that, especially with a cat on a fairly low dose like Chloe is at the moment, you should be able to use up all the insulin in the pen before it stops being as effective as the pens contain 300 units each and come in a box of 5 where the vial is 1000 units which is difficult to use before the 6 months is up unless a cat is on a high dose! Your vet will be able to prescribe the pens instead of the vial, but you might have to ask them to do it that way - my vet prescribed the vial and I didn't know any better at the time and paid almost $300 for it at Costco. :rolleyes: Though I was able to pass about 2/3 of it on to someone else whose cat is on a higher dose, so at least I didn't have to throw the rest of it in the trash.

And, as @BJM said, I didn't need a prescription for the syringes - I just went to the pharmacy counter in our local Walmart and asked for them though whether or not you can do that will depend on the laws in your state. My vet had added syringes to the prescription initially, but the ones I was given when I bought the insulin were 1/2 cc with whole unit markings only so I had to replace them almost immediately as I couldn't measure even a half unit with them never mind 1/4 or 3/4.

I'm so very glad you found this board and were able to save Chloe. Hopefully your vet will be more optimistic with any other cat that is taken to them with DKA in future - Chloe has proved to them that it really is something that cats can recover well from. :)
 
I'm worried that you will pick some dry off the shelf thinking it's "good" but there really aren't any. Grain free does not equal carb free or even low carbs.

there really is only one "low carb' dry that seems to do the least damage if one needs a dry food....
it's call Young Again Zero Carb
some here calculate it to actually be 5% carbs....
it seems expensive but because it's higher calorie, kitties only need 2 tablespoons a day so a bag will last quite a while. And warmer climates should
keep it in the freezer... or at least part of it until needed.
this is the one dry that we've actually seen a few kitties achieve remission status.
I think they will send you a sample if you call.... and it's only available online. You can't buy it in stores.

Evo is the next least worst.... BUT .... i haven't heard ( not yet anyway) of any cats every achieving remission eating it.


If you can manage to stay with wet only, that's truly the best option....
I just want you to have the right info..... since it's your decision.


I'm really glad you are sticking around....
this is the best place to be with FD.
It's a lot to learn really fast but it becomes second nature over time....and you gain time with your furbabies.
 
Thanks @BJM , do we need a Rx here?

@manxcat419 - Ok, I will have to look into those more. And 6 months? I thought it was good until it was gone? Our old vet, before we relocated, told me to just hold onto it until it was gone. I'll have to look to see when I last purchased the Lantus, but it was probably late last year sometime. Not until yesterday did I even know that other syringes existed. I do know that one time our pharmacy (where I lived, they required a Rx) gave us ones that were 1/100 I think? They were so large that one unit was impossible to see - let alone ones thatYes, thank you, I'm glad to be here too. I feel like I have a family of supporters, and it's just so nice! I really am excited to get Chloe OTJ and hope that she can be! :D

@rhiannon and shadow Ok, thanks for the info. It would be only for the days that we were out of town for hours on end (not for overnight stays) like we have coming up this weekend. But, I can try a bowl or even two of canned food with water added to help it last longer. It's warm here, but we keep the house very cool, so I will try that. I think she'll eventually slow down on the eating, once we get her stabilized. (Hopefully)

:bighug: Thank you all for your continued support and help! :bighug:
 
As @manxcat419 suggested above "You might want to think about 150 as a no-shot number (or at least the number you ask for help) with Chloe as you've already handled some low numbers so you do have a good idea of what to do with them." , I'm asking since her AMPS was 148, taken just moments ago. She's eating, etc, but wondering if that is too low, or a better number since she's purely on the diabetic foods?
 
There is 1 cat I know who went OTJ on a combo of Evo dry and Fancy Feast Classics - Dusty. He belonged to a woman with diabetic retinopathy and arthritis who had difficulty testing. I went over ther weekly for a few weeks, and would run a curve. He was OTJ in about a month.
When you get a low pre-shot number, stall 30 minutes and re-test, then evaluate what the glucose is doing - dropping, maintaining the level, or rising.
Starting out, you don't want to shoot a dropping number, especially if you won't be able to monitor.
Shooting a stable glucose level may be OK if you have data in your spreadsheet which show it could be safe.
Shooting a rising number is often safe; if you are starting much lower than usual, you may want to monitor the first few times.
 
