9/28 Olive-Feeling frustrated over constant bouncing/ Which is better: TR or SLGS?

[OlivesMom]

https://www.felinediabetes.com/FDMB/threads/9-27-olive-amps-482.236007/

It's 2 hours before her AM injection and I should be in bed until then. Instead, I'm feeling so frustrated at this time I just needed to get on here and blow off some steam. I was finally able to shoot lower at the PM injection last night then her BG has allowed in days (232) and I was so happy about that. I thought she would have a great cycle that ended in great numbers that would allow me to be able to shoot lower than her average lately once again. But no. Here it is +10 and she's doubled since +7. She's already at 489 with 2 hours to go before the AM injection. I just don't get it. I don't understand why she keeps bouncing like this. Well, I should try and get a bit more sleep before the shot. Thanks for listening to the rants of this tired mom.

 

[OlivesMom]

I just found this website and here's the information on Lantus for those who haven't see it. One thing I read that stood out to me that I've been doing wrong is it says, "When you dose Lantus, after pushing the plunger down, you should leave the needle in place and slowly count to ten before removing it. When you have removed the syringe, gently apply some pressure to the spot for a few seconds. You should NOT rub the area as that will damage the Lantus molecues." I usually rub the injection area for Olive for a second or two just to get her mind off the sting I know I would feel if it were me. So I'm going to immediately stop doing this. I'm also NOT leaving the needle in for 10 seconds before I pull it out. Also, I wonder even more so now if her insulin needs increased. This is what it says:
Starting Scale for Lantus (After 24-hour Detox):

Imperial BG……….Metric BG………..Dose of insulin
150 – 250…………..8.3 – 13.9……………….0.25u
251 – 400………….14.0 – 22.0………………0.50u
400 +………………..22.2 +……………………0.75u

Dosing Criteria for Lantus:

The dosing criteria to be able to give insulin for Lantus (all criteria need to be in place) :
• A minimum of 10 hours since the last dose of insulin
• A BG of a minimum of 150/8.3
• A BG that is rising if it is between 150/8.3 and around 225/12.5: if the BG is higher than this it is more important that the cat gets the insulin it needs to bring its BGs down to normal numbers and to maintain overlap

It's always the last part of the cycle where she rises rapidly and I'm always thinking to myself at +10 if only I could give her another injection I might ward off the numbers from going so much higher by +12. It's crazy, but it always seems Olive needs a shot at least every 10 hours and not every 12. I've never done that, just to confirm. I know NOTHING about TR either as I've never researched it. The SLGS method just sounded like the best from the moment I did read that one. Would Olive do better on TR than on SLGS? Or is it just that either her diet isn't right or she's not getting enough insulin?
It is important to note that I can't really use the data I collected on Olive's SS before the 2nd cycle on 9-22-20 since I was using a different syringe brand that wasn't maintaining the correct and consistent insulin dose that I now have since switching to the Relion syringes. And I'm now feeding the bulk of her carbs during the first half of the cycle and the lower amount of carbs for the second half.





http://www.diabeticcatinternational.com/knowledge/insulin-information-scales/
Lantus (Glargine)
General Information

Lantus/Glargine is a U100 human insulin that is therefore dosed with U100 syringes. Glargine is the actual name of the insulin; it is sold under the brand name Lantus.

Lantus is available in 10ml vials or 3ml cartridges or pens. Cartridges are not available in the US. If you have Lantus pens you still need U100 syringes (3/10cc-0.3ml U100 syringes with half unit markings). The pen itself only doses 1u increments. You will need to draw the amount of insulin you need to dose from the cartridge that is in the pen. The top of the cartridge (the rubber stopper) is visible when you take the cap of the pen off. That is where you need to insert the syringe to draw insulin.

If you live in a country where cartridges are available that is recommended. The cartridges cost more… but there is less chance of insulin losing potency vs. the vial as there is less insulin contained in a cartridge, so it will be used more quickly. With the small doses we do use with our cats (vs much higher human doses) we do not go through a vial as quickly as people do. There is therefore much less waste with the cartridges (or pens) vs. the vial.

Lantus is available at any pharmacy or chemists and will probably be less expensive there than if you buy via your vet. If you are in North America, purchasing at Wal-Mart or Costco is probably the cheapest option.

