5/7 Eegie AMPS=404;+3=171;+6=170;+9=274;PMPS=368

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Sgans and Eegie - GA

Sgans and Eegie - GA

Member Since 2015
Had to try one full unit again. For the first time over 400 since the beginning. Probably from the cortisone shots two days ago.

Will monitor closely for drops. Appetite seems pretty good so far. Fingers crossed!
 
We determine the Lantus dose by the nadir, or how low it takes the cat. Try not to react to those higher preshots by changing the dose. Lantus likes consistent dosing. It's possible that he is bouncing today from getting lower than he is used to last night. In which case, upping the dose even more is not the thing to do.

What are your goals for Eegie? Do you want him to be getting green nadirs or just to spend time below renal threshold in blue?
 
@Wendy&Neko , I actually dosed according to my vet's suggestions. We JUST did Depo Medrol shots, so his glucose is likely to be highly affected. I plan on testing at +6 today as well, so I can get closer to nadir numbers. He's also eating well since the shot, which will also affect the glucose during the day, as opposed to previous weeks. Yesterday, the drop was extreme in the first 3 hours and mellowed out. Vet's plan was if >300, use 1 unit, and between 150-300, use .75, if 100-150, use .5, and if under 100 no shot. This, as the thumbnail for the adjustment time while we can watch the effects of the corticosteroid shot. We're not even sure at this stage, how long those effects will take to affect his IBD, let alone how long they'll last in him.

I eventually want to see green - I'd like to see it. I don't know if Eegie has time for that. I don't know how quickly his lung mass will spread too far. I don't know if he'll ever be able to get chemo, or if it'll be a good choice for him.

My goal, then, is to keep him as healthy, well, comfortable and happy as I can, while resolving as many issues as I can for as long as I can, until I can't anymore. For now, with all he's been subjected to, I'm thinking blue is good for this week. We were discussing whether he could get curves that are less "hilly" - smoother, so his body can do what it has to do. Then, adjust for greens... At least, as I understand it. One main goal though - is to get him to, and keep him at <200, as soon as we can. We were getting closer, before the corticosteroid need.

I'm TRYING to get him to need only .75 each dose - but for now, I'm happy if we can have daytimes/nighttimes in the blue. Once he stabilizes, we're going to discuss the next steps.

I do understand it's about the nadirs. This is his 3rd week of insulin, with a highly reactive body, lots of meds, and additional treatments. I'm also possibly going to be adding curcumin to his regimen, for his IBD and tumor, and will see how that goes.

Do you suggest then, keeping the dose at .75 despite the very high morning number today? I'm curious why that would be preferable to getting his nadirs down... learning here.....
 
I think you would still want to continue the 0.75... and just know that after you give the steroid... numbers will go up temporarily....

i'm doing the same. But the numbers will likely go back down..... you don't want the steroid to clear the system while increasing the dose.

you can always increase after 6 cycles if numbers are going up too much.

sounds like your vet is advising you like your insulin is cannisulin.... that's what they typically say. So many of them aren't really experienced
with lantus or depot insulins.....
 
Thank you, @rhiannon and shadow .. I just got off the phone with him. He's actually been conferring with an animal diabetes specialist on this (he does that - with the tumor - although I went to an oncology specialist separately, with the GI stuff). I've even clarified with him what I've been learning about Lantis, and he's been ahead of me, pretty often. He's a diligent one - not always right, but he's definitely diligent.

He does want me to try to be using 1 unit daytime - especially considering today's numbers - and wants me to run a curve on it asap. He says, so I can sleep better, .75 at night until we see the curve (hoping to be able to do that tomorrow, but I have to find a day with no particular commitments). THEN, he's feeling 1 unit's probably where we'll end up, after seeing what was happening pre-shot. I can see that this 1 unit is doing him very evenly today....

From today's numbers, he actually feels like maybe the glucose effect of the depo medrol is already fading a bit. Cat's had so much experience on it, maybe it's not as crazy as it can be.

I know his goal is to find even numbers, too, and he definitely knows my cat. No vet has known or been so attentive to any of my animal's particular needs, but he watches Eegie even when I'm not bugging him (I have him my spreadsheet link).

Depending on tonight's numbers (and if +9 is at 170-ish again) I think we'll do one more night like this, and hopefully the curve tomorrow... Or, Sunday if I can't do tomorrow...
 
