hi amy,
thanks for getting those numbers into the spreadsheet. next assignment - would you put the doses in the blue columns for each day too - it's hard to swing the ss back and forth to catch the doses over in the notes section. thanks.
so . . .
i feel for you - it's hard to see your cat in high numbers.
i don't see your data from the first 2-3 months after you joined here, so i'm just going to make some general observations and perhaps you can see what parts apply to you and what you can implement. if you want him to get better, you really have to make some changes - there's not really any other bottom line answer.
you must get at least 4 tests every single day. both preshot tests and then one more mid-cycle test. i think if you understand how lantus works it will help you understand the need for it.
lantus injects as a liquid, but then it forms a precipitate that slow releases into the body. we call that precipitate a shed. that's really important to understand, because a particular dose can remain the same and the way the body reacts to it can change. for example, let's say you were injecting 1unit into revson: at the beginning he might have numbers averaging in the 250-300 range, but as it builds up in his body and slow releases, his numbers might drop down to a lower range, even down into less than 100's.
insulin is a hormone - so it's not like a pill you take every day and the dose never changes. it's kind of counter-intuitive because logically, you'd think if you keep feeding the same food, keep giving the same dose, you'd get the same result. nope. doesn't work that way. i liken it to 13 year old girls - ever been one? i've been one and raised 2. hormones go on and off and take you on the wild ride with them. in a non-diabetic cat the pancreas puts out the perfect amount of insulin all the time so the wild swings don't happen, but when we inject insulin we can't exactly duplicate that process - the consequence being a fluctuation of blood sugar in the cat's body.
if you don't want to ever change his dose, you have to give a small enough dose that he never goes low (i don't know if that's even possible with a cat) and that would result in constant high numbers. high numbers mean a sick-feeling kitty who pees & drinks too much and whose organs are being damaged by the overwhelming sugar bath.
does that all make sense? ask about anything that doesn't.
the purpose of the tight regulation protocol we follow is to push a cat's blood sugar down low enough, into a normal non-diabetic cat range so that the cat's pancreas can heal and turn itself back on, hopefully resulting in a cat going off of insulin. there's great success with the protocol. if that is your goal, then testing and adjusting dosage is key.
with lantus, the number that determines the dose is the lowest number that a cat gets to in each 12 hour cycle. when there are a lot of tests on a spreadsheet, it's easy to look at the ss and say to hold, increase or decrease a dose. it's like a jigsaw puzzle. the preshot tests are edge pieces, but the picture only emerges with the mid-cycle tests.
it's not that no one wants to help you, it's that it's impossible to say what Revson's picture is without more tests.
i can tell you that adjustments are only made by .25 units - that's 1/4 unit. so after a time on 1 unit, if his dose needed to be adjusted, you would increase to 1.25 or decrease to .75. then, remembering how the "shed" works, that precipitate that has formed in revson's body has to adjust to the new dose. if you've increased the dose, we hold it for 3 days to let the shed adjust also. then we can see if that dose is a good dose.
it's possible that revson is bouncing too - high numbers can be high from not enough insulin, but they can also be high if the cat is getting too much insulin. the mid-cycle numbers tell us which situation it is. if you click on punkin's ss in my signature line and look at 11/7 and 11/8. on 11/7 punkin got down to 56. he's not used to being that low, so his body went into "save the punkin" mode, responding as though punkin was hypoglycemic (even though he wasn't). when that happens the liver lets loose hormones and stored sugar to save the kitter - and then look at the 24 hours after that. the numbers went straight up: 192-240-244-289-273-302-307 - and then they start to come down. With your few high numbers combined with 2 fairly rapid dose increases of .5units each, it's very possible that revson is getting lower at some point, then bouncing. but without the tests, there's no way to know if that's it, or if it's not enough insulin, or some other factor.
that's your first decision - are you wanting to follow the protocol? if so, 4 tests every day will fill out the picture.
i'm not trying to be mean or anything - i hear your frustration. i know you love him or you wouldn't be here. i know it's expensive to pay for the tests strips. i also know it's hard to get the mid-cycle tests in - they tend to be in the middle of a workday or in the middle of the night, but without those numbers it's truly impossible to know what's really happening within revson's body. if you could get some tests in tonight and tomorrow, even that much would help us see what's going on.
questions? is it as clear as mud? ask away. you know we all just want to help the cats be as healthy as possible.
:YMHUG:
