7/25 Clare and Georgette PMPS 287 0.25 u. +2 323 +4 315

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Georgette and Clare

Georgette and Clare

Member Since 2014
Clare and I are new to this group and would appreciate your advice. Hopefully, Clare's spreadsheet is now up and viewable to everyone. We've had a large learning curve and quite a lot of variability in our approach. Her numbers have reflected that. She still has strong curves, it appears. I'd like to give her a consistent 12/12 dose of insulin but at this low dosage, I'm wary about giving her a shot tonight. She had a BG of 70 at this afternoon's nadir. Shall I shoot? Thanks.
 
Re: 7/25 Clare and Georgette AMPS 241 New to Group

Hi Georgette! yes, clare's spreadsheet is visible - great job getting that going!

can you get a test about an hour before her shot is due and post what that number is, so we have time to look at it before you need to shoot? Chances are you're going to stick with the same dose. 70 is a great mid-cycle test. We wouldn't have you reduce until she goes below 50, unless there is an unusual circumstance like she's not eating, or you're out of strips or not going to be able to monitor her.

welcome! we're glad to have you and Clare here. Ask questions and you'll have lots of answers. :-D

by the way, the Freestyle Lite is the meter we started with. It typically doesn't show the high numbers as high as they are. That's not really a problem but, just so you know . . . it'll reflect the low numbers accurately and that's what matters most. Lantus dosing decisions are made by how LOW a dose gets a cat, rather than by the high numbers.

I see you just switched from the Alpha Trak, so don't go get another meter at the moment. Just know that is the issue with Freestyle Lites.
 
Re: 7/25 Clare and Georgette AMPS 241 New to Group

I should ask - what time will you be shooting and what time zone are we talking about? For example, do you shoot at 6pm pacific time or ?
 
Re: 7/25 Clare and Georgette AMPS 241 New to Group

I'll also suggest that you print out the part from this yellow starred sticky post at the top of the Lantus/Lev TR forum that is about handling low numbers. Once in a while we have trouble with this website, and i don't want you to get caught without help if that happens. :-D

Shooting & Handling Low Numbers
 
Re: 7/25 Clare and Georgette AMPS 241 New to Group

Welcome to Lantus Land Georgette and extra sweet Clare!

It will take some time before you will see how well Clare will do on the Lantus because you haven't been giving it every 12 hours. It takes about 5-7 days of consistent dosing to "fill the depot".

Lantus is what we call a "depot" insulin which basically means that each time you shoot, a little goes to work quickly and the rest goes "in the depot" and is released slowly...when the depot is full, you'll start to see the real results of the .25 dose.

I noticed you bought a new vial on 7/21, but Clare was just diagnosed in June. Do you know that if you keep it in the refrigerator (not the door) that it will last up to 6 months? Pharmacists will tell you it's only good for 28 days, but if it's cared for properly it will last much longer.

Again, welcome to the Lantus family and we're all here to help in any way we can!
 
Re: 7/25 Clare and Georgette AMPS 241 New to Group

7/25 Clare and Georgette PMPS 287
Thanks, everyone, for your help and support.

We live in the Central Time Zone in the U.S. I just checked your messages. It's 6 PM here now and we're feeding Clare and her pal, Coral. We just took Clare's PMPS and it was 287 on the Freestyle. Sorry I didn't send an earlier test number.

I guess one of my concerns is that her nadir is usually at about +7 and that will be 1-2 AM our time. If we continue with the 0.25 dose now (or shortly) should I set an alarm or do some more tests to make sure she's safe tonight?

Thanks for the explanation about the "depot," I've seen the term in the posts on the Board but didn't know what it meant. I guess that's what I'm worried about -- the effect if that building up. Will it likely take Clare's nadir lower tonight than it was this afternoon?

It's very comforting to be a part of this group. Thanks again!
 
Re: 7/25 Clare and Georgette AMPS 241 New to Group

get a test 2 hrs after her shot tonight. the +2 is a great test, because in many cats it will act as an indicator about what is to come. we compare the preshot to the +2.

If it is significantly higher than the preshot, that can signify the cat's BGs are on the rise, maybe into a bounce or New Dose Wonkiness if the cat's just had a dose increase.

if the +2 is significantly lower than the preshot, that's a giant "HEADS UP" that the cat's BGs are dropping and you can expect to have to monitor more.

If the +2 is about the same as the preshot, that's an indication that the cat is likely to have a "normal active" Lantus cycle, where the BGs drop until mid-cycle and then rise up to the next shot time.

