? 8/11 Simon AMPS 96, +2 317, PMPS 306, went w/ 0.75 unit tonight. Hoping for a smoother day tomorrow!

Kyle & Simon (GA)

Kyle & Simon (GA)

Member Since 2020
Good morning! This is my first post to the Lantus forum :) and I am very new to all of this. Simon was diagnosed 7/6/2020 and we just started Lantus on Thursday 8/6/20. I was planning on using the SLGS dosing method since this is all so new to me, and I just barely learned how to take his BG. However, his numbers are already going down and Im wondering if I should switch to the TR method. If I was using SLGS I would ask for help this morning before shooting, but with TR I would just go ahead. I guess I am wondering how one decides which method to use? I am hoping he is headed straight for remission and I don't want to interfere with that. Is it too risky for a newbie to use TR? Any advice would be most appreciated! Thanks in advance, Kyle & Simon
 
Deciding on a method can be difficult. Are you feeding any dry food? Looks like just ff but want to be sure. That’s a low PMPS for new diabetes. I’m going to look at your ss. Be right back.
 
tiffmaxee said:
Deciding on a method can be difficult. Are you feeding any dry food? Looks like just ff but want to be sure. That’s a low PMPS for new diabetes. I’m going to look at your ss. Be right back.
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Thank you! Yes Fancy Feast classic. He is not eating well - so I offer food every 1-2 hours. I just gave him 1 unit. My vet told me not to test at all for 2 weeks, so my spreadsheet is pretty empty right now!
 
tiffmaxee said:
Did you shoot? If so you need to get a +1 and +2 and post. With a new diabetic I would have skipped. But we will help you. I think the starting dose might have been too high.
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Yes I went ahead, but will get +1 and +2 as suggested. Now I am worried. :( I guess I am just so hopeful he will go straight into remission! Thank you!
 
Kyle & Simon said:
Thank you! Yes Fancy Feast classic. He is not eating well - so I offer food every 1-2 hours. I just gave him 1 unit. My vet told me not to test at all for 2 weeks, so my spreadsheet is pretty empty right now!
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Your vet would have you at the ER with that advice! Not the first nor the last with that advice. Are you giving her ondansetron (zofran) or Cerenia for nausea. Are you pulse dosing the chlorambucil? I would join groupsiosmallcell forum.

Don’t want to scare you but stopping the steroid can have a huge impact.
 
@tiffmaxee Whoops! Somehow I posted in your response? This is what I meant to post:

Right? Not a fan of either of my vets right now! Yes, we are taking Cerenia, ondansetron, plus fomatidine! I am not a fan of the chlorambucil and hoping to add or switch to budesonide but my vet wanted to see if we could get a handle on the diabetes first. Chlorambucil right now is EOD, but have suggested switching to the pulsed (2 week) dosing if we continue it.

What do you mean by huge impact?

Thanks again for your help!
 
WELCOME to the forum! I see that you're brand new and that @tiffmaxee has been answering your questions :)

If I might ask please, why do you feel you need to switch from SLGS to TR? It's generally recommended her to pick on and stick with it for a couple of weeks...you can certainly test more if you wish. The only other significant difference is that you can change the dose more quickly on TR than on SLGS.

With that being said, most new folks start on SLGS...it's a bit slower as far as changing doses and the testing requirements aren't as often...and of course no dry food is allowed which from your post isn't an issue already.

So sorry to hear that your vet told you 1)Not to test and 2)Caused the diabetes by giving steroids...

Unfortunately vets are not trained about FD (Feline Diabetes) and many just don't know and tend to go with treatments, etc. that are best for dogs...not cats.

Stick around, please post and ask questions...we'll try to help guide you! Nice job on the signature and the SS!
 
