8/23/19 Blaze AMPS 410, +3 299, +7 354, +9 379, PMPS 399, +2 256, +3 325, +4 385

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Yes I would given you can't monitor him all day. I think those higher BGs in the AM are simply a bit of a bounce from the yellows overnight which Blaze isn't used to. Let's talk a bit of an increase maybe on the weekend if you can monitor then.
 
MrWorfMen's Mom said:
Yes I would given you can't monitor him all day. I think those higher BGs in the AM are simply a bit of a bounce from the yellows overnight which Blaze isn't used to. Let's talk a bit of an increase maybe on the weekend if you can monitor then.
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I have a bridal shower to go to at 11 tomorrow so I won’t be home for a few hours in the middle of the day to monitor and test him. But I should be home Sunday all day for the most part, besides some grocery shopping. I will do some testing today when I’m home, have to run a few errands today.

After PMPS tonight, I will hopefully to be able to chat with you to see if I should stay at 0.5U or increase a bit, depending on his number. Possibly increase to 0.75U, is that what you’re thinking?

And his AMPS numbers are lower each day, still high but dropping a little bit every morning. Is that a good sign?
 
You are grasping this puzzle very quickly.:D Yes I think you could try 0.75u dose but I'd also like to see what happens at current dose with the dry reduced a tad more too. Since we don't know how much Blaze is eating vs. his siblings reduce the dry a little more today. The pre-shots coming down is definitely a good thing along with that smoother less dramatic drop.

I'll be around tonight so we can discuss next steps more then. :)
 
MrWorfMen's Mom said:
You are grasping this puzzle very quickly.:D Yes I think you could try 0.75u dose but I'd also like to see what happens at current dose with the dry reduced a tad more too. Since we don't know how much Blaze is eating vs. his siblings reduce the dry a little more today. The pre-shots coming down is definitely a good thing along with that smoother less dramatic drop.

I'll be around tonight so we can discuss next steps more then. :)
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Okay sounds good Linda! Thank you! Have a Good Friday, talk later!:)
 
Good morning Sarah! Blaze is doing well, it's no good second guessing the dose last night. It's better to be slow and steady and see what cuddly Blaze is going to do today.

This is the first day you get to get more tests and watch the progress, and I am eager to see what happens. Deep breaths, you are doing great and Blaze's progress is showing that.
 
Idjit's mom said:
Good morning Sarah! Blaze is doing well, it's no good second guessing the dose last night. It's better to be slow and steady and see what cuddly Blaze is going to do today.

This is the first day you get to get more tests and watch the progress, and I am eager to see what happens. Deep breaths, you are doing great and Blaze's progress is showing that.
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Good morning Lou! Thank you! I definitely feel more confident with BG testing but not with reading the numbers and knowing what dose to give based on his numbers, whether I should increase or decrease, hence me posting here every day!

I’m happy to have more time today to get more tests in and see how he’s reacting to the insulin throughout the day. I also need to call Mark’s Marine to order his new Lantus prescription. I know it takes about a week to ship so he will be on Novolin for another week or so until I receive the Lantus. Excited to get him on something that will be better for him.
 
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It's ok that he's going to be on Novolin for another week, and he's safe Sarah. You, Linda, Nan and others are making sure of that. You may see different results when he gets on Lantus, it's just differently shaped tool in your diabetic treatment toolbox and the depot will need to build. So, you will be starting a new learning process there. It's all a step by step work in progress, but you and Blaze are going to get there.
 
Idjit's mom said:
It's ok that he's going to be on Novolin for another week, and he's safe Sarah. You, Linda, Nan and others are making sure of that. You may see different results when he gets on Lantus, it's just differently shaped tool in your diabetic treatment toolbox and the depot will need to build. So, you will be starting a new learning process there. It's all a step by step work in progress, but you and Blaze are going to get there.
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@Idjit's mom Thank's Lou, I feel like Blaze is safe. I know it would be good to see lower numbers but I know we are figuring out a good dose for him and I don't want him dropping too low on days I'm at work or during the night when I'm asleep. He seems to be feeling so much better than last week and seems to be gaining a little weight back that he had lost in the last couple weeks before diagnosis and his diabetic neuropathy in his back legs has seemed to gone away, he's walking normally again! And he's grooming himself again and he's playful. All good things that make me so happy!