The insulin in the vial or cartridge should be clear. If you see crystals developing, you should discard the vial or cartridge and start with a new one.

Lantus is a long lasting insulin: Onset (when the insulin starts working) is usually around +3-+4. Nadir (when it is strongest and the BG lowest) tends to be around +6-+8 for most cats. It starts wearing off around +8-+10.

Ideally when starting TR at least, +10 dosing works best with Lantus: that timing makes the best use of overlap between the two doses of insulin. A +10 schedule is though very difficult to keep up for most people with professional or other obligations. +12 dosing is possible; it may take a little more time for your cat to become regulated. If you are unable to dose +10 on a regular basis, doing so over weekends/days off and using a +12 base during the week/when you are working is also a strategy that some members have used successfully.

Each insulin has its own challenge… the biggest challenge with Lantus is the way it works. When you inject Lantus it creates a depot under the skin. Insulin is then released over time from there.

Because of the strong depot characteristics of Lantus, it takes 3, or for some cats even 4, doses before you see the full effect of any changes to what you are doing or what has happened (scale adjustments, a longer duration between shots, etc). You do not see “instant” results with lantus.. patience is required!

Lantus is a powerful insulin, and small adjustments may make a big difference. Dosing adjustments are therefore usually made by small increments (0.25u, 0.125u – also known as a fat). Depending on your cat’s results, a larger increase may be suggested. Senior Members will help you with what is best for your cat.

When you dose Lantus, after pushing the plunger down, you should leave the needle in place and slowly count to ten before removing it. When you have removed the syringe, gently apply some pressure to the spot for a few seconds. You should NOT rub the area as that will damage the Lantus molecues.

Starting Scale for Lantus (After 24-hour Detox):

Imperial BG……….Metric BG………..Dose of insulin
150 – 250…………..8.3 – 13.9……………….0.25u
251 – 400………….14.0 – 22.0………………0.50u
400 +………………..22.2 +……………………0.75u

Dosing Criteria for Lantus:

The dosing criteria to be able to give insulin for Lantus (all criteria need to be in place) :
• A minimum of 10 hours since the last dose of insulin
• A BG of a minimum of 150/8.3
• A BG that is rising if it is between 150/8.3 and around 225/12.5: if the BG is higher than this it is more important that the cat gets the insulin it needs to bring its BGs down to normal numbers and to maintain overlap

 

[Sue and Luci]

Good Morning,

I want to take a moment and share a couple of points with you.

You're only six weeks into this...and this is a long long journey. Many call it a marathon, not a sprint. You're going to need several pair of patience pants - lots of people do. We go into this thinking, ok, sure, a few shots of insulin and everything will be fine. I for one can tell you, it's not gonna happen like that. Regulating cats can be quite challenging...and can take, in some cases, years.

So relax, take a deep breath and kick off your shoes..you're going to be here for a while.

Olive is bouncing. Since you're reading up - look into bouncing. It's a completely normal reaction and it takes time for kitties to stop bouncing and level off. Lantus and Levimer are insulins that are known to bring about flat smooth cycles with minimal bouncing - but that takes TIME! Lots of time...

When Olive hits lower numbers like those blues she hit the other day - this is so foreign to her body that her liver with all it's stored up glycogen perceives this as an emergency and dumps it's load of stored sugars into her bloodstream...when the numbers are high like that you can ease off on the testing. It can take up to 3 days for a bounce to clear.

You'll start to see that improving over time...and cats will clear the bounces faster as they become more accustomed to better numbers and at some point won't have them at all...

In the early days you'll have to sort out calipers, food, etc. These are the early days...try to relax and go with the flow...you're doing a great job - just try not to obsess...(I'm a great one for that...my boss says I'm the only other person he knows that obsesses as much as he does)...

Hang in there

 

[OlivesMom]

Thank you for the pep talk. I needed that. I've always been an obsessor when it comes to things that need fixed. When there's a problem I want to fix it NOW. I've never been a procrastinator. So this isn't easy for me by any means. There's never been a problem in my life that I haven't turned the world upside down until I've found a way to resolve or at least help it. I can relate to you and your boss. So all this is NORMAL?! Well, that make me feel a little better, but it can take years in some cases? OMG. I'm terrified she's going to go blind or end up with diabetic neuropathy before I can manage to help her. I'm afraid the more time she goes unregulated like this that she'll never go into remission later. It scares me.

