? 1/12 - Would like input on Wally's numbers. Need a fresh set(s) of eyes

Ginger Cat

Ginger Cat

Member Since 2017
I've had Wally on Lantus, at 2 units, TR, for quite a while. He seems to be in a pattern of going low (sometimes within hypo range) and then bouncing, clearing the bounce and then going low again and starting the cycle over again.

When I've lowered his dose, he doesn't respond and continues to have high numbers so I go back up. I've tried dosing at 1.5, 1.75 and skinny 2, but nothing seems to work.

Would love to hear your thoughts on this. Do I just come to terms with the fact that he's always going to be so bouncy or is there hope? Thoughts on dosing?
 
Here's the link to your last post here.

If you are still following TR, Wally would be considered a long term diabetic - diabetic longer than one year. The criteria for reductions change in a long term diabetic to 1 time below 40, or a week in normal green numbers. Alternatively, if the cat doesn't hold reductions well, some people reduce after three times between 40 and 49 on separate days, or once below 40.

I see you did a skinny dose on 1/7 AM. I'm not sure why? It looks like you were around to monitor. Shooting low produces a lot flatter cycles than shooting high numbers, and gives Wally's body the opportunity to get used to normal numbers. Which is what needs go happen go help him from bouncing so much.

You are also holding doses too long if you are following TR. We hold doses with green nadirs for 10 cycles. You've held a lot longer than that. Time for an increase to 2.25 units. Don't bother with the fat/skinny increases for now.
 
Wendy&Neko said:
Here's the link to your last post here.

If you are still following TR, Wally would be considered a long term diabetic - diabetic longer than one year. The criteria for reductions change in a long term diabetic to 1 time below 40, or a week in normal green numbers. Alternatively, if the cat doesn't hold reductions well, some people reduce after three times between 40 and 49 on separate days, or once below 40.

I see you did a skinny dose on 1/7 AM. I'm not sure why? It looks like you were around to monitor. Shooting low produces a lot flatter cycles than shooting high numbers, and gives Wally's body the opportunity to get used to normal numbers. Which is what needs go happen go help him from bouncing so much.

You are also holding doses too long if you are following TR. We hold doses with green nadirs for 10 cycles. You've held a lot longer than that. Time for an increase to 2.25 units. Don't bother with the fat/skinny increases for now.
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I have hesitated to increase because when I've gone up, he totally crashes. I'm using the AlphaTrak2 meter so numbers under 68 are considered hypo range... I've never given him more than 2 units since starting the Lantus if you look at his 2020 spread sheet.

I did the skinny 2 because he was so low AMPS and had been going down since his PM shot the night before and was afraid a full dose will drop him too fast...

And his numbers today are good so I'm hesitant to increase...
 
Sorry, not seeing any below 68's on this dose this year. What a cat needs now vs ages aren't comparable. A cat's insulin needs can change over time. I don't know what carb food you are feeding him now, but another consideration is to find a slightly higher carb LC, maybe around 8% carbs and feed him that. That might help him from diving so much. Are you spreading out his meals in the first half of the cycle too?

As for reduction guidelines if a long term diabetic, we don't know what "40" on a human meter means on an AT, so I can only quote you what it is on a human meter.
 
He gets FF classic pate, watered down. He also gets some Friskies pate if my other cats haven't finished their meal by the time I let Wally out of my room.
He gets 1 can FF am and small snacks during the day and another can PM. He often only eats 1/2 or 3/4 of the initial can AM and PM and then finishes within 2 hours. I also top his FF with pulverized freeze-dried chicken, nutritional yeast and Forti Flora.
 
