? Insulin Regulation

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Scarlette & Fluffy

Scarlette & Fluffy

Member Since 2022
Fluffy's BG's have been all over the place since we started this Journey in March. Three times in the last 2 weeks inconsistently his numbers were in the blue, 172,, it's in the spreadsheet. How do I know when I need to reduce his usual dose of insulin from 4 units to something lower?

He is still currently taking Novolin-N. His usual dose is 4 units every 12 hours. I can switch to Lantus today if that's the best however I don't know the correct dosage to give him.

I purchased a bag of Crave dry food because fluffy really goes after the dry food I know it's not ideal but it had 21% carbs versus the 33 plus carbs that he was eating originally. If I could afford those ridiculously priced low carb foods I would rather do that but we all know how that goes. Your funds dictate to you what you can and cannot do. I am trying to switch him to completely wet food and currently he is eating Friskies pate or other pate's whatever is available to me special Kitty or Fancy Feast are usually the three that are accessible in my area just not all at the same time.

I feed him a half a can of the Pate first thing in the morning 8 am and then between 12 and 2 I feed him about a quarter of the can and then at 8pm he gets another half a can and then he doesn't get anything after that until the morning. He usually doesn't get any kind of treats or snacks unless I'm eating hamburger or chicken or something and I will give him Nibbles from my plate of meat. But nibbles from my plate are not consistent since I don't always have meat to give him. I am also feeding 7 cats, including Fluffy.

Please advise! This morning before eating his BG was 172 and that's him not having any food all night long. He ate last night at 10 p.m.

https://www.felinediabetes.com/FDMB/threads/photo-gallery.265866/

@Suzanne & Darcy
@Bron and Sheba (GA)

@Bandit's Mom

@Wendy&Neko

@tiffmaxee
 
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I am not a Novolin N user but I would suggest you get some tests in during this cycle as the 172 is the lowest pre shot you have given.
Not getting any tests in during the cycles is risky.
Are you giving snacks during the first half of all cycles?
If Fluffy was my cat, I would be swapping him over to Lantus now and not waiting until the end of the novolin N bottle.
 
Is Fluffy eating consistently? I am asking since sometimes he gets a good, in the 200's, preshot but most of the time the preshots are very high. I think 4 units is too high, especially for N insulin. O agree with Bron that I would change to Lantus (I would get the generic/biosimilar glargine) since it is less expensive) as soon as possible and not wait til the N is used up.
 
Bron and Sheba (GA) said:
I am not a Novolin N user but I would suggest you get some tests in during this cycle as the 172 is the lowest pre shot you have given.
Not getting any tests in during the cycles is risky.
Are you giving snacks during the first half of all cycles?
If Fluffy was my cat, I would be swapping him over to Lantus now and not waiting until the end of the novolin N bottle.
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How much Lantus should I give him? I haven't been able to be consistent every 2 hours constantly. I've been very busy with some house renovations and care of my ailing mother and working.

I do appreciate your wisdom and your quick response.
 
Do you have Lantus? Can you have Lantus? Can you get any tests beyond pmps at night? It will take 5-7 days for the depot to build. Then doses are based upon how low it takes your cat. Cats often have lower BG at night. Only testing during the day gives you just half of the picture.
 
Larry and Kitties said:
Is Fluffy eating consistently? I am asking since sometimes he gets a good, in the 200's, preshot but most of the time the preshots are very high. I think 4 units is too high, especially for N insulin. O agree with Bron that I would change to Lantus (I would get the generic/biosimilar glargine) since it is less expensive) as soon as possible and not wait til the N is used up.
Click to expand...
Larry and Kitties said:
Is Fluffy eating consistently? I am asking since sometimes he gets a good, in the 200's, preshot but most of the time the preshots are very high. I think 4 units is too high, especially for N insulin. O agree with Bron that I would change to Lantus (I would get the generic/biosimilar glargine) since it is less expensive) as soon as possible and not wait til the N is used up.
Click to expand...
See original post for how Fluffy's been eating.
 
tiffmaxee said:
Do you have Lantus? Can you have Lantus? Can you get any tests beyond pmps at night? It will take 5-7 days for the depot to build. Then doses are based upon how low it takes your cat. Cats often have lower BG at night. Only testing during the day gives you just half of the picture.
Click to expand...
Please clarify. Are you suggesting I blood test him every hour in pm till what time? Or all night long? Or every 2 hours thru the night? How much insulin do I give of Lantus? I did not give him any insulin this morning because I did not know the correct dosage to give for a BG 172. I appreciate your feed back and clarification as I need my boy to be around a ling time!
 
