What do do when insulin doesn't work?
- Thread starter Theresa6
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Vicky & Gandalf (GA) & Murrlin
Member Since 2009
Hi Theresa,
First of all, congratulations for learning to home-test! That will help you figure this out.
Yours is a very good question and one we see frequently here. A new diabetic cat caregiver is going to assume the insulin "isn't working." It is working, it's just not working correctly.
Did your vet start out with 1U twice a day for your kitty? If not, that's possibly why you are still seeing higher blood glucose values. I don't have any more time to elaborate this AM, but here's a link to get you started.
http://www.tillydiabetes.net/en_6_protocol2.htm
Please note the dosing advice is for "ideal weight." We just use 1U to start as insulin is a hormone and should not be dosed by weight, ideal or otherwise. Here's another guide done by the American Animal Hospital Assoc.
http://www.aahanet.org/PublicDocuments/AAHADiabetesGuidelines.pdf
Others will be along to give you more details. You're doing great already and home-testing will help you figure this out and it will get easier.
First of all, congratulations for learning to home-test! That will help you figure this out.
Yours is a very good question and one we see frequently here. A new diabetic cat caregiver is going to assume the insulin "isn't working." It is working, it's just not working correctly.
Did your vet start out with 1U twice a day for your kitty? If not, that's possibly why you are still seeing higher blood glucose values. I don't have any more time to elaborate this AM, but here's a link to get you started.
http://www.tillydiabetes.net/en_6_protocol2.htm
Please note the dosing advice is for "ideal weight." We just use 1U to start as insulin is a hormone and should not be dosed by weight, ideal or otherwise. Here's another guide done by the American Animal Hospital Assoc.
http://www.aahanet.org/PublicDocuments/AAHADiabetesGuidelines.pdf
Others will be along to give you more details. You're doing great already and home-testing will help you figure this out and it will get easier.
Teresa and Poopy
Member Since 2011
Hi Theresa! I don't think Poopy and I have met you yet. :smile:
I use ProZinc so I am not much help....Setting up a spreadsheet to record the BGs and insulin dosages, and attaching it to your signature, will not only help you but help others helping you. :smile: Holler if you need help with this.
Also, you might want to post in the Lantus forum for other Lantus users to see your post and assist.
Furry paw hugs coming at you! cat_pet_icon
I use ProZinc so I am not much help....Setting up a spreadsheet to record the BGs and insulin dosages, and attaching it to your signature, will not only help you but help others helping you. :smile: Holler if you need help with this.
Also, you might want to post in the Lantus forum for other Lantus users to see your post and assist.
Furry paw hugs coming at you! cat_pet_icon
MommaOfMuse
Member Since 2010
When I first adopted Musette her numbers were pretty crazy as well and her previous owner had kept raising her dose until she was on 2u twice daily. When I got her, I dropped her dose way back and basically started over right now she is very well regulated at a mere .8u b.i.d. although she is an atypical diabetic and I had to learn a different way to dose her. But the only way I was able to get her to where she is today is by what you are already doing home testing (something Musette's previous owners weren't doing).
Now that you are testing at home, if you either get a spreadsheet set up or until you can get that up give us the numbers you have been seeing in relationship to her shots we should be able to help you figure out if she is getting too much or not enough insulin. The biggest problem we see with newly diagnoised cats is that too much insulin and too little can look alot a like until we see the patterns.
An easy way until you get a spreadsheet up to give us numbers is:
AMPS (morning preshot)
+1
+2
+3
+4
+5
+6
+7
+8
+9
+10
+11
PMPS (evening preshot)
The plus numbers are how many hours since the insulin was given. Also at this stage of the sugardance the more random tests you can get in the better, as they will give us and you a better picture of what is going on in your cat's body.
Mel, Maxwell, Musette & The Fur Gang
Now that you are testing at home, if you either get a spreadsheet set up or until you can get that up give us the numbers you have been seeing in relationship to her shots we should be able to help you figure out if she is getting too much or not enough insulin. The biggest problem we see with newly diagnoised cats is that too much insulin and too little can look alot a like until we see the patterns.
An easy way until you get a spreadsheet up to give us numbers is:
AMPS (morning preshot)
+1
+2
+3
+4
+5
+6
+7
+8
+9
+10
+11
PMPS (evening preshot)
The plus numbers are how many hours since the insulin was given. Also at this stage of the sugardance the more random tests you can get in the better, as they will give us and you a better picture of what is going on in your cat's body.
Mel, Maxwell, Musette & The Fur Gang
Hi Theresa and welcome to FDMB. This is a great place to get help and support for you and your kitty.
I know I could offer you better suggestions if I was able to see the results of your home testing. It can take several weeks for your cat to begin to have a response to Lantus. One of the important lessons all Lantus users learn is patience!