I know I will be starting over with learning once we switch to Lantus but I'm okay with that, now that I am better at testing BG and have so much help here!

I just tested BG at +7 and he's at 354.
 
+7 BG 354. Unfortunately, Novolin isn't a long lasting insulin..according to what I have read and I'm not very knowledgeable about it. I'm sure Linda will be watching for the PMPS and be able to tell you what dose tonight. But it's really good that you are seeing how the insulin is actually working for Blaze today, you can get a clearer idea by seeing when BG goes lower, then begins to rise again.

As for: He seems to be feeling so much better than last week and seems to be gaining a little weight back that he had lost in the last couple weeks before diagnosis and his diabetic neuropathy in his back legs has seemed to gone away, he's walking normally again! And he's grooming himself again and he's playful. All good things that make me so happy!

That is Happy stuff indeed! He was probably in the "black and red" ranges last week and not feeling good at all. My vet told me it was like a human having the flu..and we all know how icky that feels. So, he's showing improvement and we are also very glad.
 
Ya, I think we might try for 0.75U tonight, depending on where he's at with his PMPS. I can't wait to get him on Lantus, which will last longer for him and not have him bouncing so much (hopefully).
 
On the subject of Lantus, Nan has given you great info.

There are two dosing methods we follow here. Start Low and Go Slow and Tight Regulation. Tight Regulation or TR is a little more aggressive and I think a bit more challenging when you are working but a lot of folks still do it and manage just fine. In the big scheme of things, very few people have the luxury of coming home to test kitty on their lunch hour so if you can and are willing to do it some days, you are already at an advantage.

You have about a half hour leeway with Lantus shots and as long as you don't anticipate late or early shots every day, you will be fine.

HERE is some info about using TR protocol with Lantus while working a full time job. I'm sure you will find it helpful to alleviate some if not all of your concerns. And of course if you choose, you can also use the Start Low Go Slow method (required if kitty is still on dry food).
Read the stickies in the Lantus forum and ask any questions your have so you can decide what you think will work best for you and Blaze. You can always switch anytime from one method to the other if you choose.
 
MrWorfMen's Mom said:
On the subject of Lantus, Nan has given you great info.

There are two dosing methods we follow here. Start Low and Go Slow and Tight Regulation. Tight Regulation or TR is a little more aggressive and I think a bit more challenging when you are working but a lot of folks still do it and manage just fine. In the big scheme of things, very few people have the luxury of coming home to test kitty on their lunch hour so if you can and are willing to do it some days, you are already at an advantage.

You have about a half hour leeway with Lantus shots and as long as you don't anticipate late or early shots every day, you will be fine.

HERE is some info about using TR protocol with Lantus while working a full time job. I'm sure you will find it helpful to alleviate some if not all of your concerns. And of course if you choose, you can also use the Start Low Go Slow method (required if kitty is still on dry food).
Read the stickies in the Lantus forum and ask any questions your have so you can decide what you think will work best for you and Blaze. You can always switch anytime from one method to the other if you choose.
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Thank you for the info Linda and Nan!

I just ordered Blaze's new Lantus prescription from Mark's Marine so I have a week or so to do some reading on Lantus. I have read through a lot of the stickies and threads on the Lantus board, trying to learn about it. I will read up on the TR protocol with Lantus and see what might work best for me and Blaze. I am hoping to be able to make it home on my lunch hour a couple times a week, but I know it won't always work out that. There may be weeks were I can come home and test a couple times in a week and there may be other weeks where I can't come home on my lunch at all. I know we will make it work and get through it with all your help:)
 
Sarah Hamrick said:
Thank you for the info Linda and Nan!

