summers numbers

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Summers Mom

Summers Mom

Member Since 2017
Good morning everyone! This is Summers 7th day on Lantus. I am using the TR protocol and i have read what it says but i still don't fully understand what to look for in her bg numbers or if or when i may need to make a change. I would hate for the TR not to work for her because i am new to this and don't fully understand so i ask you all, anyone to follow and watch Summers spreadsheet and help me along and point out what her numbers are saying to me and to make me understand what i need to do. I just don't know what i am doing and i would hate her to suffer because of me not understanding the protocol. I am testing her at Am pre shot and all through the day and at Pm shot and then before bed and giving her .5 units 2 x a day but i feel so blind to really what to look for or what to do. I have read and read but i still don't know what her numbers are saying to me OR what i need to do. Please help me to help Summer. Thank you all so much!

Another thing about Summer is her thin skin which i know could be cushings. It is impossible to tent her skin because its as thin as tissue paper. So if anyone else on the message board has a cat or had a cat with super thin skin, how did you give the shots with their skin so thin?? Any tips?? I just make sure it does not go through to the other side before i release the insulin but its not easy being her skin is so thin and it makes me wonder if its even absorbing into her.
 
Hello and welcome! You are doing a great job testing. I would suggest that you have 2 objectives at this point:
1) Testing before each shot to make sure it is safe to give insulin. You are already doing this - great.
2) Collecting data to determine how Summer responds to insulin. Every cat is different, but you want to understand how low she goes and when the insulin starts to affect her. Lantus is dosed based on the low point - you need to know what her lowest point is and in general when this occurs. It is usually +5/+6, but again every cat is different. You are doing the testing, but I don't think it is clear how she responds to insulin yet. I would suggest an increase, but I see you are worried about thin skin, so I would ask you to confirm she has received .5 consistently this first week.

Most people post a thread each day and use that to get answers to questions or feedback on how things are going. I have no experience with Cushings, but want to make sure you know there is a subgroup to discuss specifics for high dose conditions including Cushings. The only other suggestions I have are to update your signature to indicate you are following TR and to include a link to your previous post to make it easier for others to give advice based on the history of what has been said before. I linked your discussion re: day 5 because it includes suggestions for testing. Please feel free to ask specific questions - for example, you might want advice about making an increase soon.
 
Carol in Chicago said:
Hello and welcome! You are doing a great job testing. I would suggest that you have 2 objectives at this point:
1) Testing before each shot to make sure it is safe to give insulin. You are already doing this - great.
2) Collecting data to determine how Summer responds to insulin. Every cat is different, but you want to understand how low she goes and when the insulin starts to affect her. Lantus is dosed based on the low point - you need to know what her lowest point is and in general when this occurs. It is usually +5/+6, but again every cat is different. You are doing the testing, but I don't think it is clear how she responds to insulin yet. I would suggest an increase, but I see you are worried about thin skin, so I would ask you to confirm she has received .5 consistently this first week.

Most people post a thread each day and use that to get answers to questions or feedback on how things are going. I have no experience with Cushings, but want to make sure you know there is a subgroup to discuss specifics for high dose conditions including Cushings. The only other suggestions I have are to update your signature to indicate you are following TR and to include a link to your previous post to make it easier for others to give advice based on the history of what has been said before. I linked your discussion re: day 5 because it includes suggestions for testing. Please feel free to ask specific questions - for example, you might want advice about making an increase soon.
Click to expand...

Thank You so much for responding! Yes Summer has had .5 units of Lantus 2 x a day consistently for 7 days. Well it will be a full 7 days when i give her PM shot tonight. I will update my signature about the TR protocol but how do i actually link my previous post as you mentioned? So to fully understand Summers numbers, you are saying to watch when she drops in her numbers and see how she responds?? What do i actually look for in her "responding to the insulin"? I am reading and reading but i still have so much to learn. I am just overwhelmed at the moment and i don't want to let Summer down. And i am also worried about not doing the TR protocol properly. I really do't know if i should be increasing OR not. So i need to make another thread on Maybe increasing?? Thank you again so much for helping out a newbie that is trying to learn but seems alot of what i read goes in one ear and out the other!!
 