I actually disagree with Vicky on this point. The dosing protocol that she linked is based on clinical research and the weight-based starting dose is actually very safe and we use it routinely on the Lantus board here. That said, it frequently works out that when you use the weight-based formula (starting dose = ideal weight in kilograms x 0.25) that your starting dose is often in the neighborhood of 1.0u. Was Stella started on 2.0u or did your vet start your cat at a lower dose and gradually increase the dose over the last 2 weeks? (It looked like you were starting insulin in mid-Dec.)Vicky & Gandolf (GA) said:
I know I could offer you better suggestions if I was able to see the results of your home testing. It can take several weeks for your cat to begin to have a response to Lantus. One of the important lessons all Lantus users learn is patience!
squeem3
Member Since 2009
Theresa6 said:
A few numbers isn't enough to tell if the insulin and dose is working or not. Keep testing the blood glucose levels and keep track of them, such as the way Mel posted above or use the popular spreadsheet on Google (instructions on the Tech board).
Can you post the numbers you have so far? 300s and 400s are pretty common for new diabetics. Remember, insulin is not a miracle hormone that works to regulate blood glucose levels after one or two shots. You need to have patience with your cat's diabetes :smile: How long has your cat been on 2 units twice a day?
BJM
Member Since 2010
Theresa6 said:
If you have been using insulin 3 - 5 days, then what you need to do now is run a curve - pick a day when you'll have 12 hours straight to do testing.
Begin with the AM pre-shot test which lets you know if it is safe to give insulin (since you are new, never give it under 200; later, you may lower the pre-shot number when your data indicates it should be safe)
Now, every 2 hours from when you give the insulin, test and record the levels
Finally, using the guidelines for tight regulation (posted in the Lantus forum - good to print out for reference), compare your lowest test value on the curve with the criteria for dose adjustment. And after reading the Lantus stickies, consider posting in the Lantus forum, as they have a great deal of experience in using and adjusting doses of Lantus.
Note that if you are feeding dry food, or high carb wet food, it will not be surprising if the numbers are all somewhat high. At that point, you'll have a decision to make about what you want to do - reduce carbs in food OR increase insulin dose. We encourage the former, as it may assist with becoming diet-controlled.
On the other hand, if the dose is actually too high, you might see a very unexpected low at some point (on the curve, or at a pre-test), followed by high test values which occur due to the liver compensating for the low through a number of biochemical processes. This requires a dose reduction.
If you have already lowered the carb levels, you could be looking at a dose increase. At the current dose of 2 units every 12 hours, an increase should be small - 0.25 units - which you will have to estimate on your syringes. Using syringes with half unit marks will make this less difficult, and using a magnifier of some sort definitely helps those of us who are visually challenged (like me!)
Dose changes should be held stable for 3-5 days (6 - 10 cycles) unless there is an immediate need to change (ex. very low pre-shot, too low nadir/low point, or very high urine ketones/ketoacidosis), before running another curve to see how the new dose is working.
This process of dose adjustment is careful and keeps your cat safe.
Thank you everyone. I have been keeping track of her numbers using the little booklet that came with the testing unit 
She was started on 2 units twice a day and her first day of insulin was December 14th. I only started home testing this week because I noticed that she was still drinking excessively and flooding the box.
In terms of food, she has some digestive issues (vommits a ton) and she is on a dry prescription diet which makes it not really possible to diet control. She cannot tolerate any canned food and royal canin hydrolized (soy) protein food is the only one we have found to keep the vomitting at bay.
Here are her testing results (so far).. her shots are given around 7 am/pm each day:
12/29 2:30pm 380
12/30 8:20pm 400
1/1 4:30pm 355
1/3 7:10am 429
She was started on 2 units twice a day and her first day of insulin was December 14th. I only started home testing this week because I noticed that she was still drinking excessively and flooding the box.
In terms of food, she has some digestive issues (vommits a ton) and she is on a dry prescription diet which makes it not really possible to diet control. She cannot tolerate any canned food and royal canin hydrolized (soy) protein food is the only one we have found to keep the vomitting at bay.
Here are her testing results (so far).. her shots are given around 7 am/pm each day:
12/29 2:30pm 380
12/30 8:20pm 400
1/1 4:30pm 355
1/3 7:10am 429
Sue and Oliver (GA)
Member Since 2009
The dry food will make this really difficult, Theresa. On our food charts, they don't have that specific Royal Canin flavor, but the ones listed run from 30-58% carbs. http://binkyspage.tripod.com/dryfood.html We try to stay under 8-10%.
To be honest, I would think to get her regulated, it will require a lot of insulin to counteract the carbs. (Sort of like dealing with human diabetic who takes insulin but lives on McDonalds Big Macs and fries.....) The lowest dry food in carbs is Evo. I don't know if you have tried it yet. The other thing you might consider is to do a consult with the Feline Diabetes specialist vet who posts here often. She does have a lot of knowledge about cats and diet: http://www.catinfo.org There is a charge for the consult but you should gain a lot of information that might help you.
To be honest, I would think to get her regulated, it will require a lot of insulin to counteract the carbs. (Sort of like dealing with human diabetic who takes insulin but lives on McDonalds Big Macs and fries.....) The lowest dry food in carbs is Evo. I don't know if you have tried it yet. The other thing you might consider is to do a consult with the Feline Diabetes specialist vet who posts here often. She does have a lot of knowledge about cats and diet: http://www.catinfo.org There is a charge for the consult but you should gain a lot of information that might help you.
BJM
Member Since 2010
Were you ever able to identify the ingredient(s) that set her off?
