Remission???

Status
Not open for further replies.
harleywulf

harleywulf

Member Since 2018
Question.....how do you know if your cat is heading toward remission? And when do you decide to test it insulin free? For weeks ours has steadily been having his dose increased. The most recent about two weeks ago. We are now up to 7 units of Lantus. His curves have been in the 200s. Down from 400s initially. Good appetite always. Has been on high protein low carb wet food for a little over 2 weeks.
So these are his readings today.
7am - 261 he was then fed and given his 7 units
+3 - 123
+6 - 52 (was concerned so rechecked and at 51). Gave some food.
+7 - 86
+8 - 109
+10 - 185

He's supposed to have 7 units again at 7pm. Should I be doing anything differently right now other than rechecking his BG more closely? Reduce dosage at 7pm?

Thanks
 
You might want to put this on the lantus forum, I just started lantus yesterday or I would try and help, I don’t think I would give 7u with numbers like those
 
Are you following the TR protocol or SLGS? If you don’t know what I’m talking about, head on over to the Lantus Levemir forum and read through the yellow stickys. It will be overwhelming but very informative. All dose decreases and increases are usually done in .25 or .5u. That way you don’t miss the correct dose. I don’t feel comfortable giving you dose advice as I’m new to this myself. I would post on the L and L forum. It is very busy over there and can be overwhelming as well but once you get the hang of it you’ll be happy. Introduce yourself and ask your questions.
 
With those numbers he's not ready for an OTJ trial. You should see mostly greens for that. There is a sticky on starting OTJ trials in the Lantus forum.
 
Juliet said:
With those numbers he's not ready for an OTJ trial. You should see mostly greens for that. There is a sticky on starting OTJ trials in the Lantus forum.
Click to expand...
Ok thsnks. What about his next dose then? Stay at 7 or reduce? Emergency vet won't give advice over the phone. Hes back up to 233 now and ready for his PM.dose.
 
if you are doing TR ( tight regulation protocol) then you want to shoot the same dose.

If you are doing slgs ( go slow) then you would reduce his dose to 6.75 u ( decrease by 0.25 units) because he would have earned a reduction with that 52 this afternoon. ( decreases earned at below 80 on slgs)

Reductions for SLGS are taken at 90 (I said 80).
to earn a reduction on TR, the number has to drop below 50 ( so you want a 49 )
 
Last edited:
harleywulf said:
Question.....how do you know if your cat is heading toward remission? And when do you decide to test it insulin free? For weeks ours has steadily been having his dose increased. The most recent about two weeks ago. We are now up to 7 units of Lantus. His curves have been in the 200s. Down from 400s initially. Good appetite always. Has been on high protein low carb wet food for a little over 2 weeks.
So these are his readings today.
7am - 261 he was then fed and given his 7 units
+3 - 123
+6 - 52 (was concerned so rechecked and at 51). Gave some food.
+7 - 86
+8 - 109
+10 - 185

He's supposed to have 7 units again at 7pm. Should I be doing anything differently right now other than rechecking his BG more closely? Reduce dosage at 7pm?

Thanks
Click to expand...
If you're using a human meter to test that 51 is very close to the "take action" number of 50. By that we mean you should feed a small snack of regular food because BG is dipping very low. If it took 7 units of insulin to achieve those numbers, your kitty isn't near remission. If you had numbers in the low 100s or high double digits on a tiny dose that would be a sign of impending remission.

It's possible that the 7 unit dose is a bit too high. You've been increasing the dose in whole units and might have skipped past a good dose. Now what to do about dosing: if you were following TR (Tight Regulation) protocol, you could stay at this dose because he didn't drop below 50. If you were following SLGS (Start Low Go Slow) you would immediately reduce the dose because he dropped under 90. That's why we refer people to the Lantus forum and ask them to study the yellow info stickies to see which set of dosing guidelines would work for them.

Because this is a last minute situation and you don't seem to have decided on which dosing method is best for you, why not drop the dose to 6.5 u for tonight. Please go post all of this on the Lantus forum where the people with a lot of experience can help you.
 
you do mention you've been at this for weeks....
but you've been increasing too much in the last few days....
that's why you are seeing that low number....

very very likely too much insulin .... safetly is more important.
 
