10/4 Booger AMPS 508, +2 618

[Booger's Mom]

YESTERDAY: http://www.felinediabetes.com/FDMB/threads/10-2-booger-amps-249-2-382.204090/

I know Booger has only been on Lantus for going on 5 days now, but his numbers concern me. Only because he is acting like he used to when his numbers were high (bc they are now) and just laying around and looking like he doesn't feel good. As I stated in the notes on his SS, he acts normal when it comes to feed time or when he thinks its time for him to be fed, or when I get the shredded cheese bag out. I know cheese is not good for cats but I give him a little shred here and there. He does this little pacing/excited number when I get the bag out. Anyway, just need some encouragement. Feeling quite down about his numbers. He just seems to be all over the place (nothing new with him) but like I said, I do know that its only the first half of day 5.

 

[Bellasmom]

I hope he comes down for you! Come on Booger bring it on down
I think you will see better numbers as the lantus kicks in better

 

[Gill & George]

Hi there,

I don't know if you will see this in time but if you do I would increase the dose to 2.25u in the morning.

I'm working on a response for you about the depot, I've been busy at home and haven't had a chance to sit down and think about it to write for you, hopefully in a different way so that it can make sense to you.

 

[Booger's Mom]

Hi there,

I don't know if you will see this in time but if you do I would increase the dose to 2.25u in the morning.

I'm working on a response for you about the depot, I've been busy at home and haven't had a chance to sit down and think about it to write for you, hopefully in a different way so that it can make sense to you.

Hey, yeah I didn't see this in time lol. It ok though. He was 508 this morning at 8am. Do I have to wait until tomorrow to increase him or can I increase him next cycle? I guess we will see how today goes. Booger has always been a very bouncy kitty. I do not know why.

 

[Booger's Mom]

I just do not know whats going on with Booger today! Its driving me nuts. Now he is 618! ugh!!!!

 

[Gill & George]

Hey, yeah I didn't see this in time lol. It ok though. He was 508 this morning at 8am. Do I have to wait until tomorrow to increase him or can I increase him next cycle? I guess we will see how today goes. Booger has always been a very bouncy kitty. I do not know why.

Yes you can increase tonoght.

I just do not know whats going on with Booger today! Its driving me nuts. Now he is 618! ugh!!!!

How is he feeling? Anything else going on? Pooping peeing ok? Eating ok?
Can you test for ketones?

Sorry about the numbers

OK this is how I think of the depot.

When you inject Lantus, part of the dose goes to work straight away and part of the dose is 'stored' to be slowly released later.
The size of the store is directly dependent on the dose you shoot, the larger the dose the larger the store and vice versa.
It takes time for the store to adjust to it's correct size. (experience tells us up to 6 cycles)
Even if we skip a dose the depot can still affect numbers as it continues to leach insulin into the blood stream, and when we take a reduction the depot of the higher dose has to size down, so the larger depot can still influence the numbers (keep them lower) for up to six cycles.
The larger the dose the larger the depot and the longer it typically takes for the depot to readjust.

What does this mean.
When you make your first shot, some of the insulin goes to work right away, but at this point the 'store' is still filling so usually you won't see the complete effect of the dose, as the store get's bigger, with each consecutive shot, it slowly increases in size, leaches more insulin into the system and you can start to see more movement in numbers reaching an equilibrium at around 6 cycles, where we expect to see the maximum effect of the dose, at this point we consider that we have seen what the dose is capable of and we look at the numbers to decide what to do.

We look at the nadirs, see if they are in the range we want (on TR 50-80 on a human meter), holding the dose if the nadirs are looking good, or increasing if they are not. It's important when looking at the numbers to know if we are seeing the full effect of the dose(the depot is full), and to take bounces into consideration, in some circumstances you might need to wait for them to clear.
If we skip or change the dose then we start counting cycles again, as any dose adjustment will have affected the depot and therefore the ultimate effect of that dose on the insulin so we need to wait for it to stabilise, with TR it is important to try and be consistent with the dosing, flip flopping with doses is counterproductive as it affects the depot and in turn makes the numbers go all 'wonky' making it hard to know what the right dose is.

On the depot sticky I like this link which explains the depot in layman terms. Worth a look if you have not already read it.
https://www.diabeteshealth.com/lantus-and-levemir-whats-the-difference/

 

[Booger's Mom]

Yes you can increase tonoght.

How is he feeling? Anything else going on? Pooping peeing ok? Eating ok?
Can you test for ketones?

Sorry about the numbers

OK this is how I think of the depot.

When you inject Lantus, part of the dose goes to work straight away and part of the dose is 'stored' to be slowly released later.
The size of the store is directly dependent on the dose you shoot, the larger the dose the larger the store and vice versa.
It takes time for the store to adjust to it's correct size. (experience tells us up to 6 cycles)
Even if we skip a dose the depot can still affect numbers as it continues to leach insulin into the blood stream, and when we take a reduction the depot of the higher dose has to size down, so the larger depot can still influence the numbers (keep them lower) for up to six cycles.
The larger the dose the larger the depot and the longer it typically takes for the depot to readjust.

What does this mean.
When you make your first shot, some of the insulin goes to work right away, but at this point the 'store' is still filling so usually you won't see the complete effect of the dose, as the store get's bigger, with each consecutive shot, it slowly increases in size, leaches more insulin into the system and you can start to see more movement in numbers reaching an equilibrium at around 6 cycles, where we expect to see the maximum effect of the dose, at this point we consider that we have seen what the dose is capable of and we look at the numbers to decide what to do.

We look at the nadirs, see if they are in the range we want (on TR 50-80 on a human meter), holding the dose if the nadirs are looking good, or increasing if they are not. It's important when looking at the numbers to know if we are seeing the full effect of the dose(the depot is full), and to take bounces into consideration, in some circumstances you might need to wait for them to clear.
If we skip or change the dose then we start counting cycles again, as any dose adjustment will have affected the depot and therefore the ultimate effect of that dose on the insulin so we need to wait for it to stabilise, with TR it is important to try and be consistent with the dosing, flip flopping with doses is counterproductive as it affects the depot and in turn makes the numbers go all 'wonky' making it hard to know what the right dose is.

On the depot sticky I like this link which explains the depot in layman terms. Worth a look if you have not already read it.
https://www.diabeteshealth.com/lantus-and-levemir-whats-the-difference/

He is just laying around (as usual) He seems fine in the pooping and peeing department. I was able to check for ketones earlier and it was negative. Do you think he is so super high today because I have been giving him his insulin 30 minutes earlier each day to get him back on an 8/8 schedule? Thank you for explaining all this. It makes more sense now.

 

[Booger's Mom]

Honestly, the insulin must not have gone in him this morning. I always check to make sure I dont feel liquid (furshot) and I always take my time to make sure I inject it in to him. This is the only explanation I can think of for why he is so high today!

 

[Booger's Mom]

He is on Friskies Pate wet food. I made sure that the ones I got him had 5% carbs or less in them. Why on earth is his blood sugar so high if he is barely getting carbs????