3/4 Sabrina AMPS 238, +1 250 - Is it normal that BG is almost always much higher after PM shot?

[Jia&Sabrina]

Hi Everyone,

It has been four days since we first started Sabrina on insulin on 2/28. She has been responding well after AM shot. We got lots of blue numbers yesterday and we felt very promising.

Unfortunately, Sabrina’s PM numbers are almost always higher at night and they are without pattern. Most of her PM numbers are even higher than PMPS number. Particularly this morning, her numbers climbed up to 300+ ;(

We are quite confused right now and wonder if anyone knows if Sabrina’s PM numbers make sense. If it’s not normal, is there any thing we could do?

Any advices are very much appreciated. Thank you!


Background info:

Sabrina is going to be 16 by the end of this month. She sleeps with me at night and has small meals around 3-4am(+6+7) and 6-7am(+9+10). During the day she has multiple small meals around 9am(AMPS), 12pm(+3), 4pm(+7), 7pm(+10), 9pm(PMPS), 11pm(pm+2), and 12pm(pm+3).

Her food includes: freeze dried raw, FF natural gourmet (gravy), Pro plan true nature (gravy), some pate texture food when she is willing to have some (rarely happen). * In terms of food, we tried very possible way/food but failed to make her eat pate as she has been eating food with gravy for 15 years. So we had to compromise to give her relatively low carb gravy food.

 

[Hercule's mum]

Hi!
Just looked at your SS. Really liked the idea of highlight the nadir. I am going to copy it!

Most kitties I see here, tend to have night numbers lower than morning numbers.

When I read your message I was pretty sure Sabrina was likely bouncing, and she might... but it is oddd that it is so regularly at night...

I am not sure what is going on, and as you will hear often, every cat is different! also, the patterns change all the time... which is quite frustrating!

I would give a bit more time, since she is quite new to insulin. However, I went to look at what method you are follwoing and it doesn't say anything... Have you considered which method you will follow to decide whether she needs an increase or decrease?

 

[Wendy&Neko]

Sabrina is still very new to Lantus. Insulin is a hormone, which means it can take a while for cat's bodies to work well with it. Sabrina's Lantus depot isn't even built up yet, that can take 5-7 days. Plus, some cats just aren't consistent their nadirs. I used to joke that Neko's nadirs on Lantus were reliably between +3.5 and +13. Though more common between +7 and +9. Many things can change the nadir, bouncing being one of them. Typically when bounces break the nadir is later. There is a great explanation of why the variability in this post:
What is the Insulin Depot?

 

[Katherine&Ruby]

Hi Jia, and welcome to the Lantus forum! Here's your last post from the Feline Health/Main forum for continuity (we like to have this in every new day's condo so we can review before commenting on current updates and concerns): https://www.felinediabetes.com/FDMB/threads/dose-help-for-pm-shot-in-four-hours-ty.243953/

My cat tends to run higher at night than during the day, and once she became more regulated her nadirs also became more predictable, falling between +2 and +6. Every cat is different though. I consider myself lucky because it allows for better sleep for me! Give the insulin some time to help heal Sabrina's pancreas and liver. She seems to be going great so far!

 

[SashaV]

Is it possible to do the pate, but putting water in it? Make it gravy-like?
Hot water is best, makes the food more smelly.

And another thing. You're freaking awesome! That's some serious testing from a newbie! And wonderful blue numbers. You'll do great with this!

If possible, could you add time of diagnosis to your signature? I was convinced you were an old-timer at this!

 

[Jia&Sabrina]

Hi!
Just looked at your SS. Really liked the idea of highlight the nadir. I am going to copy it!

Most kitties I see here, tend to have night numbers lower than morning numbers.

When I read your message I was pretty sure Sabrina was likely bouncing, and she might... but it is oddd that it is so regularly at night...

I am not sure what is going on, and as you will hear often, every cat is different! also, the patterns change all the time... which is quite frustrating!

I would give a bit more time, since she is quite new to insulin. However, I went to look at what method you are follwoing and it doesn't say anything... Have you considered which method you will follow to decide whether she needs an increase or decrease?

Thank you for your reply Hercule’s mom! =^••^=

There were a few times that Sabrina’s numbers dropped too fast and too low (relatively speaking >_<) and then they raised back up. I thought those might be bouncing - body is in a process to learn how to handle low numbers. Her daily graph on 3/1 was like a big W.

I know I should probably have waited for another two days to post about my concern. But I’m just worried too much when it comes to Sabrina. I set up alarm every night to check her BG, to feed her, and put her food away before pre shot testing. I bet many on this forum can relate!

I’ll definitely give it a bit more time and hope things will get more... smooth.

As for method, I think I’ll stick to start slow go slow, at least for now. Thanks for checking

 

[Jia&Sabrina]

Sabrina is still very new to Lantus. Insulin is a hormone, which means it can take a while for cat's bodies to work well with it. Sabrina's Lantus depot isn't even built up yet, that can take 5-7 days. Plus, some cats just aren't consistent their nadirs. I used to joke that Neko's nadirs on Lantus were reliably between +3.5 and +13. Though more common between +7 and +9. Many things can change the nadir, bouncing being one of them. Typically when bounces break the nadir is later. There is a great explanation of why the variability in this post:
What is the Insulin Depot?

Thank you Wendy for the explanation! It’s interesting to know that nadir gets delayed when bounces happen. There are a few times that I think I noticed bounces I’ll keep an eye on it and hopefully I can figure out the pattern behind the numbers

 

[Wendy&Neko]

But I’m just worried too much when it comes to Sabrina.

Welcome to the club of helicopter cat parents - we get it.

 

[Jia&Sabrina]

Hi Jia, and welcome to the Lantus forum! Here's your last post from the Feline Health/Main forum for continuity (we like to have this in every new day's condo so we can review before commenting on current updates and concerns): https://www.felinediabetes.com/FDMB/threads/dose-help-for-pm-shot-in-four-hours-ty.243953/

My cat tends to run higher at night than during the day, and once she became more regulated her nadirs also became more predictable, falling between +2 and +6. Every cat is different though. I consider myself lucky because it allows for better sleep for me! Give the insulin some time to help heal Sabrina's pancreas and liver. She seems to be going great so far!

Thank you for the welcome Katherine! I’ll make sure to include link(s) of my previous threads when I make another post next time.

And thank you for the encouragement! I know it takes time for depot to fill up and work better but sometimes I just got stuck with those thoughts.... “why is the number still yellow?” “oh no! She’s drinking again! Is she not feeling well?!?!” “she’s sleeping... or she’s lethargic..?” >.<

I am going to be more patient this time

 

[Jia&Sabrina]

Is it possible to do the pate, but putting water in it? Make it gravy-like?
Hot water is best, makes the food more smelly.

And another thing. You're freaking awesome! That's some serious testing from a newbie! And wonderful blue numbers. You'll do great with this!

If possible, could you add time of diagnosis to your signature? I was convinced you were an old-timer at this!

Hi Sasha!

I really really really really really want pate to work... I got almost all the proper food for sugar kitties on the market. Yesterday she was willing to eat 1/4 can of nature’s logical duck and salmon flavor. I was thrilled and almost got her a whole pack from chewy. BUT I decided to wait for another day to see if she would be willing to eat it again. T_T today she turned her nose up to it.......... compared to smoothie like pate texture, she is more willing (relatively speaking...) to eat some pate that are dry and firm. She nibbles on tiki after dark venison (she might be allergic to venison as she coughs after eating it) and identity pork. She loves Fancy Feast but refused to all FF pate. Sigh.......

Im going to add diagnosis time to my signature! Thanks for the reminder