You'll start to see that improving over time...and cats will clear the bounces faster as they become more accustomed to better numbers and at some point won't have them at all...

Now that's something I can hold on to...knowing things will slowly improve over time. And yes, the next thing I'll research is bouncing. I really want to thank you for all your feedback and words of encouragement. If anything, I feel a lot calmer now. So I think I'll go back to bed and get in some sleep before +3. Thank you!

 

[Olive & Paula]

Olive is bouncing from the blues she had. Some cats always bounce until they start staying steady in blues. Some never stop bouncing. The bounces do get lower though and end quicker.

I never understood the 0.01 dose you were giving. With TR you can raise the dose every three days. Minimum 4 tests a day. You are testing enough for TR.

Lantus pens are your more economical choice. You get a total of 15 ml when you get box of 5 pens. The bottle only had 10 ml. If you break a bottle you don't normally have a back up and kitty goes without until you get another. With pens you always have a fresh one available and very little chance of breaking it. Marks Marine in Canada is the most affordable, under $200 for 5 pens.

Everyone has their own preference for syringes. I preferred monoject short needle from ADW. They were very consistent in markings, however, I used calipers regardless of dose. It certainly easier to see at the crack of dawn when your half asleep.

My Smokey was diabetic 6 yrs when I took him in. He had a long interruption of not receiving insulin from previous owner. My Ollie was just not going to be regulated. When you thought finally she is staying steady, wham, p'titis would hit and back up we go. You just have to go with the flow, Olive is the leader.

I do think you are ready for an increase once this bounce clears. Use the bounces to get more sleep, and errands done. It's the time for pokie breaks for her.

 

[Butters & Lyla]

Hi Mom to Olive! You are doing amazing. The care you are giving her is very admirable.
So great you are doing so much research, although I do find some of it a bit confusing...is what you quoted somewhere on the FDMB site? I've just never really heard of people here doing a +10 cycle of dosing, but I acknowledge I have not read everything that there is to read!

When you ask whether SLGS or TR is "better", what do you mean by "better"? SLGS is a dosing method and TR is a published protocol. TR is more aggressive with increases and works to get a cat regulated sooner and hopefully into remission. It requires far more BG testing than SLGS. And TR is not for the faint of heart, in my experience. Since you like to read, here is a link that gives you some background on TR and more detail into it. https://www.tillydiabetes.net/en_index.htm

As @Sue and Luci said, FD is definitely a marathon and requires patience pants. I have a couple of suggestions for you:

Your signature & SS says you are doing SLGS. Maybe you want to consider switching to the TR protocol? Review the dosing methods sticky and have a think about whether TR would be a better fit for you and Olive, now. You are certainly doing more than enough testing for it. TR allows you to take increases as soon as every six cycles provided Olive's BG numbers are inline with the rules for increasing.

Study as many spreadsheets as you can. While Every Cat is Different (ECID), you are sure to spot some commonalities such as bouncing. I usually have four or five kitties' spreadsheets open on my computer at any given time, as well as another five browser tabs with important info from stickies or other posts. It helps to keep re-reading information over and over again, especially in the early days. It doesn't matter how many times I have read a sticky, I always find a new nugget of info that makes me think.

Give yourself a break . These are indeed early days and you need to be prepared to be in this for the long haul. Make sure you get sleep when Olive is bouncing. Because when she is not bouncing there will be no sleep (or very little), so stock up on it now.

 

[JOJI and Kit]

slgs vs tr

in addition to what lyla said above, you'll hear folks say that the decision between the two is also a lifestyle choice for the care giver and that you can try one and try the other.
we started on slgs because, tbh, it seemed "less scary" to us. i'm trying to recall why exactly that was, and i think it had to do with shooting lower numbers. well, after about 2 weeks we decided to try tr because we were already testing enough for that method and eventually we had enough data to get comfortable with shooting "those greens" all with significant support (i.e. hand holding) of people here. so the answer is that there really is no right, or wrong. you can try one on and if it doesn't fit, you can return it.​

other thought

a wise member here once told me that you need to be part scientist and part detective on this journey. so, data, protocols, reading and figuring out what your own cat is likely to do in response to things like what food when, reductions, etc. and, slowly over time you will become comfortable with the different scenarios that olive challenges you with. ​

^jw​

 

[OlivesMom]

I never understood the 0.01 dose you were giving. With TR you can raise the dose every three days. Minimum 4 tests a day. You are testing enough for TR.