I just ordered Blaze's new Lantus prescription from Mark's Marine so I have a week or so to do some reading on Lantus. I have read through a lot of the stickies and threads on the Lantus board, trying to learn about it. I will read up on the TR protocol with Lantus and see what might work best for me and Blaze. I am hoping to be able to make it home on my lunch hour a couple times a week, but I know it won't always work out that. There may be weeks were I can come home and test a couple times in a week and there may be other weeks where I can't come home on my lunch at all. I know we will make it work and get through it with all your help:)
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@MrWorfMen's Mom @Nan & Amber

One question I have a about Lantus right now, is it harder to see cats getting into remission doing the low and slow method on insulin? I’m not sure I could do tight regulation, I wouldn’t be able to stay up until midnight possibly testing Blaze if he gets too low, because I get up at 5 am for work. I have to get some sleep too, I don’t do well on minimal sleep. So I’m not sure I could handle TR once on Lantus.
 
The short answer is YES. Cats can go and do go into remission on SLGS. I personally used that method through most of my journey with my girl. Now she was a bit of an odd ball because she was also a high dose kitty with a secondary condition that made her remission somewhat of a surprise/miracle. I admit I switched over to TR late in the game to see her to the completion of reducing her insulin and getting to an Off The Juice trial but then she kind of forced my hand when she was suddenly staying in dark green numbers continually and all I was doing was reductions. I switched over to TR in the end more to ensure she really was headed to remission than anything else.
 
You can try the 0.75u BUT you will need to monitor closely from about +2 to at least +5 and preferably to +6 to ensure Blaze doesn't drop too low. I doubt he will drop too low but they can surprise us sometimes so better to monitor and head them off at the pass.
 
I agree with everything Linda says. SLGS is great for getting your kitty down into the "remission zone" of healthy numbers. It can get a little weird at the end, and you might have to switch to TR to cross the finish line to a strong remission, but by that point you should have a good handle on how Blaze responds to the insulin and be able to work things out.
 
MrWorfMen's Mom said:
You can try the 0.75u BUT you will need to monitor closely from about +2 to at least +5 and preferably to +6 to ensure Blaze doesn't drop too low. I doubt he will drop too low but they can surprise us sometimes so better to monitor and head them off at the pass.
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@MrWorfMen's Mom

Okay sounds good, I will give 0.75U at 6:00 pm and monitor him. So test at +2, +5 and +6? and if he's not dropped too much from +5 and +6, I should be okay to stop testing for the night?
 
Nan & Amber said:
I agree with everything Linda says. SLGS is great for getting your kitty down into the "remission zone" of healthy numbers. It can get a little weird at the end, and you might have to switch to TR to cross the finish line to a strong remission, but by that point you should have a good handle on how Blaze responds to the insulin and be able to work things out.
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@Nan & Amber
Okay great, thanks so much. I think once we receive the Lantus, I will start with SLGS and if we need to switch to TR at some point, we will. Hopefully by then, like you said, I will have a better idea of how Blaze responds to the insulin. I just don't want to overwhelm myself all over again. It feels a little scary and like I will be starting over once we switch to Lantus.

I keep thinking of questions, I'm sorry. So when switching from Novolin to Lantus, how do you decide where to start the dose? Do you use the same dose you have been using with Novolin, or how does that all work?
 
From the SLGS guidelines:

  • 1u BID if kitty is not on a wet/canned low carb diet
  • 0.5u BID if kitty has been switched to a wet/canned low carb diet
  • If the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration
If he were starting tomorrow, I'd probably start him on 0.5U (assuming the dry is pretty much out of the picture), although his numbers have been high enough that 0.75U would not be unreasonable. We'll see what he does in the next week, though!
 
