6/13 Loki amps 290 pmps 121 + 2 173

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Re: 6/13 Loki amps 290

Hi Michelle--how are you? and Loki?

I took a good look at 2013 Loki's SS. I'm not the best interpreter, but here is what I see:

1. Loki's dose was 4 units 0n 1/1/13, then was up and down the "dosing ladder" from 3 units to .8 units through 4/9/2013.

2. Loki's insulin was changed to Lantus on 4/10/2013; thus, Loki has been on Lantus for 2 months now. Loki's dose has gone up and down the dosing ladder from just 1 unit to 2 units. That's awesome and a big difference from the time Loki was on the other insulin (correct me if I'm wrong--you were using PZI/ProZinc?)

3. You are doing a great job being patient with dose changing (per the Tight Regulation protocol)--1 to 2 units in only 2 months is very good.

4. Loki's BG's since you started using Lantus are much better than pre-Lantus; you've only had 2 BG readings in the "red". I am elated about that!

5. With the numbers so far since you started Lantus; I believe that's what we call "regulated". (I will get you information on the different levels of regulation; I was so totally confused with that as I thought that "regulated" meant OTJ--but it does not)

6. All in all, Loki is doing much better on Lantus since you've switched insulins.

7. Since Loki's been on Lantus and since you are more experienced shooting low numbers, the lowest number you've shot is 118 on 6/4/13; I think that's a result of being more confident and brave to shoot a blue number AND the guidance and support you're received here at FDMB Lantus Tight Regulation. So now, 118 is your "comfort zone"!!! That is so wonderful. Are you ready to set a lower "comfort zone" number (that is, a lower number that you will shoot?)? If so, that's awesome and if not, that's great too because you know your limitation--It was very scary for me when I started to shoot low numbers; in fact, when I look at Gobbles SS compared to your SS, it took me much longer to be brave/experienced to shoot a blue number.

I'm going to look at the SS more; if I see anything that merits a comment; I'll post it. I'm sure there are more experienced users that can jump in this post and give more interpretations and/or correct me if I missed something or posted a wrong interpretation.
 
Re: 6/13 Loki amps 290

Here you go:


Not treated [blood glucose typically above 300 mg/dl (16.7 mmol/L), poor clinical signs

Treated but not regulated [often above 300 (16.7) and rarely near 100 (5.6), poor clinical signs

Regulated [generally below 300 (16.7) with glucose nadir near 100 (5.6), good clinical signs, no hypoglycemia

Well regulated [generally below 200-250 (11.1-13.9) and often near 100 (5.6), no hypoglycemia

Tightly regulated [generally below 150 (8.3) and usually in the 60-120 (3.3-6.7) range, no hypoglycemia, still receiving insulin

Normalized [60-120 (3.3-6.7) except perhaps directly after meals -- usually not receiving insulin

Note: by "hypoglycemia" -- that means getting readings that are below 40....

(per "Binkys' site)
 
Re: 6/13 Loki amps 290

Wow thanks so much for taking the time and doing this, makes me feel much better. I am not kidding myself that Loki will ever be OTJ but regulated is awesome, because at 16 I feel he deserves to be confortable (which he is). I will print this out and study it closely. I am not scared to shoot low just not confident with how much depending on his BG's of course.
Thanks so very much again.
HUGS
 
Re: 6/13 Loki amps 290

Wow thanks so much for taking the time and doing this, makes me feel much better. I am not kidding myself that Loki will ever be OTJ but regulated is awesome, because at 16 I feel he deserves to be confortable (which he is). I will print this out and study it closely. I am not scared to shoot low just not confident with how much depending on his BG's of course.
Thanks so very much again.
HUGS
 
Re: 6/13 Loki amps 290

mimi4neeyah and Loki said:
Wow thanks so much for taking the time and doing this, makes me feel much better. I am not kidding myself that Loki will ever be OTJ but regulated is awesome, because at 16 I feel he deserves to be confortable (which he is). I will print this out and study it closely. I am not scared to shoot low just not confident with how much depending on his BG's of course.
Thanks so very much again.
HUGS
Click to expand...
You're very welcome Michelle--I'm so glad to read it helps you to feel better. it helps me as well when I pour over someone's SS; FD is a continuous learning experience for everyone. Even though Gobbles is OTJ, I'm not going anywhere :-D

OTJ is possible for Loki;; I note that you joined on February 27, 2012; the same day that Loki was at the vet's and diagnosed. So it has been about 16 months since Loki's diagnosis. OTJ is possible for a cat at any age, and at just 16 months of insulin, Loki certainly has a chance at being OTJ. I honestly think that by you starting Loki on Lantus and in addition to that--by you following the Tight Regulation Protocol--is the best decision you've made since your FD journey has started and gives Loki the best chance of going OTJ.

Just keep on keepin' on! Look at all the progress both of you have made! I don't think you give yourself enough credit for all you've accomplished, and you should flip_cat

And just think of how more comfortable you've made him feel~you are really a loving mommy to him and I'm sure he knows how much you care for him. I honestly believe that FD strengthens the bond we have with our kitties.

