From 510 to 185 in one day?

Status
Not open for further replies.
Cherie Hogan

Cherie Hogan

Member Since 2016
Just a little concerned here. Seems like a huge drop in one day. I will test again before I go to bed but will be gone long hours tomorrow and won't be able to test. Should I reduce the dose back down to 2.75 from 3 units tomorrow morning if his numbers are low or continue with the 3unit protocal for four cycles? Also, I saw this advice for shooting to the nadir and I am unsure if I should follow it. 150-250 give .25 u, 251-400 give .5, 400 plus give.75 and don't shoot at all if Riley falls below 150 and it's been 10-12 hours since the last shot. I am happy his numbers are down but don't want to make a mistake and overdose him on Lantus should his numbers be low.

Thanks for any help you can give me!!!
 
Cherie Hogan said:
Also, I saw this advice for shooting to the nadir and I am unsure if I should follow it. 150-250 give .25 u, 251-400 give .5, 400 plus give.75 and don't shoot at all if Riley falls below 150 and it's been 10-12 hours since the last shot.
Click to expand...
Where did you get that advice, Cherie? Surely it wasn't here. That isn't a part of the TR protocol or SLGS program.

I don't think you should be worried about the drop, but I do think you need to get at least one more test in tonight, and if he's still dropping, it may be advisable to set an alarm for another test. Did you just get that 185? Did you give him some food at that time? How much longer will you be up?
 
Yes, wrote the numbers in my book so I wouldn't have to look them up again. I've navigated the message board so much, I started a book specific to Riley and what different methods I would try. So those numbers are wrong then?

I also wrote down the way to reduce method but I am not doing anything before getting advice.

I got the 185 about an hour and a half ago. I have an early meeting in the morning so must go to bed. I free feed him but he really hadn't eaten much and I will feed him now before I go to bed. His appetite and peeing have almost returned to normal.

Thanks for responding.
 
Now dropping to 134 @ +4. Started the day at 510. I am leaving extra wet food down but that's all I can do. Will make sure it is the gravy wet food.
 
Are you following SLGS or TR? I think that might be a condensed version of SLGS guidelines. No, I went back and reviewed SLGS and couldn't find that. Not sure where you got it.

Can you get up in a couple hours to test or does that not work for you? If it doesn't work, gravy is not a bad idea.
 
That is a very safe number but he might continue to drop for a couple more hours. It will be a very good idea to read the sticky on SLGS and TR to learn how we dose in this forum. It sounds to me like SLGS will be the one you want since you can't monitor. With that you would hold the same dose for a week and then do a curve.

Oops I see Tricia is helping.
 
Hey 134 is a great number for his nadir! I know you are worried but the lantus is building up in his system. Tricia and Tiffany are right you might want to follow the SLGS and stick to that protocol. Its easy to get mixed up with all this information at once. Your still doing great and the fact his peeing and appetite are returning to normal and now his blood sugar is coming into normal range is exciting! I know @Marje and Gracie is also following you so don't be afraid to tag someone for a quick response if they can.
 
Cherie Hogan said:
I saw this advice for shooting to the nadir and I am unsure if I should follow it. 150-250 give .25 u, 251-400 give .5, 400 plus give.75 and don't shoot at all if Riley falls below 150 and it's been 10-12 hours since the last shot.
Click to expand...
This looks to me like some advice using R, which you don't use Cherie, and maybe some other advice mixed up with it. If this was advice for someone using R insulin, we always try to tell everyone looking or lurking that R can be very dangerous without someone experienced helping and guiding.
 
Wherever that advice came from, it doesn't apply to you using Lantus. So glad you asked about it - well done!

Cherie, just a comment about last night - those blue numbers last night were new to Riley. He hasn't been in that range for some time. It's going to be very likely that his body will have perceived that as a hypo, and release hormones and stored sugars to bring it back up. These are not related to anything he's eaten, they are from the liver/organs. We call that a bounce. High bounce numbers do not mean that a cat needs more insulin - they pass. At this phase for him, it would be typical for the bounce to last 3 days and then as those hormones and sugars clear out, his blood sugar will drop again.

So don't worry if he is high for a few days - 3 days counting forward from last night would be Wednesday night. It could take him that long to clear out those high numbers. He also could clear it earlier, although I'd suspect it will go close to that long. I would watch for a yellow number and if you see one, test again in a couple of hours to see if his blood sugar is dropping.
 
julie & punkin (ga) said:
Wherever that advice came from, it doesn't apply to you using Lantus. So glad you asked about it - well done!

