3/30/2018 Ravan 10:00am 285 1 unit lantus +2 367

[JoyBee&Ravan]

Hello,
Ravan is still eating good Acts like he feels better.

I went to my Vet yesterday. He said he was not familiar with a spreadsheet. He asked what were all the colored boxes? I told him those are the times i tested his bg. He was Not Happy! He said How would you feel if every 2 hour someone came & stuck you for blood? Every day! I told him I would not like it. He agreed. He suggested I pay careful attention to how Ravan acts & stop chasing the numbers!

Can you understand why I'm confused what to do?

Magic,
Sorry I didn't answer your question the other day (Are you just wanting to vent and not have ideas or solutions suggested? ) Yes I want suggestions. But I also need to explain why I'm confused or just not sure what to do. I feel I also need to pay careful attention to how my Ravan is reacting to all the stabs in his ears. I backed off & he acts much better "right now" if he looks sick or goes off his food I will feel the need to test more often.

It seemed I was testing frequently for a couple days. Why wasn't it enough to see a pattern? How long do I need to test every 2-3 hrs before it's Enough? These are things that disturb me & get me confused. I see some people test many times a day regularly. I don't feel right doing that to him. Like my Vet said, how would you like it?

When is it enough?
I want his bg to come down lower but I'm OK with it in the 150 to 250 range. (I don't want to "Swim with the Sharks!")
Is that OK?

 

[Tanya and Ducia]

@JoyBee
Hi JoyBee and Ravan ( I hope I do not misspell the name as you keep calling him RavAn but the SS is titled RavEn's SS) ,

I went to my Vet yesterday.

He was Not Happy! He said How would you feel if every 2 hour someone came & stuck you for blood? Every day! I told him I would not like it. He agreed. He suggested I pay careful attention to how Ravan acts & stop chasing the numbers!

No one of a sane mind would like to be poked daily. I totally agree.

However, when I was reading your post I kept thinking of my cat girl Ducia when she was in severe symptomatic Hypo - a situation which is more than real possibility for a diabetic on Insulin any day...

I remember so very vividly her little adorable body being crooked, bent and twisted in seizures, a body-knot really, her widely open grey colored lip, mouth panting and a foam bubbling at the sides. The suffering - pain fear terror - she went thru in a couple of hours is immeasurable, it was a torture. Especially well I remember myself trying to pour more honey into her mouth and all of it coming back with foaming...Nothing worked - she was going in to a coma.

One of the scariest moment in my life.. I was lucky - I saved her.

This situation can happen to any insulin receiving cat any day if one shoots a dose without knowing what the current BG level is like.
Poking the ears - which thanks to Mother Nature is not a painful spot for such - is incomparably lesser evil/ harm/ pain than going into Hypo. For me anyway.

Not testing enough at mid cycles takes valuable info as to how cat behaves on a certain dose and if the preshot taken every cycle and comes back High most vets suggest large dose increases (usually). That strategy combined with no testing thru the cycles created perfect precondition for a real Hypo to explode. Only by testing the dose at various times can one say if the dose is a keeper, or if a cat needs an increase./ decrease.

Your vet is safe from seeing killing Hypo in action, from bearing tremendous guilt for endangering the most loved one and (please forgive me for saying it) your vet might like your cat but for him he is just another patient in the "see as many patients/ day as you can" conveyor of any modern medical practice (btw, that stands for any human health management organizations as well, imho).

He suggested I pay careful attention to how Ravan acts & stop chasing the numbers!

Clinical signs observation is very important, indeed. I watch it all of the time.

The problem comes , though, once one learns that her/ his cat is completely asymptomatic in low numbers - such my Ducia.
One moment she was totally all right - and in the next 60 min she was fighting for her life - literally.

Why was she Hypo-ing? (I thought)
Because she looked so ok to me a short while ago -"why do test?!..," I though t.. Well..
Grey hair, reading glasses, psych. trauma up till now and over $1000 spent on learning that easy lesson - do test pre-shots. Period. And do test often enough thru day and night to know if the current dose is a good one.

What is enough you asked? - it's when you know how he reacts to a dose and a food and he repeats his doings time and again and thus creates a reliable pattern - then you 'll know you test enough.

