Julie & Tux
Member Since 2014
How are Tux's numbers looking? I did his first curve yesterday and will be talking to the vet today to go over his numbers.
5/23, Tux, AMPS 276
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Hi Julie - here is the link to your last post on May 19th for Tux. We like to see the link to the previous post so we can go back and see what was discussed or recommended previously. To get the link, you bring up your last post, copy the web address, go to your new post and select the URL button, then paste the web address inside of it.
At the last post, Julie (&Punkin) suggested waiting 6 cycles at 2.0U starting that day. This is now the 9th cycle which normally would mean time to increase. However, I noticed a couple of nights on Tux's SS, like last night, where there was no mid-cycle test to help us evaluate how the dose is doing.
It's too bad the curve wasn't more interesting yesterday, but Tux was probably bouncing from the green the day before. Bounces can last up to 6 cycles. If you can get some mid cycle tests in today and tonight (even just before bed is good), you are probably good to increase to 2.25 tomorrow night if you don't get any numbers under 50 before then.
At the last post, Julie (&Punkin) suggested waiting 6 cycles at 2.0U starting that day. This is now the 9th cycle which normally would mean time to increase. However, I noticed a couple of nights on Tux's SS, like last night, where there was no mid-cycle test to help us evaluate how the dose is doing.
It's too bad the curve wasn't more interesting yesterday, but Tux was probably bouncing from the green the day before. Bounces can last up to 6 cycles. If you can get some mid cycle tests in today and tonight (even just before bed is good), you are probably good to increase to 2.25 tomorrow night if you don't get any numbers under 50 before then.
Julie & Tux
Member Since 2014
Thank you, Wendy. I thought he was bouncing but I wasn't sure since we are still new with insulin. I'm still trying to figure out how to get some later checks in since my schedule is all messed up right now.
julie & punkin (ga)
Member Since 2011
wendy's right - you don't want to hold a dose too long if it isn't getting you the numbers you want (50-120).
many people have observed that after their cat has a cycle (or day) of all yellows, an active cycle follows it (ie, headed into low numbers.) i didn't see that personally, but enough people do that it's worth paying attention to see if your cat is one that does it as well.
adding feline diabetes onto a "normal" life sure throws everything out the window, doesn't it? it gets easier and more routine once you get used to it, though.
when you're trying to add tests in, you'd be surprised how much it will tell us if you can just get one pm cycle test between +2 and +5 or so. If there is any diving going on, it will let us know. So many cats go lower at night than during the day that data in the night cycle can be very helpful.
many people have observed that after their cat has a cycle (or day) of all yellows, an active cycle follows it (ie, headed into low numbers.) i didn't see that personally, but enough people do that it's worth paying attention to see if your cat is one that does it as well.
adding feline diabetes onto a "normal" life sure throws everything out the window, doesn't it? it gets easier and more routine once you get used to it, though.
when you're trying to add tests in, you'd be surprised how much it will tell us if you can just get one pm cycle test between +2 and +5 or so. If there is any diving going on, it will let us know. So many cats go lower at night than during the day that data in the night cycle can be very helpful.
Julie & Tux
Member Since 2014
He was all yellows when I tested again today. My vet told me to bump him up to 3 units twice daily.
Julie, Tux got down to 57 on 2.0U on the 18th. It would be dangerous to increase a whole unit to 3.0U. The protocol we use here goes up by .25U increases which is a safe amount to increase. Unfortunately Tux was bouncing the day you did the curve which made that a higher than usual cycle. Did you share the entire spreadsheet with the vet? I wouldn't increase anymore than to 2.25U.
From the protocol sticky:
You've now held the dose long enough. After tonight it will be 10 cycles after that first green. And you've seen some nadirs below 100 so a dose increase of .25U is appropriate. I hope you do manage to get a test in tonight. As Julie(Punkin) says, some cats will have an active cycle after a flat yellow cycle.
From the protocol sticky:
You've now held the dose long enough. After tonight it will be 10 cycles after that first green. And you've seen some nadirs below 100 so a dose increase of .25U is appropriate. I hope you do manage to get a test in tonight. As Julie(Punkin) says, some cats will have an active cycle after a flat yellow cycle.
Sandy and Black Kitty
Member Since 2009
Hi there 
I'm adding my voice to the 'follow the protocol' chorus.
I don't see a reason for an increase of 1u for Tux, all things considered
And right now I would not recommend any increase.
You have caught green on this dose twice within a week an it's very likely he has been seeing green on the overnights as well.
To make the best, safest dosing decisions you need the full picture .
The bare minimum BG testing required for safety is: right before you shoot and at least once during the cycle, both AM & PM
The between shot tests don't all have to all be at +6; as a matter of fact it's more revealing if you stagger the times you do those tests.
Take a step back from the ss and look for the 'wide open spaces' that do not contain data.
Then try and place your next test in a +hour that has not seen a test in a while. In this way you are sprinkling tests throughout.
If you can manage to do this consistently, I'll bet in a week a clearer picture of what is going on with Tuxs' BGs will emerge.
Take a look at Dimitris ss - it's a testament to what a difference data can make.
On April 21st Janet was thinking he needed an increase and posted asking for input.
She stepped up testing and in under a week discovered Dimitri needed a decrease
Many decreases followed and on May 21st, one month later, Dimitri was officially off the juice.
Now I'm not saying that's how it will play out for Tux - ECID. What I am saying is the TR protocol offers the best chance for remission., if it is in the cards.
Being a newly diagnosed (<1yr) diabetic is an advantage.
Make the most of it.
Hang in there - and hang in here. We have all been where you are
I'm adding my voice to the 'follow the protocol' chorus.
