? 6/15 TiTi AMP 324...+6 205 +7.5 207 +8.5 185 +9 192 +11.25 164 +12.75 125 +17.5 180 +19 197

Status
Not open for further replies.
Kathleen (Kathy) said:
Yes.
Click to expand...


Julie called it : Well, except for shooting. I could not shoot, not with that slow decline. I might fall asleep during monitoring, and that would be very bad indeed.


It is basically a bounce-clearing cycle. She's declined since amps . .. but it's been pretty slow. If we knew this dose was a just right one, I'd be yelling shoot. Right now she's plenty high enough that ordinarily I'd also yell shoot.

But it's up to you. I suspect she's headed back into green numbers tonight, possibly whether you shoot or not.

The thing about frequent dose changes, including skipping, is that each of those is like rocking the boat. We need still waters to see what's going on and what a dose can do, but in Titi's case we have lots of boat-rocking events because of all the things in the past week, and so it's hard to know what to suggest. She is only 3 cycles past the 11u dose, so the depot from that dose is likely still involved.

If she were mine, I'd shoot and then monitor. It's completely up to you, though.
Sandy and Black Kitty said:
was her most recent shot at 8:30am?
Click to expand...
 
I don't know of any way for a high dose kitty to gracefully glide down the dosing ladder.
It's like running up an escalator that is going down at varying speeds - you will occasionally stumble.

The goal is to find a dose that you can safely shoot every 12 hours. Lantus likes consistency.
Since Lantus is slow acting, you may have to occasionally sit on your hands for a cycle or 2 and give the dust a chance to settle. Even in the face of less than desirable numbers.

Get some rest tonight and see what the morning brings.
 
I hope you're getting some sleep in tonight. The decline in her blood sugar is very slow. I don't know what you're doing with feeding her (I do see you fed her at +13.75) but food is your tool when blood sugar needs to be steered.

If you want to stop her from dropping, you can always add a drop of honey to her food to increase the carbs. That might be enough to do it. Hard to say - this is a trial and error thing that is different from cat to cat, but it's something you can try.

She's not in any danger in this range right now. These aren't low numbers. But if you're worried she's going to continue sliding down, you can use carbs to put the brakes on so you can sleep.

As far as morning goes, what Sandy said is really important. You need to be able to give the same dose every 12 hours if possible so we can let the water calm down and stop rocking the boat! Reducing the dose again so that you can shoot every 12 hours may mean that you have some temporarily higher numbers. That's just part of this Sugar Dance. The good news is that numbers that are high from bouncing will pass, and then we can see what the dose will do.
 
julie & punkin (ga) said:
I hope you're getting some sleep in tonight. The decline in her blood sugar is very slow. I don't know what you're doing with feeding her (I do see you fed her at +13.75) but food is your tool when blood sugar needs to be steered.

If you want to stop her from dropping, you can always add a drop of honey to her food to increase the carbs. That might be enough to do it. Hard to say - this is a trial and error thing that is different from cat to cat, but it's something you can try.

She's not in any danger in this range right now. These aren't low numbers. But if you're worried she's going to continue sliding down, you can use carbs to put the brakes on so you can sleep.

As far as morning goes, what Sandy said is really important. You need to be able to give the same dose every 12 hours if possible so we can let the water calm down and stop rocking the boat! Reducing the dose again so that you can shoot every 12 hours may mean that you have some temporarily higher numbers. That's just part of this Sugar Dance. The good news is that numbers that are high from bouncing will pass, and then we can see what the dose will do.
Click to expand...

Good grief, I slept thru my alarm. ok, well. +17.5 280 is present value. Some of that is due to the honey, probably not all. Dunno if anyone is awake, but I am puzzled. Just fed MC to TiTi, who continues tom seem completely normal - all 5 Ps
 
Kathleen (Kathy) said:
Good grief, I slept thru my alarm. ok, well. +17.5 280 is present value. Some of that is due to the honey, probably not all. Dunno if anyone is awake, but I am puzzled. Just fed MC to TiTi, who continues to seem completely normal - all 5 Ps
Click to expand...

I guess I'll monitor one more test, then sleep to +24 and do AMPS 10. I didn't sleep thru my alarm after all - I forgot to hit the check mark to activate my alarm. I cannot believe I forgot to activate it.
 
julie & punkin (ga) said:
I hope you're getting some sleep in tonight. The decline in her blood sugar is very slow. I don't know what you're doing with feeding her (I do see you fed her at +13.75) but food is your tool when blood sugar needs to be steered.

If you want to stop her from dropping, you can always add a drop of honey to her food to increase the carbs. That might be enough to do it. Hard to say - this is a trial and error thing that is different from cat to cat, but it's something you can try.

