? 4/11/18/Ravan/amps424/+2 581/+4 374/pmps458/+3 351/+9 322

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Dose increases can take a few days to reveal themselves, the depot will take several cycles to fill and then you can see what's going on with the increase, don't worry.

From your yesterday's thread:

JoyBee said:
I'm hoping this increase is going to lower his bg into a lot of blues. I've seen more blues at 1 unit.
I'm trying to understand why the increase was needed in the first place? Does it mean his diabetes is getting worse?
I always thought with Lantus it's a low dose?

(I'm going to start a new thread for today.)
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No, I don't think needing an increase means his diabetes is getting worse. Cats need however much insulin they need. Often times in the beginning, a cat will keep needing increases and then after a time will start coming back down and needing decreases, and might keep going up and down with dose from there. It's just the nature of hormones, I suppose.

As far as seeing more blues at 1 unit, that was then, this is now. I don't have a satisfying answer for you why you saw some better numbers at a lower dose and then they went away. All I can say is if you look at other cat's SS and go back to when they first started insulin, it's not at all uncommon. What we do know is that most of the time, if you would attempt to go back to that dose to see if it worked now is that it wouldn't and would be a big setback. I wish there was a name for what that is and why is happens, but if there is, I haven't discovered it. I just call them flukes.

My unofficial explanation for it is that FD is a journey and the beginning in particular can be frustrating. I think cat's show you previews of what is to come so you don't get discouraged and keep trucking along. ;)

Happy to see the blue, hope you see a lot more on this dose. :bighug:
 
@Stacy & Asia

Thank you for your reply. I guess I'm just disappointed (a bit grumpy ,Not Much Sleep!)

I'm also getting frustrated with the ketones. I checked this am & it looked like a trace again!

My son had stopped over & I asked him . He kept looking & squinting his eyes,he said it was really difficult to say.

In one light it looked neg & another it might be a trace. I agree. The 2 colors are so close.

Ravan is eating his Raw meat more. Last pm & am today he didn't touch the FF only wanted Raw! This is a very good change!

He's also asking to go out more. I put some catnip on the Patio & he was rolling around wrestling with Peggy Sue.

BIG improvement in how he's feeling!
 
When you a high number like that retest him , it could be a bad step or something
Retest him now
 
Likely a big bounce after yellows and blues yesterday. He did a similar thing on April 03. It’s just one number. The trends tell you the real story.
 
It’s great Ravan is eating and is feeling better :cool:

I’m glad you increased. Please take every opportunity to test for ketones.

When I was using the ketostix, I found they were easier to read in natural light ( next to a window). The strip will sort of glow.

Are all Ps in place? Is there a chance he is in pain?

 
He's just bouncing. Ravan's not used to that lovely bit of blues he saw last night. On the up side, put away the test kit until tonight and do something for yourself. Like sleep!

As for the ketones, make sure you are looking at the strip in daylight. Check the strips on yourself if you want to make sure what none looks like. Ketones by themselves, even at a trace level are worrying, but more so as an indicator of the potential of DKA. The recipe for developing DKA is not enough insulin + inappetance/not eating enough + infection/inflammation. You definitely don't want to lower his insulin if you are seeing ketones. In fact, it's entirely likely he may eventually need even more insulin. He's still on a relatively tiny dose so don't worry about that. Cats need however much insulin they need. I'm glad to hear he's eating his raw with gusto
 
@Wendy&Neko

Thank you for replying. I'm aware of a Bounce but it feels a lot more scary now with this HIGH reading than it did yesterday before I increased his dose.

Last time Ravan did a bounce & his bg went high It stayed high for Days!

I would have felt a LOT safer waiting ,in the Pinks & yellows, for a few more days . This huge jump has me scared.

I can only check his ketones when he pees & if i'm there to check. He seems to only pee 2 or 3 times a day,large amounts.

I'm still afraid to leave the house in case he goes into DKA!
 