I know, it has confused everyone. I'm sorry. Here's what happened: We'd been using Walgreens syringes from day one without realizing that the stamped zero lines were NEVER in the same spot twice. When Olive started going too low it was suggested we decrease her insulin which we did. We took her down to .25. So this is when things got really chaotic because we were going by the syringe marks and then guessing where the quarter unit would be. Olive was still dropping too low so it was suggested we drop her down to 0.01 being just a drop of insulin to see how she'd do on that amount. When she was still all over the map we bought a caliper. Little did we know that the caliper was faulty and it didn't matter how many tests my husband and I did with the thing, we always hit the same spot on the syringe at the 0.01 line according to what the digital caliper reading was telling us. So I'd always place the upper caliper arm up against the underside of the "brim of the hat" as I called it...the lip of the syringe. So I KNEW that Olive was always getting the same amount of insulin because of this....or so I thought. We noticed something odd and tested something like 20 syringes and discovered that not only was the stamped zero line NOT actually at or near zero, but that some of the necks on these syringes (the part that meets the underside of the "brim of the hat" weren't even in the same spot. So once again we knew we still weren't measuring the same insulin each time. I'd had enough. Once the Walgreens syringes were almost gone we bought Relions at Walmart. I bought a second caliper too. After testing 20 of the Relion syringes we realized they were in fact tons more accurate. We figured out the average and set the new caliper. When we compared the two calipers, the new caliper was telling us that the old caliper's 0.01 readout was in face closer to the half unit mark (0.5). It was a skinny half, but very close. Since we'd had a month of filling those walgreens syringes under our belt, we were wiser now. The new caliper was right in line with the actual stamped lines on the Relion and so we now KNEW that from that point forward Olive was going to get the exact same amount of insulin because the Relion syringes have a zero line you can actually SEE so I simply put the calipers arm in line with that and regardless of what's stamped on the syringe, Olive gets 0.5 units of insulin twice a day. It's wonderful. The only thing I'm still dealing with are air bubbles with every syringe I fill and I firmly believe it was the lack of knowledge from this one vet tech that messed my insulin pen up and put air into it because I didn't have a problem until then. So now you know the story behind the 0.01 and even the .25.

Lantus pens are your more economical choice. You get a total of 15 ml when you get box of 5 pens. The bottle only had 10 ml. If you break a bottle you don't normally have a back up and kitty goes without until you get another. With pens you always have a fresh one available and very little chance of breaking it. Marks Marine in Canada is the most affordable, under $200 for 5 pens.

Lantus pens are what I've used from the beginning. I paid $90 for it. Ouch! Is it possible to buy the lantus pens through Canada from America? What savings that would be.

I do think you are ready for an increase once this bounce clears

So do I. I'd want to increase it slowly. How much are you guys thinking?

Hi Mom to Olive! You are doing amazing. The care you are giving her is very admirable.

Thank you. Appreciate that.

When you ask whether SLGS or TR is "better", what do you mean by "better"? SLGS is a dosing method and TR is a published protocol. TR is more aggressive with increases and works to get a cat regulated sooner and hopefully into remission. It requires far more BG testing than SLGS. And TR is not for the faint of heart, in my experience

You see, I learned something new today. I was somehow thinking SLGS and TR were two different ways of shooting but you say one is a dosing method and the other a published protocol. TR not for the faint of heart, eh? Then I don't think I'm ready for that. I've been working hard to drop my anxiety level down and I don't need anymore stress right now. I read through the stickie on it but it just seemed very confusing to me. Of course, I was tired too as it was the middle of the night. lol.

o the answer is that there really is no right, or wrong. you can try one on and if it doesn't fit, you can return it. other thought
a wise member here once told me that you need to be part scientist and part detective on this journey. so, data, protocols, reading and figuring out what your own cat is likely to do in response to things like what food when, reductions, etc. and, slowly over time you will become comfortable with the different scenarios that olive challenges you with.

