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Sheila and Minky

Sheila and Minky

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On Friday we gave three units of the Lantus len as opposed to two units in the morning because Minky was just constanly high. When she didn't come down, we thought the pen was bad so 5 hours later we gave another 3 units (we are new to this and know better now). She went low over Saturday night, and we kept checking and gave corn syrup when she was low (the lowest was in the 70s). By Saturday night she was up over 400 and has not come down below 400 since then despite giving 2 units twice a day. We are doing the Lantus pen. What can we do to break this cycle? Keep giving the 2 units every twelve hours, forget the insulin for a few days, do something else? She just came out of DKA so it is my understanding we should still keep giving insulin but we are at a loss and I feel so bad she is constantly over 400. Please help!!
 
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Do not give insulin every two hours!! How often are you checking BG? (I just saw you asked if you should give insulin every two hours and I wanted to respond to that right away!)
 
JulieL said:
Do not give insulin every two hours!! How often are you checking BG? (I just saw you asked if you should give insulin every two hours and I wanted to respond to that right away!)
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Ok, I see you edited your post! Originally you said “every two hours” and I panicked! Whew.

I’m not experienced with Lantus, so I’ll let more experienced members respond, but I just jumped in when I saw your question about shooting every two hours!
 
Sheila305 said:
On Friday we gave three units of the Lantus len as opposed to two units in the morning because Minky was just constanly high. When she didn't come down, we thought the pen was bad so 5 hours later we gave another 3 units (we are new to this and know better now). She went low over Saturday night, and we kept checking and gave corn syrup when she was low (the lowest was in the 70s). By Saturday night she was up over 400 and has not come down below 400 since then despite giving 2 units twice a day. We are doing the Lantus pen. What can we do to break this cycle? Keep giving the 2 units every twelve hours, forget the insulin for a few days, do something else? She just came out of DKA so it is my understanding we should still keep giving insulin but we are at a loss and I feel so bad she is constantly over 400. Please help!!
Click to expand...
@Bron and Sheba (GA)
@Wendy&Neko
@Bandit's Mom
@tiffmaxee


Sheila's introduction post
https://felinediabetes.com/FDMB/threads/introduction-minkys-mum-dka.294038/#post-3206710
 
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JulieL said:
Ok, I see you edited your post! Originally you said “every two hours” and I panicked! Whew.

I’m not experienced with Lantus, so I’ll let more experienced members respond, but I just jumped in when I saw your question about shooting every two hours!
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Thank you so much. My husband told me I made an error so I fixed it.
 
I don't know if you saw this ,I replied to your introduction post about the syringes
Diane Tyler's Mom GA
If you don't have the syringes with the half unit markings,you can order the half unit markings without a vets script
https://www.amazon.com/UltiCare-31-Gauge-Veterinary-Insulin-Syringes/dp/B009LTE0DO

The spreadsheet you have is not ours
Here is the link and it will also explain how to use it, it's very easy
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

Take a look at this members spreadsheet to get an idea what it looks like
https://felinediabetes.com/FDMB/threads/9-14-tansi-amps104-4-81-7-77-pmps92.294029/

Tap on Tansi's spreadsheet it's at the end of Cindy's signature

Please read all the yellow stickys above Lantus
https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/

If you need help with our spreadsheet just ask we have a member who will do it for you

Can't really make head or tails out of your spreadsheet


@Sheila305
 
Diane Tyler's Mom GA said:
I don't know if you saw this ,I replied to your introduction post about the syringes
Diane Tyler's Mom GA
If you don't have the syringes with the half unit markings,you can order the half unit markings without a vets script
https://www.amazon.com/UltiCare-31-Gauge-Veterinary-Insulin-Syringes/dp/B009LTE0DO

The spreadsheet you have is not ours
Here is the link and it will also explain how to use it, it's very easy
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

Take a look at this members spreadsheet to get an idea what it looks like
https://felinediabetes.com/FDMB/threads/9-14-tansi-amps104-4-81-7-77-pmps92.294029/

Tap on Tansi's spreadsheet it's at the end of Cindy's signature

Please read all the yellow stickys above Lantus
https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/

If you need help with our spreadsheet just ask we have a member who will do it for you


@Sheila305
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Thank you for the information as it is helpful. I did see it but it was late last night. I am feeling very overwhelmed with information overload and haven't been able to study how to do the spreadsheet yet with multiple readings. I just have the one we have done for now. I am working two jobs today so will look later tonight when I am on my laptop.
 