Highs from not enough insulin are worse than highs from bouncing. Yes, it can take 6 cycles or 3 days to get over the bounce. Since Ravan seems to be fine, eating and playing/wrestling, he's fine. Inappetance and lethargy are what you worry about. Take a break, get out of the house. You need to take care of you to take care of Ravan. :bighug:
 
@Sandy and Black Kitty

Now I'm really upset. I just checked Ravan's ketones & mine.

They both look identical! It must just be the color chart or the strips.

Ravan was always neg for ketones .Sometimes I couldn't tell for sure because of the color chart on the container.

Now I went outside in the sun & the color is not pink at all. It's like the neg color,more yellow ( I think it always has been, I just got myself all worried & started thinking it was trace.)

Even my son said he couldn't tell the difference.

This experience tells me NO one can predict what's going to happen. Just because you had something bad happen doesn't mean my cat will react the same way.

As I've gotten older I have begun feeling that I should trust my Gut feeling. I did not feel comfortable increasing Ravan's dose .

It was just increased 4 days previous. I always thought Lantus is a gentle insulin,slow to work.

Now I'll never know if i had waited 3 more days his bg may have come down slow without this huge increase!

What does ,"are all his Ps in place" mean?

He doesn't show any indication of Pain. I rub & squeeze him all over,checking every day .

He was outside yesterday & today wrestling with his sister peggy Sue.
 
Great news the ketones are negative.
JoyBee said:
Now I'll never know if i had waited 3 more days his bg may have come down slow without this huge increase!
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Lantus is slow acting, not that slow. You did enough testing on the old dose to know it wasn't going to take him any lower. Once the depot is full (about 3 days), you can see what a dose can do. The last dose showed no blues. Your goal is nadirs between 90 and 150 on SLGS.

The 5 P's are playing, preeing, purring, pooing, peeing.
 
@Wendy&Neko

(bg was in the blue on 4/7 169 7/ )

Checked +4 374 Glad to see it came down a bit.

I'm going to buy different ketone strips. I do believe Ravan has been neg all along.

I'll have to remember the 5 P's!

Thank you for your help & advice. I need to calm down! I'm going for a walk. It's finally 60 degrees here in Chicago.
 
Ketone strips can be fussy. You have to follow the instructions regarding where to store them and they really do have an expiration date once the container is opened. Otherwise, the reading can be unreliable. The other option for testing for ketones is to get a blood ketone meter. NovoMax and Precision Xtra both make meters that will test for ketones. The strips cost a lot but it's much easier to test for blood ketones and you get a number that is much easier to interpret that the color on the side of the strip container.

I'd encourage you to think about insulin/Lantus a bit differently. Insulin doesn't act like most other medications. If you compare it to an antibiotic, the antibiotic targets a bacteria and after a week or several, the bacteria is gone and everything is back to normal. Insulin is a hormone. It's produced in the pancreas and any number of external variables can effect its utilization (e.g., activity, stress, food). This isn't the case with an antibiotic. With diabetes, the pancreas is either not producing enough or isn't producing any insulin. So we provide exogenous insulin that helps to lower blood glucose levels.

Lantus is a gentle insulin as you noted. However, it has a longer duration and is not as potent as shorter acting types of insulin. Hence, it takes longer to see a response. You have to find an effective dose -- and there's no way to know what that will be. Clearly, from Ravan's spreadsheet, he's not yet at that point. The safest course is to systematically raise the dose until you see a better trend in the numbers. While Lantus does take time to see results, holding doses for longer than is needed doesn't yield good results either. You end up with glucose toxicity which makes it even more difficult to get numbers out of an undesirable range.


 
JoyBee said:
@Wendy & Neko
@Judy and Boomer
@Tracey & Jones

Can I get some comments,PLEASE?

Just Checked bg +2 581 !!! His reading has NEVER been this HIGH!

Now I'm REALLY worried about Ketones!
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Posted this yesterday in your condo.....

"Don't be surprised if his numbers don't come down right after you increase his dosage. Lantus is a depot insulin and when you increase the dosage the depot has to "catch up". So you may not see lower numbers and you might actually see higher ones!

Edited to add: This is referred to as "New Dose Wonkiness" or NDW!"
 