Cats patterns and insulin needs change over time. Many adjustments to both food and dose are to be made. It means, I am afraid, that testing frequently remain daily routine for those aiming at good control, a good regulation.

It seemed I was testing frequently for a couple days. Why wasn't it enough to see a pattern? How long do I need to test every 2-3 hrs before it's Enough? These are things that disturb me & get me confused.

Every 2 hours every day is excessive - but you need to pin point the onset of insulin, the nadir and it's duration - then you 'll be able to see how many pokes, or at what hours to do limited pokes to know that he is safe on the dose and it works well for him.

Sorry but you vet contributed a lot to your confusion and frustration - he gave yo u bad advise.

Here is what I'd loved to hear from him instead:
"JoeBee, How about making sure that you take every pre-shot test, and then another 2 hours later every cycle?"
2 hours after the injection is when a lot of cats see the Lantus on-setting - taking a test at this time will give you a clue as to what's in store for this cycle - if the +2 read the same or lower than the preshot value was - there will be lowering in BG down the road, it might be a sharp drop and you test more frequently.
But if the +2 much higher than the preshot value - put down the lancet, it'll be a quiet (most often than not) cycle and you can test minimal - like preshot, the +2 (high read), + 6 or +7 or later and then as needed.

I don't feel right doing that to him. Like my Vet said, how would you like it?

again - I disagree with your vet a lot. It's rather question of "who get insulin and stays alive?" rather than "who likes a pokey right now?".

I want his bg to come down lower but I'm OK with it in the 150 to 250 range. (I don't want to "Swim with the Sharks!")

My cat started to see better numbers after she swam with the sharks many times.. and then few times more..as of today I haven't discovered a way to get the range lower without letting a cat to swim w/ sharks now and then.

Dear JoyBee, this post is meant as a help - sorry I had to say what I truly think about your vet. But Hypo kills and he seems to be not very familiar with the death by Hypo...

I understand so well what you are going thru right now, so very well..
Things will get better - with time and perseverance.
Just do not force your self to get it all in too soon - it's a lot to process. And good regulation takes time.

 

[Sharon14]

Hi Joy, glad Ravan is feeling better! I agree with Tanya that testing is important. You do not need to test every 2 hours everyday. I test Colin before his shot, then 3hours after both cycles. That number tells me if I need to test anymore in that cycle. Occasionally I grab tests at other times as well. If I sit in the testing chair and shake the test strips he comes right to me and purrs the whole time. In fact when I have company and they sit in that chair he comes out from hiding (he’s scared of company) and goes to them for a test! Does he like testing? I don’t know, but it doesn’t sound like he’s too stressed by it. The night Colin went into hypo if I hadn’t gotten that +3 before bed test, who knows what could have happened. Yes I had to stay up all night feeding and testing, but he’s alive and doing well, so i think it’s worth a few pokes.

 

[JoyBee&Ravan]

Thank for your input Tanya & Sharon 14, I am always Happy to hear Honest answers! I totally agree that I need to test at times like 2 hrs after a shot. I'm home most of the time & always aware of what my cats are doing. I'm what my son would call a " HOVER" parent to my kitties & (I was to my boys)

If I'm going out even for an hour I check Ravan's bg. I always check before shot & 2 hrs after.
My Vet is referring to the couple times i was testing every 2 hrs When he saw all the boxes he was shocked! He's a good guy, Old school & owns his own practice. He told me " back in the day " they played it by ear, if kitty was eating & acting normal they weren't too concerned.

I do understand what you mean about going Hypo I am scared to death of that happening. Neither of you commented if you think 150- 250 bg is acceptable to you . I just tested Ravan & bg is 272. I'd like it lower but I'm not upset at that number.
I'm willing to wait a few days longer to see if he goes down more. I need to take it slow. I was having some real trouble trying to go without sleep to test for the curve. I have major problems sleeping to begin with. Takes me at least 1/2 hr to fall asleep every time.

Sharon 14 I would LOVE it if my Ravan was so accepting of his test! He 's just not! Last night ,1st time in 2 months he came to my bed purring! I was so amazed & shocked I cried! I think it was his way of giving ME a TREAT! for not sticking his ear so much! HA!

