7/7/2015 NORMAN amps 248 +5 113 + 7 94 +9 109 pmps 103 +3 164 going back to 2 units

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Cindywith4cutecats

Cindywith4cutecats

Member Since 2014
Norman is doing pretty good is spite of shooting late by 2 1/2 hours last night. He has been alert, actually asked to go out on the screen porch and watch his butterflies. His +7 being 94 makes me wonder where he will fall tonight, his nadirs are happening +9 to +11 of his cycles, not sure why or if it has anything to do with his chow changes. He has gone from Friskies Special diet and FF Classic to Wellness Turkey Formula. I will shoot him his 1 3/4 units tonight and hubby will watch him while I sleep for awhile and then I am up for the night to watch him and hubby gets up at 4:30 am for work so that will +9.5 of his cycle where we need to check his BG again.....Correct me if I am wrong since I shot late yesterday I have changed my shooting times to get 12 hours cycles and I can back up by 15 minutes daily....So tomorrow I could shoot at 7am and 7pm then the following day 6:45 am and 6:45 pm etc...correct ? I need to get him back to 5 am and 5pm since I am going out of town July 30th

previous condo http://www.felinediabetes.com/FDMB/...m-bg-101-not-sure-of-dosing-need-help.140575/
 
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You can move it ahead by 30 minutes per day in most cats, without it having much of an effect on the blood sugar. So that means 15 minutes earlier on each shot, or 30 minutes once a day.

Just a heads-up about his dose. Since you reduced yesterday because of reasons other than him going below 40, then it's possible this dose may be too low. With Lantus being a depot insulin, that means that a larger dose keeps on giving for as many as 3 days (6 cycles) after you've reduced the dose. I think it looks like his numbers may be trending up since the depot from the larger dose is depleting. You were getting great numbers on the 2.0u and starting to see progress. If you're aiming for remission again, solid green is the goal. See what he does tonight, but if he isn't spending a lot of hours in green, I'd consider calling it a failed reduction and going back up to the 2.0u dose.

Here's some reading on failed reductions. The idea with a reduction is that the blood sugar continues to be in good green numbers after the dose is reduced. If the numbers trend up as the depot reduces and equalizes with the new lower dose, then that's telling you the dose isn't large enough.

I saw your comment about him being hungry when he got under 60, but that's ok. That's not hypoglycemia. Cats that are off of insulin can test even in the 30's. The guidelines suggest with a cat that's been diabetic more than a year that they need to go under 40 for a dose reduction. As long as you're monitoring and you're using carbs to bring him back up, that's safe to do.

With a cat back from remission, you have to be more aggressive than the person with a newly diagnosed cat, at least if you're hoping to get him back into remission again.
 
We had reduced cause he went to 70 . I had printed out the guidelines but what I had actually printed out was the star low go slow method and was reading in that paperwork that a bg below 90 warranted a reduction. Now I do have a clearer understanding of this. last time around was trial and a lot of error but I just ended up lucky yet I wonder if thats why he didn't stay remission also , who knows lol. BG no matter where is falls in the cycle 50-100 is where we want to be for a min of 7 days before earning a reduction of .25 although he fell below 40 that would an immediate .25 reduction . I think where I always got stuck some others get stuck is that we read some of the paperwork saying under 150 you shoot this and if under 150 you don't shoot etc and I think for some of us we get confused over OMG my cats at 100 I guess I don't shoot. I have been looking at a lot of others peoples SS and I notice some doing the same darn thing......But now that I have a little bit more a grip on it......not sure how to coast the little guy while I am out of town July 30th thru August 9.... I am wondering about allowing him to coast a tish higher in numbers and keeping him safe ? He will be all alone from AMPS to +9 hours ...thats a long stretch but I still have time yet to cross that bridge
 
It's true - it is confusing. On Main Health they tell people not to shoot under 200. Here on LLL we suggest newbies post and ask for advice if they are shooting under 150. But the goal with Lantus & Lev is to get to the point of shooting everything over 50 if you're following Tight Reg. And if you had SLGS paperwork that would be even more confusing.