Generally the dose is a direct switch so same dose on Lantus as the dose is on Novolin.

On the testing front tonight, I'd test at +2 and see what Blaze does. Then it may be necessary to test between +2 and +5 but we'll let Blaze direct traffic on this one. If he drops off a lot by +2, then a little more testing is needed. If he doesn't drop too much then testing is a little less intense. I'll stick around to coach you through.

I think it's a good choice to go with SLGS for now. Get your feet wet and get comfortable then if you want to change you can do so. While there are differences between Lantus and Novolin there's also things that are not so different. Some folks will suggest that dosing with Novolin is based on pre-shots which is not the case at all. You can sometimes dose Novolin on pre-shots after you have copious amounts of data and the cat is regulated but until then, the lowest point in the cycle still needs to be part of the dosing equation and that's where you are right now and that's what you will be looking to determine with Lantus. The other difference is the depot with Lantus which is still available and active after the 12 hour cycle. With Novolin the dose is used up and there is nothing left. With Lantus, the depot is still there and acting although not as strongly as it does when shots are given every 12 hours.
 
Nan & Amber said:
From the SLGS guidelines:

  • 1u BID if kitty is not on a wet/canned low carb diet
  • 0.5u BID if kitty has been switched to a wet/canned low carb diet
  • If the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration
If he were starting tomorrow, I'd probably start him on 0.5U (assuming the dry is pretty much out of the picture), although his numbers have been high enough that 0.75U would not be unreasonable. We'll see what he does in the next week, though!
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Okay sounds good, I’m copying this for when I’m ready. We will be on Novolin for another week or so, Lantus was ordered today from Marks Marine. So we’ll see where he is at once the Lantus comes in and I will post for dosing once we’re ready to start Lantus. Maybe start with 0.5U unless I can start Lantus on a Friday when I’m home and can monitor him. Thank you!
 
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MrWorfMen's Mom said:
Generally the dose is a direct switch so same dose on Lantus as the dose is on Novolin.

On the testing front tonight, I'd test at +2 and see what Blaze does. Then it may be necessary to test between +2 and +5 but we'll let Blaze direct traffic on this one. If he drops off a lot by +2, then a little more testing is needed. If he doesn't drop too much then testing is a little less intense. I'll stick around to coach you through.

I think it's a good choice to go with SLGS for now. Get your feet wet and get comfortable then if you want to change you can do so. While there are differences between Lantus and Novolin there's also things that are not so different. Some folks will suggest that dosing with Novolin is based on pre-shots which is not the case at all. You can sometimes dose Novolin on pre-shots after you have copious amounts of data and the cat is regulated but until then, the lowest point in the cycle still needs to be part of the dosing equation and that's where you are right now and that's what you will be looking to determine with Lantus. The other difference is the depot with Lantus which is still available and active after the 12 hour cycle. With Novolin the dose is used up and there is nothing left. With Lantus, the depot is still there and acting although not as strongly as it does when shots are given every 12 hours.
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Okay thank you! You and @Nan & Amber have so much great info that is helping me immensely. So glad to have found this forum:bighug:

I will test at +2 (in about 45 minutes) and post here again, check in with you, see where Blaze is. Then maybe again at +4.
 
Okay +2 test is 256. should I test again at +4?

He's eating some wet food right now left over from the other civvies dinner. And there’s a very small amount of dry food out too.
 
re the transition -- Catcat was on .8u of Vetsulin -- to get that odd number I was using U-100 syringes and the conversion chart, since it was easier for me (my U-40 syringes did not have half unit marks)

so when we switched to Lantus, we started with .75u .. now using the U-100 syringes as they are marked .. worked out great .. basically the same dosage, and that's proved to be a good one (you can look at Catcat's SS , link in my signature, to see how it went)

yes make sure you are using the correct syringes for Lantus -- trying to use the wrong ones (U-40s) is LOUSY ...
 
