? 6/22 I did a curve on Callie yesterday. It wasn't an active cycle, and

[Glennie]

I know I need more data, but could someone take a peek at her SS and see what you think about her dosage? I will get more tests in. We've had so much company and so much going on that even finding her for the tests she had was a challenge. Thanks!

 

[Tanya and Ducia]

Good morning Glennie and Callie,
I thought I stop by and bump your post so here we go:
BUMP!

 

[Gill & George]

Hi there Glennie,

as you are doing slgs, that 142 in there a few days ago would see you hold the dose for a week.
From the SLGS guidelines

After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours:
Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet.

• If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit

• If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose

• If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit

As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], do lengthen the waiting time between dose increases.

If you decide to change another factor (e.g., diet or other medications), don't increase the insulin dose until the other change is complete (but do decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change).

Don't be tempted to rush the process along by increasing the dose more quickly or in larger increments-- no matter how high your cat's blood glucose is! Rushing towards regulation will cost you time in the long run, because you may shoot past the right dose.


Those couple of blue amps readings you've got have me wondering if she is getting to see blue more often than you are catching, though since she is not bouncing up to red or even pink, I don't think she is likely dropping fast or to low green.
You probably have some margin to take her up, you have held this dose for 13 days now, but that would depend on your availability over the next week, if you were able to monitor more, following up with tests if you find her dropping then you might be OK to take her up a notch, but if you are not able to do that then I think a more conservative approach of holding would be a sensible choice.

 

[Glennie]

Good morning Glennie and Callie,
I thought I stop by and bump your post so here we go:
BUMP!

Thanks, Tanya! Hope you have a great day!

 

[Glennie]

Hi there Glennie,

as you are doing slgs, that 142 in there a few days ago would see you hold the dose for a week.
From the SLGS guidelines

After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours:
Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet.

• If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit

• If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose

• If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit

As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], do lengthen the waiting time between dose increases.

If you decide to change another factor (e.g., diet or other medications), don't increase the insulin dose until the other change is complete (but do decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change).

Don't be tempted to rush the process along by increasing the dose more quickly or in larger increments-- no matter how high your cat's blood glucose is! Rushing towards regulation will cost you time in the long run, because you may shoot past the right dose.


Those couple of blue amps readings you've got have me wondering if she is getting to see blue more often than you are catching, though since she is not bouncing up to red or even pink, I don't think she is likely dropping fast or to low green.
You probably have some margin to take her up, you have held this dose for 13 days now, but that would depend on your availability over the next week, if you were able to monitor more, following up with tests if you find her dropping then you might be OK to take her up a notch, but if you are not able to do that then I think a more conservative approach of holding would be a sensible choice.

Thanks, Gill! I appreciate your input. I'll see what this weekend holds, and what her +6 is today. I do like conservative, (for me it's being chicken) but I want to do what she needs. Thanks again for taking a peek for me.

 

[Bobbie And Bubba]

Hey Glennie, yes, some more test will help to interpret the dosing better. For instance last night when you got the lower +2 in the PM cycle, that would indicate a possible active cycle and some more testing would have been a good idea. It could have just been a flat yellow cycle but a +5 or +6 would have given you a bit more info. I am not criticizing, just pointing it out.

 

[Glennie]

Hey Glennie, yes, some more test will help to interpret the dosing better. For instance last night when you got the lower +2 in the PM cycle, that would indicate a possible active cycle and some more testing would have been a good idea. It could have just been a flat yellow cycle but a +5 or +6 would have given you a bit more info. I am not criticizing, just pointing it out.

No, Bobbie, I don't take it as criticism at all. I appreciate the input so thanks. I can't set my alarm during the night since it wakes my DH up, and he can't go back to sleep. Unfortunately the last time I did it, he was up the rest of the night, and his job can be dangerous. If I sleep somewhere else, he gets a little testy. If it goes down again soon, I'll try to just stay up (hope he goes to sleep and doesn't realize I'm not there) and get a later test. Thanks again!

 

[Bobbie And Bubba]

No, Bobbie, I don't take it as criticism at all. I appreciate the input so thanks. I can't set my alarm during the night since it wakes my DH up, and he can't go back to sleep. Unfortunately the last time I did it, he was up the rest of the night, and his job can be dangerous. If I sleep somewhere else, he gets a little testy. If it goes down again soon, I'll try to just stay up (hope he goes to sleep and doesn't realize I'm not there) and get a later test. Thanks again!

