How to keep BG stable tweeks?

teresazu

teresazu

Member Since 2020
Yesterday was an ideal day for me, I had all pink across. what I am trying to accomplish is a slow reduction, such as from 400 range, to 300's, 200's and so on, so that all one color is across the spreadsheet for awhile until it's near normal. Reason being the sudden drops can't be good for kitty, and because it triggers a bounce. I am currently using a skinny 1.5 units of Lantus twice daily. Last time she was on the full 1.5u there was a hypo, so I'm concerned about that.

Also an unusual thing is that if she doesn't eat for several hours seems to be when she drops, sometimes too low. I let her eat throughout the day, and ideally every 2 hours. But if she sleeps longer than that, or I am out and she doesn't bother to eat on her own or maybe wants something other than what I left out, then she drops too much, so I'm nervous to be gone too long. Although I know it's good for them to have small frequent meals, their BG shouldn't depend on the food every 2 hours, maybe that means the dose is too high?

I hate the drop and then return to the HI reading. I'm trying to sneak by her liver reaction. to do this maybe I should decrease a bit? She was 119 during the night, and bam HI this morning, but yesterday was great. @Bron and Sheba (GA) @Sienne and Gabby (GA)
 
Welcome to the best possible place you never wanted to find You actually don’t want to have an all day pink day or any other except for green and low blue. That’s not how Lantus works. It’s a depot drug. Dosing is based upon how low the dose, the nadir, takes your cat rather than AMPS//PMPS. In a typical Lantus cycle , it starts working about 2-3 hours after you inject. Most cats but not all get a food bump. It goes down until it hits nadir and then back up again around the next preshot.

I suggest that you read the sticky on Lantus and the methods again. Increases and decreases are in .25 increments but you seem to not be doing complete .25. Fine dosing is usually done after a cat has reached better control. After you read tgem you will have more questions so please ask away.

You test enough to try TR. I’m not trying to push you to switch. It’s just an observation.
 
teresazu said:
Yesterday was an ideal day for me, I had all pink across. what I am trying to accomplish is a slow reduction, such as from 400 range, to 300's, 200's and so on, so that all one color is across the spreadsheet for awhile until it's near normal. Reason being the sudden drops can't be good for kitty, and because it triggers a bounce. I am currently using a skinny 1.5 units of Lantus twice daily. Last time she was on the full 1.5u there was a hypo, so I'm concerned about that.

Also an unusual thing is that if she doesn't eat for several hours seems to be when she drops, sometimes too low. I let her eat throughout the day, and ideally every 2 hours. But if she sleeps longer than that, or I am out and she doesn't bother to eat on her own or maybe wants something other than what I left out, then she drops too much, so I'm nervous to be gone too long. Although I know it's good for them to have small frequent meals, their BG shouldn't depend on the food every 2 hours, maybe that means the dose is too high?

I hate the drop and then return to the HI reading. I'm trying to sneak by her liver reaction. to do this maybe I should decrease a bit? She was 119 during the night, and bam HI this morning, but yesterday was great. @Bron and Sheba (GA) @Sienne and Gabby (GA)
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I am by no means an expert, but I wonder if Cleo isn't getting enough insulin? Admins, weigh in as I don't want to give any bad advice. @Wendy&Neko helped me a lot when we were SLGS, maybe she can chime in?

Like Max, Cleo seems to reach lower nadirs at night, which is very frustrating. When I look at Cleo's day cycles, though, there has been only one nadir that was between the 90-149 'hold the dose' since you started the 1.5s nine days ago. If went back to the SLGS sticky, and it says to only hold the dose longer than 7 days if they have nadirs in that range. Otherwise, over 150 means a 0.25U dose increase - which is what Cleo had during the day. That may or may not affect your nighttime reads - that's just something you will have to watch, unfortunately. I know you said the 1.5U dose caused a hypo, but that was back in June and no longer relevant to today's numbers. It's hard to get that, but that's what I was told and they were right. Last time Max was on 0.25U he was over 500 at times - now 0.25U is TOO much. Just because it happened once isn't a guarantee it will happen again two months later ( a day or two yes, but not after 2 months). Once her liver can understand it's okay to be in those 100s her highs should start to lower as well.

While the sudden drops will trigger a bounce, I think that also works as a wake-up call to the pancreas. Kind of like a swift kick to get it going. They are extremely frustrating, and as I have mentioned to you on the FB page, it took switching to TR to get Max's settled. I hated having to hold the dose for 7 days even more so than my fear of him going too low. What frustrated me was it took Max the six cycles to clear the bounce. Looks to me like Cleo may have a hard time clearing them too? The Lantus depot still perplexes me, even though I have read all the notes on it - including Chris'. I only noticed that since switching to TR, it hasn't been as big of an issue. Okay, too much as usual, and maybe even all wrong, but I figured I'd try. Hang in there!!
 