A couple of days before your vacation post and ask for help with a vacation dose. You probably want to reduce it a little bit in case he doesn't eat as well with you gone, and since he won't be tested as much. Are you doing something fun?
 
OMG I just went at looked at his SS, I see what you are saying omg I think I think I get it now....I see what you mean about trending up. I already shot him for the night, so if this is failed reduction and not a result of shooting late last night then he will need to be increased back to 2 units.....then at 2 units he only gets a reduction if drops below the 40 mark ( I am so scared of the 40 mark , terrified in fact , he has never gone below 50 )...so after spending 7 days in the green zone we get to try the .25 reduction. I was always reducing the second I saw what I considered a low number..NO wonder he didn't stay in remission. I was so sick then and so brain dead with being hyperthyroid (omg do I feel bad for kitties with that disease ) no wonder I was off on my own and never really understanding this insulin stuff. I just keep thinking if his Pre Shot is a low number then I he is going to tank out...under tight regulation what would be considered an unshootable number or does it depend upon the dose of insulin or trial and error ?
 
under the tight regulation protocol guidelines, if a cat is eating ok, ie, not sick or seeming off, then the no-shoot number for most people is 50. There are a few long-term members who might shoot 40's, or if a cat is on Lev where the nadir could be at preshot, then they might regularly have to shoot 40's. But for Lantus, typically it's 50.

I wrote a bit a while back about the difference between shooting a high number and shooting low. I'll link it here and maybe it will help you a bit.

I didn't understand the whole mechanics of shooting low very well for a long time - that's why when I finally got it, I've pushed it here. I'd seen the "shoot low to stay low" slogan, but like everyone else, I thought if a dose could drop punkin 200 points when I shot him at 300, then the same dose shot at 100 would kill him. Only it just doesn't work like that. Read the link above and see if it makes sense. It's worth taking the time to look at the spreadsheets that are linked.
 
can someone tell me if I have this or not .....the insulin depot is the gas tank once built its full of gas . My cat uses some the insulin and it keeps him trending down into the green numbers and as I refill twice a day basically the amount of the gas he used in this 12 hour period ...so as a result of refilling the gas tank daily he never runs out of gas and refilling the tank will not cause his numbers to bottom out on me, I would see some gas spillage hence the lower numbers in the nadir that would earn him a reduction . I have always been afraid of the insulin taking him to low as I see him trending down at this dose out of fear....I never had problems shooting lower numbers once on .50 unit and lower..
 
thank you so much..I think I have a better grip on this now....and Yes I am going to Texas to see both of my adult daughters and my its my granddaughters 2nd birthday. I had to miss her 1st birthday last year cause all 3 of my medical specialist would not allow me to fly . they treat Hyperthyroidism in cats the same way, we both get tapazole to start with and I was that 1 in a million that had a sever reaction to tapazole , my liver hated it and I almost ended up on liver transplant list but luckily my numbers trended down within a week of stopping that drug. So I am super happy to go be with them....My husband last year flew my children here to Florida to see me before my treatment so that I could see them though
 
Think of it this way - if you've increased his dose carefully and methodically, which you have, then you can be confident that is the dose that he needs. If a cat comes here to FDMB at 10u and the dose was increased 1u at a time, once a week, then we don't have confidence in the dose. But in your case, you started at a low dose, worked it up 0.25u at a time, allowing appropriate lengths of time in between increases, and you tested lots to make sure he wasn't going low. Now you arrived at 2.0u and he started with lots of green numbers. BINGO! It's the dose that he needed!

It's not any different from when he was on the dose-reduction path before and you were shooting green numbers with a smaller dose. The amount they need at a particular time is the amount they need then.

As his pancreas heals, it might begin to start sputtering out some insulin again. Cats are the only mammal that can have their pancreas heal and begin working again, which is why dogs and people stay on insulin once they start on insulin. They're on for life. But if a cat's blood sugar is gotten back into normal range as quickly as possible, some of the beta cells on the pancreas may be able to heal and begin working again. That's how Norman got OTJ before.