Thanks again guys. I know it's difficult to understand me at times. But please believe me, I do want your suggestions & input!

 

[Bobbie And Bubba]

@JoyBee
Hi JoyBee and Ravan ( I hope I do not misspell the name as you keep calling him RavAn but the SS is titled RavEn's SS) ,



No one of a sane mind would like to be poked daily. I totally agree.

However, when I was reading your post I kept thinking of my cat girl Ducia when she was in severe symptomatic Hypo - a situation which is more than real possibility for a diabetic on Insulin any day...

I remember so very vividly her little adorable body being crooked, bent and twisted in seizures, a body-knot really, her widely open grey colored lip, mouth panting and a foam bubbling at the sides. The suffering - pain fear terror - she went thru in a couple of hours is immeasurable, it was a torture. Especially well I remember myself trying to pour more honey into her mouth and all of it coming back with foaming...Nothing worked - she was going in to a coma.

One of the scariest moment in my life.. I was lucky - I saved her.

This situation can happen to any insulin receiving cat any day if one shoots a dose without knowing what the current BG level is like.
Poking the ears - which thanks to Mother Nature is not a painful spot for such - is incomparably lesser evil/ harm/ pain than going into Hypo. For me anyway.

Not testing enough at mid cycles takes valuable info as to how cat behaves on a certain dose and if the preshot taken every cycle and comes back High most vets suggest large dose increases (usually). That strategy combined with no testing thru the cycles created perfect precondition for a real Hypo to explode. Only by testing the dose at various times can one say if the dose is a keeper, or if a cat needs an increase./ decrease.

Your vet is safe from seeing killing Hypo in action, from bearing tremendous guilt for endangering the most loved one and (please forgive me for saying it) your vet might like your cat but for him he is just another patient in the "see as many patients/ day as you can" conveyor of any modern medical practice (btw, that stands for any human health management organizations as well, imho).

Clinical signs observation is very important, indeed. I watch it all of the time.

The problem comes , though, once one learns that her/ his cat is completely asymptomatic in low numbers - such my Ducia.
One moment she was totally all right - and in the next 60 min she was fighting for her life - literally.

Why was she Hypo-ing? (I thought)
Because she looked so ok to me a short while ago -"why do test?!..," I though t.. Well..
Grey hair, reading glasses, psych. trauma up till now and over $1000 spent on learning that easy lesson - do test pre-shots. Period. And do test often enough thru day and night to know if the current dose is a good one.

What is enough you asked? - it's when you know how he reacts to a dose and a food and he repeats his doings time and again and thus creates a reliable pattern - then you 'll know you test enough.

Cats patterns and insulin needs change over time. Many adjustments to both food and dose are to be made. It means, I am afraid, that testing frequently remain daily routine for those aiming at good control, a good regulation.

Every 2 hours every day is excessive - but you need to pin point the onset of insulin, the nadir and it's duration - then you 'll be able to see how many pokes, or at what hours to do limited pokes to know that he is safe on the dose and it works well for him.

Sorry but you vet contributed a lot to your confusion and frustration - he gave yo u bad advise.

Here is what I'd loved to hear from him instead:
"JoeBee, How about making sure that you take every pre-shot test, and then another 2 hours later every cycle?"
2 hours after the injection is when a lot of cats see the Lantus on-setting - taking a test at this time will give you a clue as to what's in store for this cycle - if the +2 read the same or lower than the preshot value was - there will be lowering in BG down the road, it might be a sharp drop and you test more frequently.
But if the +2 much higher than the preshot value - put down the lancet, it'll be a quiet (most often than not) cycle and you can test minimal - like preshot, the +2 (high read), + 6 or +7 or later and then as needed.


again - I disagree with your vet a lot. It's rather question of "who get insulin and stays alive?" rather than "who likes a pokey right now?".


My cat started to see better numbers after she swam with the sharks many times.. and then few times more..as of today I haven't discovered a way to get the range lower without letting a cat to swim w/ sharks now and then.