I
Larry and Kitties said:
Is Fluffy eating consistently? I am asking since sometimes he gets a good, in the 200's, preshot but most of the time the preshots are very high. I think 4 units is too high, especially for N insulin. O agree with Bron that I would change to Lantus (I would get the generic/biosimilar glargine) since it is less expensive) as soon as possible and not wait til the N is used up.
Click to expand...
I have Lantus ....what dose do I start him on?? His pre shot BG this morning was 172 and I have not given him any insulin at all of any kind. Please advise.
 
He eats slowly. He and 1 other cat get 1/2 a can. She definitely finishes her half faster. The others get 1/4 can. The others have not lost weight for only getting 1/4 of a can. They get another 1/4 in the evening. Fluffy is a slow eater. If he hears the dry food bag he will abandon the pate and come running but I have an outside cat that strictly gets dry food. She's 5yrs. The rest are all over 12yrs. I sit and watch/guard him eating as he will let the others steal if from him. I tried for a while locking him up alone but he didn't want to eat that way. I have better results when he's amongst the rest of the crew.

If I find that any of the other cats currently eating 1/4 can at feedings drops weight, I'll have to increase the intake but I cannot afford anything more. I'm at my limit. I research pet food pantry's but there are none in my area. I made a commitment to these cats and I will care for them and love them until their time comes.
 
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Scarlett's I know money is tight
I don't know what you paid for lantus
If you need more down the road

This was from one of our members whose cat was on lantus which is very expensive in the US
Basaglar has worked wonderfully, we were using Lantus and when we switched there wasn't even a blip. Hendrick did not seem to notice at all.

Check this out also
https://www.goodrx.com/insulin-glargine?dosage=five-3ml-prefilled-pens-of-100-units-ml&form=carton&label_override=insulin glargine&quantity=1
The 5 pens will last about a year

Basaglar is also Insulin Glargine, it acts the same way.

Here is a saving card for basaglar for 5 pens they will last you at least a year depending on the dose
Check it out just put in where it says set your location
https://www.goodrx.com/basaglar

I see some members will call CVS, Rite Aid, Costco to get the price for 5 pens

Lantus usually kicks in about 2 hours after giving it, just try to get as many tests in as you can , evening also. Not saying you have to test every hour
Maybe like +2, +4 and +6

Evening maybe +2 and +6. Of course if the BG drops much lower where you have to intervene with med or higher carbs you would need to test sooner

I think you will really like lantus

You should read the 2 dosing methods for lantus and pick one that best suits you
If you are definitely going to stay with lantus starting tonight you will need to go to your signature and put Lantus as of then Date. I would also add you are feeding Crave Dry

Also on your spreadsheet above , I would make a blank line above the date you start lantus and put Started Lantus I don't think members will see it in your remarks column
If you need help doing any of this I'm sure Bhooma can do it for you
 
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Diane Tyler's Mom said:
Scarlett's I know money is tight
I don't know what you paid for lantus
If you need more down the road

This was from one of our members whose cat was on lantus which is very expensive in the US
Basaglar has worked wonderfully, we were using Lantus and when we switched there wasn't even a blip. Hendrick did not seem to notice at all.

Check this out also
https://www.goodrx.com/insulin-glargine?dosage=five-3ml-prefilled-pens-of-100-units-ml&form=carton&label_override=insulin glargine&quantity=1
The 5 pens will last about a year

Basaglar is also Insulin Glargine, it acts the same way.

