? 09/21 Dweezil - a good stable day for once!

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I tried to look, but no data in the SS for the 21st. Oops, there it comes. I see you are still having a hard time with the concept of sticking to the same dose every cycle. The dosing methods we use here work better with consistent dosing. Changing the dose every cycle can get you wonky numbers.

Here is the link to your post from last time, for continuity: http://www.felinediabetes.com/FDMB/...amps-high-again-but-now-pm-sharp-drop.184158/
 
This has been a bone of contention with us. In the morning he gets 1.2 as my partner sees such high reds everyday, and fears ketones. In the evening I fear hypo so I give a TINY amount under 1 unit.

Still, until we get these new half mark syringes and our jeweller binocular glasses, she could be giving him 1.5 and I could be giving 0.7. We just can't tell with our plain eyes with needles with only 1 unit increments.

Also...a question. Someone somewhere mentioned having to feed high carb food while finding the right dose for when the numbers drop too much due to too much insulin. But surely this is not good! Shouldn't it be the opposite so lower carbs are given to require less insulin!? I feel bad whenever I give my furry higher carb food.
 
monty_dweezil said:
Someone somewhere mentioned having to feed high carb food while finding the right dose for when the numbers drop too much due to too much insulin.
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When numbers are dropping fast early in the cycle, we encourage you to feed a higher carb food. How high depends on each cat and how it responds to carbs. Some are more carb sensitive than others. I could feed Cinco a 9% and it would slow him down, but some have to feel 12 or 15% to get a reaction. That's why we say to keep notes on what you fed, so you can look back and see what worked and what didn't.

You feed HC when kitty is too low - below 50 - to bring him up.

monty_dweezil said:
This has been a bone of contention with us. In the morning he gets 1.2 as my partner sees such high reds everyday, and fears ketones. In the evening I fear hypo so I give a TINY amount under 1 unit.
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Have you explained bouncing to your partner? Seriously, she isn't helping by changing the dose. Between you, you've got the depot totally confused! :p

Have you looked into calipers?
 
Tricia Cinco(GA) & Harvey said:
When numbers are dropping fast early in the cycle, we encourage you to feed a higher carb food. How high depends on each cat and how it responds to carbs. Some are more carb sensitive than others. I could feed Cinco a 9% and it would slow him down, but some have to feel 12 or 15% to get a reaction. That's why we say to keep notes on what you fed, so you can look back and see what worked and what didn't.

You feed HC when kitty is too low - below 50 - to bring him up.


Have you explained bouncing to your partner? Seriously, she isn't helping by changing the dose. Between you, you've got the depot totally confused! :p

Have you looked into calipers?
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Just wanted to stay I agree re: the inconsistent doses, Tricia. :-)

And spot on re: the carbs: only by trial and error (and lots of swimming with the sharks!) have I learned what MC or HC food will bring Girlie up and by how much and when I have to go that step further and use glucose syrup (emergency measure). Then again, she's a cat, so she likes to surprise me by not reacting as I expect her to, but there's always a plan b in my back pocket... :-)
 
I'm kind of working out most foods in the 8-12% carb range don't bring him up for longer than 10 minutes when he's already green.

I need to stockpile higher carb options. Luckily, he loves anything remotely carb-y.

We are curious about callipers. I can't get my head around how they actually work.

Is there any detriment in feeding MC or HC food (in an emergency or to steer a curve) in the medium to long term? Like would it cause a BG to be higher for days?I haven't seen this with Dweez but was curious.

Yes...the different doses. I know. lol. I want 1 unit. She wants at least 1.2. Our vet wants 2. At the cattery in July he was on 3. AAAAAGH!!!
 
Now, I have yet another question. :)

When I gave Dwee his 1 unit 3 nights ago he went too low. Last night's 1 unit did nothing much and his nadir was high. Tonight's 1 unit was looking good but it seems at only +5 hours his nadir has been and gone at 180. Now already on the rise again and will most likely be pinks and reds for the rest of the night.

