8/9 Regs AMPS 289 +4 393 +6 379 Question about Lantus timing

[Britta and Regs]

Happy Sunday all,
I have a quick question. Would you have any idea why Regs glucose always goes super high after breakfast? When I see other spreadsheets most cats drop @+2/3/4 after the pre and for example Regs had a pre of 289 and at +4 he is at 393. Yes he is a good eater and has big 5oz breakfasts because he has to gain weight, but all food he is getting is low carb and I would still hope he drops a bit after all that food. Even during the day he stays high and most time drops a bit at the pm pre.

Plus his values are still super high, but sometimes he has the drops thats why our vet doesn't want to raise the Lantus dose, but I don't think that will bring him into mostly blues and greens.

Any opinion and advice is highly appreciated

 

[Connie & Parker & Moonie]

Honestly some cycles for Moonie are active and others aren’t. I’m not really sure why. Sometimes she goes up after a shot, sometimes she goes down. I think that’s unfortunately fairly common for most kitties.

Her evening cycles are also much more active than her morning ones. Kind of a blessing when I have to go to work, a curse when I have to sleep

 

[Marje and Gracie]

Happy Sunday all,
I have a quick question. Would you have any idea why Regs glucose always goes super high after breakfast? When I see other spreadsheets most cats drop @+2/3/4 after the pre and for example Regs had a pre of 289 and at +4 he is at 393. Yes he is a good eater and has big 5oz breakfasts because he has to gain weight, but all food he is getting is low carb and I would still hope he drops a bit after all that food. Even during the day he stays high and most time drops a bit at the pm pre.

Plus his values are still super high, but sometimes he has the drops thats why our vet doesn't want to raise the Lantus dose, but I don't think that will bring him into mostly blues and greens.

Any opinion and advice is highly appreciated

Can you tell me if you are doing SLGS or TR? Could you then, please, put it in her SS and your signature block? If she is eating any dry food at all, you must do SLGS.

Getting a +2 every single cycle that you are there gives us a great deal of info. You can’t really say ahead of time goes up if you don’t have a +2. We need to see if she is insetting and then heading back up and onset is usually around +2.

To understand her curves, you need to be able to identify tidy her onset, nadir, and duration but letting her go so long without tests makes that more difficult.

 

[Britta and Regs]

Can you tell me if you are doing SLGS or TR? Could you then, please, put it in her SS and your signature block? If she is eating any dry food at all, you must do SLGS.

Getting a +2 every single cycle that you are there gives us a great deal of info. You can’t really say ahead of time goes up if you don’t have a +2. We need to see if she is insetting and then heading back up and onset is usually around +2.

To understand her curves, you need to be able to identify tidy her onset, nadir, and duration but letting her go so long without tests makes that more difficult.

Hey Marje,

I think it's more SLGS but not really. Every Monday I text out vet the values from last week and every Monday she tells me what to do. Like last week she did not want to raise the dose, and then we had the crazy 77 amps that really freaked me out but the rest of the week is mostly in the 300. So not sure what she will tell me tomorrow. She is a very good vet but even she said do not give insulin if he is under 250. And Regs is my first sugar kitty so I'm super afraid doing anything wrong with him.

Regs does not get any dry food anymore, that made his glucose even spike so much more. But I found out that he is very sensitive to any carbs, so I try to stay as LC as I can be in his food.

I always assumes the +2 value was not important because it's right in the food spike, but you are right if I don't know where we are starting we can't really see how it is going during the cycle. It is just so confusing that most cats drop already at +2 or +4 and Regs sugars are just climbing like crazy. Next weekend I will make a tight curve and see how the numbers are during a whole cycle.

 

[Britta and Regs]

Honestly some cycles for Moonie are active and others aren’t. I’m not really sure why. Sometimes she goes up after a shot, sometimes she goes down. I think that’s unfortunately fairly common for most kitties.

Her evening cycles are also much more active than her morning ones. Kind of a blessing when I have to go to work, a curse when I have to sleep

But you have such beautiful numbers even I know that it was taking time to get to the greens and blues.
Regs cycles are just always going up and many many days the pres are the lowest point in our cycles. I know I should skip on some food, he is almost eating 12 oz per day but the vet said feed him as much as possible because he is underweight and to prevent ketones.

Right now neither is really working for me. I get up in the middle of the night to check on him and I come home in lunchbreak and measure his sugar and make him lunch. And watch him in the kitty cam when I am at work

 

[Wendy&Neko]

If you were following SLGS for dosing, that 77 you saw meant you should lower the dose by 0.25 units to 2.25 units. Any time they go under 90 you reduce. However, if you weren't sure that 77 was correct and seemed out of place, then checking a second time is a good idea.