You'd need to make a list of the foods you have tried, and the ingredients in them, to see what repeats.
Also, any food changes must always be made very slowly, to avoid that being the cause of the hurling. For example, if you want to test the Wellness Core or Evo Cat and Kitten dry, given her history, I'd add 1 pellet a meal, to see at what point the new food generated a problem (ie will just 1 pellet do it? 2?).
You'd need to make a list of the foods you have tried, and the ingredients in them, to see what repeats.
Also, any food changes must always be made very slowly, to avoid that being the cause of the hurling. For example, if you want to test the Wellness Core or Evo Cat and Kitten dry, given her history, I'd add 1 pellet a meal, to see at what point the new food generated a problem (ie will just 1 pellet do it? 2?).
The whole food thing was exhausting. We struggled for years with constant throwing up. I tried TONS of canned food from friskies and fancy feast to natures balance limited ingredient diets to novel protein sources like rabbit, venison etc. Same with dry food. I always did grain free but tried pretty much everything on the market. We did hundreds of dollars worth of blood and urine tests to see what could be causing it (nothing medical, apparently) and went on famatidine and the hydrolized protein diet. The vomiting stopped and about 8 months later she was diagnosed with diabetes and hyperthyroidism. I do understand what everyone is saying, but if I change her diet I am guaranteed to have more constant vomiting. It was really bad... multiple times a day. So I fix one thing and break another.
BJM
Member Since 2010
You didn't break it, so don't beat yourself up over it.
So, you're looking at needing to do a curve and probably after that, raising the insulin to meet the carb load with a small increase after each curve that has a nadir above 150 (if the lowest point is above 300, it would be OK to go up 0.5 units).
We tell folks whose cats have to be on steroids to do the same thing. Yes, it may be a higher insulin dose than a low carb diet might take - so what? Control is control and it helps prevent secondary complications. Is diet-regulation possible? Eh, probably not. Again, so what? You work with what you've got and dose the insulin around it.
So, you're looking at needing to do a curve and probably after that, raising the insulin to meet the carb load with a small increase after each curve that has a nadir above 150 (if the lowest point is above 300, it would be OK to go up 0.5 units).
We tell folks whose cats have to be on steroids to do the same thing. Yes, it may be a higher insulin dose than a low carb diet might take - so what? Control is control and it helps prevent secondary complications. Is diet-regulation possible? Eh, probably not. Again, so what? You work with what you've got and dose the insulin around it.
Thank you 
I spoke to the vet today and she suggested going up to 3 units twice a day and checking regularly over the next two weeks and seeing if that helps. It sounds like everyone thinks thats too much, right? So should I try going up to 2.5 units twice a day?
I am sorry I didn't quite understand why I would want to go the opposite route and go down to 1 unit.
I spoke to the vet today and she suggested going up to 3 units twice a day and checking regularly over the next two weeks and seeing if that helps. It sounds like everyone thinks thats too much, right? So should I try going up to 2.5 units twice a day?I am sorry I didn't quite understand why I would want to go the opposite route and go down to 1 unit.
Libby and Lucy
Member Since 2009
just a clarification to BJM's posts about doing curves - if the amount of testing you can do is limited, it is FAR more valuable to get a variety of spot checks at different times over several days and nights than it is to do a curve in one 12-hour period. With Lantus, especially at the beginning, it is not uncommon for cats to go lower in one cycle and then bounce up and stay high for the next couple of cycles. If you decide to do a 12-hour curve and the cycle you happen to choose to do the curve in is one of the high ones, then you might mistakenly think that your cat is high all the time.
It looks like you have done random checks each day and that is great. If you can be sure to get the preshot readings too, and continue getting some mid-cycle checks, and do that for a couple more days, then we can get a more clear idea of what the insulin is doing. Of course if you can do curves AND the other spot checks that is ideal (there's no such thing as too much data!), but for most people just doing spot checks here and there is easier and much more informative.
And Sienne is right, we do regularly use 0.25u/kg of ideal weight as a guideline for starting dose for Lantus according to the Tight Regulation with Lantus or Levemir protocol, unless the cat is underweight, in which case we use 0.25u/kg of current weight. Usually it does work out to around 1 unit, though. About how much does your cat weigh, and is she at an ok weight?
It looks like you have done random checks each day and that is great. If you can be sure to get the preshot readings too, and continue getting some mid-cycle checks, and do that for a couple more days, then we can get a more clear idea of what the insulin is doing. Of course if you can do curves AND the other spot checks that is ideal (there's no such thing as too much data!), but for most people just doing spot checks here and there is easier and much more informative.
And Sienne is right, we do regularly use 0.25u/kg of ideal weight as a guideline for starting dose for Lantus according to the Tight Regulation with Lantus or Levemir protocol, unless the cat is underweight, in which case we use 0.25u/kg of current weight. Usually it does work out to around 1 unit, though. About how much does your cat weigh, and is she at an ok weight?
Sue and Oliver (GA)
Member Since 2009
Libby,
Did you see that she is feeding 40% carbs and may not be able to change? I think a reduction to one unit might cause some very high numbers?
Did you see that she is feeding 40% carbs and may not be able to change? I think a reduction to one unit might cause some very high numbers?
