10/3 Shylo AMPS 179 PMPS 239 - advice?

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Emily & Shylo

Emily & Shylo

Member Since 2014
This morning I tested Shylo's BG with our new glucometer (we just got it!) and was surprised to say the least that his glucose level was only at 179. Since I had to work all afternoon and into the night I ended up skipping that dose since no one would be home to monitor him until late and I didn't want to risk him going hypo with no one around (especially since I'm not super familiar with his cycle yet, either).

I just got home a little bit ago and tested again, and his BG is still not as high as it was last night - just 239. Is it safe to give him his usual dose or should I consider lowering it a little bit? Right now he's on 1 unit of Lantus every 12 hours, and has been on that schedule for about two weeks or so. My spreadsheet is looking a little barren unfortunately as well, hoping to remedy that now that I have my own meter.

Thanks for any insight!
 
welcome to the Lantus/Lev TR group!

Typically, we suggest new people ask for advice on whether or not it's safe to shoot if the cat is under 150. As you said, there isn't a lot to go on yet for you to make that decision, but as you get more data, it will be easier to know what to do.

I can't stay with you tonight, and our custom is that if someone encourages a person to shoot, they need to be willing to be available to help if that person gets into low numbers (under 50). So . . . I wonder if it would be best to drop the dose to 0.5u tonight. I'm waffling because I can't stay with you. If I could, and you could test at +2 and possibly later, and you had high carb cat food and plenty of test strips, it would probably be ok to give the 1.0u. But since I can't, I'm thinking perhaps it would be smart to decrease the dose until you can monitor.

Gosh, this isn't the most helpful answer, but it's the best i can offer right now.
 
Thank you for the reply! I totally understand, it's alright. I think I'll just lower his dose to .5u to be on the safe side and test as often as I can before I go to bed later. I have some higher-carb food on hand that I grabbed today just in case, and I do have plenty of strips... but definitely better safe than sorry.

Thanks for the advice! I'll go do that now and then keep an eye on it. (:
 
the +2 test (2 hrs after the shot) can be really helpful for predicting how the cycle might go. If it's higher than the preshot test, that might signal the start of a bounce, where there are higher numbers for a while.

if the +2 is about the same as the preshot, that signifies a typical active lantus cycle, meaning that the blood sugar numbers will decrease gradually until mid-cycle (varies from cat to cat, anywhere from +3 to +8 or so for most cats), after which it will rise to the next shot time.

if the +2 is lower than the preshot, that is a red flag. That means the cat is dropping quickly and you need to be extra vigilant.

Each cat tends to have its own patterns on insulin, and once you have a little more information, we'll be able to help you see the patterns Shylo has. That will help you a lot in knowing what might come next.

It's really helpful to try to get at least the preshot tests and one more test in each cycle. You can vary the times of the mid-cycle tests and it helps fill in the picture. I think of the spreadsheet like a jigsaw puzzle. If you have only the corners and edge pieces, it's pretty hard to see what the picture is. But if you have pieces spread here and there all over the puzzle, it becomes easier to decipher the picture. That's exactly what the spreadsheet is for us. It helps us to see what the Lantus is doing when we can see the past 3 or more days with a sprinkling of tests here and there.
 
That's super helpful information, thank you so much. It's all a little overwhelming when you first get going but I think I'm getting the hang of it. Tuesday I'll be home all day so I'm going to do my best to do an actual curve at home and see what that looks like.

If the +2 is lower than the preshot is it ok to give him a small snack to help boost him a little bit, or is it better to just wait and test again soon after?
 
Ok so just did the +2 test and his BG was 259... so since it's pretty close to his preshot does that mean it's a pretty regular Lantus cycle? If I can drag myself up early enough I can catch one close towards the end of his cycle as well, we'll have to see how that goes hahaha.
 
Hi and welcome to you and Shylo! We're glad found us here in lantus land.

You might want to get a +4 test and see if he's coming down still. Even though you shot a reduced dose, a higher dose can affect six subsequent cycles and so it's possible you might still see a somewhat active cycle tonight. We don't really know since you just got your meter. Good job testing.

His medical history is very interesting. My Gracie, also 8, has been having elevated ALT levels and an u/s shows a dilated bIle duct but her gallbladder is normal so they don't think she has an obstruction. They havent been able to figure out why her ALT goes up and down. She's also on Ursosdil and had a bile assay test which was normal. I hope Shylo has fully recovered.
 
Good morning! i wanted to get back to you today about Shylo's dose. Overall, the 1u looks pretty good for him - i just wasn't prepared to stay with you last night, although i can today.

I read you work long hours at the Petco. It is possible to follow Tight Regulation even if you work full-time. There are a couple of things that help make that possible and still safe for Shylo. Newly diagnosed kitties have the best chance at remission if it's at all possible for a cat, so getting him into normal numbers (50-120 on your relion) as soon as is safely possible is important.