Here is a saving card for basaglar for 5 pens they will last you at least a year depending on the dose
Check it out just put in where it says set your location
https://www.goodrx.com/basaglar

I see some members will call CVS, Rite Aid, Costco to get the price for 5 pens
Click to expand...
These are excellent resources to know about and keep in my remembrance. I appreciate you sharing this valuable information. As for now, DCIN has supplied me with the Lantus, some syringes and test strips. I'm nervous to switch because I hear Lantus isn't forgiving! 12/12. Sometimes with life and church I may be late or early with his insulin shot. I was giving shots at 7:30/7:30, but with church he would get it at wed 9:30pm. So I was able to begin working from home, changed my work schedule and changed his dosage times to 9:30/9:30. But now on Sunday morning he needs insulin @8:15 because I need to leave for church. No matter what I do, there's going to be a "regular" time in which his insulin cannot be on-time at least 1x week. What am I to do?

Thank you for the info.
 
Scarlette & Fluffy said:
These are excellent resources to know about and keep in my remembrance. I appreciate you sharing this valuable information. As for now, DCIN has supplied me with the Lantus, some syringes and test strips. I'm nervous to switch because I hear Lantus isn't forgiving! 12/12. Sometimes with life and church I may be late or early with his insulin shot. I was giving shots at 7:30/7:30, but with church he would get it at wed 9:30pm. So I was able to begin working from home, changed my work schedule and changed his dosage times to 9:30/9:30. But now on Sunday morning he needs insulin @8:15 because I need to leave for church. No matter what I do, there's going to be a "regular" time in which his insulin cannot be on-time at least 1x week.
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That's great you are getting it from DCIN
About the dosing time for that one day I know you can adjust the time 15 minutes for each cycle or 30 minutes for one cycle
I'm not really good at figuring it our lol but I'll tag Bhooma @Bandit's Mom to see if she can give you some advice
I'll also tag
time, since Fluffy has been on Novlin N this whole time
@tiffmaxee

@@Wendy&Neko

@Suzanne & Darcy

@Bron and Sheba (GA)

@Bandit's Mom

@Sienne and Gabby (GA)
 
Diane Tyler's Mom said:
That's great you are getting it from DCIN
About the dosing time for that one day I know you can adjust the time 15 minutes for each cycle or 30 minutes for one cycle
I'm not really good at figuring it our lol but I'll tag Bhooma @Bandit's Mom to see if she can give you some advice
I'll also tag
time, since Fluffy has been on Novlin N this whole time
@tiffmaxee

@@Wendy&Neko

@Suzanne & Darcy

@Bron and Sheba (GA)

@Bandit's Mom

@Sienne and Gabby (GA)
Click to expand...
We cross posted...we are on it :bighug:@Diane Tyler's Mom
 
Scarlette & Fluffy said:
Please clarify. Are you suggesting I blood test him every hour in pm till what time? Or all night long? Or every 2 hours thru the night? How much insulin do I give of Lantus? I did not give him any insulin this morning because I did not know the correct dosage to give for a BG 172. I appreciate your feed back and clarification as I need my boy to be around a ling time!
Click to expand...
No. Not testing every hour. Elise is suggesting that you get some evening tests in. It is a good idea to get a +2 test in the p.m. cycle. If that test is much lower than the PMPS number was, then it’s a good indication that you may have an “active cycle” where Fluffy will be dropping lower and you will need to monitor and feed him. Then another test before bed is always a good idea in order to see if you need to intervene at that point and/or set an alarm to test later in the evening.
 
With lantus there should not be any issues shooting a half hour early or late. With more than that every 24 hours adjusting by 30 minutes every day or 15 minutes every cycle is fine. Sometimes once you have data you can adjust by more. Late is never an issue. It’s when getting back on schedule that you need to be careful as more than 30 minutes early MAY act like a slight increase.
 
I believe you will be safe starting with four units since Fluffy is currently on 4 units and has had a few higher blues. Please try to get a mid-cycle test in for each cycle though. It will be impossible to advise on dose increases unless we can see how low the dose is taking Fluffy - since doses are generally based upon the nadirs.
 
