7/13Ravan/amps500/+7 420/pmps486/+4 342/+8 438

[JoyBee&Ravan]

7/12Ravan/amps524/+5 362/+9 140/pmps100/+2 169/+5 254

I do NOT increase the dose if he's going into Blue & green on this dose? Is that correct?

 

[Mandy & Rex (GA)]

7/12Ravan/amps524/+5 362/+9 140/pmps100/+2 169/+5 254

I do NOT increase the dose if he's going into Blue & green on this dose? Is that correct?

That's correct. Do not mind the high numbers. We look at the nadirs only with Lantus.

 

[Judy and Boomer]

Oh Ravan!
JoyBee, when I was having glucose toxicity issues with Boomer last year, I was advised (by Wendy I believe) to increase every 6-8 cycles until we broke through it. And I too had issues increasing his dose when I was seeing some lower blues and greens (Wendy can tell you how very stubborn I was lol). So I'm not sure I'm the best one to advise you in these circumstances!

I do believe that there is such a thing as an overfilled depot (although I don't think it's actually documented anywhere) and that's what causes the blues/greens once a week or sometimes longer.

I think you are perfectly safe in increasing his dose. However, I found it hard to do with Boomer and, if anything, it's more difficult for me to suggest it to you!

So I'm going to suggest that you tag Wendy and ask her advice again since her post yesterday did happen before Ravan presented you with a lovely blue number at +9!

 

[Mandy & Rex (GA)]

Ditto on listening to Wendy!

 

[JoyBee&Ravan]

@Mandy & Rex
Ravan's lab report shows he now has stage 2 kidney disease & pancreatitis (he's had diabetes nearly 6 months.) I am very concerned that the high bg is is what caused these problems.
Some are advising me to increase the dose even with the blue & green #'s. I'm very confused as to what to do. Ravan went down to 39 the last time he was on this dose.

I'd like to hear more opinions on if I should or not increase the dose?

 

[JoyBee&Ravan]

@Judy and Boomer
When you increased the dose did his bg drop real low at times? I need to know what to expect might happen if i did increase the dose?

 

[Judy and Boomer]

@Judy and Boomer
When you increased the dose did his bg drop real low at times? I need to know what to expect might happen if i did increase the dose?

Sometimes after a dose increase he would drop into greens briefly then he would go back up. Once he dropped low enough that he actually earned a reduction...so I reduced his dose but eventually had to raise it back up. Here is a link to his 2017 ss....you'll see his numbers were all over the place (later in the year) and then all of a sudden in October I started to see a lot more blues and greens and this was the breakthrough finally and he went down is dose quickly after that.

 

[JoyBee&Ravan]

@Judy and Boomer

I did look at his SS I did not see you increasing his dose if he had 2 days in a row of Green & blue #'s? The thing that worries me is Ravan dropped to 39 the last time he was on this dose & that was 2 weeks after he was on it. He seems to take quite a while on a dose before he goes lower.
I know some people do well increasing every 3 days,but how would they know if they waited he might go lower?

I keep being told "Know your Cat!" " Every cat is different" but then I'm advised to do what everyone else has done?

Chris & China advised me "Lantus doesn't do well with Frequent dose changes"

Sienne and Gabby (GA) advised me to hold the dose for one week. And that "39BG was a clear message that it was too much insulin"

If Ravan starts staying up , NO blue or Green I'd be fine with increasing the dose. I'm really confused now, I want to do the best to help him!

 

[Wendy&Neko]

What a cat needed for an insulin dose a few weeks ago is no indicator of what they need now. Just because Ravan went to 39 when he was in this dose a while ago, doesn't mean he will again.

As for not increasing because you are seeing blue and green, not true. You look at the nadirs primarily, and a bit at the overall range to see if it's the dose you want to stay at. High green nadirs leave room for an increase. My Neko also had CKD, and I wanted to maximize the amount of time her numbers were below renal threshold. For her, and it took some experimenting, I found that if nadirs were no higher than the seventies, the majority of the overall range was below renal threshold. Having said that, with the 67 a couple night ago, I might hold the dose and see where he is when the bounce clears.

 

[Judy and Boomer]

I did look at his SS I did not see you increasing his dose if he had 2 days in a row of Green & blue #'s?

No, I hesitated to increase at all if I saw blue/green. And, like you and Ravan, I would be ready to increase his dose after several cycles and then BAM he would give me green numbers.

There is a standing "joke" on this site that the kitties read our condos and know when we're planning a dose increase

I would do what Wendy suggested above. Since he gave you a 67 a couple of nights ago and some nice blue numbers yesterday, I would hold the dose until the bounce clears.

It's all very frustrating, I know. We've all been there!

 

[JoyBee&Ravan]

@Wendy&Neko
@Judy and Boomer
Is it always a Bounce when Bg goes to Black on the Am or Pm shot time? Or is it the depot getting empty?
I'm still thinking about switching to Levemir. I read it works a bit slower than Lantus. What your thought on switching to Levemir?
(I would wait till I used up the Lantus)

 

[Bellasmom]

What a cat needed for an insulin dose a few weeks ago is no indicator of what they need now. Just because Ravan went to 39 when he was in this dose a while ago, doesn't mean he will again.

As for not increasing because you are seeing blue and green, not true. You look at the nadirs primarily, and a bit at the overall range to see if it's the dose you want to stay at. High green nadirs leave room for an increase. My Neko also had CKD, and I wanted to maximize the amount of time her numbers were below renal threshold. For her, and it took some experimenting, I found that if nadirs were no higher than the seventies, the majority of the overall range was below renal threshold. Having said that, with the 67 a couple night ago, I might hold the dose and see where he is when the bounce clears.