Hello there, I looked at your SS's as well...he does look a little bouncie...but a lot of cats are - my Luci was a real diver in the early days...and I had to make some changes along the way with her. Here's what I did:
1-Used a human meter (so I could optimize the dosing method information, they're written using human meters).
2-Stopped listening to my vets (yes, multiple, and they were all wrong with their information/advice.
3-Started trying my best to 'feed the curve' - Luci would start dropping and I often failed to catch those drops in time OR didn't realize what carb food I was supposed to feed her - trial and error helped me figure out which foods she's most responsive to.
4-Aligned my Spreadsheets, signature and titles to match the guidelines for posting on this forum - the LB&L forum is one of the busiest so it's hard to get attention when your title isn't formatted properly and tends to drop to the bottom of the pile or just overlooked ... lots of people just won't look unless there's a date for that day - generic posts often get shuffled way down and are not seen by as many helpful folks.
5-Ask for help with my SS, signature, etc. I was overwhelmed with the sheer magnitude of information here - and I'd asked for help a LOT!
6-Look at other people's condos and spreadsheets - I'd read what they were being told with various situations and what to expect when it happened to me - did I get it right? Nope...but I still learned a lot from reading and trying again and again to learn a new tidbit as often as I could.
7-Using calipers to measure the dose - Lord I cannot tell you what a difference that made in getting the dosing consistent! Timing daily for consistency - same time of day every day - 12 hours apart; and yes I had to set timers to remind me to do that ...
8-Switched to Levimer - another long-lasting insulin that seems to be less prone to those big bounces.

Just suggestions - and I hope some of these will be helpful to you. The first thing I'd do though if I were in your shoes is to set aside the AT2 for a bit - you can always come back to it later if you wish - but that's just me.

Have a good day!
 
Sue has a great list of helpful things. I was also going to mention putting aside the AT2 for a bit especially since you are using third party strips - it would be great just to eliminate that variable. FWIW, I too switched from AT2 (though I was using AT2 strips) so that I could take full advantage of the dosing methods and knowledgable people here. Hope you have a wonderful day :bighug:
 
Sue and Luci said:
Hello there, I looked at your SS's as well...he does look a little bouncie...but a lot of cats are - my Luci was a real diver in the early days...and I had to make some changes along the way with her. Here's what I did:
1-Used a human meter (so I could optimize the dosing method information, they're written using human meters).
2-Stopped listening to my vets (yes, multiple, and they were all wrong with their information/advice.
3-Started trying my best to 'feed the curve' - Luci would start dropping and I often failed to catch those drops in time OR didn't realize what carb food I was supposed to feed her - trial and error helped me figure out which foods she's most responsive to.
4-Aligned my Spreadsheets, signature and titles to match the guidelines for posting on this forum - the LB&L forum is one of the busiest so it's hard to get attention when your title isn't formatted properly and tends to drop to the bottom of the pile or just overlooked ... lots of people just won't look unless there's a date for that day - generic posts often get shuffled way down and are not seen by as many helpful folks.
5-Ask for help with my SS, signature, etc. I was overwhelmed with the sheer magnitude of information here - and I'd asked for help a LOT!
6-Look at other people's condos and spreadsheets - I'd read what they were being told with various situations and what to expect when it happened to me - did I get it right? Nope...but I still learned a lot from reading and trying again and again to learn a new tidbit as often as I could.
7-Using calipers to measure the dose - Lord I cannot tell you what a difference that made in getting the dosing consistent! Timing daily for consistency - same time of day every day - 12 hours apart; and yes I had to set timers to remind me to do that ...
8-Switched to Levimer - another long-lasting insulin that seems to be less prone to those big bounces.

Just suggestions - and I hope some of these will be helpful to you. The first thing I'd do though if I were in your shoes is to set aside the AT2 for a bit - you can always come back to it later if you wish - but that's just me.

Have a good day!
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Thanks for taking the time to respond so thoroughly. I really appreciate your input. My vet is actually very supportive and immediately advised me to feed him FF and never pushed the prescription foods. She loves the spreadsheets and I send her email updates all the time. I am grateful to have her on my/Wally's side. Re: switching from the AT2 or to Levimer. Given my finances and the fact that I have 2 pens of Lantus in the fridge and about 8 boxes of PetSure strips, switching immediately really isn't an option. Maybe down the road.
 
Ginger Cat said:
Thanks for taking the time to respond so thoroughly. I really appreciate your input. My vet is actually very supportive and immediately advised me to feed him FF and never pushed the prescription foods. She loves the spreadsheets and I send her email updates all the time. I am grateful to have her on my/Wally's side. Re: switching from the AT2 or to Levimer. Given my finances and the fact that I have 2 pens of Lantus in the fridge and about 8 boxes of PetSure strips, switching immediately really isn't an option. Maybe down the road.
Click to expand...

I understand! I ended up selling my extra Lantus on the forum Supply Closet... it covered my expense fir that..

My regret is that I waited as long as I did to make the switch.. for the same reason as you.
 
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