7th day on insulin: thoughts on Micio's GB numbers?

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MISSY + Simone&MICIO (GA)

MISSY + Simone&MICIO (GA)

Member Since 2021
It may be too early to tell since I only started my Micio on insulin 7 days ago but can someone take a look at his preshot GB and tell me if there is any indicator that the 0.5u Semglee x 2 times at day insulin it may have started to effects him at all?
I have been trying to put together as much info as I can but still have some questions:
- is it too soon to do a curve?
- How many day(s) does a curve last for and every how many hours is it recommended to test GB?
- At what GB numbers do I need to stall or is it not applicable since he's newly diagnosed and started on
insulin?
- GB Testing: I have a hard time to test on his ears cause he has black hair and he doesn't like it either...I
test on his paws instead. Because he was also diagnosed with neuropathy ( I just started him on B12
Methylcobalamin yesterday), would the testing make it worse? He doesn't seem to be bothered at all when
poked..

Thanks!
 
Now that Micio's been on insulin for 7 days, it's a perfect time for a curve. A curve is either every 2 hours for a cycle (12 hours time between shots), or every 3 hours for 18 hours.

For dosing, we suggest that new people don't give a shot if below 200 at shot time. However, one option is to delay, without feeding, for around 1/2 hour and see if he comes up to a shootable numbers. That's what we call stalling. As you get more experience and and data, you will shoot lower numbers. Just not yet.

I too had a black eared cat. Two things really helped me. I put a really light smear of vaseline on her ears, so the blood welled on up it and didn't hide in the black hair. I also used a small flashlight, topped with gauze over the light, under the ears and used that as my poking surface. That helped light up the ear.

If you haven't already, I'd pop on over to the Lantus/glargine forum and read the yellow starred Sticky Notes on top. That'll help some of your questions.
Lantus / Basaglar (glargine) and Levemir (detemir)
 
Hi, one thing I notice on your spreadsheet you aren't testing after his AMPS and PMPS so you can see how the insulin is working and how low he is dropping.
I would suggest you read the yellow Lantus Sticky that Wendy suggested.
For the curve let's say you give him the insulin at 5:30 AM
5:30 AM. Give insulin
7:30 AM test him
9:30 AM test him
11:30 AM test him
1:30 PM test him
3:30 PM test him
5:30 PM PMPS you test
You can continue to feed him normally
Good luck :cat:
 
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Wendy&Neko said:
Now that Micio's been on insulin for 7 days, it's a perfect time for a curve. A curve is either every 2 hours for a cycle (12 hours time between shots), or every 3 hours for 18 hours.

For dosing, we suggest that new people don't give a shot if below 200 at shot time. However, one option is to delay, without feeding, for around 1/2 hour and see if he comes up to a shootable numbers. That's what we call stalling. As you get more experience and and data, you will shoot lower numbers. Just not yet.

I too had a black eared cat. Two things really helped me. I put a really light smear of vaseline on her ears, so the blood welled on up it and didn't hide in the black hair. I also used a small flashlight, topped with gauze over the light, under the ears and used that as my poking surface. That helped light up the ear.

If you haven't already, I'd pop on over to the Lantus/glargine forum and read the yellow starred Sticky Notes on top. That'll help some of your questions.
Lantus / Basaglar (glargine) and Levemir (detemir)
Click to expand...

I did noticed that GB numbers seems to be the highest on the AM preshot ( almost 5-1/2 hours fasting during the night is the longest he gets cause during the day he gets treats in between meals )....WHY IS THAT?
 
Diane Tyler's Mom said:
Hi, one thing I notice on your spreadsheet you aren't testing after his AMPS and PMPS so you can see how the insulin is working and how low he is dropping.
I would suggest you read the yellow Lantus Sticky that Wendy suggested.
Click to expand...

