8/2/17 Amethyst first day on 3U increase

[Pamela & Amethyst]

+8 3AM was 458 AMPS was 437 +6 at 1PM was 400 PMPS428

 

[rhiannon and shadow (GA)]

work that juice, Amethyst.

 

[Pamela & Amethyst]

work that juice, Amethyst.

THat is so cute!!!

 

[Adrian and Chino]

I like that 346 you were able to catch 2 days ago. That was a pretty quick drop, to go down by almost 100 in the first 2 hours of the cycle. I wonder if she went lower in the hours that followed. Chino showed occasional yellows and blues, even a rare green every 2-3 weeks, but until we got up to an effective dose, he was mostly showing reds and pinks. Try not to get discouraged, and celebrate each pink - it's a sign that you're on the right track! Soon enough, you'll see the first yellow, then the first blue... then the first green

 

[Marvin's Mom - Nat]

I like that 346 you were able to catch 2 days ago. That was a pretty quick drop, to go down by almost 100 in the first 2 hours of the cycle. I wonder if she went lower in the hours that followed. Chino showed occasional yellows and blues, even a rare green every 2-3 weeks, but until we got up to an effective dose, he was mostly showing reds and pinks. Try not to get discouraged, and celebrate each pink - it's a sign that you're on the right track! Soon enough, you'll see the first yellow, then the first blue... then the first green

I so know that feeling...... was at the same spot a few months back

 

[Pamela & Amethyst]

I so know that feeling...... was at the same spot a few months back

THank you but her numbers went back up again? Oh I thought it was just Amethyst??

 

[Pamela & Amethyst]

I like that 346 you were able to catch 2 days ago. That was a pretty quick drop, to go down by almost 100 in the first 2 hours of the cycle. I wonder if she went lower in the hours that followed. Chino showed occasional yellows and blues, even a rare green every 2-3 weeks, but until we got up to an effective dose, he was mostly showing reds and pinks. Try not to get discouraged, and celebrate each pink - it's a sign that you're on the right track! Soon enough, you'll see the first yellow, then the first blue... then the first green

Thank you but her numbers went back up again??

 

[Marvin's Mom - Nat]

That is normal, the numbers are always going up and down. The pre-shot numbers are typically higher. After you give insulin, the numbers if she is going to have an active cycle should start to go down a little 2 hours after the shot. It continues to go down until nadir (typically 6 or 7 hours after the shot), then starts to go up again until next shot is given. Also when the insulin dose is changed, it can takes up to 6 cycles (3 days) for the new dose to take affect, during that time some cats go up a bit, or stay about the same, some cats it starts to work faster than others.

Take a look at other peoples Spread sheet in their signature. you will start to see that pattern. Marvin was in the Red and Pink numbers for months before I started seeing some movement, ended up he had an insulin resistant condition. So I worked on that with the folks here, and started seeing results once we took care of that condition. Every cat is different, some just need more insulin than others. There is no magic dose, and even when their numbers are better you still may need to increase or decrease the insulin from time to time. This is normal too.

The following is from one of the stickies that explains how the cycles typically works.

Example of an ACTIVE, but NOT necessarily typical Lantus cycle:
NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. Onset begins around +2 for most cats. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Often lower than the PreShot number.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.

An active Levemir cycle will have an onset at approximately +4 and a nadir around +8 - +10. However, please keep in mind every cat is different (ECID). Data collection will offer you a better picture of YOUR cat's response to either of these insulins.

Initially, don't expect to see "active" cycles after every single shot whether you're using Lantus or Levemir. Chances are, your kitty had diabetes for some time before diagnosis. It requires time for kitty's body to become used to dropping into lower numbers than their bodies have become accustomed. Don't expect immediate results! Regulation takes time and patience:

• "Fluctuations are very common in this phase before BGs start to stabilize under consistent dosing: a typical curve of cat over the first 1.5 months on Lantus can be seen here: Lantus Starting Graph". http://www.tillydiabetes.net/en_6_protocol2.htm

• Also worth noting: "Many cats will occasionally react to an increased dose with increased BGs - within the first 2 to 3 days after an increase, usually lasting for less than 24 hours. Nobody really knows what the reason for this phenomenon is (perhaps a "panicky liver"?) - hold the dose and ignore the fluctuations."http://www.tillydiabetes.net/en_6_protocol2.htm. Here in the Lantus and Levemir Insulin Support Group (ISG), we've affectionately dubbed this unexplained phenomenon "New Dose Wonkiness" (NDW).