Suzanne & Darcy said:
No. Not testing every hour. Elise is suggesting that you get some evening tests in. It is a good idea to get a +2 test in the p.m. cycle. If that test is much lower than the PMPS number was, then it’s a good indication that you may have an “active cycle” where Fluffy will be dropping lower and you will need to monitor and feed him. Then another test before bed is always a good idea in order to see if you need to intervene at that point and/or set an alarm to test later in the evening.
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ok so by +2 do you mean more than 2 tests before PMP? or after PMP?
 
I keep rereading these posts trying to get it straight in my brain.......so here's what I'm understanding.....PMPS is the time of the BG Test? Not the insulin shot? If this is True, than in Fluffy's case His PMPS BG test is at 9PM (cause his shot is at 9:30 and need to wait 30 mins after eating to inject insulin? (Lantus ?) Blood test at 9pm and feed him, 9:30pm inject 4U Lantus, 10:30p another BG, 11:30p BG, beyond that I'll be asleep.

What if his BG at 9pm is under 300? does he still get 4U Lantus?
What if his BG at 9pm is under 200? does he still get 4U Lantus?
What if his BG at 9pm is above 400? does he still get 4U Lantus?
What if his BG at 9pm is above 500? does he still get 4U Lantus?
above 600? does he still get 4U Lantus?

Am I understanding this correctly?

Thank you so much for your patience in my thinking processes.

@tiffmaxee
@Wendy&Neko
@Suzanne & Darcy
@Bron and Sheba (GA)
@Bandit's Mom
@Sienne and Gabby (GA)
 
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Scarlette & Fluffy said:
ok so by +2 do you mean more than 2 tests before PMP? or after PMP?
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I was suggesting that you try to get a test two hours after his insulin injection- that’s what we call +2. Then another test before bed, which could be +4 for you or who knows when…. It depends on your schedule and when you go to bed.

Since there are so many different people in different time zones on this Board, we use the + times to talk about how many hours after the insulin shot was given - that way we are able to understand each other. If I am on Eastern time and another member is in Australia, it would not work to use regular clock time. I hope this makes sense.
 
Suzanne & Darcy said:
I was suggesting that you try to get a test two hours after his insulin injection- that’s what we call +2. Then another test before bed, which could be +4 for you or who knows when…. It depends on your schedule and when you go to bed.

Since there are so many different people in different time zones on this Board, we use the + times to talk about how many hours after the insulin shot was given - that way we are able to understand each other. If I am on Eastern time and another member is in Australia, it would not work to use regular clock time. I hope this makes sense.
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Yes...perfect sense and thank you for spelling it out. Sometimes in texting or messaging, things get lost in translation or in interpretation. I thought I was supposed to test 1 hour after shot (at 10:30p) and then 2 hours after that and another 2hrs beyond that, if I'm awake? But that might have been specific for Novolin_N and not generally for all insulins, IDK.
 
Scarlette & Fluffy said:
I keep rereading these posts trying to get it straight in my brain.......so here's what I'm understanding.....PMPS is the time of the BG Test? Not the insulin shot? If this is True, than in Fluffy's case His PMPS BG test is at 9PM (cause his shot is at 9:30 and need to wait 30 mins after eating to inject insulin? (Lantus ?) Blood test at 9pm and feed him, 9:30pm inject 4U Lantus, 10:30p another BG, 11:30p BG, beyond that I'll be asleep.

What if his BG at 9pm is under 300? does he still get 4U Lantus?
What if his BG at 9pm is under 200? does he still get 4U Lantus?
What if his BG at 9pm is above 400? does he still get 4U Lantus?
What if his BG at 9pm is above 500? does he still get 4U Lantus?
above 600? does he still get 4U Lantus?

Am I understanding this correctly?

Thank you so much for your patience in my thinking processes.

@tiffmaxee
@Wendy&Neko
@Suzanne & Darcy
@Bron and Sheba (GA)
@Bandit's Mom
@Sienne and Gabby (GA)
Click to expand...
You will not need to wait any longer with Lantus. The procedure is to test (the AMPS or PMPS test) and then feed right away, and then to shoot the insulin. This whole process is usually accomplished in 10-15 minutes. There’s no need to wait 30 minutes or more to feed and then shoot. Lantus is a much more gentle insulin than the one you have been using. The onset (when it kicks in and you start to see a downward trend in blood glucose) is about +2 for most cats.
 