If you can monitor and test through the day at 2 hour increments, go ahead and shoot. Otherwise, I'd drop to 0.5 units, as we don't have enough data to know what her best dose may be and we want her safe.
It is possible to shoot low to stay low when you have data to show it is safe. It is collecting that data which may turn your hair white! When you get it, though, you can get to the point that the numbers are near normal non-diabetic ones which helps the pancreas recover (if it can).
 
And 6 months? I thought it was good until it was gone?
If you were lucky with it, it might last longer than 6 months but most people here seem to find it stops being as effective around then. Your vet might not have known - it's not always easy to be certain...the manufacturer says 28 days, a lot of vets say 3 months, but people here have found that up to 6 months is possible. If you're still using that original vial and it's clearly still working, then that's fine - you can keep using it. If you can get a prescription for the pens anyway, you can still go ahead and order those (unopened they're good until the expiry date) and that way if you find her numbers start rising, you'd have new insulin to use without having to wait for delivery of it. :)

The 148 this morning is a good number and close enough to the 150 that, as BJM said, if you can monitor it would be fine to shoot the full dose. But if you reduced for safety, that's fine too - the way Chloe's going, you'll have other chances to shoot those lower numbers soon I'm sure. :)
 
Well, busy day today, so I didn't shoot at the 148, and now she's coasting in the 300's. I gave her a shot at 1:15pm (so not the right time, but wanted to wait until #'s were higher) and so her next dose is due at 1:15 am.. zzzzzzz.... I just checked her 30 mins ago and she's at 316. I was almost wondering if I should shoot her now? Honestly, the 1pm/1am thing won't work for long... oy.
 
The thing you need to be careful of is that shooting early acts like a dose increase so, while she might be high now, shooting early might make her drop low later on. You could do an 18-hour shot instead of the 12 hour to get your next shot back to the morning, but with her running fairly high now I don't know if that's something you'd want to do as it would mean delaying her shot until about 7am?
 
If you're tired, I think I'd go with setting an alarm and trying to get at least an hour's sleep before her shot - there's no point in exhausting yourself when she's not going to do anything alarming in the next 2 hours. :) You can always work on adjusting her shot time back starting tomorrow - and you will still have the option of doing an 18 hour cycle at some point or skipping a shot if she's low enough to get back on track.
 
I think it's going to depend very much on whether or not it's a cycle you can monitor. If you can't be home with her, then I don't think I'd shoot below 150 at the moment - she definitely is throwing you plenty of surprises...our cats don't like to let us get too used to them having the same reaction to the same dose in case they finish up getting less attention if they're too predictable! :rolleyes: ;)

On a cycle you can monitor, especially if you've got someone here who can stick around in case she drops low, you could shoot a bit lower than that but that would really depend on how confident you're feeling at the time. :) Of course you can always post asking for advice if you get a low preshot - that way you'll know if there's someone who can be available until after her nadir in case you need some moral support if you decide to shoot a lower number. :)
 
Yes, she's keeping me alert, that's for certain! ;) So, if she's below 150 and I can't be around to watch her, then I should skip, but if I want to get on better hours, and she's in the 200's, going 18hours might be ok? I'm going to go snooze and I'll be back in 2 hours to give her a dose. Thanks again!!! :bighug::cat:
 
Yes, that will definitely work. If she doesn't give you the opportunity to go longer between shots, you can move them back by 30 minutes a day until you get back to your preferred time too. It doesn't sound like much, but it adds up quickly and you get back to your regular shot time before you know it! :)

I'll be here for your shot time in case you have any questions, though I'm sure the 0.75U will be fine this time - I can't imagine her dropping 200 points in the next 2 hours, but then she is a cat! ;) :bighug:
 
3/4 sounds good to me. :) And then try and get a least a couple of hours sleep before you test again - no point killing yourself to stay awake when she's unlikely to drop very low in the next 2 hours.
 
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