Dear JoyBee, this post is meant as a help - sorry I had to say what I truly think about your vet. But Hypo kills and he seems to be not very familiar with the death by Hypo...

I understand so well what you are going thru right now, so very well..
Things will get better - with time and perseverance.
Just do not force your self to get it all in too soon - it's a lot to process. And good regulation takes time.

This day that Tanya talks about with Ducia was probably one of the scariest days on this forum as I have experienced. Even just reading about it again got me so upset. For those of us that were along guiding her, we were going through it also. And it's not something that I would want to go through again.

Please don't be complacent. Hypos do kill.

 

[Sharon14]

Glad you’re going to keep testing, I guess I misunderstood and thought you were going to stop daily tests. As far as numbers go, I think 250 is the renal threashold, so you’d want to stay under that number as much as possible. Since we consider 50-120 as normal numbers, that range would be the healthiest and best to help his pancreas heal and possibly go into remission. You have to do what you feel is best for you and Ravan. Losing sleep and having frazzled nerves isn’t good for either of you! I think after you’re here awhile you won’t be as afraid of the normal numbers and you’ll start wanting to see them.

 

[Tanya and Ducia]

This day that Tanya talks about with Ducia was probably one of the scariest days on this forum as I have experienced. Even just reading about it again got me so upset. For those of us that were along guiding her, we were going through it also. And it's not something that I would want to go through again.

 

[JoyBee&Ravan]

Bobbie I made a mistake on the spreadsheet His name is spelled Ravan.
I'm never "Complacent" when it comes to my Kitty kids! I just know when i'm too exhausted i can make mistakes So I need to pay attention to myself also!! I get all shaky & emotional when I'm sleep deprived. Not good for me or my Cats.
I need to take this slow. I want to comply with all your advice but sometimes I do need to be careful. You understand?

 

[JoyBee&Ravan]

Sharon I didn't intend to stop only slow down. I thought doing testing every 3 hrs or so 2 or 3 times was going to be enough to see his curve. I never thought I'd need to keep doing it!

I think your right about getting more comfortable as time goes on. I don't know about going to 50! After reading about Tanya & Ducia experience I really don't think I could go thru that.

Tanya, you must be a hell of a lot stronger than me I'd be a basket case,probably have a heart attack & the both of us would of been gone!

I really am doing the best I can, Believe me I love my cats & would do anything for them !

 

[Tanya and Ducia]

Tanya, you must be a hell of a lot stronger than me I'd be a basket case,probably have a heart attack & the both of us would of been gone!

I was terrified out of my wits - literally, .
I think all of us like that at a start - it's a lot to take in.
I myself cannot believe now that back then I did not know that :
a) cats CAN have diabetics,
b) if BG goes low some food can help it up ,
c) Lancet is the name of a fancy posh-y Med Doctors's monthly magazine, , not a sharp object to poke your cat, lol.

I am in no way stronger than anyone else but Ducia got me thru Hypo and DKA - I had to learn fast.
Also, I am in to it for over a year - you'll do much better in that same period of time, you'll see.

The most important source of any (IF I have any) strength - is this Forum. Honestly - stating the fact, not paying any compliments now. Stick with us. (keep your vet near by, too).

Give it some time, don't push yourself to understand it all right now - I never met anyone who got it all overnight.

 

[JoyBee&Ravan]

Thanks Tanya! I have a question. I looked at Ducia's sheet. What do the letters signify after the dose 1.25sk or 1F

On the 25th all green. What made it go up to 293 then to 344 in the evening? I've looked at several cats sheets & I can't see a Pattern It looks all over the place Even if for a few days it evens out then it's all weird again?

It seems to me there never is a stable pattern that you can be sure of?

My Vet is an Older guy & has had his clinic for a long time. He said the majority of people give up after 6 months! ( I could never give up! )

Yrs ago I had to give a pill to my cat Andy every night. I'd rub butter over the pill & used one of those tools to insert the pill in his mouth. Every night for a week. The last night the pill got stuck in his throat!

He was choking. I tried everything. I couldn't see the pill to remove it with forceps I had him upside down pounding on his back, did the Heimlich, breathed into his mouth ,everything .