Yes, I'm going to test more. I gave him a little break after my initial failed pokes and such... he trust me again now. Going to read the Lantus Sticky again cause I'm sure I've missed things. Tnx
 
MissyKat said:
I did noticed that GB numbers seems to be the highest on the AM preshot ( almost 5-1/2 hours fasting during the night is the longest he gets cause during the day he gets treats in between meals )....WHY IS THAT?
Click to expand...
It could be that he is dropping lower during the PM cycle and that's why his AM pre shots are higher.
Most of us feed our cats cats multiple times a day like 2 or 3 times after the morning meal, same for the night cycle during the first half of the cycle
It's easier on the pancreas
Read over the dosing methods for SLGS

Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
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. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • 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
You could be seeing those higher AM numbers because of bouncing, but we won't know because there is no testing after the PM cycle

I did a search on the site to explain what it means
Here is the definition:
Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

We have to find out when his nadir happens
Part of that process is getting a feel for basic concepts:



    • Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
    • Duration - the length of time insulin continues to lower blood glucose
    • As long as you are sure that he will eat you don't have to wait 30-40 minutes to give him his insulin which I see written on your spreadsheet.
    • With Semglee it usually doesn't take effect until @+2 (onset)
 
Last edited:
Diane Tyler's Mom said:
It could be that he is dropping lower during the PM cycle and that's why his AM pre shots are higher.
Most of us feed our cats cats multiple times a day like 2 or 3 times after the morning meal, same for the night cycle during the first half of the cycle
It's easier on the pancreas
Read over the dosing methods for SLGS

Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
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. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • 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
You could be seeing those higher AM numbers because of bouncing, but we won't know because there is no testing after the PM cycle

I did a search on the site to explain what it means
Here is the definition:
Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

We have to find out when his nadir happens
Part of that process is getting a feel for basic concepts:



    • Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
    • Duration - the length of time insulin continues to lower blood glucose
    • As long as you are sure that he will eat you don't have to wait 30-40 minutes to give him his insulin which I see written on your spreadsheet.
    • With Semglee it usually doesn't take effect until @+2 (onset)
Click to expand...

It all make sense, Thank you very much...really hope I can get this right for my boy and make him feel better soon!
 
MissyKat said:
I did noticed that GB numbers seems to be the highest on the AM preshot ( almost 5-1/2 hours fasting during the night is the longest he gets cause during the day he gets treats in between meals )....WHY IS THAT?
Click to expand...
It's quite common for numbers to be higher in the morning. Dawn phenomenon is a common thing for both cats, and humans! It has to do with natural hormones produced by the body overnight.
 
Wendy&Neko said:
Now that Micio's been on insulin for 7 days, it's a perfect time for a curve. A curve is either every 2 hours for a cycle (12 hours time between shots), or every 3 hours for 18 hours.

For dosing, we suggest that new people don't give a shot if below 200 at shot time. However, one option is to delay, without feeding, for around 1/2 hour and see if he comes up to a shootable numbers. That's what we call stalling. As you get more experience and and data, you will shoot lower numbers. Just not yet.

I too had a black eared cat. Two things really helped me. I put a really light smear of vaseline on her ears, so the blood welled on up it and didn't hide in the black hair. I also used a small flashlight, topped with gauze over the light, under the ears and used that as my poking surface. That helped light up the ear.

If you haven't already, I'd pop on over to the Lantus/glargine forum and read the yellow starred Sticky Notes on top. That'll help some of your questions.
Lantus / Basaglar (glargine) and Levemir (detemir)
Click to expand...

@Wendy&Neko , UPDATE: Please disregard my question...in my mind I was thinking I'll have to give him a shot at noon so I got worried about his BG drop but instead I only took his BG and fed him (his shots are at around 6am and 6pm) ...Having two sick cats to take care of I guess I'm loosing my mind :(, sorry. Below is the original question..

"for the first time Micio's BG was at 196 @ +3.5 (AMPS 406 this morning); I'm suppose to feed him in 1 hour, what if his BG still low/lower than 200 even after I wait another 1/2 hour before feeding? P.S.: I was able to test on his ear when I got BG 196, would that make a difference on the readings? Tnx"
 
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