Advice Please - BGS Going Up

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Colio

Colio

Member Since 2020
Fairly new to all of this, and working on adjusting Cole's shots. Today I thought we started off at a better level at 22.4 but this afternoon he has gone up to 29.3.

Can anyone take a look at my spreadsheet and let me know if I should be concerned? The vet has asked me to move to 3u every 12 hours.

We start at 3u once a day, and then I gave the vet those results. Based on what I've been reading, I decided to move him to 2u twice a day but looks like it isn't enough and so the 3u twice a day (with testing) is better.

Any idea why he would go up like this today?

thank you!
Elizabeth
 
Elizabeth --

I'm tagging @Bandit's Mom. The World spreadsheet your using doesn't have a tab that converts the mmol/L values from your meter to mg/dL values which is what most of us in the US use. If you didn't use the link to the spreadsheet template that we use, or if you deleted the page, it makes it very hard for those of us who are not as familiar with the "other" system to read your spreadsheet. We would need to multiply everything by 18 and it would be very time consuming!! I provided the link to our template. Bhooma, Bandit's Mom, can give you some help if you need it.

Have you transitioned Cole to a low carb diet? Are all of your kitties going to make the transition with Cole? If your other cats are not eating low carb, there's always the chance that Cole got into their food or found some other form of contraband which drove up the numbers.

The other issue is the depot. Lantus is a depot type of insulin. When you were only giving insulin once a day, the depot would never stabilize since Lantus needs to be dosed twice a day in cats. (Their metabolism is faster than a humans.) It takes roughly 5 - 7 days when dosing twice a day for the depot to stabilize. Right now, a small amount of every shot is going into the depot so numbers will not be ideal. Also, I'd encourage you to visit the Lantus board and read the sticky notes at the top of the board. With Lantus, you want to raise or lower the dose slowly and methodically. Generally, doses are changed by 0.25u. This is my long winded way of encouraging you to be patient. It will take a bit of time to get Cole's depot established and then you'll be able to work on getting him to a good dose.
 
I "speak" World numbers. Hi from the west coast. You will however need to get that US tab back so more people can help you.

First, you haven't given Cole enough time on the 2.0 unit dose. He saw some nice blues on 3.0 units, as low as 7.2 (130) but that was just six cycles ago. Then he bounced. If you aren't familiar with the term, here is the definition:
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).
Click to expand...
However, it's possible he cleared that bounce last night, and is bouncing again today. Numbers that go up during the cycle are an indication a bounce is happening.

So moving forward, hold the 2.0 unit dose for at least a few more days to build that depot. You also had a skip in there a few nights ago which depletes the depot, causing higher numbers. Then visit the Lantus forum, read our Sticky Notes, especially the ones on Dosing Methods. Depending which ones suites your lifestyle and goals, your next increase will either be by 0.25 units, or 0.5 units, also depending on what numbers you see the next couple cycles. The choice of dosing method also depends on type of food you are feeding Cole now.
 
Sienne and Gabby (GA) said:
Elizabeth --

I'm tagging @Bandit's Mom. The World spreadsheet your using doesn't have a tab that converts the mmol/L values from your meter to mg/dL values which is what most of us in the US use. If you didn't use the link to the spreadsheet template that we use, or if you deleted the page, it makes it very hard for those of us who are not as familiar with the "other" system to read your spreadsheet. We would need to multiply everything by 18 and it would be very time consuming!! I provided the link to our template. Bhooma, Bandit's Mom, can give you some help if you need it.

Hi there = the US tab is there - just opened it to check - maybe you could look again if you have time?


Have you transitioned Cole to a low carb diet? Are all of your kitties going to make the transition with Cole? If your other cats are not eating low carb, there's always the chance that Cole got into their food or found some other form of contraband which drove up the numbers.

Everyone is on low carb wet food now.


The other issue is the depot. Lantus is a depot type of insulin. When you were only giving insulin once a day, the depot would never stabilize since Lantus needs to be dosed twice a day in cats. (Their metabolism is faster than a humans.) It takes roughly 5 - 7 days when dosing twice a day for the depot to stabilize. Right now, a small amount of every shot is going into the depot so numbers will not be ideal. Also, I'd encourage you to visit the Lantus board and read the sticky notes at the top of the board. With Lantus, you want to raise or lower the dose slowly and methodically. Generally, doses are changed by 0.25u. This is my long winded way of encouraging you to be patient. It will take a bit of time to get Cole's depot established and then you'll be able to work on getting him to a good dose.
Click to expand...

Yes someone explained that which is why I adjusted to twice a day. Appreciate the advice on being patient :)
 
Wendy&Neko said:
I "speak" World numbers. Hi from the west coast. You will however need to get that US tab back so more people can help you.

First, you haven't given Cole enough time on the 2.0 unit dose. He saw some nice blues on 3.0 units, as low as 7.2 (130) but that was just six cycles ago. Then he bounced. If you aren't familiar with the term, here is the definition:

However, it's possible he cleared that bounce last night, and is bouncing again today. Numbers that go up during the cycle are an indication a bounce is happening.