@tiffmaxee Hi again. Not sure if I am supposed to add this to my thread title, or just post here, but Simon's +2 is 317! I was actually trying to do a +1 but I was so upset with myself for going ahead with the insulin this morning and potentially sending him towards hypoglycemia, my hands were shaking and I just couldn't get a sample. I finally had to ask my husband to help, and you know how that can go! ;) By the time we got a sample, it was +2 and Im sure poor Simon is totally traumatized- as am I- which may have contributed to this high number. Anyway, Im hoping this means I don't have to worry about his numbers getting too low today? I will take another sample at +4? Or what would you suggest? Thanks again for your help! Im going to go buy some FF gravy lovers just in case. And Im getting the message that I should be using the SLGS approach!
 
Sue and Luci said:
WELCOME to the forum! I see that you're brand new and that @tiffmaxee has been answering your questions :)

If I might ask please, why do you feel you need to switch from SLGS to TR? It's generally recommended her to pick on and stick with it for a couple of weeks...you can certainly test more if you wish. The only other significant difference is that you can change the dose more quickly on TR than on SLGS.

With that being said, most new folks start on SLGS...it's a bit slower as far as changing doses and the testing requirements aren't as often...and of course no dry food is allowed which from your post isn't an issue already.

So sorry to hear that your vet told you 1)Not to test and 2)Caused the diabetes by giving steroids...

Unfortunately vets are not trained about FD (Feline Diabetes) and many just don't know and tend to go with treatments, etc. that are best for dogs...not cats.

Stick around, please post and ask questions...we'll try to help guide you! Nice job on the signature and the SS!
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Thank you Sue! I am pretty stressed out about all this. Since my vet is completely useless I feel so responsible for poor Simon's health right now and I know nothing! Anyway, some of the reference material made it sound like TR was more likely to lead to remission, but it sounds like the SLGS method is a better approach to begin with. Thanks for your message and for your help! Take care, Kyle
 
I'd say Simon is in a proper bounce - his liver is just unloading some stored up glucose/sugar into his blood stream - need not worry about that higher number. However, with that said, and it's early on for him...you can probably take a break this afternoon from the testing. It may take several days for him to clear that bounce...

You may want to read up about bouncing if you have a little time. I'll see if I can find an article here on the forum about that.
 
Sue and Luci said:
I'd say Simon is in a proper bounce - his liver is just unloading some stored up glucose/sugar into his blood stream - need not worry about that higher number. However, with that said, and it's early on for him...you can probably take a break this afternoon from the testing. It may take several days for him to clear that bounce...

You may want to read up about bouncing if you have a little time. I'll see if I can find an article here on the forum about that.
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Thank you Sue! For some reason I thought bouncing was related to a change in insulin dose? I will definitely try to read up on it! Taking a break from testing sounds wonderful! We are both frazzled right now! :blackeye:
 
Kyle & Simon said:
Thank you Sue! For some reason I thought bouncing was related to a change in insulin dose? I will definitely try to read up on it! Taking a break from testing sounds wonderful! We are both frazzled right now! :blackeye:
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I hear ya! Been there, done that...especially in the early days...every test was exhausting because every test was a wrestling match...Luci didn't want to cooperate...but now, she purrs and sits perfectly still for the tests...and we test a lot...

Here's one thread I found that might be interesting to you:
https://www.felinediabetes.com/FDMB/threads/discussion-pogo-stick-cat-how-to-dose-stop-bounce.76617/
 
Kyle & Simon said:
Okay good. From what I am reading about bouncing, it can be a reaction to being overdosed with insulin. Does that mean I should consider lowering Simon's dose tonight? TIA!
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If a cat drops into bg numbers they are t used to the body will release insulin and they will bounce. You don’t yet have enough data to know what is normal for him. See where he is tonight. Post for help by adding the ? Prefix.

looking at that amps it might need t be lowered but let’s see.
 
tiffmaxee said:
If a cat drops into bg numbers they are t used to the body will release insulin and they will bounce. You don’t yet have enough data to know what is normal for him. See where he is tonight. Post for help by adding the ? Prefix.

looking at that amps it might need t be lowered but let’s see.
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Thank you @tiffmaxee ! I really appreciate your help with this :cat:
 
Sue and Luci said:
I hear ya! Been there, done that...especially in the early days...every test was exhausting because every test was a wrestling match...Luci didn't want to cooperate...but now, she purrs and sits perfectly still for the tests...and we test a lot...