Cherie, just a comment about last night - those blue numbers last night were new to Riley. He hasn't been in that range for some time. It's going to be very likely that his body will have perceived that as a hypo, and release hormones and stored sugars to bring it back up. These are not related to anything he's eaten, they are from the liver/organs. We call that a bounce. High bounce numbers do not mean that a cat needs more insulin - they pass. At this phase for him, it would be typical for the bounce to last 3 days and then as those hormones and sugars clear out, his blood sugar will drop again.

So don't worry if he is high for a few days - 3 days counting forward from last night would be Wednesday night. It could take him that long to clear out those high numbers. He also could clear it earlier, although I'd suspect it will go close to that long. I would watch for a yellow number and if you see one, test again in a couple of hours to see if his blood sugar is dropping.
Click to expand...
 
Yes, he did bounce, poor boy. He was miserable when I got home last night. But because he dropped dramatically so quickly I shaved the dose by a hair. I won't do that again.
I have some questions though. First, I have been testing using the back of his ears not using the tips or front by his eyes. Do you use the vein around the whole ear? This boy has been picked so much in that small one inch area it just looks sore to me.
Also, when do I know it's safe to start reducing Riley's dose? Does he need to be on 3 units until his numbers stay low for a specified amount of time?What if he falls into the 100 range? Do I still give the full 3 unit dose on the next shot?

Just not sure on what to do when he drops.

Thanks.
 
Hi Cherie, I know the feeling when you see them in high numbers from a bounce. In the beginning it would dissappoint and worry me.

I think the trick is to try to stay positive knowing that it is a normal reaction to getting Riley into good numbers (I see he got into blue!).
It just takes time, patience and definitely sticking with following either one of the protocols (Tight Regulation) or methods (StayLowGoSlow).
I'm not sure which one of the two you are following but I know you have been getting guidance from really experienced people here, so I don't have any dosing advice at all. I have only been at this for a little less than 4 months.
When you have a questions and you want to get someone's attention, you can put the blue question mark in from of your heading like you see others do. If you don't know how to do it, let me know I'll tell you. It's easy!
 
Cherie Hogan said:
I'm on the slgs protocol. Hoping someday to get Riley off the juice!
Click to expand...
Totally! Anyway, for right now seems Riley has made a lot of improvement since you started. When you read the SLGS sticky it is a guide on when/hw to reduce or increase. I always ask for help anyway to make sure I didn't miss anything.
Here is a link regarding ear testing http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/#p1665
If I were you, I would update your thread title and put that blue question mark in front of it, so people know you have a new question about dosing.
 
Hi Cherie
The best thing to do when he drops is to get that up on the board, it's really hard to remember while that's happening what to do. :bighug: The board is the lifeline!

I printed out what to do and kept it on the nightstand so I could grab and follow it. I copied it from one of my threads when Gussie was dropping, the steps the pros walked me thru. It made it easier to not do the wrong thing while I waited for the Calvary.
I also wrote out the basic steps in big bold pen.

But posting is your best bet and make sure your thread title lets folks scanning the threads know right away and quickly what's happening.
When Gussie was diving fast I would post
"? Gussie Diving, need HELP!!" And I would add the numbers I was seeing.
Folks usually came onboard before too many panicked moments had passed;)

If you are thinking of a dose adjustment, or aren't sure what you should shoot, make sure you get that ? Up like Barbara pointed out.
"? Riley Dose Help Please, need to shoot" is likely to get some help.

For what it's worth, I NEVER increased or decreased Gussies dose unless advised by the pros. I did not always understand Why I was advised to increase, decrease, or hold but I never second guessed them. It worked for us. There are specific basic rules for dosing but the folks here have so much experience, they can tailor those rules and recommendations to what they are seeing your cat do any given cycle, so long as you have enough data. The depot is hard to understand but the length of time doses are held is specifically designed to allow the insulin to work to its fullest potential before decisions on dose changes are made. It was hard but I let go the reins...

What worked best for us, ( and being a get things done kind of person it was very hard,) was to take this one single cycle at a time..so much can change in one 12 hr period that it's just not that easy to predict 12 hours in the future even, without tons of experience!

Nice to see Riley is trying out some lower numbers! :cat: That is exciting!!:bighug:
 
Yes, he is finally making some progress. His appetite and peeing is almost normal again. But can you tell me how you keep your cat's ears from getting sore from all those pokes? I am using Neosporen to help him.
 
Yay for feeling and acting more normal!!! That is SO great!!

