Update on Felix

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This is Sandy's daughter Brittini again :) We have decided to skip the shot, so should we test him at some point before his morning test? Also, if we needed to give him a morning shot, would it be at 9:30 am or our normal 8:30 since we did not give him the night shot and therefore did not change the shot time?
Thanks!
 
If you didn't shoot, you can pick whatever time you want in the morning to get on a schedule. So you have the latitude to pick 8:30 or 9:30 and then shoot 12 hours from then.

Again...I'd recommend you post a +11 in the morning and ask for help if he is low.
 
We have decided to shoot .25 per Julie and Punkin's recommendations. We will be monitoring him over the next several hours, checking his sugar levels about every 2-3 hours. I will let everyone know what happens with the new dosage and it will also be entered into the spreadsheet.

Thank you very much :-D
 
This is Brittini, Sandy's daughter. I filled the needle to the first line on the syringe, which is above the line for our old .5 dosage. I am hoping this line represents .25, am i correct or is that a different dosage amount?
On our needles to the right is full units starting with 1 unit and the left is half units staring with .5.
We have 3/10 syringes.
Thanks!
 
Not sure which way you are looking at the syringe, but there isn't a line for .25u.

If you are looking at the syringe with the needle pointing up at the ceiling the very first line from the tip of the needle is the zero, then the first small mark down from that is .5u so to get .25 you need to try to hit about halfway between that first and second mark, or between the zero and the .5u mark

Mel, Maxwell, Musette & The Fur Gang
 
brittini and sandy, those are great numbers. you're doing just super with this.

if he's still in numbers like this by the weekend, you could decrease the dose even further and see if he holds these numbers. just fyi, a vet would have you just go off of insulin at this point . . . my point being if you want to do that it's an option. i would keep it up a few more days to give his pancreas support, but there is more than 1 way to do this.

always what you are watching for is to keep him above 50 - and mid-cycle is when he will go the lowest. 40's are that safety zone that means you need to take action and bump him back up into the 50's with high carb food (gravy) or a dime sized bit of karo syrup. if you can't check him during the day from +4-+6, i'd leave him a snack of low carb food just before that so he can eat if he needs it. check when you leave and as soon as you walk back in the door. also, many, many cats have lower numbers at night for some reason, so you could try getting a +5 or so at night.

i'll keep watching for your posts. i'm back at work and gone during the school day, so won't be able to answer about how low is ok to shoot in the mornings. i don't think you should shoot less than 100, maybe even not less than 120, i'm ambiguous about it - i guess it depends on if you're around to monitor. for sure, if you see less than a 100 in your preshot blood test, just skip the shot and let's see how he does. non-diabetic cats run 40-120ish.

at the point you are at, i'd rather see you skip a shot if you have any doubts. always, always, safety comes first. we'd rather see a cat be too high for days than too low for a minute. felix needs to be monitored during that mid-cycle time.

you are so close i can smell it! :lol: :-D pat yourselves on the back - you're so incredibly lucky!

and just fyi - once he goes off of insulin you must consider he is still diabetic, just diet-controlled. for the first 2 weeks off of insulin, check his BG a couple of times a day - it's easy to continue to check about the same times you were giving shots before. after 2 weeks, check him about 1/week for another month, then you can skip to checking about 1/month. most people continue checking once a month.

a diet-controlled diabetic cat can need to resume insulin if they have an infection or illness, or if they need their teeth cleaned. if you start seeing diabetic symptoms again - excessive thirst and urination, etc., then test him to see if he's still ok.

thoughts? questions? how are you doing tonight?
 
This is Sandy's daughter Brittini again :)
I have been testing Felix throughout the day as my mom has been away at work. he just tested at 133. The last time we took him to the vet we were told that he did need to have a tooth pulled, he has really bad plaque build up due to eating wet food. He has yet to have the tooth pulled however, so you are absolutely right about the tooth infection being a contributor to diabetes coming back. His diabetes started back up right around the time the vet informed us of his poor little teeth.

Since he tested at 133, does this mean that i give him .5 or .25 at the PM pre-shot?
Thank you!
 
Bummer on the tooth thing. The vet wants to see a curve first and then they will treat the tooth. Does anyone think that today's testing could be used as a curve and given to the vet?
 
I would think today's testing should give a vet a cear enough picture of Felix's BGs to be considered a curve.

Hopefully they will think so as well and you can get the tooth problem addressed sooner rather than later.

Mel, Maxwell, Musette & The Fur Gang
 
yes - that was definitely a curve.

it's well-established that any infection or pain will raise blood glucose levels. i would think he will do better as soon as his teeth issues are resolved. if he's feeling pain, that alone could cause increased BG levels. cats are notorious for hiding their pain. and with my own cat, being given a painkiller has immediately dropped his numbers. if your vet won't address his teeth, perhaps there is another vet who will.
 
Thank you everyone for helping my daughter today. It's so tough when I work 1-1/2 hours away from home and have to endure commute traffic and also worry about a kitty at home. Thank goodness my daughter is home during college break. I don't know what I will do when she is gone!