Here's one thread I found that might be interesting to you:
https://www.felinediabetes.com/FDMB/threads/discussion-pogo-stick-cat-how-to-dose-stop-bounce.76617/
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Thank you Sue! That was a good thread and definitely highlights how confusing feline diabetes and the bounce response can be. I am looking forward to learning more and being a better caregiver for Simon. I feel like I really failed him this morning after going ahead with that dose! Live and learn :bookworm:
 
tiffmaxee said:
We learn from everything we do with FD. Every cat is different is a common response around here. Lots of things are trial and error. :bighug:
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Well I hope for Simon's sake that I can minimize the error part of this. I just feel terrible that I forced him into that bounce today. :facepalm:
 
Kyle & Simon said:
Anyway, some of the reference material made it sound like TR was more likely to lead to remission, but it sounds like the SLGS method is a better approach to begin with.
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TR does give a better chance at remission because you can change the dose more frequently if it's not getting you where you want.

There's absolutely no reason you can't start with TR....You just haven't been here long enough for us to give you the "speech". (and cats don't usually react that quickly!) Getting the steroid out of his system should really help lower his BG)

At first, if you get a PS under 150, you should stall, don't feed and test again in 20-30 minutes to see if the number comes up without the influence of food. Use that time to post here with a clear subject line. I often suggest "STALLING! NEED HELP!!"...LOL It usually gets somebody's attention! Once you have someone's help, you can go back and "edit" the subject line.

As you gain more experience and data, you gradually learn to shoot lower and lower Pre-shot numbers. You just jumped the gun a little! Simon is fine, so no harm done!

There's no reason you have to do TR if you don't feel like it's right for you either. We do have cats that go OTJ on SLGS too, but less often.

The main difference is that on TR, if the dose you're giving isn't getting the results you want, you can increase as often as every 3 days. On SLGS, you hold the dose a full week even if they're running too high.

For now, I'd suggest reducing the dose down to .75 because it looks like he probably went a lot lower on the PM cycle last night and the 90 you got this morning was probably "on the way up".....then his liver kicked in from the low last night and he "bounced".

Be sure to also get tests on the PM cycle. Most cats go lower at night so it's important to get at least a "before bed" test to make sure he's not dropping too low or too fast (and if he is, you'll learn all about sleep deprivation...also known as feline diabetes!...LOL)
 
Chris & China (GA) said:
TR does give a better chance at remission because you can change the dose more frequently if it's not getting you where you want.

There's absolutely no reason you can't start with TR....You just haven't been here long enough for us to give you the "speech". (and cats don't usually react that quickly!) Getting the steroid out of his system should really help lower his BG)

At first, if you get a PS under 150, you should stall, don't feed and test again in 20-30 minutes to see if the number comes up without the influence of food. Use that time to post here with a clear subject line. I often suggest "STALLING! NEED HELP!!"...LOL It usually gets somebody's attention! Once you have someone's help, you can go back and "edit" the subject line.

As you gain more experience and data, you gradually learn to shoot lower and lower Pre-shot numbers. You just jumped the gun a little! Simon is fine, so no harm done!

There's no reason you have to do TR if you don't feel like it's right for you either. We do have cats that go OTJ on SLGS too, but less often.

The main difference is that on TR, if the dose you're giving isn't getting the results you want, you can increase as often as every 3 days. On SLGS, you hold the dose a full week even if they're running too high.

For now, I'd suggest reducing the dose down to .75 because it looks like he probably went a lot lower on the PM cycle last night and the 90 you got this morning was probably "on the way up".....then his liver kicked in from the low last night and he "bounced".