@MrWorfMen's Mom okay, tested +3 and Blaze is at 325. I gave him some Tuna (a couple flakes) after his +2 test because I'm trying to "condition" him to get used to testing. I'm not sure if that could have raised his BG?

I took away the dry food after this +3 reading, didn’t look like any of the cats ate any of it.

I'm so confused, his numbers are so up and down. An hour ago it was 256, now it's 325. I don't understand why it's so up and down.
 
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Okay good, I was worried the tuna flakes raised the BG. Is it okay that I took away the dry food tonight? There’s some wet food still out.

Will he ever stop Bouncing? Does the bouncing have to do with not finding the correct dose yet? Or does his body just need more time to figure things out?

Thank you for helping me through this.
 
It's fine that you took the dry food away given how high his BG is.

Most cats will stop bouncing eventually and Lantus should definitely help reduce it. Unfortunately this is one of the problems with a fast acting insulin like Novolin that pulls BG down so swiftly. My guess is that Blaze's defences are reacting and releases hormones to bring BG back up to levels he perceives as more normal. It's one thing to have BG drop 140 points over several hours or the cycle vs. doing it in 2 hours. Right now it's about trying to get Blaze to understand those lower BGs are OK. With some cats you can just keep pushing until eventually they stop bouncing. In others you have to sort of ease them into lower numbers. Let's see where he's at in a few minutes.
 
be patient -- bounces happen -- after four months Catcat is still bouncing, only not as high, not as often -- Lantus doesn't cure the bouncies, but it helps smooth them out, I suspect part of what is happening is that his pancreas is healing and thus releasing insulin, just not regularly nor routinely, so yes, his BG goes up and down and up and down -- as we continue to sing the chorus -- ECID -- every cat is different
 
+4 test is 385 so he's up more again. Is it okay if I give him a break for the rest of the night and not test again until AMPS?
 
Yes you can definitely call it a night. Tomorrow I suggest you give 0.75u provided pre-shot BG is high enough and feed Blaze again (a snack) around +1.5 post shot. The food should slow his drop down a bit. Using food to manipulate the cycle may help to smooth it out/extend it a bit. Let's see what his BG is in the AM.
 
@MrWorfMen's Mom
Okay, so if AMPS BG is 300 or more (which it will be with tonight’s numbers) give 0.75 U after breakfast, and then feed him a snack at +1.5, like a little bit more wet food? Or some tuna flakes?

I have dry food automatic feeders right now but since we are moving off dry food (I took all dry food away after +3 test tonight) I just ordered a different automatic feeder for wet food, so if we have to use food to manipulate the cycle, this will help.

Is it okay to leave a little wet food out when I go to bed? I'm not really sure how much I'm supposed to be feeding him.

Also, thank you for staying up to help me tonight. Feeling a little lost/confused right now so I appreciate your constant help.
 
CandyH and Catcat said:
be patient -- bounces happen -- after four months Catcat is still bouncing, only not as high, not as often -- Lantus doesn't cure the bouncies, but it helps smooth them out, I suspect part of what is happening is that his pancreas is healing and thus releasing insulin, just not regularly nor routinely, so yes, his BG goes up and down and up and down -- as we continue to sing the chorus -- ECID -- every cat is different
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@CandyH and Catcat

Thank you! I’m trying to better understand the bouncing and you and @MrWorfMen's Mom explained it really well. I know he has only been on insulin for a week but it’s discouraging to test and see numbers rising. I know I have s long road ahead and need to just be patient like you said.
 
Yes use the wet food for the snack tomorrow. You can leave wet food out for tonight too.

I expect BG will be in the area of 400+ tomorrow AM given where he is tonight. I think for now, if BG happened to be 300, I'd stick to 0.5u tomorrow. If over 350 then go with the 0.75u. This is just to leave a little more cushion for those drops should he drop more than tonight. I've seen much larger drops than his tonight with other kitties and if memory serves, you have a shower to attend tomorrow.
 
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