Hi
Having just had a scary episode of DKA with my kitty landing up in the ER and a hospital stay I can totally relate re your fear of ketones. You could do what I did and purchae a keytone blood meter and strips. I bought the novamax. I can't see colors too well so even if I could get a urine sample, I'd never be able to see it changing.

Re the dose increases - I have said the exact same as you - many times. Why am I seeing lower numbers on a lower dose. There is no easy answer to that one. So long as you have picked a protocol (TR or the SLGS method) you can't go wrong. There is good advice on here - and honestly - trust them over your gut. They have years of experience that we don't have and I have learned to my cost what happens when I do it my way.

Just my two cents.
 
JoyBee said:
Sienne and Gabby,

Thanks for the info about ketones. I really can't afford a Ketone meter & the strips. I just bought a different brand of Test strips & they look a lot better,easier to see the difference between neg & trace.

I just checked Ravan & it was neg.
Click to expand...

I’ve always just looked at the strip and waited the length of time your strips specify to read. If it pinks up any, it’s a trace. My eyes would play tricks on me trying to decipher negative and trace comparing it to those two colors. So I just look at the negative result and compare my strip to that looking for more pink than the neutral beige.

I’m glad you found a different brand that’s easier to read and very happy to hear the result was negative! :)
 
Juliet,

I agree there is good advice,but i still feel ultimately we know our cat better than anyone else.

No matter how much experience you have with "your" cat, doesn't mean my cat will react the same way.

I'm just now learning a lot from all of you about diabetes & insulin. And what your experiences have been.

I ask questions,LOTS of questions. I feel it's good to hear a whole bunch of different view points on what to do.

Then it's up to me to try to make the right decision on what is best for my cat.

I've made terrible mistakes in the past that cost my animal it's life. I am very cautious now.

If I make the wrong decision I have no one to blame but myself.

I sincerely appreciate all of your advice & opinions.The more I learn the better caretaker I'll be to my animal companions!
 
Hi Stacy & Asia,
Exactly! The pink is what I look for instead of trying to match the color to the box. These new strips are much clearer in color. ( bought a cheap generic brand before,trying to save a few $)

Thank you!
 
JoyBee said:
No matter how much experience you have with "your" cat, doesn't mean my cat will react the same way
Click to expand...

You are so right, we even have an acronym for that around here ECID (each cat is different). It’s a valuable tool to have in your tool chest to realize that.

One of the beautiful things about this community is the enourmous membership! So many cats and caregivers have come through here for over a couple decades now. While every cat is different, many observations have been made, especially by the people that have been here a long time because they have seen a lot! The advice they give sometimes may pertain to their cat, but often it is something they have seen over and over in many cats or even something rare they have only seen in one or two. I’ve learned a lot from being here, the wisdom of some very awesome people, some who haven’t been here very long, some who have, some of whom’s cats have left this world, and they continue to share their knowledge and experience. I learned the most from visiting other people’s threads and reading about their cats and what others have shared with them. Many things apply to my situation or my cat, even if the information was given to someone else.
 
Not sure what brand you have been using however regarding Ketostix (made by Bayer) Once opened they are only good or 6 months. I used to write the date I opened a bottle on the bottle cap. Also, 15 seconds after you dip the strip into a fresh urine sample is when to read the color; color changes after 15 seconds should be ignored.
JoyBee said:
Ravan was always neg for ketones .
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We all hope that is a trend that continues.
JoyBee said:
He doesn't show any indication of Pain. I rub & squeeze him all over,checking every day .
Click to expand...
Wonderful!
JoyBee said:
This experience tells me NO one can predict what's going to happen. Just because you had something bad happen doesn't mean my cat will react the same way.
Click to expand...
Every Cat Is indeed Different and it's true that no one can predict whats going to happen.
All we have to offer here is our experiences, both collective and individual.
We share them in the interest of helping caregivers make informed decisions as well as avoid potential pitfalls. .

My BK was hospitalized for DKA twice. The second episode was a little over a month after the first and he nearly lost his life. It was both heart wrenching and gut wrenching, not to mention those two hospitalizations drained our bank account. I hate to see anyone go through it.

IMHO when it comes to ketones, an ounce of prevention is worth a pound of cure.
 
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