If a 1 unit dose results in greens AND flat pinks, that's a bounce. But if that same dose results in ok numbers but doesn't last very long, like only good-ish numbers for 4-5 hours out of 12, what does this mean? Not high enough? Despite the greens?
 
You both have yet to wrap your minds around how Lantus works.

It is a slow acting depot type insulin. When you first start using a slow acting depot type insulin, the depot takes a few cycles to get established. Once established any dose changes cause the depot to recalibrate . This means that when you increase, insulin first goes toward bringing the depot up to the level of the new dose. Once the depot is recalibrated further doses go about the business of working on bringing BG down. This may take several cycles. On the flip side, when you decrease, the depot first recalibrates by draining down to the level of the dose last shot This too may take several cycles.

It is slow acting. This means that the number you are shooting at is the BG number at onset, 2 or 3 hours after you actually shoot, not the PS number.

By continuing to dose hop based on PS values, rather than basing dose decisions on nadir values and only nadir values, you create a constant state of BG wonkiness.

Time for a leap of faith.
 
Understanding the depot is key to Lantus. Often what you shoot has more impact on the following cycle. So a little extra juice in the AM may mean you stay up at night for the PM cycle. See if that argument helps with consistent dosing in the morning.
 
I am trying to understand this. lol.

My problem is how do you know, when giving the dose, what his nadir will be either 3, 5, 7, 12 or 14 hours later??

When I give 1 unit at 6pm how do I know when his nadir will be and what it will be, hours later?

I don't even understand how the depot really works. If you give the same dose twice a day for say 2 months, what is the depot doing? Is it being continually being slowly filled up? For what purpose? Does it drain and step up as a back up source if no insulin can be given for some reason? Or does it constantly drain slowly over 24 (or rather, 12) hours alongside the normal dose you've given? So does that mean you give a dose of 1 unit but the depot adds to it?
 
In any case, the consistent 1.2 AM and 1 PM now seems to have settled in to rather stable, unmoving pinks and yellows. No more greens or even many blues and no sharp drops. Does this mean...what? Does too low? Maybe both should be 1.1.
 
monty_dweezil said:
My problem is how do you know, when giving the dose, what his nadir will be either 3, 5, 7, 12 or 14 hours later??
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short of having phsycic powers or a crystal ball, you don't know what and when nadir will be for any given cycle. You find out the general pattern through testing.
monty_dweezil said:
When I give 1 unit at 6pm how do I know when his nadir will be and what it will be, hours later?
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You make your best guess based on recent (past 2 weeks, no further back) historical data.
monty_dweezil said:
I don't even understand how the depot really works.
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Read this, then , if you are still unclear ask questions.

Im going to run through some basics on Feline Diabetes, as a refresher.

Most all FD is type 2; kitties are not born with it they develop it. The culprit is a high carb diet. You see felines are obligate carnivores- they must eat meat. Based on having evolved that way, their pancreas are designed to produce an amount of insulin appropriate to process a high protein diet. When fed a high carb diet, the pancreas attempt to increase production of insulin to process the carbs into energy the body can use. However the high demand results in the pancreas beta cells burning out and insulin production pretty much grinds to a halt.

What we seek through insulin therapy, is to provide an environment for potential healing. We want to bring the BG into the normal range so the pancreas can rest. If healing is possible, the pancreas will gradually start to produce insulin once again, in spits and spurts. With an appropriate diet and a little luck one day the pancreas can return to producing enough insulin to maintain BG in the normal range, without the help of exogenous insulin.

Healing is a dynamic process. As healing progresses, insulin needs change, resulting in the 'sugar dance' , a dance that kitty always leads.
 
Mmm. Both our cats ate the same diet all their lives, mostly Fancy Feast and funnily enough, the one I now see are low carb. Not much dry.

Dweezy was diagnosed just after his 6th birthday. His brother Monty has never had it thank goodness. He was also never overweight.

He had had some steroid treatments earlier in his life, anti-inflammatories for urinary issues (no crystals or infection, just inflammation and pain) as well as compulsive rubbing at his nose and on another occasion, his eye. I've heard that can cause a susceptibility to diabetes.
 
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