Re: Can someone make sense of these numbers?
jgriffith said:
I gave him 1 unit at 10:30am central time. Next shot will be at 10:30pm tonight.
I posted last night in the health forum and they suggested that I post here to see what may be going on. She said the same that you have said about dose changes. The only day that I would be able to get a +6 test in the daytime would be Monday's. This is my only day off. That is why I get more tests in in the PM
Moron was DX in 2006 however I was not testing him until November 2011 on my own. My vet is not very involved. I know see how important it is to test. He was being injected blindly for years!!
I had been feeding him Blue buffalo wilderness kibble for years. Then switched to Nature's Variety kibble and this is when I started feeding canned. Now he is on FF chicken classic and 9 LIVES only. I tried raw but he refused to eat it after a few feedings. I also had fed him the Nature's Variety canned rabbit which he did like but now can't get anywhere. :cry:
I have 1 other cat his name is Scrunchie and 2 dogs (Ramona,Tutu)
We live in Columbia Heights,Minnesota USA
DX: 2006
Diet: FF CHICKEN,9 LIVES
Weight: 10LB 12yrs old
Health issues: He does get diarrhea frequently
health forum post:
viewtopic.php?f=28&t=65762#p714043
I also posted some on FD FACEBOOK GROUP
https://www.facebook.com/groups/62167000201/
Alrighty, let's get you fixed up here...
First, food. Keeping all the dry food, even the dog's crunchies are important. One of my cats will go very high even if she gets just a few pieces of dry food.
Here are some food links:
Binky’s Food Lists
Feeding Your Cat: Know The Basics of Feline Nutrition
List of Low Carb Healthy Treats
Binky's has lots of low carb foods; stick under 10%
Catinfo site has tons of good info.
The 3rd link goes to a post with good treats for diabetics.
Next, testing and ss. You are doing great there and the ss looks terrific. You can't worry about getting tests round the clock; people work and what they normally do is test when they can.
For the most part, you have lots of tests in the 2nd half but the first cycle of the day does not have much.
There are 3 tests that are most important to me. Before am shot, before pm shot, and before bed test.
During the week when working, I could test in the morn, go to work, test when I got home and then maybe a couple tests in the evening. On a day off, I would do a curve, testing every 2 or 3 hrs for a 12hr cycle and maybe 2 curves on that weekend.
If you can't get a test around 3hrs after a shot, maybe you can get a test at the other end of the cydle... maybe a +10? it would be interesting to see what's going on with the numbers just a couple hours before shot time.
So, on the Monday see if you can do a curve to see how Moron's doing.
Next your insulin. Yes, I know that many people say they are able to use their container of Lantus to the last drop but it's said the guarantee is for 28days on Lantus and 42 days on Levemir. With your numbers on the ss, you may start to see Moron's numbers slowly rising and if you have been using the same Lantus for around a month, maybe your insulin needs to be replaced. It's something to keep in mind when things are going well, then all of a sudden, numbers go for crap. I added a column on my ss to track the age of my insulin container.... just in case.
Next is the Lantus. How it works is nice and steady. Think of calm waters with no ripples or waves. All nice and smooth. Now drop a spoon of water to it and you see ripples; you have rocked the boat, and there will need to be a 'settling'. The same goes if you remove some water; you have disrupted the calm.
Lantus and Lev need consistency because of the shed / depot; what I call the spare tank of gas.
Whatever your dose is, you need the same in your spare tank. If you need to increase the dose, the first few shots will likely result in higher numbers because part of your increase needs to go to that spare tank. The same goes for a reduction. if you need less insulin, you give a lesser dose but then the tank is too full and needs to dump the extra.
You will likely see a delay in the reaction you want.... dose too high so you reduce today but with the shed dump, you will still see low numbers.
OK for Moron you were giving .75u for some time, but without knowing when you made the food changes or when Moron was able to sneak some dry food, it's hard to say the reason for Mar01/12 for example... ps is 381 and dropped to 141 by next ps so you skipped the shot.
What happened? Well, if you skip the shot, Moron was able to use his spare tank of insulin, but it was not quite enough for his needs, so naturally the next shot time, he tested HI again.
Because Moron's shed needed filling, you saw higher numbers and you increased the dose, but Moron had the high numbers as the shed was filling. Next, when the shed was full, you got the same problem on Mar05/12.... ps was 346 and dropped to 110 by next ps so you skipped the shot again!
and the pattern repeated itself.
Shed filled, dropped to blue, skipped shot, shed emptied then numbers up, so increased dose.
This 3rd time you dropped back to .75u but then went back up to the 1u again and sure enough, 3days later on mar08/12, the pattern repeats ..... ps was 312 and dropped to 92 by next ps so you skipped shot again.
With the 1u dose, it's likely much too high and so now along with filling the shed, you have a doozy of a bounce happening.
to recap
Mar01/12 - amps/381 shot .75u pmps/141 NO shot next amps HI
Mar05/12 - amps/345 shot 1u pmps/110 NO shot next amps 430
Mar08/12 - amps/312 shot 1u pmps/92 NO shot next amps HI
I don't know about the others, but what about just dropping to .5u and holding it for at least 6 cycles... you want to get the shed settled, not too full, and level numbers. Even if you have mostly low 300s, it's got to be better than the current rollercoaster. Maybe .75 will suit but it seemed like you got to an uncomfortable number and felt the need to skip.... I say to try the .5u and get rid of those waves and ripples.
try these ranges for making dose changes and remember.... don't make changes on the ps numbers.... you need to know what's happening in the middle of the cycles.
"General" Guidelines:
--- Hold the initial starting dose for 5 - 7 days (10 - 14 cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 cycles).
--- Each subsequent dose is held for a minimum of 3 days (6 cycles) unless kitty earns a reduction (See: Reducing the dose...).
--- Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.
Increasing the dose...
--- Hold the dose for 3 - 5 days (6 - 10 cycles) if nadirs are less than 200 before increasing the dose.
--- After 3 consecutive days (6 cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
--- After 3 consecutive days (6 cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Reducing the dose...
--- If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.
--- If an attempted reduction fails, go right back up to the last good dose.
--- Try to go from 0.25u to 0.1u before stopping insulin completely.
Random Notes...
Because of the cumulative nature of Lantus and Levemir:
An early shot = a dose increase.
A late shot = a dose reduction.
A "cycle" refers to the period of time between shots. There are 2 cycles in one day when shooting twice a day.
Lantus & Levemir – Insulin Depot –AKA- Storage Shed
Lantus & Levemir – Data Ready to Shoot Low Numbers
You'll see it eventually