To answer the question about why he rises high after breakfast, can you tell me what times he normally eats? I see one reference to a meal at PM+10. Is that normal feeding time?

 

[Britta and Regs]

If you were following SLGS for dosing, that 77 you saw meant you should lower the dose by 0.25 units to 2.25 units. Any time they go under 90 you reduce. However, if you weren't sure that 77 was correct and seemed out of place, then checking a second time is a good idea.

To answer the question about why he rises high after breakfast, can you tell me what times he normally eats? I see one reference to a meal at PM+10. Is that normal feeding time?

Dear Wendy,
Thanks once more for your help. It's nor really SLGS what we are doing but we stay on the same dose for 7 days , every Monday I communicate with our vet and send her the numbers and she tells me what to do. But she thinks very careful and I'm sure despite all the high numbers this week she will tell me to stay put on the dose because of the 77. And I'm too afraid of low numbers to change anything by myself because I don't know if he is in a giant bounce or if thats still the real value.

I always measure right before feeding Regs, and around 10-15 min later he is getting the Lantus. The feeding in the middle of the night was only because his numbers were dropping and I was afraid he would be low when measuring the morning pre.

 

[Marje and Gracie]

Dear Wendy,
Thanks once more for your help. It's nor really SLGS what we are doing but we stay on the same dose for 7 days , every Monday I communicate with our vet and send her the numbers and she tells me what to do. But she thinks very careful and I'm sure despite all the high numbers this week she will tell me to stay put on the dose because of the 77. And I'm too afraid of low numbers to change anything by myself because I don't know if he is in a giant bounce or if thats still the real value.

I always measure right before feeding Regs, and around 10-15 min later he is getting the Lantus. The feeding in the middle of the night was only because his numbers were dropping and I was afraid he would be low when measuring the morning pre.

I agree with Wendy that you should lower the dose. I would also try to stick to SLGS. We can help you with that; you don’t need your vet

 

[Britta and Regs]

I agree with Wendy that you should lower the dose. I would also try to stick to SLGS. We can help you with that; you don’t need your vet

Good morning, you replay think he is getting too much Lantus?

The glucose levels since last Tuesday are all in the high 200 and 300. I read the link, does that mean I keep him on the same dose 7 days and then do a tight curve every 2 hours? And adjust depending on the nadir?
To be honest, our vet is great but I know she doesn’t like diabetes kitties so I really appreciate all the help I get

My husband said this values are just how they are and he will be with this values for the rest of his life but I refuse to believe that!

 

[DexterMeowgan]

Good morning, you replay think he is getting too much Lantus?

The glucose levels since last Tuesday are all in the high 200 and 300. I read the link, does that mean I keep him on the same dose 7 days and then do a tight curve every 2 hours? And adjust depending on the nadir?
To be honest, our vet is great but I know she doesn’t like diabetes kitties so I really appreciate all the help I get

My husband said this values are just how they are and he will be with this values for the rest of his life but I refuse to believe that!

As someone who has had a cat go into remission not once, but twice, using the methods found here I can assure you that it can get better over time.

I personally follow SLGS, and it used to be a task I'd have to negotiate with my partner who gives him insulin not to listen to the vet but we've accustomed.

High 200s and low 300s is expected as their body still isn't making the right amount of insulin to counteract their food and you are feeding them far more than needed to maintain their weight.

I noticed your spreadsheet they went from 500s to 300s preshot within the last 5 days. This dose, or 2.25U, would be my recommendation.

 

[Britta and Regs]

As someone who has had a cat go into remission not once, but twice, using the methods found here I can assure you that it can get better over time.

I personally follow SLGS, and it used to be a task I'd have to negotiate with my partner who gives him insulin not to listen to the vet but we've accustomed.

High 200s and low 300s is expected as their body still isn't making the right amount of insulin to counteract their food and you are feeding them far more than needed to maintain their weight.

I noticed your spreadsheet they went from 500s to 300s preshot within the last 5 days. This dose, or 2.25U, would be my recommendation.

Thank you so much for your response.
You got two kitties into remission? That is awesome, I did not know that there is really such a big success rate.

When he had the high values was when I did not give him the Lantus am and pm I was so nervous and he felt that I think he got a fur shot since I could smell Lantus everywhere after.
I always thought values in the 300 are really damaging for the organs and make neuropathy not speaking about dka risk, so I thought if I would lower his dose his values would go back in the 400, but then I still don’t know why he was so low this one morning!

Regs is a Maine coon Persian mix and before it all started he had over 15 lbs, not we got him back up to 11.7 but he still is very skinny. Could the high values be that the insulin can not keep up with the food?

 

[DexterMeowgan]

The same cat slipped out, and we got him back into remission in 2023.