 

[Pamela & Amethyst]

That is normal, the numbers are always going up and down. The pre-shot numbers are typically higher. After you give insulin, the numbers if she is going to have an active cycle should start to go down a little 2 hours after the shot. It continues to go down until nadir (typically 6 or 7 hours after the shot), then starts to go up again until next shot is given. Also when the insulin dose is changed, it can takes up to 6 cycles (3 days) for the new dose to take affect, during that time some cats go up a bit, or stay about the same, some cats it starts to work faster than others.

Take a look at other peoples Spread sheet in their signature. you will start to see that pattern. Marvin was in the Red and Pink numbers for months before I started seeing some movement, ended up he had an insulin resistant condition. So I worked on that with the folks here, and started seeing results once we took care of that condition. Every cat is different, some just need more insulin than others. There is no magic dose, and even when their numbers are better you still may need to increase or decrease the insulin from time to time. This is normal too.

The following is from one of the stickies that explains how the cycles typically works.

Example of an ACTIVE, but NOT necessarily typical Lantus cycle:
NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. Onset begins around +2 for most cats. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Often lower than the PreShot number.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.

An active Levemir cycle will have an onset at approximately +4 and a nadir around +8 - +10. However, please keep in mind every cat is different (ECID). Data collection will offer you a better picture of YOUR cat's response to either of these insulins.

Initially, don't expect to see "active" cycles after every single shot whether you're using Lantus or Levemir. Chances are, your kitty had diabetes for some time before diagnosis. It requires time for kitty's body to become used to dropping into lower numbers than their bodies have become accustomed. Don't expect immediate results! Regulation takes time and patience:

• "Fluctuations are very common in this phase before BGs start to stabilize under consistent dosing: a typical curve of cat over the first 1.5 months on Lantus can be seen here: Lantus Starting Graph". http://www.tillydiabetes.net/en_6_protocol2.htm

• Also worth noting: "Many cats will occasionally react to an increased dose with increased BGs - within the first 2 to 3 days after an increase, usually lasting for less than 24 hours. Nobody really knows what the reason for this phenomenon is (perhaps a "panicky liver"?) - hold the dose and ignore the fluctuations."http://www.tillydiabetes.net/en_6_protocol2.htm. Here in the Lantus and Levemir Insulin Support Group (ISG), we've affectionately dubbed this unexplained phenomenon "New Dose Wonkiness" (NDW).

That is normal, the numbers are always going up and down. The pre-shot numbers are typically higher. After you give insulin, the numbers if she is going to have an active cycle should start to go down a little 2 hours after the shot. It continues to go down until nadir (typically 6 or 7 hours after the shot), then starts to go up again until next shot is given. Also when the insulin dose is changed, it can takes up to 6 cycles (3 days) for the new dose to take affect, during that time some cats go up a bit, or stay about the same, some cats it starts to work faster than others.

Take a look at other peoples Spread sheet in their signature. you will start to see that pattern. Marvin was in the Red and Pink numbers for months before I started seeing some movement, ended up he had an insulin resistant condition. So I worked on that with the folks here, and started seeing results once we took care of that condition. Every cat is different, some just need more insulin than others. There is no magic dose, and even when their numbers are better you still may need to increase or decrease the insulin from time to time. This is normal too.

The following is from one of the stickies that explains how the cycles typically works.

Example of an ACTIVE, but NOT necessarily typical Lantus cycle:
NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. Onset begins around +2 for most cats. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Often lower than the PreShot number.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.

An active Levemir cycle will have an onset at approximately +4 and a nadir around +8 - +10. However, please keep in mind every cat is different (ECID). Data collection will offer you a better picture of YOUR cat's response to either of these insulins.

Initially, don't expect to see "active" cycles after every single shot whether you're using Lantus or Levemir. Chances are, your kitty had diabetes for some time before diagnosis. It requires time for kitty's body to become used to dropping into lower numbers than their bodies have become accustomed. Don't expect immediate results! Regulation takes time and patience:

• "Fluctuations are very common in this phase before BGs start to stabilize under consistent dosing: a typical curve of cat over the first 1.5 months on Lantus can be seen here: Lantus Starting Graph". http://www.tillydiabetes.net/en_6_protocol2.htm

• Also worth noting: "Many cats will occasionally react to an increased dose with increased BGs - within the first 2 to 3 days after an increase, usually lasting for less than 24 hours. Nobody really knows what the reason for this phenomenon is (perhaps a "panicky liver"?) - hold the dose and ignore the fluctuations."http://www.tillydiabetes.net/en_6_protocol2.htm. Here in the Lantus and Levemir Insulin Support Group (ISG), we've affectionately dubbed this unexplained phenomenon "New Dose Wonkiness" (NDW).

THank you this is helpful and encouraging Thank you all for your help and daily support!!

 

[Pamela & Amethyst]

Hi again how do you decide your cat my be insulin reisistant??????