That makes me feel better too. I just don't want to do anything to jeopardize Olive's progress. It's nice knowing I have another option with TR if that ends up being something we gravitate towards later. part scientist and detective....I had to smile at that statement as I already wear so many "hats" that I wonder how many more I can stack on. lol. It's sound advice. Thank you!

 

[Red & Rover (GA)]

Lantus pens are what I've used from the beginning. I paid $90 for it. Ouch! Is it possible to buy the lantus pens through Canada from America? What savings that would be.

You need a written prescription from your vet that you can fax. Many people here buy their Lantus from Mark's. It is a reputable business. It even has a storefront that one of our members has visited.

• Ordering Lantus, Basaglar, or Levemir from Canadian pharmacies

 

[OlivesMom]

You need a written prescription from your vet that you can fax. Many people here buy their Lantus from Mark's. It is a reputable business. It even has a storefront that one of our members has visited.

• Ordering Lantus, Basaglar, or Levemir from Canadian pharmacies

Thank you so much for this information. It makes me feel better knowing one of the members has actually visited their store.

 

[Red & Rover (GA)]

Thank you so much for this information. It makes me feel better knowing one of the members has actually visited their store.

Storefront

 

[Butters & Lyla]

You see, I learned something new today. I was somehow thinking SLGS and TR were two different ways of shooting but you say one is a dosing method and the other a published protocol. TR not for the faint of heart, eh? Then I don't think I'm ready for that. I've been working hard to drop my anxiety level down and I don't need anymore stress right now. I read through the stickie on it but it just seemed very confusing to me. Of course, I was tired too as it was the middle of the night. lol.

Just my opinion, tbh. The reason I say TR is not for the faint of heart, is, as jw pointed out, you shoot lower numbers. With TR you can shoot insulin with a preshot number as low as 50, but on SLGS the cutoff number is 90, I believe. I had to get over shooting as low as 50, but once I did it a couple of times with support from people here, I since do it without batting an eye. If you are thinking of TR at some point, this sticky on shooting lower numbers is a must-read. The TR mantra is "shoot low to stay low".

As jw said, whichever you choose now, you are not beholden to it. You can change your mind anytime.

Reading stickys over and over, and over again, is pretty much a must-do IMO. I still ask questions about how to interpret parts of the TR protocol. I find it to be quite nuanced. But there is an experienced community here, willing to support you and answer your questions if you do change your mind.

 

[OlivesMom]

s jw said, whichever you choose now, you are not beholden to it. You can change your mind anytime.

I really like the sound of that. I had thought from the start that I had to pick one method or the other. This is quite nice to know. I, too, and forever going over the stickies. I have had Olive's SS and this website on tabs at the top of my computer screen since the beginning too so it's always there and accessible.

Just my opinion, tbh. The reason I say TR is not for the faint of heart, is, as jw pointed out, you shoot lower numbers. With TR you can shoot insulin with a preshot number as low as 50, but on SLGS the cutoff number is 90, I believe. I had to get over shooting as low as 50, but once I did it a couple of times with support from people here, I since do it without batting an eye.

That's been my feelings too. Olive's first "low" number (low for me) I shot at was 154 and I wanted to puke. lol. That went really well and so I shot 130 the next available time and I still wanted to puke, but I felt easier about it. If she'll ever come down enough for me to shoot low again then I'll still be concerned but not nearly as much as the first couple times. So I can understand how you don't even bat an eye at it now.

 

[Wendy&Neko]

TR not for the faint of heart, eh? Then I don't think I'm ready for that. I've been working hard to drop my anxiety level down and I don't need anymore stress right now. I read through the stickie on it but it just seemed very confusing to me.

I too started on SLGS, for a few days at least. I too was nervous - but the impatient part of me looking at my cat in high numbers got me over my fears. That plus I started reading all the posts from other people, specifically how they managed low numbers, and how other members jumped in to help. That taught be a lot about how to handle the situations I was afraid of. My impatient self couldn't wait a week with no improvements before changing the dose. It really helps to look at other people's spreadsheets. The other thing, you aren't stuck with a dosing method, unless you are feeding high carb or dry food. You can always try one for a while then move back if you want.