I 'm alone. The nearest emergency clinic is 40 mins away. I tried desperately to save him. He died in my arms. I felt like I was trying forever but it all happened so fast. I was sick for weeks. To this day I often feel so guilty that he died because of me. I will never give up trying to help Ravan or any of my animals!

 

[JoyBee&Ravan]

I had the screen on my computer go all Red today An Alert said "There is A Major Threat to your computer,call this number immediately" I know this is a scam to get you to call. But the scary part is my computer was Frozen I couldn't shut it off, nothing! I had to hold the shut off button for a long time till it finally shut off.

When I turned it on I ran a Malware check & did a clean . I'm mentioning this because it happened while i was on this web site. Before i turn off my computer every night i run a security scan to check everything. Since I've be going on this web site I get hundreds,even 1000 tracks that I delete. Before i'd get maybe 10 or 20.

I don't know a whole lot about computers but i thought i'd mention this in case anyone else has this problem?

 

[JoyBee&Ravan]

Hi Tanya and Ducia,
Yesterday you wrote, likes this ,but didn't answer my questions?

 

[Tanya and Ducia]

Hi Tanya and Ducia,
Yesterday you wrote, likes this ,but didn't answer my questions?

Hi JoyBee,

I read your question but could not reply as I received a Skype call from my Dad from overseas just then. I can read English and talk another language but not write in English whilst having a conversation in another language – I can focus on either one a time, not both simultaneously. Sorry, I had to stay on that call.

I tried desperately to save him. He died in my arms.

I am so very sorry about the loss of your kitty! I think you did everything you could to safe him but sometimes, unfortunately, bad things are meant to happened no matter what.

looked at Ducia's sheet. What do the letters signify after the dose 1.25sk or 1F

1.25 Skinny means dose which just a tiny bit lesser than the full 1 and a quarter unit dose; 1Fat - just a bit more than 1 unit.

I looked at Ducia's sheet.

On the 25th all green. What made it go up to 293 then to 344 in the evening?

Ducia is a bouncer. Going (temporarily) higher after a low number is called bouncing. There many triggers for bouncing.On 3/26 she reached 65 at preshot and this nice low number triggered the bounce by the cycle end.

When Ducia was Dxed w/FD she already lived with high BG levels for a while so her body adjusted itself to that new higher than normal BG range and made it its new norm. Then she got Dx and began receiving daily Lantus injections which pulled her numbers down. Although Green numbers are good and healthy her body perceives it as life threatening Hypo event and releases glucose stored in the liver for exactly such moments - it is a part of the defense mechanism programmed by Mother Nature. Ducia can bounce for several cycles, and then it clears and things go back to normal until the next bounce. Some cats bounce longer than other. Some don’t bounce at all. There are tricks to ease up a bounce but I don’t know if it’s possible to eliminate it completely. I don’t want to overwhelm you with too much info right now. You do not know if Ravan is a bouncer.

It seems to me there never is a stable pattern that you can be sure of?

Yes and no. Mostly no.

It’s hard in general to expect the same reaction to a dose of hormone (Insulin is the hormone, not a medication like pills) from a living/breathing organism whose hormone productive endocrine system is already burdened by diabetes. Too many things can affect the reaction – from how’s cat feeling, how much or what s/he is eating to what kind of weather is out there. Ducia’s numbers tend to go up if it is too hot outside even if the rest is unchanged (like food or water). So, to be brief – patterns change. (That’s another reason to take mid cycle tests – to keep on eye on the changes and adjust your strategy accordingly. )

However there are some patterns that stay long/ longer and when you learn what they are you can try using them to your advantage. Every cat is different. One stubborn pattern I can count on is that Ducia does bounces – and I rely on it often. Bounce itself is her stable pattern. Another stable one is that she drops a lot of points at +2 and the large drops make her bounce. I feed her an hour before the expected bounce and slow it down this way. This pattern is 6-8 months old – and I use it - but I don’t know for how long it’ll stay. I keep testing to keep an eye on it.

I don't know a whole lot about computers but i thought i'd mention this in case anyone else has this problem?

I am a not computer person either. My old PC freezes a lot - several times a day esp if I run Skype and this Forum at once. I do whay you do - power off and reboot.