Could you please update your title?

If you could edit it to set it up like this: 8/16 Cleo AMPS ### and then your question about how to maintain steady numbers...

Looks like Carla did mention though that Lantus doesn't work best that way - what we're looking for are numbers that drop steadily throughout the cycle - so starting at a higher number, then dropping thru the blues and hitting a green or two and then climbing back up to blues and even yellows and higher are very typical of kitties getting started on this journey.

If you haven't already please read this stickie (from the yellow tabbed items at the top of this forum)...
https://www.felinediabetes.com/FDMB/threads/the-basics-new-to-the-group-start-here.18139/

it talks about the numbers and how they will look during the cycles...flat cycles are achievable but we hope for them to be blues and a lovely flat green cycle is what we're all striving for...
 
teresazu said:
Yesterday was an ideal day for me, I had all pink across. what I am trying to accomplish is a slow reduction, such as from 400 range, to 300's, 200's and so on, so that all one color is across the spreadsheet for awhile until it's near normal. Reason being the sudden drops can't be good for kitty, and because it triggers a bounce.
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It doesn't work that way. Kitties don't get used to 300's, then 200's, etc. Instead, they just develop glucose toxicity meaning they get used to higher numbers, which means even more insulin to get over it. Best just to go for it and get them used to healing numbers as soon as you can. As others have said, ideal is that 90-149 range if following SLGS.

Here is the link to your last post here: https://www.felinediabetes.com/FDMB/threads/high-to-hypo-decrease-regular-shot.231461/ We ask that people include those links so we can easily see the history. In that last post, we speculated that Cleo was dropping during the night and bouncing during the day. Your stepped up testing has shown just that.

The "1.5 caused a hypo" was waaaay back early June. That's ancient history in terms of dosing. A cats body insulin needs change over time, partly because of that glucose toxicity you are seeing. We typically just look back a couple weeks, which tells me she could use a little more insulin. She would let you see a below 90 if the dose were too high.
 
Wendy&Neko said:
It doesn't work that way. Kitties don't get used to 300's, then 200's, etc. Instead, they just develop glucose toxicity meaning they get used to higher numbers, which means even more insulin to get over it. Best just to go for it and get them used to healing numbers as soon as you can. As others have said, ideal is that 90-149 range if following SLGS.

Here is the link to your last post here: https://www.felinediabetes.com/FDMB/threads/high-to-hypo-decrease-regular-shot.231461/ We ask that people include those links so we can easily see the history. In that last post, we speculated that Cleo was dropping during the night and bouncing during the day. Your stepped up testing has shown just that.

The "1.5 caused a hypo" was waaaay back early June. That's ancient history in terms of dosing. A cats body insulin needs change over time, partly because of that glucose toxicity you are seeing. We typically just look back a couple weeks, which tells me she could use a little more insulin. She would let you see a below 90 if the dose were too high.
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so would that mean going from a skinny 1.5 to 1.5 or a full blown 1.75? yikes! well I test her often, at least during the day when I'm home, and I can tell when she's acting funny so. today she seems so much better even tho she is currently in the 400's. she's perky, more active, alert etc.
 
Your kitty is ready for an increase of .25. Yes, that means giving 1.75 u of insulin twice a day consistently.

Her numbers are simply too high. Let's hope that she'll start to get some better mid-cycle numbers once she gets a bit more insulin on board.
 
Hi! Little Cleo looks so cute in those glasses. I snapped a picture of Tina wearing sunglasses once:)

I promise Cleo will feel a lot better when she is out of those high numbers. High numbers aren't good for the kidneys or the rest of the body. The sooner you see blues and greens a lot more often, the sooner Cleo will thank you and be even perkier :cat: I vote for an increase - just want to see how you answer Sue about that skinny 1.5 dose so we can feel good about the increase.

Sending hugs to hopefully ease your mind over this FD "game" :bighug: and please give Cleo extra scritches and a kiss.
 
Does anyone have input about the unique eating scenario explained? that was one of my biggest questions, shouldn't get a hypo if not eating for more than 2 hours? (explained in original post)
 
Could you possibly start a new thread for today with today's date - using the proper format for your question?

I saw the reference in your first post yesterday - however, a new thread would help everyone get on the same page with continued comments.
 