Kris & Teasel said:
If you're using a human meter to test that 51 is very close to the "take action" number of 50. By that we mean you should feed a small snack of regular food because BG is dipping very low. If it took 7 units of insulin to achieve those numbers, your kitty isn't near remission. If you had numbers in the low 100s or high double digits on a tiny dose that would be a sign of impending remission.

It's possible that the 7 unit dose is a bit too high. You've been increasing the dose in whole units and might have skipped past a good dose. Now what to do about dosing: if you were following TR (Tight Regulation) protocol, you could stay at this dose because he didn't drop below 50. If you were following SLGS (Start Low Go Slow) you would immediately reduce the dose because he dropped under 90. That's why we refer people to the Lantus forum and ask them to study the yellow info stickies to see which set of dosing guidelines would work for them.

Because this is a last minute situation and you don't seem to have decided on which dosing method is best for you, why not drop the dose to 6.5 u for tonight. Please go post all of this on the Lantus forum where the people with a lot of experience can help you.
Click to expand...
Ok. Yes this has been a steady increase since October of last year.
 
rhiannon and shadow (GA) said:
if you are doing TR ( tight regulation protocol) then you want to shoot the same dose.

If you are doing slgs ( go slow) then you would reduce his dose to 6.75 u ( decrease by 0.25 units) because he would have earned a reduction with that 52 this afternoon. ( decreases earned at below 80 on slgs)


to earn a reduction on TR, the number has to drop below 50 ( so you want a 49 )
Click to expand...
 
rhiannon and shadow (GA) said:
you do mention you've been at this for weeks....
but you've been increasing too much in the last few days....
that's why you are seeing that low number....

very very likely too much insulin .... safetly is more important.
Click to expand...
The last increase was two weeks ago from 6 to 7 per the vet. We've been at this since last October. Starting at one unit.
 
rhiannon and shadow (GA) said:
you do mention you've been at this for weeks....
but you've been increasing too much in the last few days....
that's why you are seeing that low number....

very very likely too much insulin .... safetly is more important.
Click to expand...
I need to get the curves I've submitted to the vet back so I can enter them on.my spreadsheet.
 
I beleive he said Tank has been on this dose for 2 weeks. I don't think he know what SLGS and TR are, because he is working with vet on dosing.
 
rhiannon and shadow (GA) said:
okay.
have any other changes happened recently? I noticed a food change in the notes. Is he just now starting with canned food?
Click to expand...
Started canned food maybe a month ago. Curve done on 3/14 at 6 units is when vet said to raise to 7 units. Vet has never said half or quarter units. I don't think syringe even measures quarters so I'd have to gurssa tick between halves. I just dontd think I should be giving him the 7 units again right now cuz I don't want him to fall in 50s in the middle of the night.
 
tight regulation protocol is the most aggressive treatment. You need to get a preshot test every cycle and at least one other test during the cycle. Many of us here prefer more than one. That data is the only way you know what's happening.

slgs is a little more laid back where you still need to always get a preshot test, still need to monitor during the cycle when you can, but you take reductions sooner.
I would recommend that you do this one until you learn a little more , let us continue helping you by posting daily and then you can switch to TR if you want to.

IF the food change is a new occurence, that will drop numbers all by itself and we need to adjust the dose back down.
If it's just a new brand of canned food and you've been shooting 7 units for the last 2 weeks, then technically your new dose would be 6.75 u.

Yes , the inbetween doses are hard. Most of us have syringes with half unit markings and you have to estimate the quarter . The most important thing is to be consistent with what you call the dose.

Since you are feeling nervous, let's reduce the dose more.
HOWEVER, with lantus there is a continuing amount ( we call this the depot) in his system .... so he could very well go low tonite even if you shoot a lesser dose. That's a lot of insulin ( 7 units) and it doesn't wear off just because you don't shoot.
Does that make sense?
 
rhiannon and shadow (GA) said:
tight regulation protocol is the most aggressive treatment. You need to get a preshot test every cycle and at least one other test during the cycle. Many of us here prefer more than one. That data is the only way you know what's happening.

slgs is a little more laid back where you still need to always get a preshot test, still need to monitor during the cycle when you can, but you take reductions sooner.
I would recommend that you do this one until you learn a little more , let us continue helping you by posting daily and then you can switch to TR if you want to.

