162 PMPS, 247 +2, 351 +4 pls advise

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TanyaG

Member Since 2016
Hi all so Tinka has been on insulin (Lantus 2 weeks now), we reduced her to 0.5u twice daily as she came off steroids and her BG was dropping quite low early in the cycle when dosing both am and pm and other days we were struggling to get in 0.75u twice daily without skipping her am shoot as she was quite low. Coming off the steroids I think made it a bit inconsisten but I think that should be out of her system now as we stopped them on 12th Dec? She's been on the 0.5u twice daily for 6 days now and we have only seen a green value once and blue's only 4 times. The rest of her values are mostly yellows and then purples. She has improved a lot in behaviour though, she's eating well, putting on some weight as she lost a lot of weight, still has neuropathy though, not drinking much water, but more social and playing a bit, but still sleeping quite a lot and struggling with atopic dermatitis.

My concern is one we are not seeing much of a pattern or any consistency? Some days she seems to be reaching lower numbers at +6, other days they are high on those days. Can anyone tell me if there is a pattern or what her nadir is? On the 27th Dec and tonight after her PMPS her numbers are just going up since shooting and we even shot a lower number than most days this evening. I wrote fur shot? on the the 27th Dec however my husband believes he did not fur shot then or tonight. Tonight was 9 mmol/L or 162 at PMPS and she's just going up since then and is now 351 at +4 which is really high for her. My husband says he's sure he did not do a fur shot as he knows he got it in and didn't retract when shooting. Could we be doing something wrong with shooting? Isn't it strange to have values increase that much after insulin. We are struggling with air bubbles often and have watched one of the videos and following it but we still get air bubbles in our syringe, our vial doesn't contain any air, its pretty air tight. We always do our very best to remove the air bubbles by extracting more insulin to begin then flicking the syringe and trying to push out the air bubbles with some of the extra liquid. Sometimes I use three syringes though and have to throw out the insulin because I can't remove all the airbubbles without loosing too much of the required insulin so then I to throw it out and start with a new syringe again so I don't contaminate the vial. This is costly and a waste of time but I don't know how to improve this. Im wondering is it normal to see a BG go from 162 before shooting to 351 +4 hours later? Should we increase her dose to 0.75 going forward to get some better values? I am following TR method. I test min 4 times a day, often more if needed and she is fed only LC food and currently just one brand and protein type. Thank you!
 
Hi Tanya, you ask a lot of really good questions here! I have only been at this for three months, so I won't be giving any advice. However, if you get a chance, take look at Uncle's spreadsheet. You will see for the first month especially his numbers were all over the place! People here were able to help me sort out what it all meant (I could start seeing some patterns that they were pointing out) and they help me make informed dosing decisions.
It's pretty late now and from my experience this a kind of a quiet period on the board. I'm not sure how many (if at all) experienced people are on right now. I noticed it will usually start to pick up again at around 5am. Please don't get discouraged if you don't get a lot of response tonight.
I would also put the blue question mark at the beginning of your post to draw more attention. I forget, have you done this before or do you want me to tell you how to do it?
 
Hi Tanya, you ask a lot of really good questions here! I have only been at this for three months, so I won't be giving any advice. However, if you get a chance, take look at Uncle's spreadsheet. You will see for the first month especially his numbers were all over the place! People here were able to help me sort out what it all meant (I could start seeing some patterns that they were pointing out) and they help me make informed dosing decisions.
It's pretty late now and from my experience this a kind of a quiet period on the board. I'm not sure how many (if at all) experienced people are on right now. I noticed it will usually start to pick up again at around 5am. Please don't get discouraged if you don't get a lot of response tonight.
I would also put the blue question mark at the beginning of your post to draw more attention. I forget, have you done this before or do you want me to tell you how to do it?
Thanks so much Barbara really appreciate your encouragement and help:) Thats good to know, I'm going to head to bed myself too as its nearly 2am here. Should I repost my thread in the morning then and maybe put it as Dosing Advise? How do I put the blue question mark at the beginning of the post? Thanks again and I will definitly check out Uncle's SS, great to know you were helped along so well, I love this forum and everyone on here is so great:)
 
Here is the link to your last post: http://www.felinediabetes.com/FDMB/threads/lower-bg.170381/

First, the nadir is the lowest point of a given cycle, not necessarily the same for all cycles. On Lantus, Neko rlieably nadired somewhere between +3 and +13. :p Some cats are more predictable, but when they are bouncing or breaking a bounce, the nadir can be quite different. Tonight looks like the start of a bounce again, probably in reaction to the sting of blues today.