Be sure to also get tests on the PM cycle. Most cats go lower at night so it's important to get at least a "before bed" test to make sure he's not dropping too low or too fast (and if he is, you'll learn all about sleep deprivation...also known as feline diabetes!...LOL)
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Thank you so much for this insight Chris. I will try to get some PM test for sure, although I am a very sleepy person and testing is still very difficult for me! I do think TR is a better choice for us if he is going into remission quickly and needs more rapid dose adjustments. Stalling and asking for help sounds very prudent and I will definitely be doing that in the future. I really appreciate all of the advice I am getting here and hoping this will translate into better outcomes for Simon.
 
Kyle & Simon said:
I will try to get some PM test for sure, although I am a very sleepy person and testing is still very difficult for me!
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You don't need to stay up all night testing (although there will probably be nights that you'll need a loud alarm to make sure you do get up and test again!)

If you can get the PMPS, a +2 and a "before bed", that would be perfect (but it depends on what time you shoot and how close that is to your bedtime!)

If you can't do two tests on the PM cycle, try to get at least the +2 or +3. In a lot of cats, the +2 can act a little like a crystal ball in predicting where Simon might go later in the cycle. (in some cats, the +3 is a better indicator)

If the +2 is about the same as the PS, it's usually a pretty normal cycle...gradually down to nadir and then gradually back up again to the next PS

If the +2 is higher than the PS, that's usually the sign of a bounce....those cycles are when it's usually going to be OK to take a break in testing so much.

If the +2 is lower than the PS, that's your "early warning" that Simon might be heading a lot lower later in the cycle and it will be important to get more tests in until you know he's going to be OK
 
Chris & China (GA) said:
You don't need to stay up all night testing (although there will probably be nights that you'll need a loud alarm to make sure you do get up and test again!)

If you can get the PMPS, a +2 and a "before bed", that would be perfect (but it depends on what time you shoot and how close that is to your bedtime!)

If you can't do two tests on the PM cycle, try to get at least the +2 or +3. In a lot of cats, the +2 can act a little like a crystal ball in predicting where Simon might go later in the cycle. (in some cats, the +3 is a better indicator)

If the +2 is about the same as the PS, it's usually a pretty normal cycle...gradually down to nadir and then gradually back up again to the next PS

If the +2 is higher than the PS, that's usually the sign of a bounce....those cycles are when it's usually going to be OK to take a break in testing so much.

If the +2 is lower than the PS, that's your "early warning" that Simon might be heading a lot lower later in the cycle and it will be important to get more tests in until you know he's going to be OK
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I am currently testing at 9 am/9 pm. May have to adjust earlier to get a 2+ or later, but I will try. This is great info! Thanks again.
 
Kyle & Simon said:
I am currently testing at 9 am/9 pm. May have to adjust earlier to get a 2+ or later, but I will try. This is great info! Thanks again.
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Yeah I understand! When China was first diagnosed I decided I'd shoot her at 11am/pm because I HATE mornings and am almost always up late into the night....that worked for a little while until China started dropping low at night and I ended up being up all night long (I guess I'm getting too old for that....used to be able to do that!)

So I bit the bullet and changed her to a 6am/pm schedule. I still absolutely despised getting up at 6am, but it allowed me to get at least a few tests in (if I had to take my mom to the doctor or something during the day) and I could always get at least up to +6 or +7 at night....and I got to the point where I could Test/Feed/Shoot at 6am without really waking up so I could go back to sleep for several hours (there were several times I didn't remember giving her AM shot but luckily the meter memory said I tested so I knew I'd been up!)

The sacrifices we make for our furbabies....LOL
 
Okay, Simon's PMPS is in at 306. Obviously still on the bounce I induced this am. Im not sure- does he need a whole unit to help ride out this bounce? Or should I go ahead with 0.75 which is probably a better dose for him in the long run? Any advice/suggestions would be appreciated! Thank you!
 