Sheila305 said:
Thank you for the information as it is helpful. I did see it but it was late last night. I am feeling very overwhelmed with information overload and haven't been able to study how to do the spreadsheet yet with multiple readings. I just have the one we have done for now. I am working two jobs today so will look later tonight when I am on my laptop.
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No problem at all, it is overwhelming at first but you will catch on quick. If it wasn't for me taking the advice from the experienced members here Tyler never would have gone into remission for over 3 years. Unfortunately I had to let him go on 8-26 due to cancer :(.
Remember if you need help with the spreadsheet just ask and I will contact Bhooma , one of our members to help set it up . Hang in there ok :bighug::bighug:
@Sheila305
 
Diane Tyler's Mom GA said:
No problem at all, it is overwhelming at first but you will catch on quick. If it wasn't for me taking the advice from the experienced members here Tyler never would have gone into remission for over 3 years. Unfortunately I had to let him go on 8-26 due to cancer :(.
Remember if you need help with the spreadsheet just ask and I will contact Bhooma , one of our members to help set it up . Hang in there ok :bighug::bighug:
@Sheila305
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Thank you so much. I am so sorry about your baby :(
 
Sheila305 said:
Thank you so much. I am so sorry about your baby
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Thank you Sheila , I miss him like crazy and his brother who passed away 4 years ago from kidney disease. Tyler was 16 years old and 4 months ,I was lucky to have him that long , his brother was 12 years old when he passed. There are a lot of members here to help you , I'll keep an eye out for you and if I can't help I'll tag some experienced members for you. :bighug::bighug:
@Sheila305
 
Diane Tyler's Mom GA said:
Thank you Sheila , I miss him like crazy and his brother who passed away 4 years ago from kidney disease. Tyler was 16 years old and 4 months ,I was lucky to have him that long , his brother was 12 years old when he passed. There are a lot of members here to help you , I'll keep an eye out for you and if I can't help I'll tag some experienced members for you. :bighug::bighug:
@Sheila305
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It is so hard to lose our babies. We lost two within 3 months of each other during Covid in 2020. One had diabetes and a spleen issue along with other things. I was thankful I could be home with him then, but it was so hard.

Thank you for all your help! :bighug:
 
Any chance you could use our spreadsheet format instead? I've been reading our format for a dozen years now and it's hard for me to work with your format. Details on how to do the spreadsheet are here:
78 is not a dangerously low number but you don't want him much lower on the Alphatrak. What do you mean by "combo food"? Is that both wet and dry? If so, say that in the signature.

I suspect what you are seeing after those numbers are what we call a bounce, or his body reacting to lower numbers than he's used to. Here's a description of a bounce - which is perfectly normal for a recently diagnosed cat.
Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
 
Wendy&Neko said:
Any chance you could use our spreadsheet format instead? I've been reading our format for a dozen years now and it's hard for me to work with your format. Details on how to do the spreadsheet are here:
78 is not a dangerously low number but you don't want him much lower on the Alphatrak. What do you mean by "combo food"? Is that both wet and dry? If so, say that in the signature.

I suspect what you are seeing after those numbers are what we call a bounce, or his body reacting to lower numbers than he's used to. Here's a description of a bounce - which is perfectly normal for a recently diagnosed cat.
Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
Click to expand...
Thank you for this information as it is very helpful. I will try. I just found your board yesterday and was sent a post with link late last night. It just has been a lot of information all at once and am working two jobs today; I will try to do it tonight when I am on a laptop.
 
Wendy&Neko said:
Any chance you could use our spreadsheet format instead? I've been reading our format for a dozen years now and it's hard for me to work with your format. Details on how to do the spreadsheet are here:
78 is not a dangerously low number but you don't want him much lower on the Alphatrak. What do you mean by "combo food"? Is that both wet and dry? If so, say that in the signature.

I suspect what you are seeing after those numbers are what we call a bounce, or his body reacting to lower numbers than he's used to. Here's a description of a bounce - which is perfectly normal for a recently diagnosed cat.
Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
Click to expand...
So if this is the case do we just stay the course and keep giving 2 units every 12 hours?
 
No worries, lots of stuff to learn at the beginning. We all remember what it was like.

If he is bouncing, yes, stay the course on the 2 units at the moment. He's been seeing some numbers in the low 100's on 2 units (I think?), then bouncing high,. Once you have the spreadsheet rearranged, we can review again.
 
Wendy&Neko said:
No worries, lots of stuff to learn at the beginning. We all remember what it was like.

If he is bouncing, yes, stay the course on the 2 units at the moment. He's been seeing some numbers in the low 100's on 2 units (I think?), then bouncing high,. Once you have the spreadsheet rearranged, we can review again.
Click to expand...
Thank you so much!
 