IF the food change is a new occurence, that will drop numbers all by itself and we need to adjust the dose back down.
If it's just a new brand of canned food and you've been shooting 7 units for the last 2 weeks, then technically your new dose would be 6.75 u.

Yes , the inbetween doses are hard. Most of us have syringes with half unit markings and you have to estimate the quarter . The most important thing is to be consistent with what you call the dose.

Since you are feeling nervous, let's reduce the dose more.
HOWEVER, with lantus there is a continuing amount ( we call this the depot) in his system .... so he could very well go low tonite even if you shoot a lesser dose. That's a lot of insulin ( 7 units) and it doesn't wear off just because you don't shoot.
Does that make sense?
Click to expand...
Yes it makes sense. Maybe my vet doesn't have a clue. All he told me was to do a curve in a few weeks then I'd report the curve and he'd tell me to increase the fose one unit. Like isaod this has been going on since October. I have been cking his BG midday here and there but vet had never told me to even do that. Just raise it a dose and do another curve in two weeks has been his instructions.
 
So are you able to test some tonite? You get your preshot number , and then I'd ask for you to get a +2. That means 2 hours after you shoot. If that number is significantly less than your preshot number, that can indicate that it might be a active cycle and you need to test again in an hour or two depending on how dramatic the drop is.
 
I've hardly ever heard of a vet thinking in half units and quarter units. And they don't think their customers can do it.
But for a 12 lb cat, a 1/4 unit is a much larger amount compared to a human dose where they do increase in whole units.
 
Vets really only spend a few hours learning about diabetes and most of it is about dogs. ( Their treatment is more like humans because of the inferior insulin for dogs)
Lantus is a human insulin that it was discovered worked great on cats.
Dog insulin goes in, wears off.
Lantus doesn't. It accumulates .
 
rhiannon and shadow (GA) said:
So are you able to test some tonite? You get your preshot number , and then I'd ask for you to get a +2. That means 2 hours after you shoot. If that number is significantly less than your preshot number, that can indicate that it might be a active cycle and you need to test again in an hour or two depending on how dramatic the drop is.
Click to expand...
Ok I hsvehav given him his pm dose yet but will. His preshot bg is 233.
 
5e86c3d4.jpg
this syringe has half unit markings. but you can see how the rubber tip sits right in between 0.5 and 1.0
 
I'm not trying to step on toes or anything, but just curious. If you are on a high dose of 7 and you might have skipped over a good dose, and this is your first reduction, isn't .25 too small?
 
it would be too small if there was a lot of drama perhaps. Like a black number down to a green number.
But today's cycle looks normal, a yellow down to a green and now back to a yellow for pmps.
52 is a safe number and it indicates ( imho) that the dose may be on the right track.

If the dose needs to be lowered, we should get indicators tonite, and tomorrow.... if it's just too high.
She is willing to get more testing tonite and we'll see where the numbers go.
I have given the advise so I have to make sure to stay up with her if needed.

If she hadn't been giving this dose already for the last couple of weeks, I would have wanted to go back to a previous dose.
 
rhiannon and shadow (GA) said:
it would be too small if there was a lot of drama perhaps. Like a black number down to a green number.
But today's cycle looks normal, a yellow down to a green and now back to a yellow for pmps.
52 is a safe number and it indicates ( imho) that the dose may be on the right track.

If the dose needs to be lowered, we should get indicators tonite, and tomorrow.... if it's just too high.
She is willing to get more testing tonite and we'll see where the numbers go.
I have given the advise so I have to make sure to stay up with her if needed.

If she hadn't been giving this dose already for the last couple of weeks, I would have wanted to go back to a previous dose.
Click to expand...
Makes sense! I was in a different situation, so just trying to learn so I can give better advice in the future :)
 
harleywulf said:
I need to get the curves I've submitted to the vet back so I can enter them on.my spreadsheet.
Click to expand...
What kind of meter do you have? Pet or human? That makes a difference in the advice we give.

