a few questions; new to this forum

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KarenAmelia

Member Since 2012
Okay, I started with the newcomers forum as recommended. Diagnosis and beginning of insulin was a week ago. After a week of very steep learning curve, I feel I'm ready to graduate from there and move to this list for more detailed info on Lantus regulation.
Hoping that my spreadsheet (for Terra kitty) will show up in my signature. Wondering about some erratice numbers. AmPS today was 469, the highest yet, but by I+6/7 she was down to 84 then 77! That's a lot of fluctuation. Nothing predictable yet. Could some of you more experienced folks please look at my spreadsheet (not much data - only one week's worth and spotty at that!) and let me know if what you see is within reason?

Second question: the BG curves page on this site says: "If the nadir is < 100 mg/dl, decrease the insulin dose. " I felt nervous today when the BG was down to 77, yet I see lots of posts here where people are feeling thrilled to have numbers in the 50s/60s range. Please give some advice here. I was under the impression that below 100 was a worry.

Thanks much for the valuable sharing of information through this forum! I think y'all know more than my vet (though I'm still working with him - just supplementing his advice with what I learn here.
 
Hi Karen, welcome to Lantus Land, the greatest place you never wanted to be! You are doing great - home testing and spreadsheet up and running. I am not an expert but hopefully one will come along soon. Some of the first questions will be what does Terra weigh and what does Terra eat? We look at the carbs in food pretty closely.
Zener has two moms. I sign my posts and Anne doesn't so you know who you're "talking" to.
Liz
 
Hi Karen and welcome to Lantus Land.

Yes there is a steep learning curve and we are all still learning together here too!

It looks like you took a half unit increase a few days ago. So it looks like the insulin is working. We do worry about new users dropping below 100 because that lower range should be monitored more closely as it is a euglycemic (normal) number. Most vets get freaked out if they see those numbers on your chart or in your cat if he is at the office. Experience will have you handling lower numbers with confidence. And as my vet learned one day...to trust the caregiver. :lol: We watch and monitor more closely because cats on lantus can sneak way low without hypo symptoms. Those lower numbers are healing ranges for the pancreas too.

If those low numbers make you a bit nervous just yet, that is OK and sort of good, it means you are aware of the precautions. You could drop back to 1.75u for a few days until you get a handle of the protocol up in the stickies at the top of the forum and get most of your questions answered.

Do not be surprised if Terra shoots up for a few days. Steep drops like today cause what we call a bounce. It simply means the liver hormones kicked in because the drop was way too fast. Don't increase Terra's insulin for 72 hours as it takes that long for the hormones to leave the system. We call this process "liver training school" and some cats take a while to graduate from it.
 
Hi Karen, and welcome to the forum.

Your spreadsheet opened fine for me and great job on keeping it filled in with the latest info. As you go along you'll get better at tracking kitty's readings.

I am somewhat a novice myself but I will try to answer your questions as best as I can.

OK, so this is just my interpretation of the spreadsheet as if it were my Cini cat. I am guessing you went from 1.5 to 2.o units because you saw Terra's numbers start to go up on the evening of 1/6? The reason why that happened is because she was doing what is called a "bounce" from the low 114 reading on 1/4. The normal reaction is to say "Oh, I must increase the dose because kitty's numbers are going up." But, actually it's Terra's pancreas' reaction to such a low reading which she is not used to yet. It takes up to 72 hours for a bounce to clear. In my humble opinion, I think you should go back down to 1.5 units. But get some other input just to make sure I am on the right track.

So today, you are going to see high numbers again because of the 77 low reading at +7. Same thing here, bounce time and it could take up to 72 hours for that to clear. Don't increase the insulin dose, just ride it out. I know, you want to grit your teeth when you see the high numbers. nailbite_smile

Normal blood glucose for a diabetic cat is in the range of 50 to 120 and that's why you see some of us excited when our kitties get in that range. It means the liver and pancreas are working to regulate on their own and hopefully we won't have to give insulin injections much longer. This is another nailbiter area because you want the BG readings to stay in that range but you have to be on alert for sudden drops that may artificially push BG below 50.

Hope that helps.