Is remission (becoming diet-controlled) your goal?

When people work long shifts, they typically get a couple of extra tests in the pm cycle. You want to always get a test before you shoot the insulin. Sometimes tweaking insulin shot schedules can make it a little easier to get more tests in. Can you tell us what time you typically work and we might be able to suggest some options for shooting and testing?

Can you get an autofeeder? They are worth their weight in gold, in my opinion, when you've got to work with a diabetic cat. We had a recent discussion here about autofeeders that might be helpful to you.

For the moment, I think whether or not you stick with 0.5u or 1.0u depends upon whether or not you can monitor. In general, Lantus works best if you give the same dose repeatedly. Because it is a depot insulin, meaning it builds up in the body and sort of slow-releases, changing the dose frequently can cause wonky blood sugar responses. If you can give a little more info, we can help you decide on which dose you should go with for now.

Are your syringes ones that you can see to measure 0.5u? Your 0.5u doesn't have to look like someone else's, you just need to be able to notice where the plunger line is in relation to the syringe markings and to be able to duplicate that for future shots. There are pictures of the tiny doses in the New to the Group? yellow starred sticky - this is at the top of the main page for the Tight Reg support group.

Lots of great information in those yellow starred stickies, but the amount of info can be overwhelming when you're just starting out. Don't worry about trying to remember all of it, just skim and ask questions and we'll teach you what you need to know to help Shylo.
 
Good morning to both of you! Shylo decided he wanted his breakfast super early this morning and it was quite the battle to ignore him swatting everything off my desk, haha... although that gave me the opportunity to get a +10 from last night's dose (which was 248).

This morning's preshot was 230! He's just finishing up his food now so we're right on schedule.

@Marje and Gracie ; I definitely will stay up to check at some point, but unfortunately I have to close tonight and open tomorrow morning at work so I needed to scrounge as much sleep as I possibly could last night! He let me know he must have been feeling good by running on and off the bed maybe a dozen times to let me know it was time to play at 3am....

The gallstone problem really blindsided me (both financially and everything else). Definitely realized the importance of checkup vet visits, no matter how much kitty hates them. That's so weird about your cat's ALT. With Shylo all they had to do was an xray and we could see that his gallbladder was literally filled with stones. The u/s just confirmed that he actually had become blocked. Was a rough couple weeks but he made a full recovery without other complication. Back to his usual shenanigans, as it were.

@julie & punkin ; Thanks again for all of the helpful info here! Luckily even though I work long-ish hours I was able to put my foot down on my schedule, so I almost always have a closing shift every day. This enables me to feed/shoot/test at the same time every day, it's just a little later than most people usually do I think, haha. Since I get out at 10pm every night we typically have been eating at 10:30 and shooting at 11 (it's a great way to get out of being stuck later, too! "my cat needs his medicine" works every time). Since the earliest I have to go in for a shift is 2pm, it means I can get away with staying up later usually as well too. Tonight is a rare exception since I got stuck opening Sunday morning... inventory is soon.

Remission is definitely the goal here. Next time I drop by the vet for his other prescription I'm going to ask them to double check the data from his initial blood test to get the first glucose level, but I believe even just changing his diet alone has already helped significantly from the first week. It's impossible to say since I didn't have a testing kit yet, but when the vet saw him for his curve/recheck she was pretty stoked for how much better he was looked already. So far he's gained back at least three quarters of a pound- he dropped from 14.1 to 12.3 in less than two weeks before diagnosis.

The idea is that he'll be going full raw (or close to it). Now that I can test I feel way better about removing more carbs from his diet. I'll definitely go read the auto-feeder thread for canned at least, although I do also have a roommate that has been super helpful getting those few problem spots where I haven't been here taken care of for me. I have to teach him to test (hopefully he's comfortable with that), but he's definitely covered my ass a few times already at least getting him fed and given his insulin.

I have .5u syringes, so I can definitely measure that amount! I'll be home for three more hours today before work, so I can test a +1 and a +3 if that seems good? My roommate will at least be home to check on him while I'm gone as well. If I can get him up I can show him how to do it, hahaha. I've slowly been working my way through the forum bit by bit... definitely a lot to process but you guys have been great so far.
 
Those tests sound great.

The +1 will tell you if he is getting a little carb spike from the food he eats.

The +3 will tell you if he's on his way down from this morning's dose, and how quickly he's dropping.

What dose did you shoot this morning?
 
I did do his regular 1u this morning since someone will actually be home all day today (unlike yesterday) to keep an eye on him... going to see if I can drag my roommate out of bed when I do his +1 and +3 and show him how to do it so he can maybe do a +6 or so later on while I'm gone.