Suzanne & Darcy said:
You will not need to wait any longer with Lantus. The procedure is to test (the AMPS or PMPS test) and then feed right away, and then to shoot the insulin. This whole process is usually accomplished in 10-15 minutes. There’s no need to wait 30 minutes or more to feed and then shoot. Lantus is a much more gentle insulin than the one you have been using. The onset (when it kicks in and you start to see a downward trend in blood glucose) is about +2 for most cats.
Click to expand...
okay so I should change his eating and shooting time to 9:30pm / 9:30am? Injection 9:30p, 11:30p BG, [1:30a BG- not sure I can do this unless I set an alarm, but cannot wake up every 2 hrs to test..I won't function right later that day.] But I could do it at 1:30am and then not again till he gets his test in the AMP time. Would that be enough to get an idea what his body is doing with the Lantus???
 
Scarlette & Fluffy said:
okay so I should change his eating and shooting time to 9:30pm / 9:30am? Injection 9:30p, 11:30p BG, [1:30a BG- not sure I can do this unless I set an alarm, but cannot wake up every 2 hrs to test..I won't function right later that day.] But I could do it at 1:30am and then not again till he gets his test in the AMP time. Would that be enough to get an idea what his body is doing with the Lantus???
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What is his current shot time?
 
Your recommended testing will be different on Lantus than it was with your current insulin. Usually you will not test every two hours unless you are doing a “curve” where BG is tested every two hours to see how the insulin cycles are working, when the nadir is, etc.
 
Is there a reason why the shot time is 9:30? That puts his night nadir possibly in the middle of the night. Most shoot I think between 6-8. Some shoot while their cat is eating breakfast or dinner. You test to see if safe to shoot. You feed to make sure they will eat. Then you shoot right away. So I Woolf think the latest your shot time needs to be is around 9. You can even start the process a few minutes before 9.

You want to find a dose you can shoot consistently every 12 hours. Your no shot number or reduced shot BG will depend upon whether you follow SLGS or TR. With both you will shoot a full dose if the BG is around 200 or more. Until you decide on a method to follow, if under 200 stall, don’t feed, and recheck in 20-30 minutes. Post for dosing advice. If the second test is around 200+ shoot a full dose.

Once you have data you will know what to do if under 200. With TR you eventually shoot anything over 50 if using a human meter. With SLGS it’s over 90.

Read the dosing methods sticky and you will get an idea of how each works. No need to decide right away but when you start to see lower BG you will need to decide.
 
Quote: What if his BG at 9pm is under 300? does he still get 4U Lantus?
What if his BG at 9pm is under 200? does he still get 4U Lantus?
What if his BG at 9pm is above 400? does he still get 4U Lantus?
What if his BG at 9pm is above 500? does he still get 4U Lantus?
above 600? does he still get 4U Lantus? Quote
————-

With regard to these questions, the doses of Lantus are based upon the nadir (how low the dose takes the cat/the lowest point in the cycle.) In the beginning, if you get a lower than expected preshot number, post for advice on the Board and be sure to put a question mark in the title of your thread and ask for help.
 
Suzanne & Darcy said:
Your recommended testing will be different on Lantus than it was with your current insulin. Usually you will not test every two hours unless you are doing a “curve” where BG is tested every two hours to see how the insulin cycles are working, when the nadir is, etc.
Click to expand...
But since this Lantus is new to fluffy should I then be trying to do a curve to see how it is affecting his body?
 
tiffmaxee said:
Is there a reason why the shot time is 9:30? That puts his night nadir possibly in the middle of the night. Most shoot I think between 6-8. Some shoot while their cat is eating breakfast or dinner. You test to see if safe to shoot. You feed to make sure they will eat. Then you shoot right away. So I Woolf think the latest your shot time needs to be is around 9. You can even start the process a few minutes before 9.