Libby and Lucy
Member Since 2009
I wouldn't recommend a reduction OR an increase until seeing some numbers... For the moment the dose seems safe, so IMHO the best option is to spend a couple of days getting some data and see what is going on, then decide about the dose.
Phoebe_TiggyGA_NortonGA
Member Since 2009
You've already got lots of good advice re: diabetes --
I'd like to add my 2cents regarding the vomiting and Hyperthyroidism.
I have a Hyperthyroid cat who vomits nearly every day --- yesterday he puked SIX times.
How are you treating the Hyperthyroid? Tapazole (methimazole) pills?
That is what I'm giving my kitty. It helps most of the symptoms but NOT the vomiting.
The best treatment for Hyperthyroid is the I131 radioactive iodine. That cures the Hyperthyroid in 97% of cats and does not cause vomiting.
I'd like to add my 2cents regarding the vomiting and Hyperthyroidism.
I have a Hyperthyroid cat who vomits nearly every day --- yesterday he puked SIX times.
How are you treating the Hyperthyroid? Tapazole (methimazole) pills?
That is what I'm giving my kitty. It helps most of the symptoms but NOT the vomiting.
The best treatment for Hyperthyroid is the I131 radioactive iodine. That cures the Hyperthyroid in 97% of cats and does not cause vomiting.
Vicky & Gandalf (GA) & Murrlin
Member Since 2009
Sienne and Gabby said:
Sienne, I'm not really sure what you're disagreeing with. Why shouldn't we just tell newbies 1U is the best starting dose? It's safer and with new people coming here recently on doses large enough to cause serious, extended hypos, the idea that an insulin should be dosed even by ideal weight bothers me greatly as that part of the equation can get lost in translation.
Gandalf's starting dose by that formula would have been 1.8U. He regulated as best he did on 1.25U of Levemir. From my experience the formula is misleading and incorrect, no matter how clinical it might be, so I can't in good conscience recommend it. If there is a definitive difference between starting doses for Levemir and Lantus, according to the protocol, then please inform me as to what they are.
What is going on?
I just took her levels and she is higher than ever at 445. I went up by .5 u last night (vet recomended going up to 3 I went up to 2.5) and she seems to be doing worse, not better.
Not to mention she seems to be throwing up a lot again and more lethargic than usual (only slightly). I feel lost, I don't know what is going on or how to fix it.
I just took her levels and she is higher than ever at 445. I went up by .5 u last night (vet recomended going up to 3 I went up to 2.5) and she seems to be doing worse, not better.
Not to mention she seems to be throwing up a lot again and more lethargic than usual (only slightly). I feel lost, I don't know what is going on or how to fix it.
BJM
Member Since 2010
Theresa6 said:
You may be observing "new dose wonkiness', where a dose change may cause some extreme reactions at first, but then settles down.
Have you picked up some ketone testing urine strips? This is important - vomiting can be a sign of impending ketoacidosis. Testing the urine for ketones will identify if any are present. If there are ketones, and they are very high, get to an ER vet NOW. This is not something you'll be able to manage at home.
MommaOfMuse
Member Since 2010
Theresa,
We can help you figure it all out and how to fix it to the best of our ability, but we need more than just a couple of numbers and more than just one number per day.
We need to be able to see how she is doing from one shot to the next.
To give you an example: Here is how my Musette tested for a couple of days. Her shot schedule is much like yours she gets her shots at 7am/7pm
amps = 243
+2 = 188
+4 = 38
+4.5 = 31
+5 = 106
+6 =197
+8 = 293
+10 = 365
pmps = 431
next day
amps = 351,
+2 = 265
+4 = 159
+6 = 105
+10 = 289
pmps = 373
I picked these two days because she nearly went into hypo from a dose that needed to be lowered.
But if I hadn't seen that 31 at 4.5 hours after her shot and only looked at her numbers before each shot I would have assumed that she wasn't getting enough insulin. But because I was able to catch that low, not only was I able to bring her numbers back up safely but I also was able to tell she was getting too much insulin and needed to have her dose reduced not raised. I was also prepared to see higher numbers the next morning because I knew she was rebounding from going so very low the day before.
One or two numbers per day isn't going to tell you a lot, you need to be able to see patterns in those numbers over a 12 hour period. Now with Musette I test alot because she is a difficult case as she wasn't my life long companion when she got diabetes, I adopted her that way. And her previous owners had let her get very ill before they surrendered her to be either rehomed or put to sleep. With fairly newly diagnoised cats even just getting the preshots, the nadir and a few spot checks can help fill in the picture so you and us can figure out what is and isn't working for your little girl.
So the more numbers you can get the easier it is to see how the insulin is or isn't working for her and then we can help you change things so that it does work for her, even if that means giving more insulin to offset the carbs in the dry food.
Mel, Maxwell, Musette & The Fur Gang
We can help you figure it all out and how to fix it to the best of our ability, but we need more than just a couple of numbers and more than just one number per day.
We need to be able to see how she is doing from one shot to the next.
