6/7 Betty AMPS 208.8, +5.5 133.2, +9.5 217.8

Sandy -

I noticed that you shot late yesterday morning. Lev (and Lantus), really like consistency. Shooting late is like a dose reduction; shooting early is like a dose increase. You have about 30 min of flex time. Beyond that, the depot starts to influence the numbers. If you are off schedule, you need to slowly adjust the shot time. You can either move the time by 15 min. twice a day or by 30 min. once a day.

I usually see patterns but my variables keep changing (when I feed, when she eats, how much, when she gets her insulin, etc), so the patterns are harder to see right away.
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I would encourage you to limit the variables you're changing. It looks like you've just started tracking Betty's numbers. It can be difficult to sort out how your kitty is responding if you are adjusting time, food, etc. This is particularly the case if you move shot time given what I noted above.
 
Yeah, I didn't mean to shoot late, I was just exhausted and overslept my alarm. I haven't given her the am dose yet, as I thought I should wait.

The main variable I can't control is how much she eats. Some days she gobbles her food like a monster and other days she just wants to graze. Today, for example, she has barely eaten half a can, where normally she eats 3/4 in one sitting.

I try to keep the shots and amps/pmps tests as close to the same time as possible, but do find it really challenging some days.

She also is a beast, begging for dinner starting at 5pm. I make her wait til closer to 6, but there's no way I can get up at 5am in the mornings to do her routine... (I'm already half zombie). Which means there is a longer gap between shots from night to morning than there is from morning to night. Unless I feed her at her normal time and just dose her at the +12 mark.

Honestly, it's pretty overwhelming some days.
 
It's 530. Betty usually begs for her dinner at 530, and my vet always said "feed her then dose her immediately" to help with absorbtion.

Thing is, I have tried to get her insulin early, but it's usually 730 am when she gets her morning dose. Given what I've been learning here, and given that she prefers to graze at night, would it be better to allow her to snack and give her the insulin 12h after her am dose, or stick to the vet recommended: "must dose with dinner. Make her hungry enough to eat a full meal"?

Thoughts?

Given the pattern for her to go almost too low in the evenings, I wonder if it's because of the overlap between am and pm doses.

It does mean her 4-6h nadir will be near midnight... But I'm way better at midnight than I am at 5am.
 
Hi Sandy - we all do the best we can :bighug: Hang in there, the learning curve is steep and any comments are from place of wanting to help (though sounds like you know that :bighug:).

For timing on dosing, some people track the time so they stay on track (i.e. that 30 minute window that Sienne mentioned) - see Luci's SS as one example. So if you find that 7:30 AM works best for you and you can work with shooting at 7:30 PM, I'd go for that. When you shoot late, you lose any overlap of doses (this is what it means when people say shooting late acts like a decrease) and then when you shoot early, you are overlapping too much (so the previous dose hasn't totally left the system and then new dose is entering) Again, only an issue if you are shooting more than a 30 minute difference. And, sometimes life happens and we need to change shot time - here's some reading on it - link.

While you are still gathering data, you don't want to feed the two hours before you AMPS or PMPS (so that the reading is not food influenced...once you have an idea of a "food bump" (i.e. the impact on BG that your LC has on your kitty) this rule can be relaxed). So if Betty is asking for a snack at 5:30 PM, you could give her a little snack (say a tsp or two of low carb food) and then withhold food until 7:30PM (when you can test for PMPS, feed her dinner, and shoot). Also, do you feed Betty snacks during the day/night? The general guidance is to not feed after nadir - I fed Jax at PS and then at +2/+4/+6 but ECID and it takes a lot of experimenting to find out what works for each cat.

Betty'sMom said:
vet recommended: "must dose with dinner. Make her hungry enough to eat a full meal"?
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FWIW, this sounds like advice given for harsher acting insulins, like Vetsulin, that drop a kitty's BGs hard and fast. Lantus & Levemir are much gentler and as long as you know your cat will eat, you can shoot (and even if they aren't eating, a token dose may be okay though post for advice if you are ever in that situation!). Lantus onsets around +2 or +3...ETA I think Lev is around +4?...so there is time to get some food on board (and it's a gentle curve...not as steep as vetsulin).

Betty'sMom said:
too low in the evenings
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It's very common for cats to go lower at night (IDK why, but it's fairly common...because cats will be cats :p). Has anyone dropped off the logic for a +2 or +3 (while not "foolproof", it's generally a good indicator of the cycle to come...one of those "know thy cat things" that will come with time...maybe on Lev a +3 or +4 would be better than a +2 or +3)...
  • If the +2 is about the same as the Pre-shot, usually they're going to have a fairly "normal" cycle...slowly dropping to nadir and then slowly heading back up until the next PS
  • If it's higher than the PS, that can indicate the beginning of a bounce and those are the cycles where you can usually get by without testing as much
  • If the +2 is lower than the PS, that's your "early warning"....those are the cycles where it's important to try to get more tests in...but if you can't, you might want to leave some higher carb food down for kitty

Your are doing great and in the right place :bighug::bighug::bighug:
 
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This is all so amazing... I can't even find the words, and need to read and reread this to get the full benefit of what you're saying. (there's so much awesome!)

I will work on ensuring I have better set feeding, reading and insulin times, with the insulin 12h apart. I feel like the overlap of doses is not the best (and its harder to track in the spreadsheet too).

It is a challenge... Single mom, kids in school, work, appointments... So many things get in the way it seems. But soon school will be done, and maybe I can get Betty stabilized so that by fall we be settled into a little less intense testing /feeding /dosing routine.

I cannot express enough how much I appreciate this forum. I don't know that Betty would be here if I had to rely on instruction from my vet.

❤️
 
It will all get easier once you can establish some routine. These days Ruby's appetite is a bit off, but before she would actually come and remind me that it was testing time and she would sit still and purr the whole time because she knew that she would get a yummy snack afterwards. Cats crave routine. I never realized this when all I did was plonk some kibble in her bowl twice a day and go about my life. Betty can make this easier for you once you establish some habits. :bighug::bighug::bighug:
 
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