4/26 Dumdum AMPS403 +4 442

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akilo

akilo

Member Since 2013
Hello,
I'm new member here. Yesterday I post at the other section and some nice guy told me I should come here to seek for advice.
Dumdum's BG has been unstable this month, and he got hypo two times at 4/5 and 4/8. Since from that time my vet and I are confused about his BG number till now, and we still don't know why his BG show like this.
I follow the advice I got yesterday reduced unit to 0.75u, and his BG at +4 is 442. I am afraid that his BG number will cause ketoacidosis( he happened one year before, and I don't know what number will cause it happen). Should I still give him 0.75u at PMPS, or back to 1u?
If my expression is not clear enough or need more information, please let me know. I am sorry that English is not my mother language, and this might make my expression look little strange.
Hope for advice, and thank you for reading.
 
Welcome to Lantus Land. What is your name?

Looks like you and Dumdum have had quite the ride with low numbers.

I think reducing to .75u was smart. I also think he might need to be reduced more because you missed at least one reduction on the p.m. cycle of 4/27.

Here's what appears to be happening:

When Dumdum was first diagnosed, he had probably been at high BGs for a while. His body gets used to those numbers as normal. When he gets into lower numbers or his BG drops fast, then the liver releases counterregulatory hormones and a substance called glucagon which drives the BG back up to what the liver thinks is normal. We call this a bounce.
It can take up to 72 hours to clear a bounce.

An example is on the a.m. Cycle of 4/23; also, he bounced on the a.m. Cycle of 4/25 from the 25 on 4/24. I believe he went lower last night, too, after you quit testing, and he is bouncing today.

I would just hold this dose for now and let him clear the bounce. If he goes below 50 again, reduce the dose to .5u.

Also...you raised the dose on 4/17 probably because his numbers had been high. With lantus, we don't dose on the preshot number....we dose on the nadir (the lowest number in the cycle).

Let us know what questions you have. Did you switch him from dry food to canned food? If so, this could be why his numbers are getting so low and you have to reduce the dose.
 
Hello :) Nice to see you over here.

I agree with Marje. You want to hold this dose, because Lantus works best with consistancy. Dumdum is going through what we call a bounce right now. He will come down again. You just need to wait it out. It takes patience :-|
I would just keep the 0.75 dose for at least 3 days, unless he goes too low.
 
Marje and Gracie said:
Welcome to Lantus Land. What is your name?

Looks like you and Dumdum have had quite the ride with low numbers.

I think reducing to .75u was smart. I also think he might need to be reduced more because you missed at least one reduction on the p.m. cycle of 4/27.

Here's what appears to be happening:

When Dumdum was first diagnosed, he had probably been at high BGs for a while. His body gets used to those numbers as normal. When he gets into lower numbers or his BG drops fast, then the liver releases counterregulatory hormones and a substance called glucagon which drives the BG back up to what the liver thinks is normal. We call this a bounce.
It can take up to 72 hours to clear a bounce.

An example is on the a.m. Cycle of 4/23; also, he bounced on the a.m. Cycle of 4/25 from the 25 on 4/24. I believe he went lower last night, too, after you quit testing, and he is bouncing today.

I would just hold this dose for now and let him clear the bounce. If he goes below 50 again, reduce the dose to .5u.

Also...you raised the dose on 4/17 probably because his numbers had been high. With lantus, we don't dose on the preshot number....we dose on the nadir (the lowest number in the cycle).

Let us know what questions you have. Did you switch him from dry food to canned food? If so, this could be why his numbers are getting so low and you have to reduce the dose.
Click to expand...

Thank you for your advice. My name is akilo. :smile:
Dumdum has changed his food into canned food for more than one year. I don't know why hypo happened now, but in fact I am not sure it didn't happen before. Before 4/5, I never test his BG at home. We used to test at the vet, about 3-4 days one time. When test at the vet, his +5 BG number always about 40-60. Some days will suddenly jump to 300 up, and the vet will tell me to raise 0.5u, and keep test BG next day. If go back to 40-60, than keep on. That's how we control before, and most time I wasn't at home, so I'm not sure if hypo happened before.
Now I understand and I will hold this dose. Thank you for reply.
The other question I have is when should I notice if ketoacidosis happen or not ? For example, his BG number is up and down for many days, than will it cause ketoacidosis? Or it only happen when BG number always stay at high? I've read sticky about this, but still can't figure out when should I start to test his urine.
Again, thanks for replying.
 
Hi Akilo. My cat is a DKA survivor, too, so I know a little about ketoacidosis.
Usually the recipe for ketones is a combination of enough insulin, not enough food, and / or infection, and sometimes I think stress. I would continue to check for ketones at least daily as long as his numbers are in the high range. Also, if he goes off his food (doesn't want to eat) or seems lethargic, then check for ketones as soon as you can. Sometimes you can't tell if he has an infection somewhere because cats tend to hide it so well, so watch for the other signs.

Others will weigh in on this.
 
Welcome to Lantus Land!

Marje has provided you a very good summary of how I would interpret Dumdum's numbers, as well. For now, the reduced dose should help to get the numbers to stabilize so you can safely give an injection and not worry about numbers that are too low.

Most of us will not give an injection if the pre-shot numbers are below 50. I would encourage you to post if you have a pre-shot number that is lower than 150. While many of us do give a shot if numbers are considerably less, when someone is new to handling their cat's diabetes, we want to make sure that you are comfortable giving insulin and that your cat is safe.

My cat is a diabetic ketoacidosis (DKA) survivor as well. I agree with what Dyana posted. We usually see cats run into problems with ketones developing if they have an infection of some kind, aren't eating, and aren't getting enough insulin. There is a difference, though, between a cat developing ketones and DKA. With DKA, electrolyte levels are also effected and the condition is far more serious. The presence of ketones can quickly turn into DKA but there are ways of managing trace levels of ketones at home. You can test for ketones using Ketostix. Most of us routinely test our cat's urine for the presence of ketones but it's especially important if your cat is experiencing high blood glucose (BG) numbers or you notice a change in behavior.

When you have a chance, you may want to read the starred, sticky notes at the top of the Board. There is a great deal of information about Lantus in the notes and it will help you to get started.
 
Thank you! Dyana and Sienne,
Thank you for sharing your experience!
Now I understand when should I alert, and yes I also test Dumdum's urine at home, just once a week before. I will test more frequently now.
Thanks again!

BTW, his PMPS 342 +4 132. Looks like a good number that allow me to fall a sleep. Hope everything will be better tomorrow.
Thanks a lot to all of you. :-D
 
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