I hope the info was helpful. Let me know if it doesn't make sense I'll try to rephrase my answers better.

 

[krazy4kritters]

I don't know about going to 50! After reading about Tanya & Ducia experience I really don't think I could go thru that.

You'd be surprised how well you can handle it. Diamond dropped below 50 4 times in 7 days (last week). The first time I was a bit freaked. Now I know what to do and he bumps out of it with a little food. Shooting my first green numbers were a bit scary as well. Now I embrace them and am a little bummed if his psbg is blue.
Your doing great!

 

[JoyBee&Ravan]

Tanya and Ducia, Thank you for answering my questions! And for the advice.( Sometimes it gets very lonely here!)

I increased Ravans' dose from 1 unit to 1.25 skinny I messed up this morning. 1st time I did a fur shot I'm really bummed out! This is going to throw him off for sure! No Insulin.

Do I give a bit more at his PM shot Like 1.25 instead of 1.25 skinny?

 

[JoyBee&Ravan]

krazy4kritters, I appreciate the encouragement! Thank You.

 

[Tanya and Ducia]

Do I give a bit more at his PM shot Like 1.25 instead of 1.25 skinny?

Hmm... very good question..
The answer is somewhat dependent on several things. One is the dosing method yo are following - have you decide on what to follow - TR or SLGL? Both require different length of time to pass before evaluating/ changing the dose.

I agree that increasing tonight to 1.25U is awfully tempting.
However, a few cycles back he had nice 132 as his nadir on Fat 1U dose. Perhaps you should keep it - as long as your chosen dosing method suggests, keep testing and do reevaluation in a couple of cycles?
If you are absolutely sure that it was FS this AM then you can give the PM shot an hour earlier - early shots act like dose increase (and delayed shots act as if decrease).
Doing that will move every cycle shot time 1 h earlier and because Lantus requires dose consistency you 'll have to keep 12 h gap and either shoot early from now on or gradually return your previous shot time back by either 30 min per day or 15 per each cycle. I'll explain better if you decide to shoot early.

PS. OK, just seeing now that it is still 03/30 thread - I'll copy paste that reply here shortly so you can deal with one thread only at a time.

PPS. I am afraid Ravan too wants to be a bouncer.....so, welcome to the Club of bouncing cats!

 

[Tanya and Ducia]

I increased Ravans' dose from 1 unit to 1.25 skinny I messed up this morning. 1st time I did a fur shot I'm really bummed out! This is going to throw him off for sure! No Insulin.

Do I give a bit more at his PM shot Like 1.25 instead of 1.25 skinny?

I cannot locate your post for 04/01.
If you didn;t post for today Sunday 04/01 can you plese open a thread for today and just copy paste the same question as in your post #16 above?
Use words "Post FS dose advise for tonight please (or something like that) for the Title and it'll bring in more experienced ppl to help up. Chose the question mark prefix - an eye catcher.

 

[JoyBee&Ravan]

Hi Tanya,
Yes I'm sure of the fur shot. I had been parting his fur & injecting at an angle . I had a clear shot when I injected. Then I read the article on How to inject & it said to pinch the skin. I tried that & got a fur shot! I'll stick with my original way.

I want to take it real slow increasing his dose. So it sounds right to shoot 1 hr early tonight at the same dose. I'll need to get it back to 9pm /am I've been missing my yoga class & it helps with my back problems so I really need to get back to it.

Recently I had to delay his PM shot by over an hour (was in a Panic & waiting for an answer) I just got back to my regular time & now I'll need to gradually change the shot to get back again.

I'm going to start a new thread for today.

Thanks for your help!

 

[Tanya and Ducia]

I'm going to start a new thread for today.

Please do when you can -

Recently I had to delay his PM shot by over an hour (was in a Panic & waiting for an answer) I just got back to my regular time & now I'll need to gradually change the shot to get back again.

there are some good info about late/ early shots and what to expect or how to test afterwards - but I don't want to reply here the 03/30 thread about 04/01 situation - it's confusing.

 

[JoyBee&Ravan]

Tanya , I posted a new thread & need an answer