She's not in any danger in this range right now. These aren't low numbers. But if you're worried she's going to continue sliding down, you can use carbs to put the brakes on so you can sleep.

As far as morning goes, what Sandy said is really important. You need to be able to give the same dose every 12 hours if possible so we can let the water calm down and stop rocking the boat! Reducing the dose again so that you can shoot every 12 hours may mean that you have some temporarily higher numbers. That's just part of this Sugar Dance. The good news is that numbers that are high from bouncing will pass, and then we can see what the dose will do.
Click to expand...

ok. I opt to stay at 10u, for consistency. It looks like, the numbers bounced upward as I slept 4 hrs. Some of it is due to the honey, but not all - not for 4 hours. Or am I wrong in assuming this?

Okay last test for the evening coming up.
 
Kathleen (Kathy) said:
ok. I opt to stay at 10u, for consistency. It looks like, the numbers bounced upward as I slept 4 hrs. Some of it is due to the honey, but not all - not for 4 hours. Or am I wrong in assuming this?

Okay last test for the evening coming up.
Click to expand...
+19 197

OK. I'm off to bed until +24 which will be AMPS. Will shoot 10u unless numbers for AMPS are not good for such a shoot.

Last food at +17.5
Now I am giving her a few TSPS of MC
 
FWIW I think 10u will be too much and will set you up for another skip.

Remember the goal is to be able to find a dose you can shoot every 12 hours.
 
Last edited:
Kathleen (Kathy) said:
ok. I opt to stay at 10u, for consistency.
Click to expand...
It's your choice Kathy, but the problem with the 10u is it's not letting you be consistent.

Consistency is having a dose that enables you to shoot lantus twice a day at 12hour intervals, and quite frankly the 10 u is not letting you do that, because she is dropping and then you are having to skip, that is not consistency.

Personally I would go with the 8u that Sandy recommended, with that, hopefully you will be able to get into a routine of shooting twice a day. Are you going to see some high numbers for a while? Well, more than likely, but in all honestly I think that is the safest and quickest way forward to getting onto an even keel with her dosing.

She doesn't look to be bouncing yet with that 197 at +19 she appears to be flat since the 180, again she is staying considerably low after a skipped shot, all signs that those 10u you shot is way to much for her, the reason that you are getting away with it, is because lantus is a depot insulin not all of the insulin gets to work at once, part of the insulin starts to work straight away and another part remains in crystalline form slowly releasing insulin for a number of days after the insulin shot. The amount of 'slow release' (depot) is directly dependent on the size of the dose the large the dose the larger the depot. The depot takes 6 days to fill the fuller it gets the more the depot will influence her numbers.


The fact that Titi is still in blue since she skipped the shot is suggesting that the depot alone is keeping those numbers quite low, considering that the depot isn't full, it takes 6 consecutive cycles for it to be considered full which you haven't had on those 10u you shot yesterday morning (remember you shot that after another skip which would have drained the depot again), if you shoot the 10u again in the morning I would guess you will see her drop significantly again and will end up having to skip again, this we need to avoid as that will not give you the consistent dosing that you require to get the full benefit of lantus which is lovely flat cycles.

The Most important thing to remember is that the dosing decision is based on how low the dose can take kitty, not on the pre shot value. Looking at the numbers so far I think, like others that the 10u has potential for taking TiTi far too low, that is why we are urging you to be conservative.


Patience is the name of the game with Lantus.

:)
 
Gill & George said:
It's your choice Kathy, but the problem with the 10u is it's not letting you be consistent.

Consistency is having a dose that enables you to shoot lantus twice a day at 12hour intervals, and quite frankly the 10 u is not letting you do that, because she is dropping and then you are having to skip, that is not consistency.

Personally I would go with the 8u that Sandy recommended, with that, hopefully you will be able to get into a routine of shooting twice a day. Are you going to see some high numbers for a while? Well, more than likely, but in all honestly I think that is the safest and quickest way forward to getting onto an even keel with her dosing.

She doesn't look to be bouncing yet with that 197 at +19 she appears to be flat since the 180, again she is staying considerably low after a skipped shot, all signs that those 10u you shot is way to much for her, the reason that you are getting away with it, is because lantus is a depot insulin not all of the insulin gets to work at once, part of the insulin starts to work straight away and another part remains in crystalline form slowly releasing insulin for a number of days after the insulin shot. The amount of 'slow release' (depot) is directly dependent on the size of the dose the large the dose the larger the depot. The depot takes 6 days to fill the fuller it gets the more the depot will influence her numbers.