Most meters have a memory. You should be able to pull up readings for at least the last two weeks, which would be very helpful.
 
Tricia Cinco(GA) & Harvey said:
What kind of meter do you have? Pet or human? That makes a difference in the advice we give.

Most meters have a memory. You should be able to pull up readings for at least the last two weeks, which would be very helpful.
Click to expand...
Tricia Cinco(GA) & Harvey said:
What kind of meter do you have? Pet or human? That makes a difference in the advice we give.

Most meters have a memory. You should be able to pull up readings for at least the last two weeks, which would be very helpful.
Click to expand...
A ReliOn Ultima is what we use.
 
rhiannon and shadow (GA) said:
it would be too small if there was a lot of drama perhaps. Like a black number down to a green number.
But today's cycle looks normal, a yellow down to a green and now back to a yellow for pmps.
52 is a safe number and it indicates ( imho) that the dose may be on the right track.

If the dose needs to be lowered, we should get indicators tonite, and tomorrow.... if it's just too high.
She is willing to get more testing tonite and we'll see where the numbers go.
I have given the advise so I have to make sure to stay up with her if needed.

If she hadn't been giving this dose already for the last couple of weeks, I would have wanted to go back to a previous dose.
Click to expand...
+2 he has now jumped to 342
 
harleywulf said:
+2 he has now jumped to 342
Click to expand...
It's probably a bounce. Sometimes when they have been in higher numbers for so long their bodies get used to them and "freak out" when then get as low as Tank did today. It's pretty normal. As his body sees better numbers and gets used to them it will stop the up and down numbers.
 
Here is bouncing better explained:


Here's an explanation of what we call "bouncing". It explains why a kitty's BG can go from low to sky high:
  1. BG goes low OR lower than usual OR drops too quickly.
  2. Kitty's body panics and thinks there's danger (OMG! My BG is too low!).
  3. Complex physiologic processes take glycogen stored in the liver (I think of it as "bounce fuel"), convert it to glucose and dump it into the bloodstream to counteract the perceived dangerously low BG.
  4. These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing).
  5. Bounce prone kitty repeats this until his body learns that healthy low numbers are safe. Some kitties are slow learners.
  6. Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing.
 
I would like it if you would set an alarm and get a +6 . It is likely he will continue upward but the data is good data to have given his high dose. It is also possible he could head downward.
Feel free to take more tests than that because , after all, data is your friend.

This is definitely a bounce and we don't know his patterns yet. He could be slow to come back down Or he could be quick.
Data is how we learn his patterns.
 
Sean & Rufus said:
Here is bouncing better explained:


Here's an explanation of what we call "bouncing". It explains why a kitty's BG can go from low to sky high:
  1. BG goes low OR lower than usual OR drops too quickly.
  2. Kitty's body panics and thinks there's danger (OMG! My BG is too low!).
  3. Complex physiologic processes take glycogen stored in the liver (I think of it as "bounce fuel"), convert it to glucose and dump it into the bloodstream to counteract the perceived dangerously low BG.
  4. These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing).
  5. Bounce prone kitty repeats this until his body learns that healthy low numbers are safe. Some kitties are slow learners.
  6. Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing.
Click to expand...
OK thanks. The jump confused me but I do remember reading about bouncing. This makes sense the way you explained it with how the body reacts and tries to correct itself. I'll do another in 2 hours.
 
rhiannon and shadow (GA) said:
I would like it if you would set an alarm and get a +6 . It is likely he will continue upward but the data is good data to have given his high dose. It is also possible he could head downward.
Feel free to take more tests than that because , after all, data is your friend.

This is definitely a bounce and we don't know his patterns yet. He could be slow to come back down Or he could be quick.
Data is how we learn his patterns.
Click to expand...
OK will do. Will do one in two hours before bed and check at +6 also. Thanks
 
do you know what to do if he were to go low? Do you have a high carb gravy food and / or honey/syrup to add to his food to boost his bg ?

do you have the instructions of how to treat a hypo printed out? Everyone should have that since you never know when there might be a power outage or computer failure.
 
Status
Not open for further replies.
Back
Top