3/8 Tigger 36,27,48,150,AMPS 228,+2 36, UPDATE

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With Tigger dropping low fast the way he does the last thing I would do it is just feed him twice a day, also I wonder if maybe you should go ahead and drop down to 1.75 for the next shot to help drain the depot and then come back up to 2 units, that is if he is even high enough to shoot.
 
Carol, great job on getting Tigger through today. And thank goodness you had help from knowledgeable people here.

I also strongly disagree about feeding twice a day. Perhaps that advice is left-over from the older non-depot insulins, but when a cat's low point is likely to be several hours after the shot, as it would usually be with a depot insulin, you want food to be there to help smooth out any drops. I would feed at least 4 times a day - and taking notes will allow you to look at see what works best for a feeding schedule for Tigger.

I don't see any mention in your signature line of whether you are following dosing guidelines from Start Low Go Slow or the Tight Regulation Protocol. It would be worth your time to take a look at those, ask questions about anything that seems confusing, and decide which one you are using. That helps people help you - and the more you understand, the more you can help Tigger.
 
Nancy and Scotty said:
I wonder if maybe you should go ahead and drop down to 1.75 for the next shot to help drain the depot and then come back up to 2 units, that is if he is even high enough to shoot.
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I think usually a "depot draining" shot is about half of the scheduled one, so if he's low at AMPS, you might want to consider 1.5 or even 1U after all the drama today
 
Well, I didn't see the last few suggestions until after I just gave him his PM shot..and I gave 2 units. He was 418 just now at his PMPS. I'm going to be reading more about the Lantus protocols, depots, etc. It's just very new to me, since he's only been on it a few weeks, compared to being on Vetsulin for the last year. So bear with me! As for feeding..I've tried the twice a day feeding..and he does gobble up 1 1/2 cans of FF at a time! Then I've also tried 1 can in the morning, 1/2 can at noon, 1 can for dinner, 1/2 can evening. It's usually 3-3 1/2 cans/day. He's still at 12.5 lbs so that's good (was 18 before dx!) I really do appreciate all your help! I couldn't have gone through today without all of you! When Tigger was less than one-year-old he was attacked by a coyote. Luckily my husband was on his way home from work at 6 AM, saw the coyote running across the street with Tigger in his mouth and he honked his horn, flashed his lights. The coyote dropped the cat and took off. Luckily Tigger lived through it with a few puncture wounds and a broken jaw. Aside from that issue, he's been perfectly healthy for the last 10 years, never a trip to the vet except for regular check ups. So all of this has really thrown me for a loop! But I figure he still has some good lives left in him!
 
Looks like his liver is in good shape!! That's quite a bounce, Tigger!!

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The wonderful thing about Tiggers
Is Tiggers are wonderful things
Their tops are made out of rubber
Their bottoms are made out of springs
They're bouncy, trouncy, flouncy, pouncy
Fun, fun, fun, fun, FUN!
But the most wonderful thing about Tiggers
Is I'm the only one ;)
 
Now that all of the excitement has passed and Tigger is OK, I want to make some suggestions.

  • First, until you really and truly understand Lantus, please do whatever you can to post on a regular basis - and by that I mean daily. I know it can be time consuming. I posted a daily condo for the 6.5 years that Gabby had diabetes. It truly helped me to understand her diabetes, especially in the beginning.
  • Look at other spreadsheets and post in other people's threads/condos. It's the best way to cultivate the support you need to navigate the process. Looking at other kitty's spreadsheets will also give you a feel for how often you need to test. Right now, IMHO, you are not testing enough to know what's going on with Tigger's cycles. It is critical for you to know where Lantus onset and nadir fall and how much duration you're getting from this insulin. Lantus is vastly different than Vetsulin and everything you know from your Vetsulin experience no longer applies. Testing is the best way to keep Tigger safe. (I don't care what your vet tells you about how much to test. You're the one home with your kitty and the one managing the diabetes.)
  • Decide on an approach to dosing and know when to take dose reductions. With Tight Regulation, doses are reduced if numbers drop below 50 for a cat that's within one year of diagnosis or below 40 if more than a year past diagnosis. With the Start Low Go Slow approach, reductions occur if numbers drop below 90. TR and SLGS each has its advantages and disadvantages. Read the sticky notes at the top of the board and decide which is the best fit for you and for Tigger or ask people for their opinions.
  • Always have a supply of strips and high carb (HC) food. Get to know how your cat responds to HC. Not all cats are extremely sensitive to HC food or can tolerate it. My kitty couldn't tolerate the gluten in HC food so I used Karo syrup to steer her numbers.
  • It looks to me like you are holding doses too long. However, without more spot checks it's hard to know for sure if this is the case. Doses are evaluated every 3 - 5 days if you're following TR and every week with SLGS unless a dose reduction is warranted.
  • It's OK to feed multiple small meals throughout the day. We typically suggest that you don't feed after nadir since there's less insulin available to offset the effect of food. You should also make sure to pick up any food at least 2 hours prior to shot time. You don't want your pre-shot numbers to be influenced by food.
  • Do NOT shoot a food spike the way you did yesterday. If you stall a shot, do NOT feed. You want to see numbers rise independent of the effect of food. Yes, Tigger may want to chew your ankle off because he's hungry. I'd rather see him be annoyed over not being fed than your having to rush him to the vet because his numbers tanked. The effects of HC wear off relatively quickly. It's not always feasible to feed HC and assume all is well. There is a sticky note devoted to Shooting & Handling Low Numbers. I'd recommend reading it (several times) and printing it out so you have it at your fingertips.
Please let us know if you have questions. Everyone here is devoted to keeping our kitties safe and happy and making sure you understand the nuances of working with Lantus and Lev.
 
This is great..thanks! I'm going to try and do what I can do. I think Tight Regulation might be good for us...we will see. I have a tendency to want to test more anyway...and I know I need to. Working on that! THANKYOU for all of your suggestions..excellent info!
 
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