12-29 Effy PMPS=345 -concerned with lack of progress

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Randi & Effy

Randi & Effy

Member Since 2017
Hey All, it's been around 3 weeks of 2.5 u twice a day of Lantus. I'm concerned with his lack of progress within the three weeks we've been on it. I have a curve on his spreadsheet. The blank spots are the days he would NOT let me test his ear, sometimes he really fights me on it and I don't want to hold him down and completely break his trust. He seems to stay around the same numbers around preshot time. Also admittedly had to miss his second shot on Christmas night, I had to wait for the weather to calm down a bit before I could make the hour drive back home from my parents. Didn't get home til late that night when it finally stopped blizzarding! Anyway, just wondering if you guys can look at my spreadsheet and see what you all think. The fb forum seemed to think it was too much insulin starting out. I'm wondering if thats why I can't get him to stay low, or maybe the ff classics just isn't the right food for him. Could it be possible I am overfeeding? The day he dropped to AMPS 33 was after a 6 hour night without food, he must not have been that hungry overnight cus he slept with me the entire night and didn't ask for food but woke up hypo. I'm wondering if I fed less if his numbers would stay low. Anyway, just looking for opinions now that I've finally got a spreadsheet going!
 
Bronx's dad said:
How did he act when he was at 33? That # is real low on an AT meter, maybe it was a bad strip/test?
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Thats what the vet said when I called them after that test, I freaked out because he has never been that low since diagnosis. He was totally normal when he tested at 33. No signs of hypo whatsoever. Vet said it was either a bad strip/test or he's one of those cats that don't show hypo symptoms that easily and can handle low numbers like that. I'm leaning towards bad test since he has never gotten lower since.
 
I'm planning on doing more tests inbetween shot tests. But man, the day we did the curve was our worst day yet. He peed and pooped ALL throughout my house after every+2 test, he was REALLY angry with me lol! He's good with his amps and pmps because he's so used to getting fed right after that. But inbetween shots are the bane of his existence so far lol
 
Bronx's dad said:
I tend to agree with that, whenever I get an oddball low number I always test again right away. Are you following TR or SLGS?
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Sorry i'm still kind of new at this so I don't know what TR and SLGS means, I just browsed the slang sticky and can't find them lol :nailbiting:
 
Hi,

I am glad you are testing! When you were consistent with the 2.5u dose from the 20th to 23rd - on the 7th cycle you got a good curve in there. Those blues are some nice numbers. It looks like he went into a bounce.

It is hard to say what happened after as there is the skipped shot on the 25th which would of drained the depot which may explain the higher numbers of the 27th and the 28th. It may take up to 6 cycles after the skipped shot to stabilize the depot again. Which brings us to today. It looks like you have some lower numbers which indicates that he maybe dropping again. Is it possible to get a test each night before you go to bed? Like a +2 or +3? It will help fill in the picture a bit. Also, in the morning is it possible to get a going out the door test +1 or +2? Or a +10 or +11 coming in the door?

And just a housekeeping item, can you put NS in the unit section for not shot? A blank always leaves a question of if the information was just not entered or if there was no shot.

These are both methods for deciding when to go up or down on dose. You will find the information in the Lantus forum up top with marked with yellow stickies.

Oh, and do you have some freeze dried treats? You can give one after each test...low carb.;)
 
Tracey&Jones said:
Hi,

I am glad you are testing! When you were consistent with the 2.5u dose from the 20th to 23rd - on the 7th cycle you got a good curve in there. Those blues are some nice numbers. It looks like he went into a bounce.

It is hard to say what happened after as there is the skipped shot on the 25th which would of drained the depot which may explain the higher numbers of the 27th and the 28th. It may take up to 6 cycles after the skipped shot to stabilize the depot again. Which brings us to today. It looks like you have some lower numbers which indicates that he maybe dropping again. Is it possible to get a test each night before you go to bed? Like a +2 or +3? It will help fill in the picture a bit. Also, in the morning is it possible to get a going out the door test +1 or +2? Or a +10 or +11 coming in the door?

And just a housekeeping item, can you put NS in the unit section for not shot? A blank always leaves a question of if the information was just not entered or if there was no shot.

These are both methods for deciding when to go up or down on dose. You will find the information in the Lantus forum up top with marked with yellow stickies.

