Sam - Month 5

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Djamila

Djamila

Member Since 2015
So I've been contemplating making the switch from Prozinc to Lantus. Sam is stable, his numbers are good, but he doesn't seem to be getting any closer towards remission. We've been in more or less the same numbers and the same doses since mid-April.

My impression was that if we moved to Lantus, it probably wouldn't get him any closer to remission, but I was hoping it would flatten out his pre-shot numbers so he wasn't going up and down every day. I talked with my vet (who I really adore right now since she seems super knowledgeable about FD which is a rare and lovely thing in a vet!) and she was supportive of the switch and even suggested the same starting dose as the folks over in the Lantus forum, so that was nice.

Tonight I started to do my spreadsheet studying thing that I do, over in Lantus, and this is what I found:

https://docs.google.com/spreadsheet...ScYgX714dizI6vWCkee3Z1o9D0/edit#gid=361360320

https://docs.google.com/spreadsheets/d/1MRpUrMhTYgP02J-dzSYVPYlZe2SXWaWOANJNPeB1kAU/pubhtml

https://docs.google.com/spreadsheets/d/1w_XZrvXTTkhpRYofcYfwV33bJ_EPD-OwMkYuvj4XjDY/pubhtml

I'm curious if you all will see what I'm seeing, but it looks to me like kitties who are in similar numbers to Sam are getting similar curves throughout the day, even though they are on Lantus. Their curves don't look any flatter than the curve he's getting already.

Interesting, huh? Am I seeing this right? What do you all think?
 
I see what you mean, and I'm sure not a Lantus expert, never used it, but I wonder if the change in insulin might jump start something in him. Another difference would be that you'd shoot the greens with Lantus. That may make a difference too. But I don't know:confused:.... @Bobbie And Bubba had to shoot a very low dose for awhile before OTJ. Maybe she has some insight.
 
Hey Djamila, good job on scouring over the SS. Are you eyes crossed yet? LOL.

Just a few things that you should consider about those links:

Squallie and Rusty are long term diabetics who have never gone into remission. Squallie is on a higher dose , Rusty is on a lower dose and also Rusty is on Lev not Lantus. While they are similar in being longer lasting insulin there are some differences being Lev has a later nadir than Lantus so his curve is going to look a bit different.

Boomer has been in remission twice before and this is his 3rd rodeo on Lantus so it makes remission a bit harder to get again but not impossible.

Aurora hasn't been doing the FD dance, since April and she has had some skipped shots through out the SS due to not being able to monitor. And she is at the stage that with the .25 dose she is on now, she should be giving Aurora a mini meal at +9 through the night to bring down the AMPS number. She is currently looking into an auto feeder so she can do that . There were a few times she did get up and feed Aurora and her AMBG was in the green. After 7 days of being all green numbers she could go to a drop on insulin and possibly be done with the juice. She is soooooo close and her momma is working on it.

And Sharon brings up a good point about Lantus is easier to shoot greens because when you shoot low with Lantus the cycle stays rather flat. Good job shooting green yesterday and by the looks of his PMBG's he probably went lower and did a little bounce at PMBG. :rolleyes:

The other thing to consider that ProZinc is an in/out insulin and doesn't have the duration that Lantus has so you could possibly see him stay in green numbers longer through the cycle than you do now. Maybe last night's cycle was more about duration than bounce?

I do understand that it's hard to make the decision. You can try it and you could always go back to ProZinc if it isn't a good fit for Sam and you. And you know there will be lots of help for you over in L & L :bighug:
 
Bobbie And Bubba said:
should be giving Aurora a mini meal at +9 through the night to bring down the AMPS number. She is currently looking into an auto feeder so she can do that . There were a few times she did get up and feed Aurora and her AMBG was in the green. After 7 days of being all green numbers she could go to a drop on insulin and possibly be done with the juice. She is soooooo close and her momma is working on it.
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This is interesting :bookworm:
 
Bobbie, thanks so much for the background on those kitties. Squallie, Rusty, and Boomer were the profile I was looking for (longer duration diabetics, or more than one rodeo). I missed that Aurora was still under the 4 month line. I found two more last night that fit the right profile and still have the smile curves.

This morning I've been looking at OTJ kitties, and you're right that the cycle flattens out for those kitties as they are heading OTJ, but doesn't seem to flatten for kitties that are planning to hang around. So I guess that's one indication of what the kitty has planned. Do you know of anyone with a low flat cycle without remission?

Sam's prozinc is five months old (we just started month 6), so it's quite possible that it's losing duration at this point, but I think the last two PMPS's were food inflated. I got home from work just at shot time both evenings and watched him eat about 30-40 minutes before I got there. (I have a home security camera that lets me spy on him). And the fact that he's still getting food spikes is one thing I'm taking as an indication that he isn't heading OTJ anytime soon. Typically he never eats that late in the afternoon, but I guess he's been hungry lately. It's also possible that it's a bounce since I'm gone all day and can't check later in the cycle to verify. So many options...