Cats don't go blind from high blood sugars, that's a dog thing. However, long term high blood sugars can be damaging to organs and other parts of the body that are not getting the nutrients they need. Olive is seeing some nicer numbers, so her body is getting a bit of a break. Unfortunately, the nice numbers are only for a short while before she off and bounces again. That is completely and utterly frustratingly normal at the beginning. If I had a dollar for every new member who said "cats numbers are all over the place" or "how do I stop bouncing", I'd be rich.

I live 25 minutes drive from Marks - I haven't visited in there cause I have no need to, but it's a regular pharmacy.

Don't believe everything you read on that other website. There's a few beliefs in handling low numbers we don't agree with. Cats will get longer duration as they get to a better dose. Shooting every 10 hours is really hard on the caregiver. There is only one published TR protocol, and that's what we use here as does the German Katzen forum (tilleydiabetes site). Some other sites call theirs TR but it's not the same thing.

No one leaves the needle in either.

You need to get more sleep. Trust me, feline diabetes is hard emotionally especially when new, and also physically if you aren't getting the sleep your body needs. If Olive isn't in the greens at night, force yourself to go to sleep. There will be times you need to stay up, but probably not tonight. Get a before bed test and if unsure, post to see if you are done for the night.

 

[OlivesMom]

Question: Is Vitamin B12 okay to give to Olive even if her lab work hasn't stated she's deficient? I know the cats pee out any excess, so I was curious as I have some on hand from when I had my Sophie.

Cats don't go blind from high blood sugars, that's a dog thing

Oh! That's so good to hear. That's one thing the BAD vet said could happen which freaked me out. I'm so glad we fired her.

Unfortunately, the nice numbers are only for a short while before she off and bounces again

I know I don't have a clue how to shoot TR even though I read it several times (lol) and although I'm super happy to know I can switch at any time, I would love everyone's opinions on what YOU would do if Olive was your cat and you were seeing her numbers like this day in and day out. Would you continue to give it time, let her new diet work, and maybe increase her insulin a smidge? If it's just a matter of being patient I can work on patience...(I think) and wait and see how things play out over the next few weeks.

Cats will get longer duration as they get to a better dose.

Meaning an insulin increase? I've heard sometimes it takes very a very little adjustment to make a big impact.

You need to get more sleep.

I know. I haven't been feeling up to par these days. It's all been so draining. One really strange thing that has been happening since I've been up with Olive much of the night is that I find I'm cold all the time once I lay down and I cannot get warm even under an electric throw blanket. It's weird. I simply turn into an ice cube the moment I lay down.

 

[JaxBenji]

I just wanted to chime in on Mark's - they are the nicest people. Call them. They will tell you everything to do to get an order. One thing to keep in mind is that you cannot transfer a prescription from the US to Canada. Your vet has to write a new prescription for them like @Red & Rover (GA) said. The sweet people at Marks faxed a prescription over to my vet to sign off on (because my vet wouldn't initiate it..? IDK about my vet lol - BUT I had called my vet already and he was on board with getting insulin anywhere I wanted). Once Marks got the prescription, they called me and let me know - I called back and said to please fill it and we discussed shipment and all that jazz. I paid for upgraded insulation kit (you may not need the upgraded kit if temps have cooled down where you live) and my total was $204.99 for 5 pens. A signature is required to accept delivery but if you know your postman then he'll leave it (final delivery for me was by USPS)

 

[Wendy&Neko]

There is no difference for shooting TR. The differences are in how quickly you can increase the dose, what criteria you use for an increase, the amount of testing needed (you are hands down OK on that one!!), and the point at which a reduction is earned.

Meaning an insulin increase? I've heard sometimes it takes very a very little adjustment to make a big impact.

If you were following TR, you would do a 0.25 unit increase now. More insulin tends to help reduce the height of the bounces, plus it allows them to spend more time in normal BG numbers. It is spending time in normal numbers that allows their body to get used to them, and hence to reduce the bounces. Remember, bouncing is a reaction to numbers lower than they are used to.

What is the purpose of giving B12? I wouldn't give a med that's not needed. Is it methyl B12?