I will give the vet the curve tomorrow and also make the appointment for teeth cleaning. I hope his tooth doesn't have to get pulled :cry:.

Thanks again for everyone's concern and wonderful assistance!

Sandy
 
punkin had 3 teeth taken out last march. they cope fine without it.

but if you want advice on things that will help him cope with the anesthesia, especially if he is still on insulin at that point, just post here. people can give you tips that will minimize barfing, get appropriate pain meds and antibiotics, etc.

by the way, good idea to make a note now - metacam is still being used by some vets but it has a black box warning on it from the FDA saying not to use it on cats because it can cause organ failure and death. there are regular posters on FDMB that have had cats die from metacam. it's tough to get a good painkiller for cats that is safe for them, but there are some that are safer.

also, there is a new antibiotic called convenia. it was developed for skin infections and is most effective only on those. it mostly isn't very effective against other infections, but the reason it's become attractive is that it is a one injection, lasts 2 weeks drug. the problem arises if a cat is allergic to it. imagine if you were allergic to penicillin and got an injection of it that would last 2 weeks . . . it's only a problem if you're allergic, but how do you know you are until you get it? combine that factor with the fact that it only works on skin infections. we like to educate people on that so they can make an informed choice.

anyway, that's more than you wanted to know at this point, but i'm on a roll! :lol:

hope you have a great evening!
 
just checking in - felix's ss looks great. i don't think i mentioned that when he's not getting insulin shots, it's really good to give him frequent small meals. if he normally eats 2 cans of cat food a day, for example, feed 1/4 can about 8 times a day. use your amounts, of course, i'm just trying to illustrate the point. it's easier on his healing pancreas that way.
 
hi sandy & brittini - just keeping an eye on felix's spreadsheet. looking great!

the way lantus works it's best if you can give the same dose shot every 12 hours instead of a "larger" dose once a day. not that .25 is large, because it's not. i'm just saying that once a day dosing isn't the best.

can you reduce it to less than .25 so you're shooting the same thing every 12 hours? you're so very close . . .
 
Hello!
Yes we can reduce his shot down more (Yipee less juice!), however the reason he is getting a shot once a day is based purely on what he tests at. We went from 1 unit once a day to .5 morning and night, then lessened to .25 morning and night. Should i shoot for consistency over numbers? What is the lowest number that is high enough to shoot? I'm guessing that if the dose is smaller then his number at shooting time can be slightly smaller as well?
Brittini :D
 
i would simply drop the dose to the .1 and give it twice a day and see what happens. what you want to see is all the numbers under 120. and not to repeat myself endlessly and drive you nuts, but being new and you being here where other lantus users are not also tracking you, and you're not familiar with the lantus dosing, i just have to say it again - safety is our foremost concern. we don't want felix to become hypoglycemic and be alone.

an experienced user would shoot less than 100 . . . but i just am uncertain what to tell you regarding preshot minimum numbers.

i want to get someone else's opinion for you as well and would feel better about more eyes on you. hang on while i seek some help.
 
Normally, I would say at these numbers, IMHO, the kitty should continue to get .25u twice a day because on the days you do have mid-cycle numbers, he hasn't dropped that low. However, because you are not able to do more testing during the day, I think Julie is spot-on in recommending that you drop to .1u (read one-tenth unit) twice a day for safety. Remember,too, that we dose on nadir, not pre-shot numbers, and because we can't see what his nadirs are doing daily, it's best to take him down.

His green day on 1/4 was most likely due to his "shed" from the .25u dose. Lantus builds an insulin depot (often less formally called a storage shed) under the skin. The shed must fill before kitty starts using the daily injections. That's why we suggest holding the starting dose and increases for several cycles so the shed can fill. Because of the shed, a dose can affect up to three cycles after you give it.

ETA: Your question:
What is the lowest number that is high enough to shoot? I'm guessing that if the dose is smaller then his number at shooting time can be slightly smaller as well?
Click to expand...

I don't want to side-step your question but I don't feel I can offer you a number without you testing more. You don't have to be a testaholic but a few more mid-cycle tests every cycle would really help. We really don't have a good idea of what Felix does mid cycle and one or two curves is not enuff to determine that.

My best suggestion is for you to move this discussion to Lantus Insulin Support Group where there is a lot more activity. That way, when you get a preshot number, you can post and there are generally more people around who could walk you through it. So it isn't just a question of what is high enough to shoot but it's also a question of what you are comfortable shooting, is safe, and you can monitor.

I think if you were able to shoot consistently and monitor, you might be surprised at how fast Felix might go off insulin....just speculation but he's looking pretty good.
 
marje is right on - and i'm reminded that dosing on lantus is based off of mid-cycle tests, not the preshot tests. i have been remiss in not reminding you to get mid-cycle tests. we need to know how low felix is getting on insulin. pretty much every cycle, ie, once in the day, once in the evening, we need to know how low he goes.

this is why more brains are better than one. :-D
 
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