Honestly, you are trying to offset a large amount of calories sure but if the cat is that big they may require that just to survive and are actually burning it instead of raising blood sugars too much.

If I were you, I'd read into the SLGS method they mentioned as that's what I'm following. We're currently trying our first reduction from 2 to 1.75 units twice daily and he's bouncing.

Cats can do multiple strange things, including bouncing high and falling super low, when their blood sugars are trying to be regulated.

 

[Britta and Regs]

The same cat slipped out, and we got him back into remission in 2023.

Honestly, you are trying to offset a large amount of calories sure but if the cat is that big they may require that just to survive and are actually burning it instead of raising blood sugars too much.

If I were you, I'd read into the SLGS method they mentioned as that's what I'm following. We're currently trying our first reduction from 2 to 1.75 units twice daily and he's bouncing.

Cats can do multiple strange things, including bouncing high and falling super low, when their blood sugars are trying to be regulated.

You got the same cat into remission twice? so glad for kitty that it worked.
I thought they are just bouncing when they go too low or do they always do that when you change the dose? I really wish I would have more knowledge about diabetes....

I read about the SLGS and I think that could be a great thing for us that we do not have to contact the vet every time and she is very conservative in her opinion.

Regs glucose levels are so good today, for him good, I wonder if he could have been in a giant bounce since he had the 77 morning. But I'm really unsure if I should start with 2.5 or 2.25, if I would stay on 2.5 I could do a curve on Saturday and see where we are. but the 2.25 would be much safer but he would go back into the 400 for some time. Regs even got a small afternoon snack because he was so hungry, poor guy really needs to gain, he is a big cat but even with that he is super carb sensitive

 

[DexterMeowgan]

I honestly would post here daily and follow the advice here if you're comfortable. Your vet is always good to follow up with, too, but the day to day here is a lot of knowledge and help we can offer.

Since they fell to 70, I personally would reduce to 2.25 myself. I just did that for Dexter yesterday.

He very well may bounce or the dose doesn't hold initially, it's important to monitor and keep the same food daily too and note any treats or snacks and how they affect the readings.

Instead of giving them certain ounces, have your checked the calories in each container?

You can be feeding 15 ounces and it not be enough to get to 15 lbs.

For instance, both of my cats have 3 ounce cans of food. One has 97 calories, we feed 3 cans a day to maintain roughly 270 calories for 13 pounds. He's slightly overfed when he only needs 20 per pound.

The other is 10 pounds but only getting 6 ounces or 2 cans of food due to high calorie and carb content.

 

[Britta and Regs]

I honestly would post here daily and follow the advice here if you're comfortable. Your vet is always good to follow up with, too, but the day to day here is a lot of knowledge and help we can offer.

Since they fell to 70, I personally would reduce to 2.25 myself. I just did that for Dexter yesterday.

He very well may bounce or the dose doesn't hold initially, it's important to monitor and keep the same food daily too and note any treats or snacks and how they affect the readings.

Instead of giving them certain ounces, have your checked the calories in each container?

You can be feeding 15 ounces and it not be enough to get to 15 lbs.

For instance, both of my cats have 3 ounce cans of food. One has 97 calories, we feed 3 cans a day to maintain roughly 270 calories for 13 pounds. He's slightly overfed when he only needs 20 per pound.

The other is 10 pounds but only getting 6 ounces or 2 cans of food due to high calorie and carb content.

Does it not bother all the regulars if I start posting Regs glucose levels every day?

I honestly have not checked calories. I always was just looking at the carbs to make him stay on LC food. But that is a great idea I will start doing that, at least to known what range his usual foods are that he is getting all the energy he needs.

Even I hate the idea of him having higher blood glucose for a while I rather want him safe so I think I will stick with the recommendation you, Marje and Wendy gave and give him a only 2.25 units. Especially because he is suspiciously stable in the 260th this afternoon even after a snack and I really dont need him to drop at night again. But for the curve I would have to wait to next weekend because I guess this Sunday would be too soon.

 

[Marje and Gracie]

Good morning, you replay think he is getting too much Lantus?

SLGS is a lot less aggressive approach to regulation and holding doses for a week is consistent to SLGS. It has the caregiver (CG) reducing the dose for a drop below 90 as Regs did.

Cats do better if there is a specific method to regulation and we use either SLGs or Tight Regulation for Lantus and similar insulins.

So, no, I don’t think Regs is getting too much insulin. If you were doing TR, her BG would need to drop below 50 before reducing.

In the post I linked about SLGS, it also discusses TR. You can easily switch to it, if you wish. Just let us know.

Does it not bother all the regulars if I start posting Regs glucose levels every day?

We actually prefer you post every day