I never thought I would be shooting greens on Prozinc, but his data shows it's safe, so if I'm around for a few hours to monitor I've been trying to at least give him a little bit. I've had to just skip a few of them though because of work. This is our busy time of year so I haven't been able to work from home as much as I could in the winter.

I think I'm going to go ahead and give it a try in a couple of weeks once school is out and see if it changes anything.
 
Yong said:
This is interesting :bookworm:
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Yes, it does seem counter productive doesn't it? The +9 meal is done when kitty is on .25 unit of Lantus. The AMBG's are always the last to come down to a green number and with this feeding technique, it does that last bit of getting kitty into all greens. The idea is this: when the pancreas is producing inulin and doing it's job the body releases it after a meal to bring down the BG's thus lowering the AMBG number.
 
You are welcome. Here is one kitty who has been a long term diabetic and has a nice flat cycle but still on 1.50 units (I think, going from memory) She used the generic Lantus for a bit and you will see that on her SS ( Basaglar) and is back to Lantus now. She was doing it as a trial for another group she is in.

https://docs.google.com/spreadsheet...Ej14-xfuaYXJFPNTIC-cT8cck/edit#gid=1684765866

Djamila said:
And the fact that he's still getting food spikes is one thing I'm taking as an indication that he isn't heading OTJ anytime soon
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Maybe not. If you consider meter variance + /- the AM cycle of 6/5 was basically a flat cycle.

Also, in the last week, you have had 3 NS and 1 FS and still his numbers are mostly in normal numbers.

He is so close Djamila. With Lantus, the +2 will be your best friend to tell you how active the cycle will be and if that number is the same or lower than the Pre shot then you can intervene with some higher carb food if you have to leave for work to keep him safe.

I think I would try switching too. What do you have to lose? ;)
 
Yes, the pharmacy got my prescription today, but I missed the call, so I'll need to get in touch with them to get it shipped.

I'm thinking that either his AM cycles need more insulin, or his nadir has shifted later since those out-the-door tests aren't showing anything anymore. I'm looking forward to getting something later in the cycle this weekend to get a better idea what's going on with that.

I guess I felt like a couple of those NS cycles were kind of cheating since I would have given him a shot if I'd been home. I just didn't feel like I could shoot on a green and then leave him alone for twelve hours. It's nice to hear a more optimistic interpretation of how things are looking.

Cannot wait for the school year to end and have a little more time to take care of him!
 
Ah-ha! Yes, that is the type of spreadsheet I was expecting to see more of! Thank you for finding that one!
 
Djamila said:
Apparently the insulin only works at night here. During the day he's just flat flat flat. At least it's a nice flat.
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Freya's been doing that too lately (albeit with not-so-nice flats). o_O Weird because days used to be more active for her. They must be plotting something...
 
Maybe Sam overheard that he would be subjected to more frequent testing when we switch insulin. :D
 
Well, I already paid for it and it's on its way.

Just a few days ago he was getting higher-than-normal numbers, so this is most likely just a nice little break, but I'll enjoy it while it lasts!
 
@Bobbie And Bubba, and anyone else who might be around too, but I can see Bobbie - I'm wondering what your thoughts are on how to proceed from here? Sam is at 98 this morning, and I'll be home until +5. Normally, I would shoot at this number since I'll be home for a few hours, but given the past two days, I'm not sure. Should I let it go and see if he can keep it down on his own? Or give him a shot?
 
hmmmmmm, He is not making this easy on you. If you can monitor till +5 and have higher carb food and plenty of strips, can you give him just a drop? Do you know how to do the drop?
 
Yup, I can do the drop. Based on his past cycles with similar numbers, I'm not really worried about him going too low. It was more that I was kind of hoping to start counting days. ;)

I think giving him a small dose is probably best, I just needed someone else to give me a nudge in that direction. I think I was getting greedy for the NS's!
 
Djamila said:
Yup, I can do the drop. Based on his past cycles with similar numbers, I'm not really worried about him going too low. It was more that I was kind of hoping to start counting days. ;)

I think giving him a small dose is probably best, I just needed someone else to give me a nudge in that direction. I think I was getting greedy for the NS's!
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Because this is his second rodeo, I think as long as he will tolerate the insulin, you give the pancreas some extra support.
 
I went with something around a fat 0.1/skinny 0.2u and will monitor (although I'm pretty sure he'll ride it out just fine). This is a daytime cycle and it doesn't seem like the insulin does much during the AM cycles lately. Thanks so much for your help on this. My head knew he should have a small dose, but my heart really wanted to call it Day 3 :p:D
 
@Bobbie And Bubba, I'm studying up on Lantus, and was looking at your spreadsheet. In January of this year, you took two reductions without hypos. You went from 0.4 to 0.25, and then from 0.25 to 0.15.

Were those based on something? Or was it a gut-level decision to see if Bubba could sustain the good numbers with less insulin?
 
Good question Djamila! Those reductions were taking because of being in all green numbers for 7 days. That is the other way of earning reductions on Lantus. :cat:
 
As I get towards the end of a batch of test strips, I usually run a few side-by-side tests with the new batch of test strips on the same drop of blood to make sure they are accurate. They've always been within a few points of each other.