 

[Lisa & Oberon]

I just found this website and here's the information on Lantus for those who haven't see it. One thing I read that stood out to me that I've been doing wrong is it says, "When you dose Lantus, after pushing the plunger down, you should leave the needle in place and slowly count to ten before removing it. When you have removed the syringe, gently apply some pressure to the spot for a few seconds. You should NOT rub the area as that will damage the Lantus molecues." I usually rub the injection area for Olive for a second or two just to get her mind off the sting I know I would feel if it were me. So I'm going to immediately stop doing this. I'm also NOT leaving the needle in for 10 seconds before I pull it out.

Just curious about this part, because I don't think I've seen anyone address it. I've been doing the same thing- I don't leave the needle in for long and I rub the area a little (mostly to check for a fur shot; I then sniff my fingers to see if I smell any insulin). Is this something to be seriously concerned about, or is it "best practice" but not that big a deal?

 

[Wendy&Neko]

This post by @Sienne and Gabby (GA) describes why you don't rub the injection site.

 

[OlivesMom]

What is the purpose of giving B12? I wouldn't give a med that's not needed. Is it methyl B12

I just heard it's good for diabetic cats is all. No, it's not Methyl B12.

If you were following TR, you would do a 0.25 unit increase now. More insulin tends to help reduce the height of the bounces, plus it allows them to spend more time in normal BG numbers. It is spending time in normal numbers that allows their body to get used to them, and hence to reduce the bounces.

I'd love to try that just to see what would happen. You still have to do all these at the same beginning and end of the 12 hour cycles. correct? So if I wanted to try the 0.25 increase I'd wait until her next cycle 5 hours from now, right?

I just wanted to chime in on Mark's - they are the nicest people. Call them.

Thank you for adding your voice as well. I will call them and see about getting this ball rolling before the colder weather hits here in Wisconsin. I don't want to have to worry about it freezing.

Just curious about this part, because I don't think I've seen anyone address it. I've been doing the same thing

I'm high-fiving you. I was told not to believe everything we read out there, so I think you and I are OK. I tried leaving the needle in at her AM injection and she HATED me. I think as long as we've fully pressed on the plunger to inject everything possible that we're fine. I'm also feeling for something wet on her fur when I rub the spot but THIS has been a major no-no on my part as I've come to learn.

 

[Lisa & Oberon]

This post by @Sienne and Gabby (GA) describes why you don't rub the injection site.

Thanks! I'll change what I'm doing. (And totally kick myself if it somehow turns out that Oberon's high numbers are because I've been Doing It Wrong.)

 

[OlivesMom]

Thanks! I'll change what I'm doing. (And totally kick myself if it somehow turns out that Oberon's high numbers are because I've been Doing It Wrong.)

Don't feel too bad as I've been doing wrong too and my girl has had nothing but high numbers. I didn't read the insert to my Lantus S Pen because I was dosing a cat and I didn't think it mattered what it did to humans knowing cats are a different species. Here's a hug. We know now and now we can move forward. On second thought, maybe I should wait a week more before I mess with Olive's insulin due to the fact I've been injecting wrong all this time. Curious to see how the numbers look once I do it right.

 

[Olive & Paula]

With my first cat I did SLGS. Frankly because I was afraid of TR. Why I don't know. I worked full time, then Sundays were spent at home doing the curve. So only had Saturday to get errands done.

With Ollie I went straight to TR. Though it proved to not be enough so with help here it was modified a bit. Learned the reason was because of acro, so whole mindset changes and things tweaked a bit more. I actually think TR is easier if you test enough. Once Ollie started moving, I knew I had to test anytime I walked out the door. Sometimes I had to stay home. Then it changed where I had to stay home until +4. Always got a before bed test so I knew she was safe and I could sleep.

You will adapt to to what Olive's readings are. It will change at times, that is for sure.

 

[Wendy&Neko]

n second thought, maybe I should wait a week more before I mess with Olive's insulin due

No, rubbing can impact duration, you don't need to linger an extra week at this dose.

 

[Wendy&Neko]

I just heard it's good for diabetic cats is all. No, it's not Methyl B12.

Diabetic cats with neuropathy get methyl B12. Otherwise it's not something that necessarily helps if her blood work shows her B12 levels are fine.

 

[OlivesMom]

No, rubbing can impact duration, you don't need to linger an extra week at this dose.

Can you please say that again?

 

[OlivesMom]

Diabetic cats with neuropathy get methyl B12. Otherwise it's not something that necessarily helps if her blood work shows her B12 levels are fine.

