6/17 Tabby - where to go from here?

[EllenandRover]

Cross posted from relaxed Lantus:

Hi, I could use a few pairs of experienced eyes on Tabby's numbers. He has thrown some lower ones lately and I'm looking for advice on whether and when to skip any shots. I skipped one recently, mostly because I could just not stay up to wait it out.

Today has been a little crazy because he has thrown up twice, once first thing this morning and the second time about mid-morning. Both times after eating his usual Raw Instinct raw food (which he has eaten for weeks now, this is not a new bag and it always stays in the freezer, I microwave it just before serving). I won't be serving him that for a few days to try and isolate that as the source of any problem.

His spreadsheet is up to date. Thank you for your help.

 

[Anne & Zener GA]

Was he diagnosed in May? I would say that Tabby is responding very well to Lantus. That last skip didn't hardly slow him down. I did notice that your shot times are a bit inconsistent. That can affect his numbers. Another suggestion is to always get a before bed test so you can see how low he's going. He may not want to be on insulin too much longer. Good job, Ellen! I hope he doesn't puke any more, poor guy.
Liz

 

[EllenandRover]

Yes, life got in the way a couple times for shot time, but usually only by about hour. Or because I felt he was too low to shoot, so I waited a bit.
We do always get a +2 before bedtime. I really could not go to sleep otherwise. You know, once a tester, always a tester.

Yes, he is recently diagnosed and I hope that will work in his favor. I have spent a few hours reading other posts, looking at other cat's spreadsheets to see what numbers people are shooting at. I realize this is TR, and I never really meant to be TR, but I do like to keep him in comfortable numbers.

I'm just trying to get in my mind if I should ever skip a shot on Lantus (I was used to PZI with my other cat). The longer duration of this insulin makes me wonder if I am seeing pancreas stirrings or just long insulin duration.

 

[Anne & Zener GA]

My understanding is that Lantus works quite differently from PZI (I am trying to recall what Sienne has said). Lantus is dosed based on the nadir, that's why the midcycle tests are important. You use those values to adjust the dose. I've never used PZI but isn't it dosed based on the preshot?

When you get a low preshot with Lantus, do not feed. Wait about 20 to 30 mins and test again. Post for help and hopefully someone will be here to give advice. Lantus onset isnt for a couple of hours so the preshot isnt quite so critical. You've already shot a 102. As long as you are there to monitors, have plenty of strips and MC or HC food to steer the cycle, Tabby will be fine.
Liz

 

[Sienne and Gabby (GA)]

Tabby is doing wonderfully!! You're doing a great job, as well.

With Lantus, if you are aiming for remission, you are probably going to need to get comfortable with shooting lower numbers. Lantus has a later onset than PZI and you are working with a depot. Like Liz noted, pre-shot numbers do not cause you to adjust/slide the dose. Dosing decisions are based on the lowest number in the cycle -- numbers below 50 trigger a dose reduction.

Shooting lower numbers is a gradual process. It looks like you've shot as low as 102. At this point, I suspect you could be shooting below 100. If you do decide to shoot lower numbers, you want to get a +1 and +2 test.

At this point, I would try to keep Tabby on insulin for as long as you can. There are still lots of tests where numbers are above the normal range (i.e., above 120). I would use food to keep the numbers above dose reduction range and if Tabby should drop below 50, I would shave the dose in order to provide as much support to his pancreas for as long as you can.

 

[EllenandRover]

Thanks, I'll keep going.

 

[Wendy&Neko]

Tabby is indeed looking great. Welcome to LL. My kitties have been on raw food for the last year. Neko occasionally gets the NV Instinct. I've heard that you shouldn't microwave raw food. I have a ziploc tub and I just toss a couple chunks in it the day before I want to use it, then put that in the fridge to thaw. It usually thaws in less than 24 hours. Not sure if the microwaving is contributing to throwing up or not. I hope Tabby feels better soon.

I noticed on your SS that you are skinnying some of the doses. It's easier for people to read the SS if you just mark it under the dose column. For example, you could put "sk0.5" or "0.5s" to represent a skinny .5 instead of commenting in the remarks column. I do the fat and skinny doses too.