To give you an example: Here is how my Musette tested for a couple of days. Her shot schedule is much like yours she gets her shots at 7am/7pm
amps = 243
+2 = 188
+4 = 38
+4.5 = 31
+5 = 106
+6 =197
+8 = 293
+10 = 365
pmps = 431
next day
amps = 351,
+2 = 265
+4 = 159
+6 = 105
+10 = 289
pmps = 373
I picked these two days because she nearly went into hypo from a dose that needed to be lowered.
But if I hadn't seen that 31 at 4.5 hours after her shot and only looked at her numbers before each shot I would have assumed that she wasn't getting enough insulin. But because I was able to catch that low, not only was I able to bring her numbers back up safely but I also was able to tell she was getting too much insulin and needed to have her dose reduced not raised. I was also prepared to see higher numbers the next morning because I knew she was rebounding from going so very low the day before.
One or two numbers per day isn't going to tell you a lot, you need to be able to see patterns in those numbers over a 12 hour period. Now with Musette I test alot because she is a difficult case as she wasn't my life long companion when she got diabetes, I adopted her that way. And her previous owners had let her get very ill before they surrendered her to be either rehomed or put to sleep. With fairly newly diagnoised cats even just getting the preshots, the nadir and a few spot checks can help fill in the picture so you and us can figure out what is and isn't working for your little girl.
So the more numbers you can get the easier it is to see how the insulin is or isn't working for her and then we can help you change things so that it does work for her, even if that means giving more insulin to offset the carbs in the dry food.
Mel, Maxwell, Musette & The Fur Gang
Thank you everyone. I think part of my problem is with the home testing itself. I am not very good at it! I have read the links, watched the youtube videos, and still I don't quite have the hang of it. Poor Stella's ears look bruised along the sides, and I often have to poke her 3 or 4 times every time i try to test. I also end up throwing away one test stick for every three or so tries, so its getting wasteful. I am not sure what I am doing wrong, I am just not getting the right spots.
Sue and Oliver (GA)
Member Since 2009
Theresa,
Have you posted your city and state? Maybe we have someone who lives nearby and could come look at your technique and offer some pointers. Wasting those precious (expensive) strips isn't fun.
Have you posted your city and state? Maybe we have someone who lives nearby and could come look at your technique and offer some pointers. Wasting those precious (expensive) strips isn't fun.
MommaOfMuse
Member Since 2010
Lets see if I can give you several tricks to see what you have tried and what might help.
Have you tried warming her ears? You can either make a rice sock that you can warm for a few seconds in the microwave or fill a pill bottle with warm water and hold that on her ear. Warm ears are giving ears.
Are you backing her ear with something firm? Some folks use a folded paper towel or a cosmetic sponge, or even the rice sock, having something firm to back the ear will keep the lancet from deflecting off the ear.
What gauge lancet are you using? The smaller the number the bigger the hole that they makes, so if you are using 29 or 30 gauge you might want to try a 25-26 gauge, these are usually marked as for alternative site testing on the box.
Sometimes putting a flashlight behind the ear will help you see where you are aiming for. One of the things that helped me the most in the beginning was to use the lancet pen without the cap, that way I could see where I was aiming but still had the spring action to do the poking. Once I got the hang of it I was able to put the cap back on.
If you aren't using a lancing device and are free handing it, try poking at a 45 degree upward angle.
Quickly double poking in the same spot sometimes works as well. I hae learned that I have better luck with one of my cats if I poke low on his ear, just right abov that little double flap of skin
Things that will help with the bruising, make sure you apply slight pressure after poking to stanch the blood. Also you can use a little neosporin with pain relief in it. I do this for Musette and her ears heal almost over night. She gets poked a lot and her ears are still just as pretty as they ever were.
Mel, Maxwell, Musette & The Fur Gang
Have you tried warming her ears? You can either make a rice sock that you can warm for a few seconds in the microwave or fill a pill bottle with warm water and hold that on her ear. Warm ears are giving ears.
Are you backing her ear with something firm? Some folks use a folded paper towel or a cosmetic sponge, or even the rice sock, having something firm to back the ear will keep the lancet from deflecting off the ear.
What gauge lancet are you using? The smaller the number the bigger the hole that they makes, so if you are using 29 or 30 gauge you might want to try a 25-26 gauge, these are usually marked as for alternative site testing on the box.
Sometimes putting a flashlight behind the ear will help you see where you are aiming for. One of the things that helped me the most in the beginning was to use the lancet pen without the cap, that way I could see where I was aiming but still had the spring action to do the poking. Once I got the hang of it I was able to put the cap back on.
If you aren't using a lancing device and are free handing it, try poking at a 45 degree upward angle.
Quickly double poking in the same spot sometimes works as well. I hae learned that I have better luck with one of my cats if I poke low on his ear, just right abov that little double flap of skin
Things that will help with the bruising, make sure you apply slight pressure after poking to stanch the blood. Also you can use a little neosporin with pain relief in it. I do this for Musette and her ears heal almost over night. She gets poked a lot and her ears are still just as pretty as they ever were.