The BDs do take quite a bit of practice to remove the bubbles. I used to take out about .5u more insulin than I needed, remove the syringe from the vial or cartridge, then pull the plunger back a little more to create a bigger bubble on too. Then flick to remove bubbles. Bubbles seem to like to join other big bubbles. Then slowly twist the syringe to remove the air/bubble and extra insulin.

If you are following TR, you wouldn't have reduced from .75 units to .5 units. We reduce when they go below 50, or spend a week all in green.
 
The blues are good numbers! Our newly diagnosed cats don't seem to be used to being in these nice normal numbers in the beginning especially and so their body sort of "overcompensates" and sends them back up thinking it's keeping them safe. There is a REALLY good and clear explanation of this phenomenon. Maybe someone will help me get it to you. It's interesting and helpful to be aware of this because it can keep us from getting discouraged. The longer Uncle has been treated with insulin, the shorter his bounces have become.
 
Here is the link to your last post: http://www.felinediabetes.com/FDMB/threads/lower-bg.170381/

First, the nadir is the lowest point of a given cycle, not necessarily the same for all cycles. On Lantus, Neko rlieably nadired somewhere between +3 and +13. :p Some cats are more predictable, but when they are bouncing or breaking a bounce, the nadir can be quite different. Tonight looks like the start of a bounce again, probably in reaction to the sting of blues today.

The BDs do take quite a bit of practice to remove the bubbles. I used to take out about .5u more insulin than I needed, remove the syringe from the vial or cartridge, then pull the plunger back a little more to create a bigger bubble on too. Then flick to remove bubbles. Bubbles seem to like to join other big bubbles. Then slowly twist the syringe to remove the air/bubble and extra insulin.

If you are following TR, you wouldn't have reduced from .75 units to .5 units. We reduce when they go below 50, or spend a week all in green.
Thanks Wendy, I will try working on the bubbles that way:) Hopefully we can master it soon. I was advised on a previoud thread to lower the dose to 0.5 because of stopping the steroids and was told it could take up to a week to come out of her system. I was told that whilst Tinka didn't earn a reduction based on values that because we removed steroids this can be a factor for reducing the dose on TR. It was also over the Christmas period and I wasn't getting enough sleep with trying to monitor lower numbers. That being said I would think the steroids are hopefully now out of her system and she's been on the 0.5u dose twice daily consistently for 6 days and as we're not seeing much blue and green would it be a good idea to increase the dose to 0.75? I wont rush to do it tmrw morning as hubby is shooting in the AM ad he's already asleep as its really late here, but I'd like to increase the following day if it's advisable to do so? Thanks again!
 
The blues are good numbers! Our newly diagnosed cats don't seem to be used to being in these nice normal numbers in the beginning especially and so their body sort of "overcompensates" and sends them back up thinking it's keeping them safe. There is a REALLY good and clear explanation of this phenomenon. Maybe someone will help me get it to you. It's interesting and helpful to be aware of this because it can keep us from getting discouraged. The longer Uncle has been treated with insulin, the shorter his bounces have become.
Thanks SO much this really helps me to understand why I'm seeing the higher numbers after lower ones:) Encouraging to know it's normal and improves over time:)
 
I know, there is such a learning curve with this stuff AND we have to keep out kitties out of harms way, so sometimes it can be stressful. That's why I love this board. So much info and support.
 
It was OK you reduced. You were new, it was the holidays. Safety first. You did see green yesterday so maybe she will see more again soon. Her greens are still high enough that I think you have room for an increase when you get to it. More juice will help lower the higher end as well.
 
It was OK you reduced. You were new, it was the holidays. Safety first. You did see green yesterday so maybe she will see more again soon. Her greens are still high enough that I think you have room for an increase when you get to it. More juice will help lower the higher end as well.
Thanks Wendy, I will look to possibly increase to 0.75u twice daily soon then if we don't see much more greens. Would be great to see the increase lower the higher end of her values. Will keep you all posted when I do. Thank you for the info :)
 
Our newly diagnosed cats don't seem to be used to being in these nice normal numbers in the beginning especially and so their body sort of "overcompensates" and sends them back up thinking it's keeping them safe. There is a REALLY good and clear explanation of this phenomenon.
Found IT! Written by non-other than @Gussie's mom.
Click on this link http://www.felinediabetes.com/FDMB/threads/doing-a-little-better.170413/ and look at the #17 post. The posts are numbered in the order they were sent. The first one of the day being #1.
You will be able to find the post number just to the left of the "Like" and "Reply" near the bottom of the right hand side of the page. Hope this will be helpful to you.
 
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