So moving forward, hold the 2.0 unit dose for at least a few more days to build that depot. You also had a skip in there a few nights ago which depletes the depot, causing higher numbers. Then visit the Lantus forum, read our Sticky Notes, especially the ones on Dosing Methods. Depending which ones suites your lifestyle and goals, your next increase will either be by 0.25 units, or 0.5 units, also depending on what numbers you see the next couple cycles. The choice of dosing method also depends on type of food you are feeding Cole now.
Click to expand...


The US tab is there - not sure why it isn't showing up but I rechecked and left it on the US tab if you have time to look again.

The skip is when I was still following the vet's guidance and only dosing once a day - so I switched to 2u twice a day, instead of 3u once a day. Was worried about giving him too much.

So the vet saying go to 3u twice a day sounds too high to you? Just stick it out with 2u twice a day a bit longer?

All low carb, high protein wet food now.
 
Sienne and Gabby (GA) said:
Elizabeth --

I'm tagging @Bandit's Mom. The World spreadsheet your using doesn't have a tab that converts the mmol/L values from your meter to mg/dL values which is what most of us in the US use. If you didn't use the link to the spreadsheet template that we use, or if you deleted the page, it makes it very hard for those of us who are not as familiar with the "other" system to read your spreadsheet. We would need to multiply everything by 18 and it would be very time consuming!! I provided the link to our template. Bhooma, Bandit's Mom, can give you some help if you need it.

Have you transitioned Cole to a low carb diet? Are all of your kitties going to make the transition with Cole? If your other cats are not eating low carb, there's always the chance that Cole got into their food or found some other form of contraband which drove up the numbers.

The other issue is the depot. Lantus is a depot type of insulin. When you were only giving insulin once a day, the depot would never stabilize since Lantus needs to be dosed twice a day in cats. (Their metabolism is faster than a humans.) It takes roughly 5 - 7 days when dosing twice a day for the depot to stabilize. Right now, a small amount of every shot is going into the depot so numbers will not be ideal. Also, I'd encourage you to visit the Lantus board and read the sticky notes at the top of the board. With Lantus, you want to raise or lower the dose slowly and methodically. Generally, doses are changed by 0.25u. This is my long winded way of encouraging you to be patient. It will take a bit of time to get Cole's depot established and then you'll be able to work on getting him to a good dose.
Click to expand...

I kept the US tab but no one can see it - any thoughts why? I opened the spreadsheet again and left it on the US page - can you check again if you have time please?
 
Colio said:
I kept the US tab but no one can see it - any thoughts why? I opened the spreadsheet again and left it on the US page - can you check again if you have time please?
Click to expand...
I saw this issue with someone else - in your share link, remove "gid" and everything after - see the link below (it's to your spreadsheet :) but you'll need to update it in your signature). Basically the "gid" is saying to only share a certain tab - if you remove it then you share all tabs.

https://docs.google.com/spreadsheet...OFTjSIdzhZLcj55Wo7rlykDcv7vkAncQH-x7/pubhtml?
 
JaxBenji said:
I saw this issue with someone else - in your share link, remove "gid" and everything after - see the link below (it's to your spreadsheet :) but you'll need to update it in your signature). Basically the "gid" is saying to only share a certain tab - if you remove it then you share all tabs.

https://docs.google.com/spreadsheet...OFTjSIdzhZLcj55Wo7rlykDcv7vkAncQH-x7/pubhtml?
Click to expand...
Thank you! I edited the link and if you have a chance could you check again and see if you can see all the tabs? :nailbiting:
 
Looking for some help please just to look at Cole's spreadsheet and tell me what you think is happening? Is this clearing a bounce? He's stayed so high and I realize from all the info people have shared that he's building up a depot. Today seemed so odd - starting at 33.8, then very gradual drops, and then back up to his evening shot when he was at 31.1 and now just before I'm going to bed - dropped to 17.2. :eek:
 
I'm NOT a dosing advice helper. But I'm curious why you reduced insulin so quickly and by so much. I'n not criticizing Just want to understand. If anything this post will bump your thread to the top of the page ;)
Maybe @Diane Tyler's Mom can give this a look?
 
jt and trouble (GA) said:
I'm NOT a dosing advice helper. But I'm curious why you reduced insulin so quickly and by so much. I'n not criticizing Just want to understand. If anything this post will bump your thread to the top of the page ;)
Maybe @Diane Tyler's Mom can give this a look?
Click to expand...
Thanks for the question - I actually didn't drop - my vet recommended 3u once a day, but then I switched him to 2u twice a day so those 0 PM cells were actually days with no evening dose til I switched :)

This morning he's dropped to 12.6?
 
I should have reread this thread before I commented. Duh jeanne... I remember now. :oops:

When you get a number that is SO different than what you've been getting, Its a good practice to retest. Just to make sure you didnt get wonky strip. It would have been interesting to see a test from last night. It might have given a clue as to this mornings test.

I tagged a lantus helper, Hopefully she or another will come and check out your spread sheet.;)
 
No worries at all - there's so much info to digest! Yes late last night he was 17.2. This morning I tested 3 times because it seems so much lower - all within .3 of the 12.6 reading. I am comforted that I am doing the things you are suggesting - not easy to learn all of this. Now I'm going to test every hour to make sure he isn't dropping too much ...
 
Yes it is a steep learning curve, Once you've "learned" how Cole reacts to insulin in different circumstance it all becomes clearer.
Youre doing a good job.

KEEP UP THE GOOD FIGHT!
 
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