Mel, Maxwell, Musette & The Fur Gang
Thank you again everyone. I live in the western suburbs of Chicago, near bolingbrook (the new Ikea) and Naperville. I would love to meet someone in real life who could help me, I have to admit I am feeling a little under water here right now 
I have not tried the rice sock, but it sounds like a good idea. Luckily I have kids so i can just take one of their smaller sized socks for Stella's ear I am using the lancets and that came with my newbie kit, sorry I don't know the size! They came in a bag different than what they were. I had never thought to use the lancet without the cap, but I can see how that will be helpful. It seems that I never know exactly where I am poking with the cap on and sometimes it end up all over the place. I'll pick up some neosporin with pain relief tomorrow. I am sure Stella will thank you for the tip!
One other thing I have been finding is that by the time I do get a drop of blood, she is so wiggly and miserable that it has smooshed into her fur or my finger, and of course then I have to start all over. The whole bottom part of both of her ears have red bruise marks and I feel like I am mauling and torturing my poor kitty!
Also, what should I do in the meantime? Keep her dose at 2.5? Go back to the 2? Go down to 1?
In terms of weight and ideal weight for dosing, our vet told us that her dose based on weight (current I believe not ideal) would be 2.3 units, so we went with the 2 units as starting. but as I mentioned above, that has not been working so the vet said go up to 3u, which I just went up by half instead. but now i don't know what to do from here! I wish sometimes that Stella came with a manual.
I have not tried the rice sock, but it sounds like a good idea. Luckily I have kids so i can just take one of their smaller sized socks for Stella's ear
I am using the lancets and that came with my newbie kit, sorry I don't know the size! They came in a bag different than what they were. I had never thought to use the lancet without the cap, but I can see how that will be helpful. It seems that I never know exactly where I am poking with the cap on and sometimes it end up all over the place. I'll pick up some neosporin with pain relief tomorrow. I am sure Stella will thank you for the tip!One other thing I have been finding is that by the time I do get a drop of blood, she is so wiggly and miserable that it has smooshed into her fur or my finger, and of course then I have to start all over. The whole bottom part of both of her ears have red bruise marks and I feel like I am mauling and torturing my poor kitty!
Also, what should I do in the meantime? Keep her dose at 2.5? Go back to the 2? Go down to 1?
In terms of weight and ideal weight for dosing, our vet told us that her dose based on weight (current I believe not ideal) would be 2.3 units, so we went with the 2 units as starting. but as I mentioned above, that has not been working so the vet said go up to 3u, which I just went up by half instead. but now i don't know what to do from here! I wish sometimes that Stella came with a manual.
MommaOfMuse
Member Since 2010
As soon as you get the drop of blood, scoop it up on the back of your fingernail and test it from there...that also works. 
Also if you put a really thin coating of neosporin on her ear prior to poking it will help the blood bead up and not soak into her fur. Musette is beyond fluffy as she is a himalayan (think Persian with Siamese markings). That is her in as my avatar, so that thin coating of neosporin was a life saver in the beginning.
If you got a newbie kit from Lori there should have been a rice sock in it, or at least a little bean bag looking thing filled with rice to warm her ear with. If not, just grab one of the kids socks fill it about 2/3 full of plain uncooked white rice and toss in the microwave for few seconds until very warm but not hot. You can check the temp the same way you did for baby bottles either against your wrist or neck. Musette no longer needs her ears heated except when it is really chilly out and she has been napping in a window, but she loves her sockie so much sometimes we heat it up and just use it to massage her with it. :lol:
Mel, Maxwell, Musette & The Fur Gang
Also if you put a really thin coating of neosporin on her ear prior to poking it will help the blood bead up and not soak into her fur. Musette is beyond fluffy as she is a himalayan (think Persian with Siamese markings). That is her in as my avatar, so that thin coating of neosporin was a life saver in the beginning.If you got a newbie kit from Lori there should have been a rice sock in it, or at least a little bean bag looking thing filled with rice to warm her ear with. If not, just grab one of the kids socks fill it about 2/3 full of plain uncooked white rice and toss in the microwave for few seconds until very warm but not hot. You can check the temp the same way you did for baby bottles either against your wrist or neck. Musette no longer needs her ears heated except when it is really chilly out and she has been napping in a window, but she loves her sockie so much sometimes we heat it up and just use it to massage her with it. :lol:
Mel, Maxwell, Musette & The Fur Gang
Vicky & Gandalf (GA) & Murrlin
Member Since 2009
Theresa6 said:Thank you again everyone. I live in the western suburbs of Chicago, near bolingbrook (the new Ikea) and Naperville. I would love to meet someone in real life who could help me, I have to admit I am feeling a little under water here right now
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Also, what should I do in the meantime? Keep her dose at 2.5? Go back to the 2? Go down to 1?
In terms of weight and ideal weight for dosing, our vet told us that her dose based on weight (current I believe not ideal) would be 2.3 units, so we went with the 2 units as starting. but as I mentioned above, that has not been working so the vet said go up to 3u, which I just went up by half instead. but now i don't know what to do from here! I wish sometimes that Stella came with a manual.
We have several members in the Chicagoland area. If you think you need help, please let us know and we'll round them up!
As for dose, once you're home testing, you will see what the BG is doing and will find out fairly quickly if the dose is too much. What is her current weight? Is she considered overweight for her body frame? All the literature points to small dose as best to start and even with the formula of ideal weight a 16 pound cat would get less than 2U, so my suggestion is to lower the dose to 1U. I don't know what formula your vet used, but I don't think it was from any current literature on dosing Lantus. That would be the AAHA guidelines I linked in my first reply.