Once a cat starts getting long green stretches, that's ideal for pancreas-healing time. Yes, at some point it's possible that his pancreas will start adding some of its own insulin, and if that happens then you need to reduce the amount you're shooting. You want a balance there - does that make sense? So you just keep checking him, and each time he goes below 40, that's telling you he's ready for you to shoot a little less insulin. If 40 were dangerous, that wouldn't be the bar that was set for him to earn a reduction. You can't be complacent about it, because you don't want him going below 30, but there is time for you to carb him and pull him back up.

I'm glad you're getting to see your family! that's important!
 
after all this time that I thought I understood insulin I really didn't understand it all. For some reason its finally clicking in the brain...So if it was you since I shot late last night by 2 1/2 hours and some of the trend up could be a result of that, how long would you wait before you increased his dose back to 2 units
 
julie & punkin (ga) said:
Think of it this way - if you've increased his dose carefully and methodically, which you have, then you can be confident that is the dose that he needs. If a cat comes here to FDMB at 10u and the dose was increased 1u at a time, once a week, then we don't have confidence in the dose. But in your case, you started at a low dose, worked it up 0.25u at a time, allowing appropriate lengths of time in between increases, and you tested lots to make sure he wasn't going low. Now you arrived at 2.0u and he started with lots of green numbers. BINGO! It's the dose that he needed!

It's not any different from when he was on the dose-reduction path before and you were shooting green numbers with a smaller dose. The amount they need at a particular time is the amount they need then.

As his pancreas heals, it might begin to start sputtering out some insulin again. Cats are the only mammal that can have their pancreas heal and begin working again, which is why dogs and people stay on insulin once they start on insulin. They're on for life. But if a cat's blood sugar is gotten back into normal range as quickly as possible, some of the beta cells on the pancreas may be able to heal and begin working again. That's how Norman got OTJ before.

Once a cat starts getting long green stretches, that's ideal for pancreas-healing time. Yes, at some point it's possible that his pancreas will start adding some of its own insulin, and if that happens then you need to reduce the amount you're shooting. You want a balance there - does that make sense? So you just keep checking him, and each time he goes below 40, that's telling you he's ready for you to shoot a little less insulin. If 40 were dangerous, that wouldn't be the bar that was set for him to earn a reduction. You can't be complacent about it, because you don't want him going below 30, but there is time for you to carb him and pull him back up.

I'm glad you're getting to see your family! that's important!
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when would you increase him back to the 2 units ? I know some of the trend up could be a result of shooting 2 1/2 hours late last night..he already rec his 1 3/4 tonight so the earliest would be tomorrow morning...
 
I would see how long he's in green in the pm cycle tonight. If it's less than the 3ish hours he was getting at 2.0u, I'd go back up to 2.0u in the morning.

If' it's a longer stretch of green numbers, more than 3hrs, then I'd be wishy-washy and decide by the amps - if he had a blue amps, then I'd still increase back to 2.0.

If he has alonger stretch of green tonight and he also was green at amps, then I'd probably hold the 1.75u for the moment.
 
Well Julie, you are 110 % right. I just checked Norman and he is at 164 so he goes back to 2 units tomorrow morning. I see what happened now. I had nice green numbers , flipped out and reduced him to 1 3/4 units and used up the extra .25 units out of his depot. Now I feel horrible for doing this to him....I have learned a lot today , thank heaven I have learned and didn't lose more than what I have...We will probably see a bounce as a result grrrrrr but I am believing for better , greener pastures tomorrow afternoon. i feel more empowered and more confident than ever before...thank you so much for all your help and explanations...
 
Don't look back - we all just do things the best we can with what we know. It's more complicated than anyone would ever have thought to dose a diabetic cat. It's not straightforward at all - especially with the depot concept.

Just plow on and you'll get him under better control!

:bighug:
 
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