You want to find a dose you can shoot consistently every 12 hours. Your no shot number or reduced shot BG will depend upon whether you follow SLGS or TR. With both you will shoot a full dose if the BG is around 200 or more. Until you decide on a method to follow, if under 200 stall, don’t feed, and recheck in 20-30 minutes. Post for dosing advice. If the second test is around 200+ shoot a full dose.

Once you have data you will know what to do if under 200. With TR you eventually shoot anything over 50 if using a human meter. With SLGS it’s over 90.

Read the dosing methods sticky and you will get an idea of how each works. No need to decide right away but when you start to see lower BG you will need to decide.
Click to expand...
I suppose I could probably move his testing to 9:00 and his eating I was just trying to find the time that was convenient so that he could not be late more than once a week on his doses
 
Scarlette & Fluffy said:
But since this Lantus is new to fluffy should I then be trying to do a curve to see how it is affecting his body?
Click to expand...
Well, if you can do it on a Saturday or Sunday (if you are at home) then yes. But it will take five or more days for the depot to fill. So if you could do it next weekend that would work. It would just need to be for one cycle and not all day. Most people do the morning cycle so they don’t have to stay up all night. If enough testing is done then a curve may not be necessary. If you can test mid-cycle on other cycles and vary the times that you test, we may be able to fill in a comprehensive picture of how he’s doing on a dose.
 
You should read the 2 dosing methods for lantus to get an idea
If you are definitely going to stay with lantus starting tonight you will need to go to your signature and put Lantus as of then Date. I would also add you are feeding Crave Dry

Also on your spreadsheet above , I would make a blank line above the date you start lantus and put Started Lantus I don't think members will see it in your remarks column
If you need help doing any of this I'm sure Bhooma can do it for you

https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/
 
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Scarlette & Fluffy said:
I suppose I could probably move his testing to 9:00 and his eating I was just trying to find the time that was convenient so that he could not be late more than once a week on his doses
Click to expand...
What time do you usually get home? Is it close to 9? I’m not understanding, sorry. Why would he be last once a week? Do you have to stay out later on one day of the week?
 
Scarlette & Fluffy said:
PMPS is the time of the BG Test? Not the insulin shot?
Click to expand...
AMPS means the first test in the morning , withhold feeding 2 hours prior to testing so it's not food influenced You would put that number in the AMPS cell that means AM pre shot
If you test him 2 hours later after giving insulin that BG number goes in the +2 cell
and so on

Same thing with PMPS withold feeding 2 hours before that test then test and put that BG # in the PMPS cell if you test 3 hours after giving insulin that goes in the +3 cell and so on

The U column means how many units of insulin you are giving
You can start a new post everyday on the Lantus board , there's a lot of Lantus users there
Just say you are new to posting on the Lantus board
, you would do it like this when you start testing
Date Fluffy AMPS # and any additional tests after that
To add those tests to the right you will see the word Tool Threads tap on that then tap on Edit Thread add those tests and tap Save

We adjust the dose by 0.25 units at a time. Those syringes make it easier to do that

Do you have the U-100 syringes with the half unit marking ?
 
Suzanne & Darcy said:
What time do you usually get home? Is it close to 9? I’m not understanding, sorry. Why would he be last once a week? Do you have to stay out later on one day of the week?
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I attend church regularly Sunday morning 8:30 till noon and Wednesday evening 6 till 8:30. I get home around 9pm wed eve. I would have time to get in the door, do what I need to do to get him tested, fed, and shot wirhout being late. If I get home at 9. He won't get his shot until 9:15 while he is eating. So this means on sun/wed he woukd regularly be off schedule 2x a week. If I do 9pm.
 
I see you said above
I purchased a bag of Crave dry food because fluffy really goes after the dry food I know it's not ideal but it had 21% carbs versus the 33 plus carbs that he was eating originally. If I could afford those ridiculously priced low carb foods I would rather do that but we all know how that goes.

Are you still feeding the Crave dry? Looked st your photo gallery you posted they are all so adorable
@Scarlette & Fluffy
 
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