Chris & China (GA) said:
I got to the point where I could Test/Feed/Shoot at 6am without really waking up so I could go back to sleep for several hours (there were several times I didn't remember giving her AM shot but luckily the meter memory said I tested so I knew I'd been up!)
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The idea of not remembering testing is absolutely incredible to me right now! I don't know if I will ever forget this morning's ordeal! Any thoughts on Simon's dose tonight? 0.75? Or should we see him through this bounce first and stay at 1 unit? Thanks for your help!
 
Sorry no one got back to you. It is a quiet night on the forum. Maybe everyone in NA is out looking at the Perseids shower.

I think you made the right call. There isn't enough data yet to show how much or how little Simon bounces. Nice name, btw. I had a tux named Simon.

If you can get a +1 or +2 tonight, that may show which way Simon is heading. Re-read Chris's post above. All data is good data.
 
I am SO happy you posted on the lantus forum & have been getting excellent advice! You will be in a routine in no time! Not sure if you give treats at am/pm testing, but when I introduced the freeze dried chicken to Nova and gave her lots of love, she quit fighting me. Also, on curve days, I tested her wherever she was laying and sleeping---no struggle there either. :)
 
LindyNova said:
I am SO happy you posted on the lantus forum & have been getting excellent advice! You will be in a routine in no time! Not sure if you give treats at am/pm testing, but when I introduced the freeze dried chicken to Nova and gave her lots of love, she quit fighting me. Also, on curve days, I tested her wherever she was laying and sleeping---no struggle there either. :)
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I am so glad to be here, too! The problem with testing isn't Simon- he is the world's sweetest and gentlest cat! I am the one who is really struggling, especially yesterday when I thought I was sending him into Hypoglycemia and I was so scared my hands were shaking like crazy! Last night and this morning went MUCH better as I am starting to relax. Thank you so much for your post and your support! Im sure he would love a freeze dried treat though- I will have to make sure and give him some :cat:
 
Kyle & Simon said:
I am so glad to be here, too! The problem with testing isn't Simon- he is the world's sweetest and gentlest cat! I am the one who is really struggling, especially yesterday when I thought I was sending him into Hypoglycemia and I was so scared my hands were shaking like crazy! Last night and this morning went MUCH better as I am starting to relax. Thank you so much for your post and your support! Im sure he would love a freeze dried treat though- I will have to make sure and give him some :cat:
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Yeah, I think Nova picked up on my nervousness early on too. Sounds like you're getting the hang of it all!
 
Welcome! I’m relatively new here so I have been reading this thread with interest. Don’t worry about yesterday’s dose. I inadvertently overdosed my cat on his first dose of Lantus (I didn’t know that I had to switch from u-40 to u-100 needles. But then again, neither did my vet and the pharmacist never mentioned it either). So, we all make mistakes but we learn. In the end, Milo was just fine.

Here’s what I’m learning: the advice here is amazing, far more than any of my vets know about diabetes. None of them ever suggested doing my own testing but said to bring the cat back in 6 months to check BG! I’m afraid he wouldn’t have survived that long! He definitely needed a switch to Lantus and ongoing support and monitoring.

I was scared by the high numbers (as I was thinking about human responses to high BG). However, as one member said, it’s better to have a bunch of highs than one minute too low. Cats don’t have the same severe immediate reactions to high BG. But even the lows can be managed and people will support you if it does happen. I had a few members sit up with me on the night of the big whoops.

I hope your Simon goes into remission. The testing gets easier, I must say. I hardly traumatized Milo anymore but he’s still not a huge fan. I can’t blame him. Best of luck to you!
 
Sam&Milo&Singha said:
I hope your Simon goes into remission. The testing gets easier, I must say. I hardly traumatized Milo anymore but he’s still not a huge fan. I can’t blame him. Best of luck to you!
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Thank you! You are so kind. I am very worried about low numbers and see to be on the edge of them right now as we are trying to figure things out. As a result of his IBD Simon is often nauseous and has a hard time eating. I really appreciate the support here and we will definitely need it to get through this learning curve!
 
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