Carol in Chicago said:
Collecting data to determine how Summer responds to insulin. Every cat is different, but you want to understand how low she goes and when the insulin starts to affect her. Lantus is dosed based on the low point - you need to know what her lowest point is and in general when this occurs. It is usually +5/+6, but again every cat is different. You are doing the testing, but I don't think it is clear how she responds to insulin yet. I would suggest an increase, but I see you are worried about thin skin, so I would ask you to confirm she has received .5 consistently this first week.
Click to expand...

When looking at her numbers, what do you do when their lowest number is at different times of the day?? Summers low is at different times and i don't really understand whats happening.
 
Summers Mom said:
When looking at her numbers, what do you do when their lowest number is at different times of the day?? Summers low is at different times and i don't really understand whats happening.
Click to expand...

I copied the following from the new to the group sticky

Example of an ACTIVE, but NOT necessarily typical Lantus cycle:
NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. Onset begins around +2 for most cats. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Often lower than the PreShot number.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.

This didn't make sense to me until I looked at it graphically. Guess I'm more of a picture person. :cat:
 
Summers Mom said:
Thank You so much for responding! Yes Summer has had .5 units of Lantus 2 x a day consistently for 7 days. Well it will be a full 7 days when i give her PM shot tonight. I will update my signature about the TR protocol but how do i actually link my previous post as you mentioned? So to fully understand Summers numbers, you are saying to watch when she drops in her numbers and see how she responds?? What do i actually look for in her "responding to the insulin"? I am reading and reading but i still have so much to learn. I am just overwhelmed at the moment and i don't want to let Summer down. And i am also worried about not doing the TR protocol properly. I really do't know if i should be increasing OR not. So i need to make another thread on Maybe increasing?? Thank you again so much for helping out a newbie that is trying to learn but seems alot of what i read goes in one ear and out the other!!
Click to expand...

There is a lot to learn. Everyone here has been where you are now. I think everyone was overwhelmed early on. You are already well on your way with testing and your spreadsheet! The data in your spreadsheet will tell you how she is responding to insulin. What you need to know is when her blood glucose goes down, how low it goes, and how long it says low. This is the shape of the curve from the graphic in the post I linked above.

Give yourself some credit for all you are doing to help Summer. You aren't letting her down at all. The focus here is safety (as opposed to perfection). What you are doing now is learning how to safely reduce her blood sugar levels. My vet had to have a long talk with me early on that my cat is a live creature. I can't expect a mechanical response - It is not like fine tuning an engine!

To add a link to your post, highlight the text and click on the link icon at the top of the text box and then paste the URL for the content in the link window. My suggestion is to post tomorrow and ask for dose feedback. Make sure your spreadsheet is up to date and use a subject line in your post with the date, your PS number and ask for input regarding an increase (i.e. 10/22 Summer AMPS 202 time for increase? You can use the question icon to get more folks to weigh in. Hope this helps!
 
Carol in Chicago said:
I copied the following from the new to the group sticky

Example of an ACTIVE, but NOT necessarily typical Lantus cycle:
NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. Onset begins around +2 for most cats. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Often lower than the PreShot number.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.

This didn't make sense to me until I looked at it graphically. Guess I'm more of a picture person. :cat:
Click to expand...

So should i test her bg more right now to actually see where her lowest numbers are? She just tested 196 0n the +5. She was 230 at +3 and she was 283 at AM pre shot.
 
Hi,
what an excellent job you are doing with the tests keeping the SS so easily readable! Wow!
I write to bump your post up on the Board so you can get the attention of real dose wizards but IMHO only, per TR, you can increase by 0.25u.
Hopefully, someone will stop by to comment later on - the weekends are usually slower.
It took me several months to get the TR... don't be too hard on yourself..

If you re-title the subject line to something like" Dose advise, please" - and make the ? your prefix - more ppl with dose knowledge will reply.
 
Hi summer and mom(sorry don't know your name)

I agree with Tanya, there is room to take the dose up to 0.75u. you might want to wait till morning to do the increase, if that makes it easier for monitoring.(as long as there is no green)

As far as spotting the lows, that can be a moving target. You will find that there is a more usual time for summer to hit her low, but they can and do nadir at anytime, George for example nadired usually around +5, but he also nadired as early as +2 and as late as +12:rolleyes: you will learn to recognise when a cycle is 'normal' and when there's something up.
 
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