Back to shooting low: when not sure how much to shoot, depending on your circumstances, just ask for help if you're unsure and someone will help you. There are times when there are no Advisors on board (we have just a handful of them) and I know it is sometimes hard to wait (I have a HUGE problem with patience :lol: ) but someone will be there soon. It especially helps to add something like "dosing advice" or "help shooting low" to your subject line (in your first, original post of your daily condo) and to click the "?" icon. It took me a while to learn that and I'm not sure if you do that or not (sorry for not knowing--I haven't looked too far back on your posts in Tight Regulation), but it brings attention to your post when it shows up on the board. At times, I've seen someone asking for dosing advice and try to locate an Advisor. I hope I'm making sense? or being confusing? I have a habit of that, as well as being impatient!

Keep up the good work, Michelle. I'm real proud of you :mrgreen: :mrgreen: :mrgreen:
 
Re: 6/13 Loki amps 290

Kat asked me to look what she wrote about his SS and she had some good observations.

I'd like to just add a few others. These are JUST observations ....they are in no way meant to imply any kind of criticism. They are offered as a learning tool.

It's normal to be adjusting the dose of PZ or PZI based on the pre shot. So it does not concern me that you were doing that.....it's exactly how you use that insulin. Lantus is used differently...we don't dose on preshots but primarily on nadirs.

It's a little difficult to interpret some of the other data because we don't know if you are following the Tight Regulation Protocol or Start Low Go Slow Approach. When you have a chance, could you please let us know so our suggestions are more helpful to you?

If you are following TR, the dose changes have been erratic. Some doses were held too long (1u), dose reductions were given that weren't earned, and then you took a big increase in dose from 1u to 2u. When we do that, we take the risk of bypassing the best dose.

Since you've come to Lantus Land, you've skipped shots that we probably would have helped you with so that you didn't need to. We don't have a "below 200 no shoot" guidance here. If you get a number that you feel you are uncomfortable shooting, we ask that you stall, don't feed, and post for assistance. We have options to give you so that you don't have to skip a shot. Sometimes....it is best to skip. But generally, if it's safe to shoot, it's in Loki's best interest to do so. We can help you learn to feel comfortable shooting below 118.

We will have to see how he does on this latest reduction. I wonder if it will actually hold....the green numbers you got since you reduced are likely depot action from the lantus so you might see numbers be a little higher once the bounce has cleared.

One thing I advise all new members....EVEN if kitty gives you a high Preshot....please get at least a +2 test. Sometimes they will turn around and come right back down. Kitties don't read the manual and they might give you a high number at preshot but then decide to quickly clear any bounce and be low by mid-cycle.

We're all here to help, Michelle. You and Loki are part of our LL family. You've been doing a great job. It's often difficult to know what to do or how to do it....that's why we are here.
 
Re: 6/13 Loki amps 290

Kat asked that I stop by, as well. I agree with Marje. Let us know how we can best help.

A word about Kat's info on regulation. Binky's site, where she found the information, was written quite some time ago. In fact, it was developed before Lantus and Levemir were as widely used as they are now. I don't believe that the concept of "tight regulation" was the same then as it is now. With Lantus, tight regulation is considered when a cat's numbers are under 200 (i.e., in the 50 - 200 range) for as much time as possible. The difference with what Kat noted is that if a cat is in a range that is above roughly 220, then the cat's BG may be above renal threshold so there is a risk of kidney damage. With TR, the goal is for the cat to be below renal threshold and in normal numbers for as much time as possible.

Remission is certainly possible for a cat that has been diabetic for 16 mos. Devon's Mocha went into remission at around the 2 year point. I also want to be honest and point out that the longer a cat is diabetic, the less the chance of remission. It can happen -- the odds are less.

Loki is spending time in some very good numbers. I'd love to see him spending more time there. The challenging aspect of spending time in good numbers is getting comfortable with shooting low. The mantra here is "shoot low to stay low." That doesn't mean that you shoot haphazardly. It's a process of you understanding where Loki's Lantus onset and nadir fall and how he responds to insulin. You become data ready and feel (relatively) comfortable with giving a shot when numbers are above 50. No one does that initially. It's a process.
 
Re: 6/13 Loki amps 290 pmps 121

Wow you guys rock, thanks so much for taking the time and giving me a ton of info, I am reading and re reading it all.
Loki is fine doing well. I just got in from work and he was waiting for him momma to pick him up then feed him yet he waited on the table where I test him, he really is getting to know the routine LOL. He is just not crazy about getting the needle still but puts up with me.
Thanks again so much, will make the best effort to get more Nadirs . I am getting out of school the 24th and I hope to be able to get more data on a regular basis.
 
Re: 6/13 Loki amps 290 pmps 121

mimi4neeyah and Loki said:
Wow you guys rock, thanks so much for taking the time and giving me a ton of info, I am reading and re reading it all.
Loki is fine doing well. I just got in from work and he was waiting for him momma to pick him up then feed him yet he waited on the table where I test him, he really is getting to know the routine LOL. He is just not crazy about getting the needle still but puts up with me.
Thanks again so much, will make the best effort to get more Nadirs . I am getting out of school the 24th and I hope to be able to get more data on a regular basis.
Click to expand...
Thanks again Michelle :-D Consider all the info like a test you'd take in school; re-reading is a good idea as it does some "studying" to absorb it. Looks like Loki knows the routine! They do get used to it (Gobbles still whines for his test (which I still do once per day)and sometimes in the middle of the night (then I have to do a fake test) :lol: How sweet that he was waiting for mommy when you got in. Nice that you'll be able to get more data on him when schools out. Here's to your finals: party_cat party_cat party_cat
 
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