Cleo has never been too low according to your spreadsheet. Sorry but I don’t understand your question. Many feed every few hours but not all. The only time it’s important to feed more often is to prevent a hypo situation as food gives most a temporary food bump up. Under 50 is too low on a human meter.
 
tiffmaxee said:
Cleo has never been too low according to your spreadsheet. Sorry but I don’t understand your question. Many feed every few hours but not all. The only time it’s important to feed more often is to prevent a hypo situation as food gives most a temporary food bump up. Under 50 is too low on a human meter.
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if you read the original it explains those are the times she goes hypo. sorry you didn't see it in the spreadsheet, but it's also explained in my post.
 
yes it's always when she hasn't eaten in more than several hours or I'm not home, it's in the original post, that's why I mentioned about it
 
tiffmaxee said:
Are you saying she dropped under 50?
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Back in June Cleo went under 50 a couple of times. But the dosing is all over the place too. One time 1.50, and the next time 0 (due to not eating) although with Lantus being delayed onset, it's not necessary not to shoot the REGULAR consistent dose if the cat isn't eating UNLESS the number is not safe to shoot...

The mixture of wonky numbers and wonky dose amounts isn't helping to get her to settle down.

Have you read the stickies for consistent dosing while doing SLGS and how often you can change the dose based on that method?

I'm not going to respond on this thread any further -it's from yesterday. Once you start a new condo/thread, I'll see you there.

Thank you
 
I have nothing new to add, was just waiting on the whole post being looked at maybe by some others as well. I've been told not to start multiple threads about the same thing.
 
teresazu said:
I have nothing new to add, was just waiting on the whole post being looked at maybe by some others as well. I've been told not to start multiple threads about the same thing.
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ok the reason why they are saying your dose is all over is because your changing the dose but not because he is going under 75(i think that is the number on SLGS).
Someone correct the number please if I am wrong, I am rusty on that number.
You should only change the dose if he goes under that number.
And when he is in the blues at PMPS you need to start shooting anyway & have someone guide you.
Does that make sense?
 
No, it does not, I lowered it twice when there was a hypo, as advised by 0.25 which is the protocol. I raise it after 7 days unless there is a test under 150.
 
I do get overwhelmed with all that I tried to read everything, I mostly focus on dosing which is what's important, more so than that and my format will improve as I go. but the spreadsheet is there with plenty of data, should be able to help someone determine answer to my speicifc dosing question
 
teresazu said:
I do get overwhelmed with all that I tried to read everything, I mostly focus on dosing which is what's important, more so than that and my format will improve as I go. but the spreadsheet is there with plenty of data, should be able to help someone determine answer to my speicifc dosing question
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Ok. I agree you need to go to 1.75u dose.
You need to stay at that dose for 7 days then do a curve(test every2-3hrs for 12-18 hrs).
If lowest point(nadir)does not go below 150 then you stay at that dose. Depending on the number I would stay there for 2-3 weeks to get his body used to the lower bgs. He needs to stay in blues longer. Takes time.
You can do it. Post here every day as I explained before & you will start to see how it works. People will follow & advise on dosing & anything else.
 
teresazu said:
I lowered it twice when there was a hypo, as advised by 0.25 which is the protocol
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You haven't had a "hypo" number that required a reduction since 6/25....On that day, you would have reduced and held that dose for 7 days unless she dropped below 90 again (On SLGS)

Since then, she's had ZERO "hypo" numbers, so every 7 days, you should be increasing by .25 until she starts to see some lower blue or green numbers at nadir

On SLGS, reductions are EARNED when they drop below 90.....she hasn't done that
 
Chris & China (GA) said:
You haven't had a "hypo" number that required a reduction since 6/25....On that day, you would have reduced and held that dose for 7 days unless she dropped below 90 again (On SLGS)

Since then, she's had ZERO "hypo" numbers, so every 7 days, you should be increasing by .25 until she starts to see some lower blue or green numbers at nadir

On SLGS, reductions are EARNED when they drop below 90.....she hasn't done that
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Oops!! Thanks Chris. I got confused....I had a kitty bugging while I was trying to type so lost my train of thought.
Yes...only reduce if under 90.
Maintain if a curve nadir is between 90 & 150. Increase if nadir is above 150.

That right, Chris?
Thanks for the fix.
 
@teresazu

To answer your question. Go with 1.75 units as mentioned above. Try to stay away from skinny doses. Those are with really knowing your cat and how they react to change. It hasn't been long enough to determine that yet. Many trials and error tests are needed first.

Yes tomorrow start a new condo: date, kitties name, AMPS #. Then you edit title as the day goes on. Ask all questions in same condo for that thread.

Try to get a before bed test in or if you get up during the night grab a test. Most kitties really can drop to much over night.
 
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