 

[Marvin's Mom - Nat]

Hi again how do you decide your cat my be insulin reisistant??????

When I got to about 4U, I started to research the high resistant conditions. The two main ones is IAA and Acromegaly. There are tests that can be done for these. Sometimes you have to push for them with your vet as most vets thinks they are rare conditions and rule them out, however 25% of diabetic cats have Acromegaly. Which is what Marvin has. @Wendy&Neko is the expert here on these two conditions her kitty had both.

I pushed for the testing when Marvin reached 6U of insulin.

 

[Kris & Teasel]

There are also kitties that just need a higher dose to break through insulin resistance caused by weeks of high numbers. Once you get that breakthrough the dose can come down, sometimes quickly. @Bobbie And Bubba's kitty was like that.

 

[Pamela & Amethyst]

When I got to about 4U, I started to research the high resistant conditions. The two main ones is IAA and Acromegaly. There are tests that can be done for these. Sometimes you have to push for them with your vet as most vets thinks they are rare conditions and rule them out, however 25% of diabetic cats have Acromegaly. Which is what Marvin has. @Wendy&Neko is the expert here on these two conditions her kitty had both.

I pushed for the testing when Marvin reached 6U of insulin.

Okay THanks! I would have to ask DCIN to pay for those test if neccesary I hope not!! She has already gone 7 months on Prozoinc with no change I do not want to wait that long again

 

[Pamela & Amethyst]

There are also kitties that just need a higher dose to break through insulin resistance caused by weeks of high numbers. Once you get hat breakthrough the dose can come down, sometimes quickly. @Bobbie And Bubba's kitty was like that.

Okay THank you I a hoping it is that and not insulin resistance!!!

 

[Pamela & Amethyst]

I like that 346 you were able to catch 2 days ago. That was a pretty quick drop, to go down by almost 100 in the first 2 hours of the cycle. I wonder if she went lower in the hours that followed. Chino showed occasional yellows and blues, even a rare green every 2-3 weeks, but until we got up to an effective dose, he was mostly showing reds and pinks. Try not to get discouraged, and celebrate each pink - it's a sign that you're on the right track! Soon enough, you'll see the first yellow, then the first blue... then the first green

Thank you for the encouragement!!!

 

[Wendy&Neko]

THank you I a hoping it is that and not insulin resistance!!!

Even if there is insulin resistance present, the approach is the same. Give them as much insulin as they need. There is a dose out there for every cat that will move them into better numbers.

 

[Bobbie And Bubba]

There are also kitties that just need a higher dose to break through insulin resistance caused by weeks of high numbers. Once you get that breakthrough the dose can come down, sometimes quickly. @Bobbie And Bubba's kitty was like that.

Yep, that was Bubba, when he hit 5.25 units, he started responding and earning reductions.

Below was taken from Tilly's Homepage:

Cats are extremely variable in terms of the maximum dose they end up requiring: they have ranged from 0.5 IU to 10.0 IU BID in the German forum, with most cats lying between 1.0 IU and 5.0 IU BID.

I found that very encouraging to read and it helped me not become nervous about the increases. The kitties need what they need and the faster and safely you can get her into better numbers the better.


ETA:

 

[Pamela & Amethyst]

Even if there is insulin resistance present, the approach is the same. Give them as much insulin as they need. There is a dose out there for every cat that will move them into better numbers.

Thank you . So today is her first day on 3U hopefully the numbers to come down! Thanks for the support

Yep, that was Bubba, when he hit 5.25 units, he started responding and earning reductions.

Below was taken from Tilly's Homepage:

Cats are extremely variable in terms of the maximum dose they end up requiring: they have ranged from 0.5 IU to 10.0 IU BID in the German forum, with most cats lying between 1.0 IU and 5.0 IU BID.

I found that very encouraging to read and it helped me not become nervous about the increases. The kitties need what they need and the faster and safely you can get her into better numbers the better.


ETA:

THANK YOU It is just that we kept going up with the Prozinc with no results!!. I want her to get better I thought she would need only a little Lantus I am trying so hard not to be anxious because it affects her and her brother they are very sensitive to my feelings!

 

[Bobbie And Bubba]

Thank you . So today is her first day on 3U hopefully the numbers to come down! Thanks for the support

THANK YOU It is just that we kept going up with the Prozinc with no results!!. I want her to get better I thought she would need only a little Lantus I am trying so hard not to be anxious because it affects her and her brother they are very sensitive to my feelings!

You will get there ! Are you following TR or SLGS. You are testing enough to do TR and you can get her into better numbers faster. It looks like with the ProZinc the same dose was held too long and I am glad that you are moving her along now to help her. As long as she is on a steroid, more insulin could be necessary.