My only caveat about lowering the dose is to make sure she's eating good and is not lethargic or acting ill (meatloafing, etc). Not enough insulin for a sick cat (other than from diabetes) can mean development of ketones which are bad.
WickedSteppMom
Member Since 2011
Theresa,
Aww, shucks! I was just in the Naperville/Aurora area last week visiting my brother...I could have come to help! I grew up in the 'burbs & now live in central KY (Ha, talk about culture shock!) One thing I do want to mention is that we used to call my diabetic, Stinky, "The incredible puking cat" or "Mr. Bulimia" b/c he used to throw up after nearly EVERY meal, for years. Part of the problem was that he gobbled dry food like he was starving. Then, after having a tooth pulled & having to be on an all-wet diet while he recovered, the puking stopped...until I gave him a can of something w/beef in it. The result looked like something out of The Exorcist. I have since learned that he can't have anything w/even *a little* bit of beef. He'd previously had all kinds of testing that showed no allergies, etc, so the vet said that he likely just has an intolerance to beef. I completely understand that, since I have allergy to grapefruit but have a milk protein intolerance, and the reactions are COMPLETELY different...one requires an epi-pen & the other requires, well...you know. Anyway, to sum up my novel here, it's possible your kitty may also have an intolerance of some kind. Stinky was diagnosed w/diabetes at the beginning of Oct & with monitoring, dietary changes & some insulin, he was able to go OTJ by the beginning of Dec.
Aww, shucks! I was just in the Naperville/Aurora area last week visiting my brother...I could have come to help! I grew up in the 'burbs & now live in central KY (Ha, talk about culture shock!) One thing I do want to mention is that we used to call my diabetic, Stinky, "The incredible puking cat" or "Mr. Bulimia" b/c he used to throw up after nearly EVERY meal, for years. Part of the problem was that he gobbled dry food like he was starving. Then, after having a tooth pulled & having to be on an all-wet diet while he recovered, the puking stopped...until I gave him a can of something w/beef in it. The result looked like something out of The Exorcist. I have since learned that he can't have anything w/even *a little* bit of beef. He'd previously had all kinds of testing that showed no allergies, etc, so the vet said that he likely just has an intolerance to beef. I completely understand that, since I have allergy to grapefruit but have a milk protein intolerance, and the reactions are COMPLETELY different...one requires an epi-pen & the other requires, well...you know. Anyway, to sum up my novel here, it's possible your kitty may also have an intolerance of some kind. Stinky was diagnosed w/diabetes at the beginning of Oct & with monitoring, dietary changes & some insulin, he was able to go OTJ by the beginning of Dec.
Eva & Butters
Member Since 2010
Hi, Everyone ~
Good morning, Theresa. My hubby, Ken, and I live in Naperville. We know how overwhelming diabetes can be when our cats are first diagnosed and how alone we can feel, so we'd be glad to come over to help with testing. What's your kitty's name, Theresa? (Oh, I see "Stella"...I'd missed that :smile: ) And what's your schedule like for tomorrow (Friday) afternoon or Saturday morning? Please let me know if you'd like us to visit to show you how we test Butters, Theresa. Sometimes it's good just to have someone to talk to when are cats are diagnosed with diabetes.
Take care,
Eva
Good morning, Theresa. My hubby, Ken, and I live in Naperville. We know how overwhelming diabetes can be when our cats are first diagnosed and how alone we can feel, so we'd be glad to come over to help with testing. What's your kitty's name, Theresa? (Oh, I see "Stella"...I'd missed that :smile: ) And what's your schedule like for tomorrow (Friday) afternoon or Saturday morning? Please let me know if you'd like us to visit to show you how we test Butters, Theresa. Sometimes it's good just to have someone to talk to when are cats are diagnosed with diabetes.
Take care,
Eva
I am officially worried. Stella has been at the 2.5u of lantus for 2 days ( two full shot cycles) and I see some changes in her behavior. Her appetite has gone down and she is throwing up multiple times a day. She always has been a barfer, but we had it under control with diet and famatidine. This worries me. In terms of behavior she is more clingy than normal. Hanging out in 'open' places (usually he hides from the crawling baby ) like the computer desk and the floor on the carpets. She has been headbutting me more for attention and sitting in front of the computer when I sit down. She has always liked attention but this is more than I am used to. I am still doing random testing here at home 1-2 times daily due to my lack of skill Her numbers are still in the 350-450 range. What could be going on with her?
) like the computer desk and the floor on the carpets. She has been headbutting me more for attention and sitting in front of the computer when I sit down. She has always liked attention but this is more than I am used to. I am still doing random testing here at home 1-2 times daily due to my lack of skill Her numbers are still in the 350-450 range. What could be going on with her?
Vicky & Gandalf (GA) & Murrlin
Member Since 2009
Hi Theresa,
I hope you will take someone up on their offer to help you get better at home-test. Stella needs her BG checked at least 3 times per day, once before each shot and at least once somewhere in the middle of the cycle, say 6 or 7 hours after she received the shot. How long had it been since her shot when you got the 240?