I varied where I poked him around that edge of his ears. As you poke more, as weird as it sounds, more capillaries grow so you don't have to keep poking in the same place and will still get a sample you can use. I never went very low toward his eye ever. I used the area on the outside edge of both ears ( haha one consistently tested lower) about one 1/2-3/4 inch down on either side..that triangle of space was my target, moving around in it. I tried actually to avoid hitting the vein but on the edge close to it.

I used the neosporin with pain relief after the tests and to help heal. Gussie really did get to where he barely cracked an eye open if I was testing and he was napping. I think
a) they have a higher pain tolerance
B) they get used to it and if we are comfortable doing it they don't feel any stress coming from us and tolerate it better

Make sure as earlier posts pointed out, that you apply pressure after the test, about how long it takes for the meter read to pop up, to prevent bruising. I know where there are spots on Gussies ears that did develop scar tissue, probably because I was not as good about applying the pressure as I needed to be. I avoid those now as they do hurt when I poke them.
That moving the spot target, pressure till the meter beeped, plus the neosporin were my strategies, all learned here with help.

You can see on Gussies 2016 spreadsheet that his ears were poked A Lot. Partly because I am a fill in the blanks kind of visual person, and partly because he did some sliding down the numbers that I needed lots of tests for to keep him safe.

Each time I reminded myself that I was not doing it to be mean, I was doing it in order to keep him safe..that helped me...:bighug::bighug::bighug:
 
Gussie's mom said:
Yay for feeling and acting more normal!!! That is SO great!!

I varied where I poked him around that edge of his ears. As you poke more, as weird as it sounds, more capillaries grow so you don't have to keep poking in the same place and will still get a sample you can use. I never went very low toward his eye ever. I used the area on the outside edge of both ears ( haha one consistently tested lower) about one 1/2-3/4 inch down on either side..that triangle of space was my target, moving around in it. I tried actually to avoid hitting the vein but on the edge close to it.

I used the neosporin with pain relief after the tests and to help heal. Gussie really did get to where he barely cracked an eye open if I was testing and he was napping. I think
a) they have a higher pain tolerance
B) they get used to it and if we are comfortable doing it they don't feel any stress coming from us and tolerate it better

Make sure as earlier posts pointed out, that you apply pressure after the test, about how long it takes for the meter read to pop up, to prevent bruising. I know where there are spots on Gussies ears that did develop scar tissue, probably because I was not as good about applying the pressure as I needed to be. I avoid those now as they do hurt when I poke them.
That moving the spot target, pressure till the meter beeped, plus the neosporin were my strategies, all learned here with help.

You can see on Gussies 2016 spreadsheet that his ears were poked A Lot. Partly because I am a fill in the blanks kind of visual person, and partly because he did some sliding down the numbers that I needed lots of tests for to keep him safe.

Each time I reminded myself that I was not doing it to be mean, I was doing it in order to keep him safe..that helped me...:bighug::bighug::bighug:
Click to expand...
Thanks so much. I am pretty good now at getting a pin drop of blood but tonight I moved up his ear about a half inch below the tip and got a gusher. Boy did I panic and then landed my first fur shot. What a disaster! Me, who deliberately never had a child because I didn't want the responsibility or to be tied down, now must make sure I am home twice every day at the same time to give my Riley his shot. I love him just about more than anything but it's still taking some getting used to.
 
Take a look here for a picture of the best place to poke an ear. I think you said the other day that you got Neosporin, but not the one with pain relief? Am I remembering right? I only used the one with pain relief and I spread it on his ear generously every night and by morning his ear always looked like new. Also make sure to prevent bruising by applying pressure after you've done the test to prevent it from continuing to bleed. Only takes maybe 15 seconds, but it's important to do. We used a bit of paper towel to hold punkin's ear and apply pressure after we tested.

Did you reduce his dose to 1u tonight? Is that correct? Is that because you think you didn't get it all in? If so, rather than try to estimate how much got in, I'd just record the amount you had in the syringe and then add "fur shot" to the dose column so it shows that it's possible it didn't all get in. Everyone does a fur shot here and there, so don't worry about it. Riley will recover from it.
 
Cherie Hogan said:
Thanks so much. I am pretty good now at getting a pin drop of blood but tonight I moved up his ear about a half inch below the tip and got a gusher. Boy did I panic and then landed my first fur shot. What a disaster! Me, who deliberately never had a child because I didn't want the responsibility or to be tied down, now must make sure I am home twice every day at the same time to give my Riley his shot. I love him just about more than anything but it's still taking some getting used to.
Click to expand...
Sounds like you hit that vein we spoke of! Don't beat yourself up, it happens!:bighug:
Not a disaster if you chalk it up to a learning experience!;) I had lots of those too!:)

I found if I let my brain start telling me I was screwing up I got further into the "I have no clue what I am doing and how I am ever going to do this right" weeds. :bighug:
Instead I said "well looks like the screw up faeries are visiting again" and reminded myself I did have the tools and knowledge ( with help from the folks here) to handle this.