The FD dance and keeping DH happy is an even harder dance, LOL.

 

[Glennie]

The FD dance and keeping DH happy is an even harder dance, LOL.

No truer word was ever spoken! LOL My DH is a good guy and he really loves Callie, but he has his limits and sometimes I go way over with my animals or stray animals or any animals.

 

[Glennie]

Hi there Glennie,

as you are doing slgs, that 142 in there a few days ago would see you hold the dose for a week.
From the SLGS guidelines

After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours:
Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet.

• If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit

• If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose

• If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit

As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], do lengthen the waiting time between dose increases.

If you decide to change another factor (e.g., diet or other medications), don't increase the insulin dose until the other change is complete (but do decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change).

Don't be tempted to rush the process along by increasing the dose more quickly or in larger increments-- no matter how high your cat's blood glucose is! Rushing towards regulation will cost you time in the long run, because you may shoot past the right dose.


Those couple of blue amps readings you've got have me wondering if she is getting to see blue more often than you are catching, though since she is not bouncing up to red or even pink, I don't think she is likely dropping fast or to low green.
You probably have some margin to take her up, you have held this dose for 13 days now, but that would depend on your availability over the next week, if you were able to monitor more, following up with tests if you find her dropping then you might be OK to take her up a notch, but if you are not able to do that then I think a more conservative approach of holding would be a sensible choice.

I did get a blue at +6, but it wasn't blue enough.

 

[Glennie]

Hey Glennie, yes, some more test will help to interpret the dosing better. For instance last night when you got the lower +2 in the PM cycle, that would indicate a possible active cycle and some more testing would have been a good idea. It could have just been a flat yellow cycle but a +5 or +6 would have given you a bit more info. I am not criticizing, just pointing it out.

Bobbie, since my DD was up late writing the last two nights, she was able to wake me up for tests for Callie (without waking up DH--LOL). Friday's (6/23) PM +5 was 214. So I raised her dose to .60U (about a drop over the .50U ???). Her 6/24 PM +5 was 177. Since she had the big drop from PMPS (270) to +2 (183), I was hoping to see her get a green. I know I didn't raise her to .75--the .25 increase, but that seems too much right now.

I'll hold this dose for a week at least to see how she does. Any thoughts? I didn't want to change title since this isn't an emergency.

 

[Glennie]

Hi there Glennie,

as you are doing slgs, that 142 in there a few days ago would see you hold the dose for a week.
From the SLGS guidelines

After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours:
Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet.

• If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit

• If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose

• If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit

As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], do lengthen the waiting time between dose increases.

If you decide to change another factor (e.g., diet or other medications), don't increase the insulin dose until the other change is complete (but do decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change).

Don't be tempted to rush the process along by increasing the dose more quickly or in larger increments-- no matter how high your cat's blood glucose is! Rushing towards regulation will cost you time in the long run, because you may shoot past the right dose.


Those couple of blue amps readings you've got have me wondering if she is getting to see blue more often than you are catching, though since she is not bouncing up to red or even pink, I don't think she is likely dropping fast or to low green.
You probably have some margin to take her up, you have held this dose for 13 days now, but that would depend on your availability over the next week, if you were able to monitor more, following up with tests if you find her dropping then you might be OK to take her up a notch, but if you are not able to do that then I think a more conservative approach of holding would be a sensible choice.

Gill, repeating myself here, but I did raise her to .60 yesterday. Any thoughts? I ask after the fact. Aaaaa! I always do something and read the directions later also. It drives one of my daughters a bit crazy! I know I didn't do the whole .25 increase as guidelines say, but I was concerned it was too much for her now.

 

[Bobbie And Bubba]

Bobbie, since my DD was up late writing the last two nights, she was able to wake me up for tests for Callie (without waking up DH--LOL). Friday's (6/23) PM +5 was 214. So I raised her dose to .60U (about a drop over the .50U ???). Her 6/24 PM +5 was 177. Since she had the big drop from PMPS (270) to +2 (183), I was hoping to see her get a green. I know I didn't raise her to .75--the .25 increase, but that seems too much right now.

I'll hold this dose for a week at least to see how she does. Any thoughts? I didn't want to change title since this isn't an emergency.