What number is below the renal threshold please Wendy, thanks

 

[Judy and Boomer]

@Wendy&Neko
@Judy and Boomer
Is it always a Bounce when Bg goes to Black on the Am or Pm shot time? Or is it the depot getting empty?
I'm still thinking about switching to Levemir. I read it works a bit slower than Lantus. What your thought on switching to Levemir?
(I would wait till I used up the Lantus)

I've never used Lev but I understand that quite often Lev causes very late nadirs; the nadirs might actually happen at the next shot time.

A bounce happens when the kitty spends time in numbers lower than what they are used to. The liver panics, dumps glucose into the system, and the BG goes up as a result. Eventually (hopefully) the liver learns not to overreact. Each cat is different and some bounce dramatically and others not so much.

Ideally the lantus curves overlap from cycle to cycle. So the shot brings the BG down and as it's wearing off the next shot brings it down again. The result we all want from this is a nice flat and hopefully green curve. It doesn't really have anything to do with the depot.

Ravan is going to high numbers partially because of a bounce and partially because the insulin has worn off.

 

[JoyBee&Ravan]

@Judy and Boomer
Is this still a bounce from the Blues yesterday? I'm so worried about his Kidney's with these High #'s
It's still confusing about increasing his dose.
Do I wait & if he doesn't have any blue increase the dose am tomorrow? I think I was told not to change the dose until the Bounce clears.

 

[Wendy&Neko]

What number is below the renal threshold please Wendy, thanks

ECID. For some cats it's low 200's for others it can be as low as mid blues. You can either get ketodiastix to test when sugar is spilled into the urine, or what I did was test at home and right after going to the vet for urinalysis. That is a slower method, but I did manage to figure it out. Keep in mind that sugar shows up in the urine some time after it's in the blood stream.

You can change a dose during a bounce. What you want to try to avoid is increasing on the cycle that they break the bounce as that means extra downward momentum and often exciting cycles. I would wait until Ravan breaks this bounce, to see if he comes down to lower greens, before increasing.

 

[Judy and Boomer]

@Judy and Boomer
Is this still a bounce from the Blues yesterday? I'm so worried about his Kidney's with these High #'s
It's still confusing about increasing his dose.
Do I wait & if he doesn't have any blue increase the dose am tomorrow? I think I was told not to change the dose until the Bounce clears.

Yes he's still bouncing. Hopefully by PMPS we'll be able to tell if the bounce is breaking. Like Wendy said, you don't want to give him an increase just as the bounce is breaking....the numbers are naturally heading downward and adding extra insulin to that might create a very active cycle.

 

[Bellasmom]

ECID. For some cats it's low 200's for others it can be as low as mid blues. You can either get ketodiastix to test when sugar is spilled into the urine, or what I did was test at home and right after going to the vet for urinalysis. That is a slower method, but I did manage to figure it out. Keep in mind that sugar shows up in the urine some time after it's in the blood stream.

You can change a dose during a bounce. What you want to try to avoid is increasing on the cycle that they break the bounce as that means extra downward momentum and often exciting cycles. I would wait until Ravan breaks this bounce, to see if he comes down to lower greens, before increasing.

Would u take a little peek at Bella’s please give me your input

 

[JoyBee&Ravan]

@ Judy & Boomer
Thank you for that answer It clarified the confusion! If my computer is working. I'll post Ravan's BG at about 9:10pm I try to shoot between 9:15 & 9:30.
I've been working in my yard all day. Mowing grass & weeding. Here's a Photo of my garden OH I didn't expect it to be so large. I don't know how to make it smaller?

 

[Judy and Boomer]

@ Judy & Boomer
Thank you for that answer It clarified the confusion! If my computer is working. I'll post Ravan's BG at about 9:10pm I try to shoot between 9:15 & 9:30.
I've been working in my yard all day. Mowing grass & weeding. Here's a Photo of my garden OH I didn't expect it to be so large. I don't know how to make it smaller?

Your garden is beautiful!

 

[JoyBee&Ravan]

Thank You! A lot of work but I feel it's worth it The back half is Organic Veggies..

 

[JoyBee&Ravan]

@Judy and Boomer
Ravan's BG went up a bit instead of down. He hasn't been feeling good today from the high Bg. If I don't get some green tonight I'll increase tomorrow AM
He's been eating good & Ketones are neg. But just sleeping all day.

Is this still a bounce?

 

[Judy and Boomer]

@Judy and Boomer
Ravan's BG went up a bit instead of down. He hasn't been feeling good today from the high Bg. If I don't get some green tonight I'll increase tomorrow AM
He's been eating good & Ketones are neg. But just sleeping all day.

Is this still a bounce?

You may want to wait on the dose increase. You don't want to increase the dose when the bounce is breaking and it will likely break either tonight or tomorrow. Then, once the bounce is broken, we want to see if he's going to come down on his own. I will check in with you tomorrow!

 

[Jill & Jade]

@ Judy & Boomer
Thank you for that answer It clarified the confusion! If my computer is working. I'll post Ravan's BG at about 9:10pm I try to shoot between 9:15 & 9:30.
I've been working in my yard all day. Mowing grass & weeding. Here's a Photo of my garden OH I didn't expect it to be so large. I don't know how to make it smaller?

wow!!!!!!

 

[Judy and Boomer]

That +4 tells me the bounce is breaking. I definitely would not increase his dose this morning.