Oh, and do you have some freeze dried treats? You can give one after each test...low carb.;)
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Thank you!! I knew I had to put something in the no shot slots I just didn't know what! lol. I can definitely do one in a little bit whenever he lays down, if i get one in the next few minutes that'll be a +3. I JUST bought some of the freeze dried chicken treats! What a life saver those have been! He's had bad diarrhea since we started lantus and those treats seemed to solidify his poops right up, it's amazing. Trying not to give him too much of those though since I read that they can constipate them. I'll update with the next test in a few minutes!!
 
Tracey&Jones said:
Hi,

I am glad you are testing! When you were consistent with the 2.5u dose from the 20th to 23rd - on the 7th cycle you got a good curve in there. Those blues are some nice numbers. It looks like he went into a bounce.

It is hard to say what happened after as there is the skipped shot on the 25th which would of drained the depot which may explain the higher numbers of the 27th and the 28th. It may take up to 6 cycles after the skipped shot to stabilize the depot again. Which brings us to today. It looks like you have some lower numbers which indicates that he maybe dropping again. Is it possible to get a test each night before you go to bed? Like a +2 or +3? It will help fill in the picture a bit. Also, in the morning is it possible to get a going out the door test +1 or +2? Or a +10 or +11 coming in the door?

And just a housekeeping item, can you put NS in the unit section for not shot? A blank always leaves a question of if the information was just not entered or if there was no shot.

These are both methods for deciding when to go up or down on dose. You will find the information in the Lantus forum up top with marked with yellow stickies.

Oh, and do you have some freeze dried treats? You can give one after each test...low carb.;)
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yeah this next +3 was 441 :( but he just got done snacking right before i took it. sigh. I'll check again in a few hours. Seems like from the curve he doesn't start dropping til after +4ish
 
Which treats are you giving? 100% freeze dried chicken or turkey shouldn’t be constipating. If you give a treat after each poke and it’s something special it should help testing. Max hated fluids and hid under my bed after the first time. I gave him a treat he’d never had before and really liked. From then on he waited after his fluids for his treat.

It’s looking to me like an increase of .25 is needed.

When you get a chance read the yellow stickies on SLGS and TR.
 
I agree with @tiffaxee, it looks like an increase to 2.75 might be warranted. Are you around tomorrow to monitor? Do have plenty of test strips and some gravy good around?

May I ask how do you feed Effy? Is there several snacks throughout the day or are you only feeding twice a day?
 
I don't think I've stopped by until now so, welcome! I have a couple of thoughts.

There's no reason to feed just at shot times. Many people here feed their cats multiple, small meals each cycle. If Effy will be more cooperative with food present, you can always give her some of her food after you test. (Don't give the full meal at shot time and then spread out the remainder.) Treats also work. If freeze dried treats don't seem to be doing the job, many people will roast or poach chicken, chop it up (freeze some) and use the chicken as a treat.

TR refers to the Tight Regulation Protocol and SLGS refers to Start Low Go Slow. These are the methods for dosing that we use here. I've linked them for your convenience. TR has research behind it and has been published in a leading veterinary journal. It's more aggressive and requires a bit more monitoring. It has a strong track record of getting cats into remission. SLGS -- or some variation -- has been use here before TR existed and cats also reach remission using this approach. Many of us old timers have used TR.

Once you have a chance to read over the dosing strategies, what you'll note is that you are holding doses overly long. With TR, doses are held 3 - 5 days depending on whether the lowest point in the cycle (nadir) is under or over 200, respectively. With SLGS, doses are held for a week. Doses are reduced at different points depending on which approach you're using (below 50 with TR and below 90 with SLGS if you're using a human meter). Holding a dose for too long causes your cat to remain in high numbers and their body gets used to being in higher ranges which can mean they treat those numbers as their "new normal" and it can make it harder to get the numbers to come down.

At this point, it would be helpful to consider increasing Effy's dose by 0.25u. If you are home over weekends, holidays, etc., I would encourage you to try to get a few spot checks during the AM cycle to see whether numbers are dropping much like they did on 12/23.

Since it seems like your not home during the day, I would also encourage you to get tests -- at least a before bed test -- every, single PM cycle. Many cats experience lower numbers at night so it's good insurance to know what's going on. In addition, if you don't test at night, you're missing half of your data. If it's not abundantly obvious, we're very data driven. Your test data is the only way to make sure Effy is safe.

 
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