I don't see a reason for an increase of 1u for Tux, all things considered
And right now I would not recommend any increase.
You have caught green on this dose twice within a week an it's very likely he has been seeing green on the overnights as well.
To make the best, safest dosing decisions you need the full picture .
The bare minimum BG testing required for safety is: right before you shoot and at least once during the cycle, both AM & PM
The between shot tests don't all have to all be at +6; as a matter of fact it's more revealing if you stagger the times you do those tests.
Take a step back from the ss and look for the 'wide open spaces' that do not contain data.
Then try and place your next test in a +hour that has not seen a test in a while. In this way you are sprinkling tests throughout.
If you can manage to do this consistently, I'll bet in a week a clearer picture of what is going on with Tuxs' BGs will emerge.
Take a look at Dimitris ss - it's a testament to what a difference data can make.
On April 21st Janet was thinking he needed an increase and posted asking for input.
She stepped up testing and in under a week discovered Dimitri needed a decrease
Many decreases followed and on May 21st, one month later, Dimitri was officially off the juice.
Now I'm not saying that's how it will play out for Tux - ECID. What I am saying is the TR protocol offers the best chance for remission., if it is in the cards.
Being a newly diagnosed (<1yr) diabetic is an advantage.
Make the most of it.
Hang in there - and hang in here. We have all been where you are
julie & punkin (ga)
Member Since 2011
i don't see a condo for today, so i'll go ahead and reply on yesterday's. I'm in agreement with Wendy and Sandy - until a cat is over 6-10 units and it's becoming clear to us that the cat may have a high dose condition, we would never increase by an entire unit. Even 0.5u increases are reserved for cats that are solid over 300 for days (or more like weeks) at a time that the increases just aren't moving.
Except for those situations, we use 0.25u increases. On a 2 unit dose, a 0.25u increase is still more than 10% and it's amazing what a tiny amount of insulin can do in the small body of a cat.
Your vet may be more familiar with the older insulins that are quicker in and out of the body. Sienne likens dose changes with Lantus and Lev to moving a barge. A little change in direction can make an enormous difference farther down that river. The quicker in-out insulins are like adjusting speedboats. A little change in direction makes an enormous difference immediately. You're steering a barge and you want to make smaller adjustments and wait for the results.
I saw you increased 0.5u last night. If i were you, i'd go back to 2.25. If you stay at 2.5, of course that's your choice, but you'll want to be extra prepared for him to go into low numbers and do plenty of testing to keep him safe. As Sandy suggests, the nadir checks are essential anyway, but especially with an increase like that.
Punkin had acromegaly, which is a high dose condition. Even at 15units per shot, I could see results with a 0.25u increase.
Learning all of the fine points of treating a diabetic cat just takes time - hang in there and Tux will get regulated before long! Have you had a chance yet to read the PDF on the Tight Regulation Protocol page (about 5 paragraphs down) called "Management of Diabetic Cats Using Long-Lasting Insulins?" That's the only protocol for treating diabetic cats that has been published in a professional veterinary journal - and it works. If you haven't downloaded and looked at it yet, you might want to and also give a copy of it to your vet. It's very optimistic for newly-diagnosed cats.
Hope you're having a great saturday. I'm watching the birds and squirrels on my deck on this overcast day in western oregon. it's beautiful.
Except for those situations, we use 0.25u increases. On a 2 unit dose, a 0.25u increase is still more than 10% and it's amazing what a tiny amount of insulin can do in the small body of a cat.
Your vet may be more familiar with the older insulins that are quicker in and out of the body. Sienne likens dose changes with Lantus and Lev to moving a barge. A little change in direction can make an enormous difference farther down that river. The quicker in-out insulins are like adjusting speedboats. A little change in direction makes an enormous difference immediately. You're steering a barge and you want to make smaller adjustments and wait for the results.
I saw you increased 0.5u last night. If i were you, i'd go back to 2.25. If you stay at 2.5, of course that's your choice, but you'll want to be extra prepared for him to go into low numbers and do plenty of testing to keep him safe. As Sandy suggests, the nadir checks are essential anyway, but especially with an increase like that.
Punkin had acromegaly, which is a high dose condition. Even at 15units per shot, I could see results with a 0.25u increase.
Learning all of the fine points of treating a diabetic cat just takes time - hang in there and Tux will get regulated before long! Have you had a chance yet to read the PDF on the Tight Regulation Protocol page (about 5 paragraphs down) called "Management of Diabetic Cats Using Long-Lasting Insulins?" That's the only protocol for treating diabetic cats that has been published in a professional veterinary journal - and it works. If you haven't downloaded and looked at it yet, you might want to and also give a copy of it to your vet. It's very optimistic for newly-diagnosed cats.
Hope you're having a great saturday. I'm watching the birds and squirrels on my deck on this overcast day in western oregon. it's beautiful.
Julie & Tux
Member Since 2014
I read it and will read it again. I went with 2.5 since it was between what I was suggested here and told by the vet. The only insulin she has used it Lantus but I do know she has some outdated information. I will give her credit that she is looking into things as I suggest them but she is sticking to her guns for the most part. I gave him 2.25 units this morning. His numbers were pretty high when I tested last night. I give him Pure Bites chicken for treats after his pokes and he is fed Nature's Variety Instinct grain free. I used Dr. Lisa's chart as my source of carb info. I'm trying to stick with foods 2% or lower.
It's a bit windy and overcast here in western WA but I'm watching the goats and horses graze before going out to get more hay. Hope you all are enjoying your Saturday!
It's a bit windy and overcast here in western WA but I'm watching the goats and horses graze before going out to get more hay. Hope you all are enjoying your Saturday!
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