When I started the current batch of test strips, I hadn't done the side-by-sides before I ran out of the old ones. So I don't know if these were accurate with the old batch.

Now these are running out, I've noticed that there is a dramatic difference between these and the new batch. There is consistently around 20 points different, with the new batch running lower. 20 points isn't much if you're in the 300's, but at this point, it's the difference between hypo or not, OTJ or not.

It feels like it's a giant difference right now! SO which batch is correct?!?! The test I just ran, he's either 71 or 52. Well one of those numbers is great, the other one deserves a little nudge upward! I'm going to stop at the store and buy a new batch today so I have a third-point to compare before I run out of the higher batch to try to determine which one is more accurate. I've never seen two batches this far off from each other!
 
Djamila said:
As I get towards the end of a batch of test strips, I usually run a few side-by-side tests with the new batch of test strips on the same drop of blood to make sure they are accurate. They've always been within a few points of each other.

When I started the current batch of test strips, I hadn't done the side-by-sides before I ran out of the old ones. So I don't know if these were accurate with the old batch.

Now these are running out, I've noticed that there is a dramatic difference between these and the new batch. There is consistently around 20 points different, with the new batch running lower. 20 points isn't much if you're in the 300's, but at this point, it's the difference between hypo or not, OTJ or not.

It feels like it's a giant difference right now! SO which batch is correct?!?! The test I just ran, he's either 71 or 52. Well one of those numbers is great, the other one deserves a little nudge upward! I'm going to stop at the store and buy a new batch today so I have a third-point to compare before I run out of the higher batch to try to determine which one is more accurate. I've never seen two batches this far off from each other!
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Oh my, that is a big difference when you are in lower numbers. I hope the 3 set of strips shines some light on which set of numbers to trust. :confused:
 
I think Yong is the winner! I just tested my civvie (since I could stab his ears all day and he wouldn't care) and got 84 (old strips), 66 (new strips), 70 (newest strips - the box I just bought). That's only one test, so I'll need to run a few more side-by-sides, but based on that one, it looks like the past couple of weeks might have been reading a bit high. Which makes me think that 55 yesterday might have been a mild lime green. Oops. Thank goodness he free feeds and knows how to steer himself back up!

I'm curious to see if the pattern holds in a few more tests. I knew there was meter variation in how it read the blood sample for a cat, but didn't realize there could be this much variation from one box of strips to the next!
 
Djamila said:
I think Yong is the winner! I just tested my civvie (since I could stab his ears all day and he wouldn't care) and got 84 (old strips), 66 (new strips), 70 (newest strips - the box I just bought). That's only one test, so I'll need to run a few more side-by-sides, but based on that one, it looks like the past couple of weeks might have been reading a bit high. Which makes me think that 55 yesterday might have been a mild lime green. Oops. Thank goodness he free feeds and knows how to steer himself back up!

I'm curious to see if the pattern holds in a few more tests. I knew there was meter variation in how it read the blood sample for a cat, but didn't realize there could be this much variation from one box of strips to the next!
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This is scary! I wonder if the results box to box are more consistent with human blood?
 
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New test strips: 84. Newest test strips: 82. Didn't have enough blood to try the old test strips, and frankly ready to throw them in the trash anyway.

Oh you guys!!! What if I've been overdosing him for the past two weeks?!?!?! I mean, he's clearly survived it, but my poor kitty!!!
 
Djamila said:
New test strips: 84. Newest test strips: 82. Didn't have enough blood to try the old test strips, and frankly ready to throw them in the trash anyway.

Oh you guys!!! What if I've been overdosing him for the past two weeks?!?!?! I mean, he's clearly survived it, but my poor kitty!!!
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You'll never know, Djamila. Sam's been OK through it all, hasn't he? :bighug:
 
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Yes, he's been okay, but he's definitely been hungrier than usual the past few days -- which makes sense! I just tested myself and got 98 (old strips), 80 (new strips), 82 (3rd batch from today). So the old strips are now in the trash. Apparently they work pretty much the same for cats and humans!

And I will not acknowledge that other comment except to say that it has occurred to me too! ;):D
 
Sam hit a lime green (rare for him!) on a 0.2u dose tonight. He's fine, it's barely past the line (45) and he was gifted a few kibble pieces just for fun, and a bit of a nudge to have a bit more of his regular food. Then he was at 52. Going to get one more test before bed to make sure he's staying in the regular greens. It looks like he's probably been getting a bit too much insulin the past few days though and it makes me feel awful, even though he's clearly survived it just fine. I think the 0.2 is fine for the AM cycle, but he might need a drop or two less for the PM cycle.
 
Well look at you Djamila so cool calm and collect! Good job catching the low number and your idea of less at the PM cycle is a good idea since a lot of kitties do like to go lower during the night .

Just keep in mind that the kibble takes longer to bring the numbers up so higher carb wet food also is best.

He is looking really good!
 
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