Sienne, Wendy (I haven’t seen her post yet), and I are some of the most experienced members on the board and we are happy to try and get you through a dilemma.
When I look at his SS, what strikes me most is you are stalling or skipping on BGs that are easily shot even under SLGS. Please read the entire information on the SLGS Sticky:
There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.
You have plenty of data; alot of members doing SLGS will shoot any number above 90.
In general, when the BG is safe to shoot, stalling and skipping are for you and not for your cat. Yes, there are some times, especially when a member is brand new to FD or if the member has to shoot and leave, that caution should be given even with BGs in the range that you are skipping and stalling on. He’s had green numbers and so you obviously know how to handle them. I would suggest you start shooting any number 120 or above without stalling and then gradually lower that to 90.
I am going to take your advice and feed him at his regular breakfast time each day.
Bad advice and incorrect solution. What you and she risk is feeding, causing a food spike that you think is fine to shoot, and then the BG tanks. I’ve seen some cats get enormous food spikes so if you feed and then test, get a large food spike, shoot, and then the BG comes racing down.....not pretty. If you learn to shoot lower and lower (above 90), the need to stall and delay feeding becomes a rare event. In five years of my kitty being diabetic, I stalled one time without feeding waiting for numbers to come up.
Pick your shot time that works best for your schedule. Test him 15 or 30 mins before that shot time, if the BG is 120 or above, give his insulin on time while feeding and test at +1 and +2 to catch any dropping numbers. Use food to manage those numbers. I’m sorry you didn’t get help when you needed it but one reason you could use the 911 is the first time he drops into lower numbers (50 or below) and you need help. But please be sure and take it down as soon as someone helps you (I took it off today’s thread). Remember that you are in control of lower numbers with your meter and testing and food so be sure you have a variety of low, medium, and high carb food (the latter with gravy), and some honey or syrup on hand. (i.e. have the hypo toolkit ready).
I would not shoot a different dose each cycle. Just because 6+6=12 and 7+5=12 does not mean it works with Lantus and Levemir. Insulin is a hormone and not a medication so you will not get the results you are looking for if you do that. As others have suggested, you need to shoot a dose, consistently that doesn’t drop him too low and doesn’t cause you to stall or skip. He actually looks the best on 7u but dropping to 6u twice a day for a few days will help see what he’s doing.
The other thing that will help you is when you test. At night, test at +2 every single night and then before you go to bed. If he’s alot lower than his PMPS at +2, you need to realize his BG will likely drop that evening so you need to test again sooner rather than later and give him the food he needs to flatten him a bit. The recommendation for the PetSafe5 feeder is a good one. My girl was very smart and could get alot of things open but she couldn’t get that one open to get food out and she was very food driven.
It’s also helpful for you and us if you record what you feed him and when. Many of us have found that a few minimeals at specific times help.
Instead of getting discouraged, please read as much as you can from the Stickys and Info posts. The Health Index/FAQ has a ton of great info. The things that will help you manage this without so much frustration are:
- knowing his onset, nadir, duration
- knowing how he responds to foods of different carbs
- figuring out (specific to him) when the best time to feed those carbs is
- learning how to shoot on time without stalling and skipping when it is safe to do so (i.e. when he’s above 90).
I also see you are very frustrated on “to feed or not to feed”. That goes back to my discussion above that if you start using your data to shoot numbers above 90, then the “to feed or not to feed” goes away because you don’t need to skip or stall if you will be there to monitor. Again, in five years of FD, i skipped two shots: one was because Gracie didn’t want to come out of the 40s even with low carb food and the second was to take a day off to do something special with my hubby on our anniversary.
I hope this info helps. I’ve thrown alot at you at once.
But as far as the researched that conducted based on my readings (factual research- actual people experiences higher numbers in their BG when their insulin is past the recommended date that needs to be disposed, so they advised to just increase the dosage to compensate for its potency and effectiveness.
Two important things to consider: you are doing research on people, not cats, and the lantus pens, as humans use them typically, are for them to be carried in purse or pocket and thus 28 days is generally it. By refrigerating it as we do and recommend, it extends the life. I can only tell you that we have decades of experience here with lantus and levemir and how long they are efficacious when stored properly in the refrigerator (drawer not door). I always used my pens to the very last drop and my kitty was on a very low dose which meant it lasted months and months. I’ve even used vials to the very last drop. If they are handled correctly in their storage, there should be no reason to not use them until they are empty. Yes, you are correct that you could have gotten a bad vial because it was not properly stored at the pharmacy. Vials should always be refrigerated; early on, I also got a bad vial of Lantus and found it had not been properly handled prior to me purchasing it.
We actually don’t need to agree to disagree because we have the anecdotal evidence from, again decades, of using lantus and levemir. However, having said that, if you wish to buy a new pen or a new vial every 28 days , that is completely your decision. But I would very respectfully request that you be cautious about conveying this to newer members who don’t have the financial ability to purchase the insulin more often than it needs to be. That only serves to confuse them especially in light of our data here).