Shylo inhaled his breakfast and is now looking for more... typical. I've been feeding him his small allotment of kibble in an interactive feeder so he at least has to work that little noggin of his to get it.
 
sounds great - i think the 1u is a decent dose, from the data you have so far. i'm glad you went back to it.

just so you know, people often get the idea that the cat's nadir (low point) is at +6. It can vary from cycle to cycle, and from cat to cat. Punkin's was usually at +5.5, but i think he was unusual in that. Cats can have their nadir pretty much any time, although +3-+7 seems to be the most common time.

Yay for a roommate that will help out!

What is the dry food you're giving? Part of following Tight Reg is getting them completely on low carb canned or raw foods. You can put both in a timed feeder without problem. I added one ice cube in each compartment to keep the food fresh.
 
Yeah even to get one test done during the day would be helpful for more info on how his cycle will run, you have a point there... I won't really know how it goes until I can do a full curve on Tuesday.

Right now he's just getting 1/8 cup of the raw boost kibble by NV (turkey and duck)... he was a kibble addict prior to this, so this one bag is mostly a stepping stone. I had to get him off his previous kibble (Blue indoor formula) as it wasn't grain free and definitely was contributing to at least one of his issues. For the time being if he knows he gets a small kibble snack after, he'll clean his bowl of wet/raw... but sooner rather than later he'll hopefully be coming off of it. I was too worried about his initial weight loss to quit cold turkey on him at the time.

Hmm, ok. So I just took his +1 and it actually dropped to 200. Should I recheck at his +2 also to see if it's still dropping?
 
Morning!

No worries about the +4 test last night. It's importent to get sleep when you can. Im glad you went back to the 1u dose this morning.

If he's tolerating the tests, I'd get a +2. We should see a food spike at +1 and he's flat. Remember that each meter can have a 20% variance between tests.

Could you tell us your name please? We are all quite friendly here and like to have our members' names if they don't mind.

If and when you are able, I'd also suggest you get a backup meter. I see you are using one of the Relions and that's great. I'd suggest a backup thst is the same as what you have. If I get a wonky number and need to retest, I use the backup because immediately retesting with the same meter can give numbers that are off. Plus....if you have any problem with one, you've got another. We've had situations where the battery died, one member dropped a meter in the toilet, and I actually microwaved a meter by mistake instead of a rice sock :roll: :roll: yes, we were new and I'd had an all nighters with Gracie but it taught me a lesson :lol:
 
Of course hahaha, I should have added that to my forum profile earlier. My name is Emily! I've definitely noticed everyone has their names + cat names for their forum tags, that would have been a smart idea if I had thought of it when signing up. :P

I've been bribing him with those dried tuna flakes and he's been good so far since I switched to a smaller lancet size (30 gauge seems to be working well). I'll do the +2 in about fifteen minutes or so.

I'd be lying if I didn't laugh at the microwave incident. I'll pick up a backup when I get paid next, that's a good idea.
 
Thanks, Emily! Not everyone uses their name as their user id. But we tend to be a pretty tight knit group and its just nice to be able to put some more personal, warm touch on it. IMHO ;-)

I'm glad you got a laugh out of the microwave incident. It wasn't funny at the time because I had to race down to CVS to buy a new meter at 7 a.m. so I could give her insulin. But it's one of those very funny things that I laugh at now because boy did it STINK! :lol: :lol:
 
Of course! I usually don't mind sharing, I'm actually about to go join the Lantus group on facebook that you have linked in your signature as well.

Ok so I just tested the +2, and it only dropped to 199... which I guess is good, right? Gonna go mark it on the spreadsheet now.
 
Yes...perfect. So I'd give him a few hours and test at +4 or +5.

Could I ask a favor please? We usually do one condo (thread) per cat per day. Could you please start a new one for today and the subject line would be:
"10/4 Shylo AMPS 230 +1 200 +2 199"

Here's some more information about Making the Most of Your Lantus ISG Experience.

Several of us scan the board throughout the day and night except for the wee hours between the West Coast folks going to bed and the East Coast folks getting up. If you have a question, just open the first post of the condo, click "edit", click on the "?" above the subject line, and click "submit". Your actual question would be done by clicking on "post reply" and adding your question to the bottom of the thread. That bumps your post up so it doesn't get buried in all of the condos. If you add it to the top, we might not see it although most of us scroll back through to look for a question if you have the "?" up. You can also add something to your subject line like you did in this Condo.

The other thing that helps us immensely is if, when you open a new condo for the day, you put a link to the previous day's condo. Because we are not all on and helping all the same people every day, it allows us to quickly go back through your previous condos and read the history. To link the previous condo, just open it, copy the browser address, close it, open a "new topic", put your cursor in the text box, click on the box above the text box and then pas... so it would look like: [url]PASTE LINK HERE.

Thank you!!! You are doing great!!
 
Oh perfect, let me go do that now. (:

Thanks so much for all of the help again! It's making this a lot easier hahaha.
 
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