Sheila305 said:
It is so hard to lose our babies. We lost two within 3 months of each other during Covid in 2020. One had diabetes and a spleen issue along with other things. I was thankful I could be home with him then, but it was so hard.

Thank you for all your help! :bighug:
Click to expand...
I'm sorry about your kitties :bighug::bighug::bighug:
 
@Bron and Sheba (GA)
@Wendy&Neko
@Bandit's Mom
@tiffmaxee
@Diane Tyler's Mom GA

Sheila's introduction post
https://felinediabetes.com/FDMB/threads/introduction-minkys-mum-dka.294038/#post-3206710

I have updated the spreadsheet with all the information to the best of my ability. We cannot get her numbers out of the 400s. Yesterday at 3:32 PM it went down to 357 and then to 377 at 7:51 PM. Today it has been almost all 400s with a 395 thrown in. We have continued to do just the two units. My husband wants to stop the insulin; I don't know what to do. I know these numbers are from our terrible mistake on Friday of giving two doses of 3 units within 4.5 hours, but we thought the pen was bad because the numbers were not coming down. My husband is diabetic and says when the pen goes bad he has had that issue of his numbers not budging. Any help is very appreciated.
 
@Sheila305
Hi Sheila we can't see your spreadsheet

To set spreadsheet sharing permission:
* At the top right of the spreadsheet screen click on Share.

* In the pop-up dialog box click on the Get Link section.

* Change link access from 'Restricted' to 'Anyone with the link' and make sure that the permission on the right hand side is set to 'Viewer'.

* Click Done to save the changes.
 
Diane Tyler's Mom GA said:
@Sheila305
Hi Sheila we can't see your spreadsheet

To set spreadsheet sharing permission:
* At the top right of the spreadsheet screen click on Share.

* In the pop-up dialog box click on the Get Link section.

* Change link access from 'Restricted' to 'Anyone with the link' and make sure that the permission on the right hand side is set to 'Viewer'.

* Click Done to save the changes.
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I'm sorry, I just fixed it.
 
@Sheila305 nothing to be sorry about, I'm sure one of the other members you tagged will respond, I'm not experienced enough to give dosing advice.
One more thing if Minky is eating any dry food at all you have to follow the SLGS method, so can you please add that to your signature and on your spreadsheet where you have SLGS method get rid of I think
 
Diane Tyler's Mom GA said:
@Sheila305 nothing to be sorry about, I'm sure one of the other members you tagged will respond, I'm not experienced enough to give dosing advice.
One more thing if Minky is eating any dry food at all you have to follow the SLGS method, so can you please add that to your signature and on your spreadsheet where you have SLGS method get rid of I think
Click to expand...
Okay doing that right now
 
Diane Tyler's Mom GA said:
Ok Good, you said you thought the pen was bad
I don't think you pen was bad
We've had people use the Lantus vials for 6 months. Unopened pens last until expiration date, opened ones typically to the last drop.
Are you keeping the pens in the fridge
@Sheila305
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We don't think it was the pen now either, but at the time it made sense as to why the numbers wouldn't budge. We keep the pens in the fridge until we open them and then keep it out. My husband has done that for years and generally they are fine. We thought maybe it had gotten unusually warm sitting out, but reflecting I don't think that is it either.
 
Sheila305 said:
We don't think it was the pen now either, but at the time it made sense as to why the numbers wouldn't budge. We keep the pens in the fridge until we open them and then keep it out. My husband has done that for years and generally they are fine. We thought maybe it had gotten unusually warm sitting out, but reflecting I don't think that is it either.
Click to expand...
Please don't keep the pen out after you open it.
How many days has the pen been left out for
 
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Sheila305 said:
We cannot get her numbers out of the 400s. Yesterday at 3:32 PM it went down to 357 and then to 377 at 7:51 PM.
Click to expand...
The thing with insulin and cats, is that many cats go lower at night. It's entirely possible for them to drop low at night, then bounce during the day. We strongly recommend getting a test just before you go to bed at night. If that's at least 2 hours after the PM shot, it'll give us a clue if Minky is going lower at night. We change doses based on how the insulin is taking the cat.

With a recent history of DKA, you shouldn't skip shots and you shouldn't lower the dose unless you can show she's not going lower at night.

As Diane said, keep the pen in the fridge at all times. Humans go through pens in less than a month, so it's OK for them to keep them out, but our kitties can go much longer on a pen and it could go bad if left out too long. How long ago did you start your current pen in use?
 
Wendy&Neko said:
The thing with insulin and cats, is that many cats go lower at night. It's entirely possible for them to drop low at night, then bounce during the day. We strongly recommend getting a test just before you go to bed at night. If that's at least 2 hours after the PM shot, it'll give us a clue if Minky is going lower at night. We change doses based on how the insulin is taking the cat.