 

[Pamela & Amethyst]

You will get there ! Are you following TR or SLGS. You are testing enough to do TR and you can get her into better numbers faster. It looks like with the ProZinc the same dose was held too long and I am glad that you are moving her along now to help her. As long as she is on a steroid, more insulin could be necessary.

The Flovent just goes in to her lungs as an inhaler. Will that still affect her numbers??? I thought only if it was injected or taken orally?? I am following TR.

 

[Bobbie And Bubba]

The Flovent just goes in to her lungs as an inhaler. Will that still affect her numbers??? I thought only if it was injected or taken orally?? I am following TR.

I think it does. Hopefully others will weigh in. You could add a ? Mark on your title thread and ask this.

 

[rhiannon and shadow (GA)]

I don't know about that. I have a steroid inhaler and my doctor swears it's only local on my mucus tissues.

 

[Pamela & Amethyst]

Yes I use the same two inhalers Amethyst uses the Flovent 2x a day and the Albuterol when she or I am having an attack

 

[Bobbie And Bubba]

I'm going to tag @DebG as Fritz has used Flovent and Albuterol, she would know for sure.

 

[Marvin's Mom - Nat]

I don't know about that. I have a steroid inhaler and my doctor swears it's only local on my mucus tissues.

Not sure about that either, I remember I was prescribed Flovent years ago, I hadn't used it before so I researched it first and decided not to take it, as one of the side effects was major weight gain due to the steroids (yes I know I am conceited).

 

[rhiannon and shadow (GA)]

can i blame my weight on flonase??

yay... thanks!

 

[Pamela & Amethyst]

I'm going to tag @DebG as Fritz has used Flovent and Albuterol, she would know for sure.

OKay THank you!

 

[DebG]

Yes the Flovent inhaler doesn't go into the blood stream goes directly to the lungsthat is why if kitty can tolerate the inhaler it is so much better for them.
My Fritz has been dealing with asthma for years. For many years he did well with the inhaler twice daily and I only had to use the Rescue inhaler rarely and the oral steroids when the seasons changed for a short time.
Now Fritz has been on only the oral as the inhaler was irritating his sinuses and his throat causing him not to be able to smell his food and throat irritation.
Hope this info helps!

 

[Pamela & Amethyst]

Thank you Amethyst has ben on the FLOVENT since she was 2. She needed the Albuterol in the hospital on Monday, but thank God very rarely Will the same thing happen to Amethyst over time with the inhaler use??? THanks

 

[DebG]

Will the same thing happen to Amethyst over time with the inhaler use??? THanks

Thankfully ECID you have no way of knowing some do great long term on the inhaler some kitties can't tolerate it from the beginning.
I found with Fritz that changing his litter box to the Breeze Litter system, no chemicals of any kind in our home, I run an air cleaner and a cool mist humidifier in the home 24/7, we don't smoke and we also don't use anything in the home that as a scent of any kind.
I know keeping the weight off and exercise help with asthma. My Fritz is 28lbs and it is difficult for him to exercise so I have a kitty treadmill that I walk him on daily.
Good luck with Amethyst I wish you both the best!!!! Any one disease is awful to manage but with our furbabies that have multiple health issues it is very draining and hard on them and us
to you both!!!!! It is manageable with a ton of work and trying different things you are at the BEST forum with all these beans and kitties!!!!!

 

[Pamela & Amethyst]

Yes I have changed our kitty litter to 100% dust and fragrance free I also play with both of them at least 30 minutes a day. I do not smoke nor wear any perfume. I have Asthma my self so I know how uncomfortable it can be. I am very grateful to everyone here. Thank you again

 

[Marvin's Mom - Nat]

I have a kitty treadmill that I walk him on daily.

Lol I would love to see a video of that

 

[Bobbie And Bubba]

Thankfully ECID you have no way of knowing some do great long term on the inhaler some kitties can't tolerate it from the beginning.
I found with Fritz that changing his litter box to the Breeze Litter system, no chemicals of any kind in our home, I run an air cleaner and a cool mist humidifier in the home 24/7, we don't smoke and we also don't use anything in the home that as a scent of any kind.
I know keeping the weight off and exercise help with asthma. My Fritz is 28lbs and it is difficult for him to exercise so I have a kitty treadmill that I walk him on daily.
Good luck with Amethyst I wish you both the best!!!! Any one disease is awful to manage but with our furbabies that have multiple health issues it is very draining and hard on them and us
to you both!!!!! It is manageable with a ton of work and trying different things you are at the BEST forum with all these beans and kitties!!!!!

Thanks Deb for weighting in! I knew you would know the answer!