There are cats who don't fit this model exactly, but we don't know yet what Clare will do. If you post in a couple of hours with a +2, we can help you figure out when to test next.

As far as the dose, this is a very tiny dose. Having a nadir in the 70's is great. I wouldn't reduce the dose unless she goes below 50. Yes, there might be times when you have to stay up a little at night, but you just have to play it by ear. It is really, really important to always get at least one test in the pm cycle because so many cats go lower in the pm cycle. You can get a +2 to help tell where things are headed, and then i always grabbed a test right before i went to bed at +4.5.

It can be a bit intensive, but it's not going to be every night, and so many newly diagnosed cats heal and go off of insulin, that for many new people it's not for very long.

I don't know if you understand what the Tight Regulation is all about - the research study on treating diabetic cats with long-lasting insulin (a PDF about 5 paragraphs down from the top of the Tight Regulation Protocol yellow starred sticky - tell me if you can't find this) shows that more than 90% of diabetic cats who get tightly regulated, ie, their blood sugar is kept between 50-120, can have their pancreas heal and go off of insulin. That's a mighty powerful motivator for most people. Cats are unique in this - dogs and people become diabetic and for the most part, stay diabetic, but the cat's pancreas can heal if it's not too damaged.

Mostly this is a take things one day at a time thing. I just tried to look at that particular day and not worry too much about how i was going to manage the future.

The good thing is that this is a super nice community of people and everyone will give you a hand learning what you need to know in order to help Clare as much as possible. :-D

We have a saying, "it's the best place you never wanted to be." ;-)
 
Re: 7/25 Clare and Georgette AMPS 241 New to Group

Julie, I've printed out the "Low Numbers" advice. For potential emergencies we have a lot of test strips, corn syrup and high-carb food available in case Clare has a hypo event. When she went to 49 once, (See spreadsheet) I got scared even though she was still eating and doing okay, so I'm prepared. But I do worry that I might be asleep when it happens. Thanks for filling us in on the limitations of the Freestyle. We want a reliable meter, so what would you suggest that we get?

Chris, thanks for your advice on the insulin storage and life. We bought the new vial mainly because on the AlphaTRAK, Clare was getting consistently high numbers without much of a curve, so we thought that maybe the insulin had become stale. Turns out it was our brand-new meter that was off - giving readings >70 points higher than our vet's AlphaTRAK and also an independent lab's analysis. It had passed the "control solution" test so we assumed it was okay. But we're learning that nothing's for certain with diabetes (except that we want to do what we can to help Clare to get well). So we switched back to the Freestyle meter.

We had the new insulin vial in the door of our refrigerator but we've moved it to a shelf. It's expensive! So thank you for your help with that.
 
Re: 7/25 Clare and Georgette AMPS 241 New to Group

i had the freedom freestyle lite and loved it. i don't think you HAVE to get a new meter. If you click on punkin's ss here and take a look at the difference in colors in his spreadsheet before January 21, 2012 and afterwards. The Freestyle lite has a classic yellow/blue spreadsheet in most cat's spreadsheets. I switched to a Relion Confirm, which worked fine.

when punkin passed away, i gave away that glucometer and kept the Freestyle one to check me and my husband now and then. It's not that it's not accurate, my understanding is that it measures different components of the blood. So . . . it's up to you. if you want another one, there are many good brands. Many people buy Relion (Walmart) brands because the strips are cheap. The strips are about the most expensive part of the daily whole diabetes-treatment. One good way to help with costs is to register at http://www.mrrebates.com first, then go to American Diabetes Wholesale to buy diabetic supplies. You will get rebates back on what you order through mrrebates. There are Arkray strips that work in the Relion meters - i'm not up to date on that, so if you want help with that info, put it in your subject line and people will chime in.

On the New to the Group? sticky, there are links to evaluations of different glucometers. If you want to be able to buy strips locally, then you might want one of the name brand ones, like the Accucheck.

About the low numbers, i like to tell people that 40's are not an emergency, but they are time to take action. It took me a while when i got here to understand what was low numbers and what wasn't. Under 50 is when we take action to bring up the blood sugar, but non-diabetic cats might always run in the 40's. we don't want cats with insulin staying there because we want a margin of safety, but Clare wasn't in danger with the 49. As long as you are monitoring her, you'll be able to keep her safe.
 