Well, today she is bouncing a bit from those nice blues last night. And , it's possible she even went lower than the 177 your DD got. See how she hit a green back on June 9 when her dose was .75. That is where you want to get her. She could have probably handled the whole .25 increase as it does look like you are around to test enough. Any more test today?

Some house keeping : each day start a new thread with Callie's name and date otherwise the threads get too long for peeps to go through and read.

 

[Glennie]

Good morning Glennie and Callie,
I thought I stop by and bump your post so here we go:
BUMP!

Well, today she is bouncing a bit from those nice blues last night. And , it's possible she even went lower than the 177 your DD got. See how she hit a green back on June 9 when her dose was .75. That is where you want to get her. She could have probably handled the whole .25 increase as it does look like you are around to test enough. Any more test today?

Some house keeping : each day start a new thread with Callie's name and date otherwise the threads get too long for peeps to go through and read.

Thanks, Bobbie. I did add the +7 183 to Callie's SS. Today was the first time my daughters tested her for me. Since they did so well, maybe I can share testing duties with them occasionally.

The June 9th green was an 87. Since it was below 90 and I'm doing SLGS, I thought I was supposed to take a decrease. I hesitated to take it since it was so close to the 90, but I went ahead. I do want her in greens. I just don't want to have a nervous breakdown when she's in them or getting her there. That said, I think you're right...I should have just upped to .75U, but that's the dose she was on when she went below the 90. I do not know....

Thanks also for the housekeeping tip. I'll be sure to do that next time. And thanks also for taking the time to respond.

 

[Bobbie And Bubba]

Great that your daughter is able to test her for you so you have someone to share the testing with.

The June 9th green was an 87. Since it was below 90 and I'm doing SLGS

Yes, you are correct about the under 90 on SLGS for a reduction. What I meant was green numbers (above 90) , sorry I didn't add that part.

With as much as you test her, have you considered doing TR so that you don't have to hold the dose as long? When she hit the 87 ,keep in mind she was still in a nice safe number and it was in the middle of the cycle where she would most likely start coming up in numbers with the natural curve of Lantus. Under 50 is the start of hypo and she was 39 points from that. Green numbers are where all the healing happens and with SLGS they don't get as much of an opportunity to be there. Just my thoughts but, I do realize you need to be comfortable too. If you decided to try TR you would get lots of support posting daily for advice and support. And that said, we will continue to support you on SLGS. Just my opinion

 

[Glennie]

Great that your daughter is able to test her for you so you have someone to share the testing with.


Yes, you are correct about the under 90 on SLGS for a reduction. What I meant was green numbers (above 90) , sorry I didn't add that part.

With as much as you test her, have you considered doing TR so that you don't have to hold the dose as long? When she hit the 87 ,keep in mind she was still in a nice safe number and it was in the middle of the cycle where she would most likely start coming up in numbers with the natural curve of Lantus. Under 50 is the start of hypo and she was 39 points from that. Green numbers are where all the healing happens and with SLGS they don't get as much of an opportunity to be there. Just my thoughts but, I do realize you need to be comfortable too. If you decided to try TR you would get lots of support posting daily for advice and support. And that said, we will continue to support you on SLGS. Just my opinion

I have thought a lot about doing TR. If I knew for sure she would go into remission, I would definitely do it. I know there are no guarantees with any of it. I guess that to me it feels like it would be more nerve-wracking.

I also have YA food out for the cats. With 6 cats (one of my DH's understandable pet peeves--pun not intended but pretty good I thought after I realized it. LOL ) it would be hard to know if Callie is getting any for sure. Immediately after Callie's diagnosis I changed all of the cats over to FF classic pate, but I have a few that like some dry also so I got some YA. I kept it away from Callie for quite a while, but the others weren't eating as much and losing weight, and I was running for the food all the time to keep her out of it. I finally gave up and let her eat some and while she doesn't eat much of it, I think that would mess up the TR. I'd have to put it out for only the civvies again. (which wouldn't be the end of the world)

I was comfortable with the 87, and was unsure whether to take the decrease. (No worries about the above 90 greens. I should have known what you meant.) I know I'd have lots of support. You all are amazing with your understanding and support. I think I'll stick with SLGS for now, but I really appreciate you sharing your thoughts with me. I will keep that option in mind though and who knows--I may get brave someday. Thanks again.