The fact that Titi is still in blue since she skipped the shot is suggesting that the depot alone is keeping those numbers quite low, considering that the depot isn't full, it takes 6 consecutive cycles for it to be considered full which you haven't had on those 10u you shot yesterday morning (remember you shot that after another skip which would have drained the depot again), if you shoot the 10u again in the morning I would guess you will see her drop significantly again and will end up having to skip again, this we need to avoid as that will not give you the consistent dosing that you require to get the full benefit of lantus which is lovely flat cycles.

The Most important thing to remember is that the dosing decision is based on how low the dose can take kitty, not on the pre shot value. Looking at the numbers so far I think, like others that the 10u has potential for taking TiTi far too low, that is why we are urging you to be conservative.


Patience is the name of the game with Lantus.

:)
Click to expand...

Understood, but the previous shot was 9units. She coasted along in pink with 9. Why do we now drop to 8 units? I'm not wanting to be difficult. I just need to know the why of this new drop from 9units.

There's a new problem this morning. Last night she got sick. Throwing up, diarrhea - not much, kind of a yellowish color -doesn't that suggest pancreatitis?

And her numbers shot up, too, further indicating illness.
+23.5 324
Ketones (measured by a blood meter) .04

So what do I shoot at AMPS 30 minutes from now?

And yes, I'm calling my vet.
 
We think that the reason she 'coasted along' may have been that she was bouncing, ie her liver was artificially raising her BG because of a low the previous night, if you had allowed the dose to settle after the skipped shots, you may well have seen her BG come down, bouncing can take upto 6 cycles to clear.

You should shoot at amps, and take a reading then.
If you wanted to try 9u I think that would be a better choice than the 10u.

the suggestion of the 8u comes from a feeling that she is on way too much insulin and wanting to bring her down to a dose that if need be you can work up from. If you don't feel comfortable taking her down to 8u, then go for the 9u.

Grab a test at amps, feed (to make sure she will eat) and then shoot.

Did you give her much honey or HC food last night?

George used to get runy poo after HC food, and too much honey can make kitty puke.

Sorry I have no experience with Pancretitis, but usually it's quite painful, is she showing signs of pain? How is she in herself?
 
Gill & George said:
We think that the reason she 'coasted along' may have been that she was bouncing, ie her liver was artificially raising her BG because of a low the previous night, if you had allowed the dose to settle after the skipped shots, you may well have seen her BG come down, bouncing can take upto 6 cycles to clear.

You should shoot at amps, and take a reading then.
If you wanted to try 9u I think that would be a better choice than the 10u.

the suggestion of the 8u comes from a feeling that she is on way too much insulin and wanting to bring her down to a dose that if need be you can work up from. If you don't feel comfortable taking her down to 8u, then go for the 9u.

Grab a test at amps, feed (to make sure she will eat) and then shoot.

Did you give her much honey or HC food last night?

George used to get runy poo after HC food, and too much honey can make kitty puke.

Sorry I have no experience with Pancretitis, but usually it's quite painful, is she showing signs of pain? How is she in herself?
Click to expand...

1.4 mls honey. She has been over-eating. It may hve caught up with her, or the food might have been off, or what Mikey had might have been catching. She's acting fine now.
Her pre AMPS at 8:05 was 324. I assume from being sick.

So is it safe to shoot 9 units now? Or 8?
I may flip a clin to decide. Not in a great mood. Almost ready to throw in the towel.
 
Kathleen (Kathy) said:
1.4 mls honey. She has been over-eating. It may hve caught up with her, or the food might have been off, or what Mikey had might have been catching. She's acting fine now.
Her pre AMPS at 8:05 was 324. I assume from being sick.

So is it safe to shoot 9 units now? Or 8?
I may flip a clin to decide. Not in a great mood. Almost ready to throw in the towel.
Click to expand...
The 9 might still be a bit too much and might see you having to monitor closely, but there again the 8u might not be quite enough and you might have to come back up. The decision is yours.

I think either would be a reasonable choice.
 
Gill & George said:
The 9 might still be a bit too much and might see you having to monitor closely, but there again the 8u might not be quite enough and you might have to come back up. The decision is yours.

I think either would be a reasonable choice.
Click to expand...

Wish I could calibrate to 8.5

So the present high number is irrelevant?
 
Just as long as you eyeballed it, the important thing is to be consistent when you shoot it again, just call it 8.5u;)

Sorry you are not feeling so good, sending vines for you and TiTi
 
Gill & George said:
Just as long as you eyeballed it, the important thing is to be consistent when you shoot it again, just call it 8.5u;)

Sorry you are not feeling so good, sending vines for you and TiTi
Click to expand...
thank you
I'm just tired, which leads to my unrealistic analysises of events - it puts a shadow over everything.

TiTi seems to have rallied, but I'm still calling the vet.

I think those vines work. Mikey is totally recovered.
 
Status
Not open for further replies.
Back
Top