Re: 7/25 Clare and Georgette AMPS 241 New to Group

The meter a lot of us use is the Relion brand from WalMart because the strips are affordable and readily available.

The Relion Confirm and Micro take the tiniest sample size, and the strips are about $18 for 50

The Relion Prime takes a little bigger sample, but the strips are only $9 for 50

We use a lot of strips on Tight Regulation, so the price of the replacement strips is a big factor in choosing a meter. We started with the Confirm (because of the small sample size) and when China's ears "learned to bleed", we switched to the Prime to save money on strips
 
Re: 7/25 Clare and Georgette AMPS 241 New to Group

Welcome to LantusLand, the greatest place you never wanted to be. :lol: Is the +2 323 for the evening cycle?
Liz
 
Re: 7/25 Clare and Georgette AMPS 241 New to Group

Hi Georgette. Welcome to LL. The increase is likely due to the food she ate, a food spike. Like Julie said, I'd get a +4 to see if she is starting to come down. It's a good idea to put your result in the subject bar of your first post. So you would hit the post, then edit, and then add +2=323.

My first meter is the Relion Micro. For backup I bought an Arkray from ADW because it is pretty much the same meter and the strips can be used in my Relion and the Arkray although they say to use the Relion strips in the Relion. I've tested it several times and which strips I use don't seem to matter at all. I bought several relion boxes on ebay for a great price.
 
Re: 7/25 Clare and Georgette AMPS 241 New to Group

Don't read a lot into these numbers for a little while....remember, for the first 5-7 days, some of each shot is going "into the depot", so you're not going to really know how well it's working until the depot is "releasing" a full dose each cycle.

The increase at +2 is most likely just a food spike which is normal. That's why if the +2 is a low lower than the Pre-shot, we are concerned they are going to drop too low later

.25 is a very very tiny dose...Most cats start at around 1 unit twice/day so you're already starting at a very low dose (which is fine...better to go up slowly than to give too much and end up with a cat in a hypoglycemic crisis)

High numbers take a long time to do their damage...Low numbers kill quickly

We all understand it's hard to be patient, but you're just at the beginning of the dance...give it some time...and while you wait, let me be the first one to offer you the loan of some of our Lantus Land "Patience Pants"

Wear them with pride! They've been well used!.....LOL
ladies-trousers-250x250.jpg


You may pick your favorite color!
 
Re: 7/25 Clare and Georgette AMPS 241 New to Group

Welcome Georgette & Clare! Looks like you've got a ton of great information already and there's plenty more where that came from (don't be scared!) :-D This is the best group of people. Wishing you two a lovely evening!
 
Re: 7/25 Clare and Georgette PMPS 287 +4 315

I'll take the yellow ones -

So far her numbers are staying pretty high. Suggestions welcome!

Georgette
 
Re: 7/25 Clare and Georgette AMPS 241 New to Group

Thanks to everyone for such a warm welcome! You're right, Deborah, this whole process is a bit scary. So many factors to consider, so many moving parts.
 
Re: 7/25 Clare and Georgette AMPS 241 New to Group

Pull on a pair of those patience pants and give her a couple of days. :-D She got down to 70 today, which is a very nice nadir. We like to leave the dose the same for at least 6 cycles to see what will happen. I will defer to other more experience members advice, but I suspect they will say to stay at the same dose for a couple of days and see what happens.

Small hint: you have to change the subject line of the very first post for it to show up in the forum.

You are doing a super job with everything. Give yourself a huge pat on huge back! :-D
Liz
 
Re: 7/25 Clare and Georgette AMPS 241 New to Group

Hello Clare and Georgette!! I'm just adding my welcome :smile: You are in wonderful hands here!!!
 
Re: 7/25 Clare and Georgette PMPS 287 0.25 u. +2 323 +4

Hello Liz, Anne and Deanna, it's good to be with such a wise and experienced (and patient) group. Sometimes I've been feeling like the Mad Scientist, experimenting on our poor, sick cat. She's being very strong, really, hanging in there with us while we try to figure this out together. Although I know that we can't expect to rush things, it's just good to have some structure around all of the decisions that need to be made.

Bedtime now. I'll check on Clare at +6.5 to make sure she's doing okay.
 
Re: 7/25 Clare and Georgette PMPS 287 0.25 u. +2 323 +4

on the off chance that you see this before you head for bed, i think you're ok to sleep through the night. she's high enough and not really moving, so i don't think she's going to be below 50 on this cycle.

sleep well. see you in the morning!
 
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