I can't advise what might be going with Stella as it could be a number of things, especially at this early stage. If you feel she is really sick, please consider taking her in to the vet. I'm sure someone has explained ketone test strips to you, please get those and test her urine if you have not done so already.
It is very important that she eat. Even dry food if that will tempt her. There are varieties of dry by Wellness and EVO brands which do not have all the grains that cheaper dry foods do so they are lower in carb though still not ideal for a diabetic. Please also make sure she has plenty of water available. Diabetic cats with poorly controlled BGs are constantly thirsty. If you suddenly changed her diet, that may be why she is puking more, although usually cats will get diarrhea from a sudden food change rather than vomit. You may also consider raw food, Dr. Lisa has a good recipe for how to make your own food on her website http://www.catinfo.org so you would know you're getting all the right supplements in it. I mention raw food because I have a puker too, my elderly cat Tigget who just turned 20 always puked her food until I put her on a raw diet. She rarely pukes now. There are also a couple places where you can get ready made raw food, but it is more expensive. Some non-chain pet stores carry Nature's Variety raw medallions and there is an online company http://www.felinespride.com which is what I use for Tigget. She LOVES it!
Hope that helps, sorry I don't have an answer for you as to why she is acting differently. Again, if you think she is sick, please take her to see the vet.
I hope you will take someone up on their offer to help you get better at home-test. Stella needs her BG checked at least 3 times per day, once before each shot and at least once somewhere in the middle of the cycle, say 6 or 7 hours after she received the shot. How long had it been since her shot when you got the 240?
I can't advise what might be going with Stella as it could be a number of things, especially at this early stage. If you feel she is really sick, please consider taking her in to the vet. I'm sure someone has explained ketone test strips to you, please get those and test her urine if you have not done so already.
It is very important that she eat. Even dry food if that will tempt her. There are varieties of dry by Wellness and EVO brands which do not have all the grains that cheaper dry foods do so they are lower in carb though still not ideal for a diabetic. Please also make sure she has plenty of water available. Diabetic cats with poorly controlled BGs are constantly thirsty. If you suddenly changed her diet, that may be why she is puking more, although usually cats will get diarrhea from a sudden food change rather than vomit. You may also consider raw food, Dr. Lisa has a good recipe for how to make your own food on her website http://www.catinfo.org so you would know you're getting all the right supplements in it. I mention raw food because I have a puker too, my elderly cat Tigget who just turned 20 always puked her food until I put her on a raw diet. She rarely pukes now. There are also a couple places where you can get ready made raw food, but it is more expensive. Some non-chain pet stores carry Nature's Variety raw medallions and there is an online company http://www.felinespride.com which is what I use for Tigget. She LOVES it!
Hope that helps, sorry I don't have an answer for you as to why she is acting differently. Again, if you think she is sick, please take her to see the vet.
I got the 240 right before I gave her nightly shot. I have been testing twice a day, usually at night before her shot and somewhere in the middle of the day around 2-4 pm (ish)
I am watching her closely for signs of dehydration and she definitely has (and is drinking) plenty of water. The only change in the last few days has been the insulin, no dietary changes at all. In fact, most of what she is vomitting is just water... she is drinking so much so fast that she ends up throwing it up
I will make sure to keep my eyes out for anything else irregular, and call my vet tomorrow. I wanted to come here first because I suspect the members here know more than my vet does!
I am watching her closely for signs of dehydration and she definitely has (and is drinking) plenty of water. The only change in the last few days has been the insulin, no dietary changes at all. In fact, most of what she is vomitting is just water... she is drinking so much so fast that she ends up throwing it up
I will make sure to keep my eyes out for anything else irregular, and call my vet tomorrow. I wanted to come here first because I suspect the members here know more than my vet does!
BJM
Member Since 2010
She could be vomiting because she is low. The next time it happens, especially if it is roughly 5-7 hours from her last shot, test her glucose.
And also, 240 is not a bad pre-shot number, since a cat may drop as much as 150-200 points from an insulin dose. After a shot, the numbers will gradually go down (there could be a food spike at +1 to +2 hours after the shot)) until about +5 to +7 hours after a shot, then gradually come up. The real number to worry about is the lowest one between shots - too low in the middle of the 12 hours could be fatal quickly.
If she is throwing really high numbers in the middle of the cycle, it could be food, or it could be liver compensation for going low at some point. If the liver has compensated and raised glucose levels (by throwing out all sorts of hormones and chemicals), it may take up to 3 days for that to resolve. You just have to wait it out.
And also, 240 is not a bad pre-shot number, since a cat may drop as much as 150-200 points from an insulin dose. After a shot, the numbers will gradually go down (there could be a food spike at +1 to +2 hours after the shot)) until about +5 to +7 hours after a shot, then gradually come up. The real number to worry about is the lowest one between shots - too low in the middle of the 12 hours could be fatal quickly.
If she is throwing really high numbers in the middle of the cycle, it could be food, or it could be liver compensation for going low at some point. If the liver has compensated and raised glucose levels (by throwing out all sorts of hormones and chemicals), it may take up to 3 days for that to resolve. You just have to wait it out.
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