Lots of hugs and skritches behind the ears for Terra from me. cat_pet_icon
 
you've gotten lots of great advice so i'll just say hi - and welcome! we'll help you learn how to interpret the protocol. it looks easy and obvious but it helps a ton if someone helps you along the way.

have you read the stickies at the top of this forum? if not, start with the "new to the group" one and see what questions that brings you. ask away and we'll all do our best to help you learn the ropes.

and good for you for plunging in! it's not hard once you learn it, but there is, as you said, a steep learning curve. we've all done it and that's why everyone is so patient with the questions.
 
Thanks for all the quick replies! I have not yet read about the "bounce", so I guess that is my next assignment. I think my vet is not that informed about diabetes, because he didn't mention the bounce, and agreed that increasing the dose from 1.5 to 2 was a good idea because of the high numbers. He's a wonderful man who I think works with a lot of elderly people - he does primarily house calls. I suspect he isn't too optimistic about any of his clients' ability to really do the dosing and testing that's needed.

Couple of things: I need some syringes that show .5 unit increments. The ones I have only are in whole units and it's impossible to read a .25 unit change. I feel like even getting a straight number is a WAG (wild ass guess) at best. It could be the number plus or minus .2 units. So consistency with the dose is pretty difficult if not impossible at these low levels. I'll ask the pharmacist, but otherwise please recommend where I can purchase some of these.

Second: For today's PM shot I tried shooting into the flank but shortly thereafter I noticed sticky wetness on Terra's flank fur and smelled the insulin. I tried to be very careful about the needle - it's a 1/2" - going in only partway so as not to overshoot, but there's not much slack to "tent" the fur back there. I deliberated about what to do, considering the high numbers: her PMPS was 431. I double checked and made absolutely certain about the presence of the insulin on her fur and decided, with much trepidation, to give her 1U in the scruff, which has been successfully taking the insulin for the past week. It's a no-no, according to my vet, to shoot again like this. I know it could endanger her, but feel cautiously certain this is the right thing to do. Any comments? Hope you won't all scream at me! I'll just have to be up tonight to monitor her BG.

Lastly: Liz asked about diet: I transitioned her to canned immediately upon diagnosis and she is getting small amounts frequently throughout the day.
 
I get my insulin syringes from Walmart pharmacy, the Relion brand with half unit marks. They have the purple band on the box. And I use the "short needle."

Yes, in the case of a fur shot we highly recommend not shooting additional. The reason being is you don't really know how much was given. None, some, half , three quarters...all and what you are smelling or finding wet could only be a few drops off the normal dose.

So yes, you will likely need to stay up and monitor for low numbers. Check back in here through out the evening and night with your numbers and if you get too low there will be folks around to help you out.

Now might be a good time to go back and change your subject line in your first post to something to flag it as a potential overdose/overshoot/ furshot and dosed anyway...

We generally use the date, cat's name, and numbers and click the icons above the posting if we need attention. So you might click the ? for now and start posting your numbers for the evening.

You should also PRINT THIS OUT AND READ IT NOW http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=15887

Lantus being a long acting insulin can mean a long night....find your treats, karo, honey etc. and just be prepared.
 
Hi, have you gotten any more tests tonight? it is really important to keep close watch in case some of the first shot did go in. You may have a long night ahead. Then again Terra may be fine.

I also agree that the high numbers you have been seeing are probably bounces. From you SS it looks like you are not getting any tests in during the pm cycle. Terra could very well have had low numbers last night too and this morning was a bounce too.
 
Welcome to Lantus Land.

We do discourage shooting again if you think you gave a fur shot. You have no way of knowing how much insulin did go in. It's possible that there was insulin on the exterior of the syringe/needle and that's what your noticed. For all of these reasons, we never encourage re-shooting.

Aside from Walmart, syringes with half unit markings are available on-line. I purchase mine through Hocks. Others get their syringes through American Diabetes Warehouse.

Just out of curiosity, do you know why your spreadsheet isn't coding the numbers in color? I'd also encourage you to get at least one test during the PM cycle. This will let you know if numbers are running lower than usual.

Please let us know how we can help.
 
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