With a recent history of DKA, you shouldn't skip shots and you shouldn't lower the dose unless you can show she's not going lower at night.

As Diane said, keep the pen in the fridge at all times. Humans go through pens in less than a month, so it's OK for them to keep them out, but our kitties can go much longer on a pen and it could go bad if left out too long. How long ago did you start your current pen in use?
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The pen we thought was bad was out 22 days. This current pen has been out 4.5 days.
 
Bron and Sheba (GA) said:
Please don’t stop the insulin. With a recent history of DKA you would run the risk of it happening again.
Are you testing for ketones?
Is Minky eating lots of food?
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She is eating lots of the food she likes but it is higher in carbs (Fancy Feast Grilled Seafood in Gravy which shows on the list in the forum as 13% carbs). It is the only food she is eating consistently really well. I hesitate to take it away and try to get her to eat something else because I know she needs to eat. I don't have a ketones meter yet.
 
Lantus manufacturers says it is good for 28 days out of the fridge, so you should still be fine with those pens as long as they weren't shaken, dropped, etc.

You can also test urine for ketones, something like Ketostix can be obtained at any pharmacy.
Tips to catch and test a urine sample
 
Wendy&Neko said:
Lantus manufacturers says it is good for 28 days out of the fridge, so you should still be fine with those pens as long as they weren't shaken, dropped, etc.

You can also test urine for ketones, something like Ketostix can be obtained at any pharmacy.
Tips to catch and test a urine sample
Click to expand...
I was going to order a blood ketone test meter. Can I do that as it would be hard to do the urine. We have two other cats and I work (although I truly wish I could be home with her).
 
Diane Tyler's Mom GA said:
I see @JL and Chip suggested this one
You asked about Amazon — here are links for the Nova Max Plus supplies on Amazon.

Nova Max Plus (meter)
https://www.amazon.com/Nova-Max-Glucose-Monitoring-System/dp/B01G5OE0QY

Nova Max Plus (ketone test strips)
https://www.amazon.com/Nova-Ketone-Strips-Count-Total/dp/B008P0WMI0

Nova Max Plus (blood glucose test strips)
https://www.amazon.com/Nova-Max-Glucose-Test-Strips/dp/B00F4C1XU0
Click to expand...
I had seen these from a previous post someone made, but I also saw the Precision Xtra Blood Glucose & Ketone Monitoring System. That one seemed to get better reviews so I was going to order that. I just wanted to make sure that the blood ketone tests will work just as well as the urine ones.
 
Sheila305 said:
I had seen these from a previous post someone made, but I also saw the Precision Xtra Blood Glucose & Ketone Monitoring System. That one seemed to get better reviews so I was going to order that. I just wanted to make sure that the blood ketone tests will work just as well as the urine ones.
Click to expand...
Definitely will work just as well
, I just found this posted by one of our members


From one of our members
I prefer the blood ketone meter because he's a shy litterbox user, and I don't have time/ability to stalk him. Plus, when they're feeling ill, much more convenient to just get blood vs wait for urine . The blood test also serves as a pretty good warning system in my opinion. Anecdotally, numbers 0.4 and under seem to be pretty normal. When they start creeping up on 0.6 or 0.8 and higher, it's a pretty good sign something is coming - infection, etc. Urine strips at this point would still probably be negative.
 
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Diane Tyler's Mom GA said:
From what I have read they are better than the urine ones, I just found this posted by one of our members
You can still buy the Precision One I just wanted to show you what she said

From one of our members
I prefer the blood ketone meter (I have NovaMax Plus) because he's a shy litterbox user, and I don't have time/ability to stalk him. Plus, when they're feeling ill, much more convenient to just get blood vs wait for urine . The blood test also serves as a pretty good warning system in my opinion. Anecdotally, numbers 0.4 and under seem to be pretty normal. When they start creeping up on 0.6 or 0.8 and higher, it's a pretty good sign something is coming - infection, etc. Urine strips at this point would still probably be negative.
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This is very helpful in trusting the ketone meter. With the NovaMax some said the blood sugar testing part was off so I was worried that maybe the ketones would be too.
 
Sheila305 said:
She is eating lots of the food she likes but it is higher in carbs (Fancy Feast Grilled Seafood in Gravy which shows on the list in the forum as 13% carbs). It is the only food she is eating consistently really well. I hesitate to take it away and try to get her to eat something else because I know she needs to eat. I don't have a ketones meter yet.
Click to expand...
The most important thing at the moment is she eats and eats well. Try lower carb foods but at the end of the day, eating trumps what she eats.
 
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