Even the pros give fur shots, it's just something that does happen! And like was pointed out earlier, sometimes what you think was a fur shot actually got insulin in so remember to keep testing as necessary! And don't reshoot!:nailbiting: Tho should we shoot more? that is the question we all asked!;) Answer NOOOOOOOO! :nailbiting::)

Yep, dancing this dance does mean rearranging our lives, no way around that unfortunately if we are going to do it the way we need to..new priorities and definitely a comittment to the clock...only solace I can provide on that piece is that you do figure out how to rearrange things and find out who true friends are because they are the ones who will come to you when you can't go to them.

Most people no matter how close will never understand the roller coaster ride you are on, they just can't. But folks here living it too do, and will be your best support system.

It will get easier as you get into a routine, you learn what Riley does with the insulin, and things become habit....I remember when it struck me I was getting the hang of this, Gussies numbers were dropping, and I was not hovering watching him breathe between the 20 minute tests, honey at the ready..I realized I knew how to keep him safe so could also breathe between tests..

Hang in there, you got this!:bighug:give Riley a scritch:bighug:
 
julie & punkin (ga) said:
Take a look here for a picture of the best place to poke an ear. I think you said the other day that you got Neosporin, but not the one with pain relief? Am I remembering right? I only used the one with pain relief and I spread it on his ear generously every night and by morning his ear always looked like new. Also make sure to prevent bruising by applying pressure after you've done the test to prevent it from continuing to bleed. Only takes maybe 15 seconds, but it's important to do. We used a bit of paper towel to hold punkin's ear and apply pressure after we tested.

Did you reduce his dose to 1u tonight? Is that correct? Is that because you think you didn't get it all in? If so, rather than try to estimate how much got in, I'd just record the amount you had in the syringe and then add "fur shot" to the dose column so it shows that it's possible it didn't all get in. Everyone does a fur shot here and there, so don't worry about it. Riley will recover from it.
Click to expand...
I didn't reduce the dose by choice. It was a fur shot!
 
I'm going to put the link here for your other thread from today. We try to keep to one thread each day for each cat to help things not be so confusing. At the moment there are people posting on this thread and on the other one.

Everyone, let's post on Cherie's other thread here.
 
Gussie's mom said:
Sounds like you hit that vein we spoke of! Don't beat yourself up, it happens!:bighug:
Not a disaster if you chalk it up to a learning experience!;) I had lots of those too!:)

I found if I let my brain start telling me I was screwing up I got further into the "I have no clue what I am doing and how I am ever going to do this right" weeds. :bighug:
Instead I said "well looks like the screw up faeries are visiting again" and reminded myself I did have the tools and knowledge ( with help from the folks here) to handle this.

Even the pros give fur shots, it's just something that does happen! And like was pointed out earlier, sometimes what you think was a fur shot actually got insulin in so remember to keep testing as necessary! And don't reshoot!:nailbiting: Tho should we shoot more? that is the question we all asked!;) Answer NOOOOOOOO! :nailbiting::)

Yep, dancing this dance does mean rearranging our lives, no way around that unfortunately if we are going to do it the way we need to..new priorities and definitely a comittment to the clock...only solace I can provide on that piece is that you do figure out how to rearrange things and find out who true friends are because they are the ones who will come to you when you can't go to them.

Most people no matter how close will never understand the roller coaster ride you are on, they just can't. But folks here living it too do, and will be your best support system.

It will get easier as you get into a routine, you learn what Riley does with the insulin, and things become habit....I remember when it struck me I was getting the hang of this, Gussies numbers were dropping, and I was not hovering watching him breathe between the 20 minute tests, honey at the ready..I realized I knew how to keep him safe so could also breathe between tests..

Hang in there, you got this!:bighug:give Riley a scritch:bighug:
Click to expand...
Thanks for the encouragement!
 
julie & punkin (ga) said:
I'm going to put the link here for your other thread from today. We try to keep to one thread each day for each cat to help things not be so confusing. At the moment there are people posting on this thread and on the other one.

Everyone, let's post on Cherie's other thread here.
Click to expand...
Sorry Julie...I'm still trying to figure where I should post/be/start, etc. BTW your Punkin and my Riley could be twins except Riley is missing his left eye.
 
Status
Not open for further replies.
Back
Top