Thank you, @rhiannon and shadow for the input.
Normally, I'd go with you, but the doc wants to get a sense of the 1 unit since it would also have been time to up the dosage anyway. He really IS familiar with lantus - and he's been conferring with a vet diabetes specialist on this (he admits, he treats more dogs than cats with the disease, but he's getting a lot of input from her). He wants me to run a curve, at 1 unit. Probably going to happen tomorrow - so until then, probably .75 at night (so I don't worry, and I can sleep), and he and I will confer on Saturday as to the curve.
Neither of us liked that 404 this morning... and he's been pretty level all day today on the whole unit (doc says maybe since Eegie's body is experienced with the depo, perhaps it's glucose effects might already be ebbing).

I am confident that he's treating this like lantus, not cannisulin - I do know he's conferred with this specialist quite often - and he watches my spreadsheet regularly too...

I'm looking forward to seeing what a 2 hour curve does....
 
High tonight. Wish I could do an overnight curve. Doing .75 so I can not worry. Hope tomorrow's curve tells me more.

Getting a new supplement in a few days that may change things for the better.
 
Lantus likes consistent dosing due to the nature of the depot. This is different from the in and out insulins which tend to be dosed based on the preshot. Mixing up doses can cause wonky numbers. And the depot also means that what you shoot in one cycle can affect subsequent cycles. Shooting 1 U this morning can have an effect tonights cycle.

It could be that 1 u would be a better dose for Eegie, but until he's eating more reliably, it may not be the safest choice, especially over night. I've seen many cats go lower at night and then bounce higher during the day. Without night time tests it's hard to say if that's happening. In such cases we'd usually suggest leaving food so a cat can bring themselves up with food.
 
@Wendy&Neko , i'm afraid it's impossible to feed him at night. I have explained the reasons previously. I really wish it was possible but it would destroy the quality of his life as he have to be locked away in a room alone the entire time. He is all about being with his family and that would just make him really depressed.

We usually get to check him at about 8 to 10 hours post his p.m. injection. Right now, he's eating very reliably. Because of the prednisone shot and cerenia, so it's staying down. That's why my doctor wants to find out where his curves go while he's eating and otherwise doing normal things, And he wants to work from there.

Eegie has many many additional medical problems. We're dealing with many at once. So this is the way ,my doctor figures, for us to figure out whether not we can get ourselves up to 1 unit on a regular basis.

So far, it looks like mostly I'm getting very little overlap. And from previous testing it looks like nadiris it about 5 to 7 hours. We want to get him down into the greens with highs in the blues but we need to do something to get there. With the recent changes in meds for lower glucose and the shot,… This was a good time. If things should decently, then we both feel like one unit overnight might be a good try for a week to see what happens.

Also next week will be a much earlier week so I might be able to see him much earlier in the morning then I usually do. I'd be able to take action at +8 in the morning instead of necessarily 12. But next week is a far less flexible schedule than I've had this week.

As I've mentioned, nighttime tests are impossible. I need to maintain my health so that I can maintain his health.

I'm hoping that what my doc has in mind is going to help. We're doing our best. I realize I can't do as much as some people can do but I'm doing as much as is possible in my life for my cat.

Hopefully, after this everybody will see even 1u shots and then will be happy with me, and the treatments.
 
we here don't have to be happy with you. :cool:

You might want to say something in your signature.... or your spreadsheet too.... medical conditions... doing as much as we can...
there are very many people here in the same shoes....
saying it in bold will help you feel less frustrated with us.... because we don't know what you aren't aware of and always try to share what to do.
Let us know what you want help with....
if you just want to vent... and want support..... or if you have questions about dosing, and protocols, and day to day tips on any aspect.

your lack of overlap is very likely because of the different doses....
depot insulins confuse many people.... and they often try to shoot it like it's a short acting insulin.
I try to keep it in my mind that what I shoot this morning.... won't show up until tonights cycle.....
there isn't really an instant response... and that's really hard for some to wrap their head around.....

:bighug::bighug:
 
@rhiannon and shadow , thank you. I do have a link to his medical history and my signature, But that keeps changing all the time too, as does his medication spreadsheet that I have in my signature.

Today's AMPS wAs so high that when I spoke to the vet we agreed that we're going to go and stop the curve. Clearly the prednisone has not released his glucose as yet. one unit day and night. I too want to even things out.

It's hoped that with the one unit day and night for several days his body will get used to it by the time the pred effect wears off.

Thank you for understanding my frustration. So much input. And then of course with my cat and my gut for my cat all in for fighting in my head.

I was so crazy last night, I actually shot insulin into the syringe cap!

I think I will put in bold "doing the best I can". Thank you for your help and understanding.
 
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