Okay. Gotcha!

 

[Wendy&Neko]

Did you check out the post I linked. That explains what rubbing does to the Lantus crystals.

 

[OlivesMom]

No, rubbing can impact duration, you don't need to linger an extra week at this dose.

Are you saying I don't have to wait another week to increase her insulin a bit?

Did you check out the post I linked. That explains what rubbing does to the Lantus crystals.

I saw it, yes. Which is why I'll NEVER do that again.

 

[Wendy&Neko]

If you are following TR now, you can increase by 0.25 immediately.

 

[OlivesMom]

If you are following TR now, you can increase by 0.25 immediately.

Oh, TR. I'm confused, sorry. With TR you STILL have to wait until +12 to give the injection, correct? At which time if I were following TR I would increase her insulin from the 0.50 she's on now to 0.75, right?

And if I remain SLGS then I would stay at 0.5 for another week to see how her numbers balance out by then? Sorry, I feel quite stupid right now.

 

[Jane and Ragnar]

I think it is easy to confuse instructions for the Lantus pen vs using a syringe. The pen instructions call for holding the needle in place for 10 seconds because the mechanics of the pen are such that it may take that long to push the full dose out through the needle. This is NOT the case for insulin injected by syringe and needle. There's no need to leave it in place after fully depressing the plunger on the syringe.

 

[Olive & Paula]

Oh, TR. I'm confused, sorry. With TR you STILL have to wait until +12 to give the injection, correct? At which time if I were following TR I would increase her insulin from the 0.50 she's on now to 0.75, right?

And if I remain SLGS then I would stay at 0.5 for another week to see how her numbers balance out by then? Sorry, I feel quite stupid right now.

You would increase dose at next shot time if doing TR.. If doing SLGS you keep dose for 7 days (14 cycles). Then do curve. You would not keep this dose another week unless the curve shows otherwise.

 

[OlivesMom]

Ok, makes sense now. I think I'll try the TR another time and remain on the SLGS for now. But I think I'm going to bump her up a little to a fat 0.5 for her PM shot in an hour and keep her on a fat half unit for a week to see if it makes any difference. I did test her on the hour leading up to +12 to see exactly when she started the climb back up. I think it helped this morning NOT rubbing the injection site.

 

[Si am cat mom]

We've been at this for like 10 months. Had great regulation- lost it for 5 months and are just getting back into some better regulation. You just have to remind yourself that this takes time and patience.
I've never been able to do TR because of my work schedule, so I agree with the post about how your lifestyle and your cat tend to decide what you do as far as dosing methods and feeding schedules.
You do what you can- when you can- as best you can...and every cat really is different.

 

[Wendy&Neko]

For what it's worth, you won't need to do a curve - you already test more than a curve would do. What you do on SLGS is evaluate this dose after 7 days, then decide what to do with it. You can try a slight fattened dose, but most cats do better with a full 0.25 unit increase. Your time to experiment and see what works for Olive.

 

[OlivesMom]

We've been at this for like 10 months. Had great regulation- lost it for 5 months and are just getting back into some better regulation.

I'm glad to hear you're beginning to get back some better regulation. I'm sorry you lost it for all those months. Ugh!

What you do on SLGS is evaluate this dose after 7 days, then decide what to do with it. You can try a slight fattened dose, but most cats do better with a full 0.25 unit increase. Your time to experiment and see what works for Olive.

Ok, sounds like a plan. Will watch what the data ends up saying at the end of the next week. Hubby and I were torn tonight on exactly what she did get. Going a line's width under the half unit line was so close to actually increasing it by 0.25 that we both just looked at each other and shook our heads. I don't want to recalibrate the caliper just yet because I KNOW that's set for a half unit (0.5) We were trying to eyeball the fat half tonight. Do you guys have this same problem? Why on earth can't somebody make a proper syringe for dosing cats???! So I'll be eyeballing the rest of the doses for the next week with hopes I'm close.

most cats do better with a full 0.25 unit increase.

Well, that's good to know after tonight. I'm going to get ready for bed, test her last thing then try and get 3 hours sleep before I get up to feed her again. These small but frequent meals are really her thing. Good night to everyone and thank you all for your advice today.