Blue has curves

https://www.felinediabetes.com/FDMB/threads/newbie-patty-and-blue-from-georgia.233752/#post-2613389

I just picked up Blue from the vet. I'm going to first update his spreadsheet with new information. He is hiding from me but I'll have to keep testing until 9:00 tonight. He was given 2 units Lantus....well, I was interrupted. Realized they didn't give me the insulin back so had to drive back to the vet.

Anyway, I told them I was giving one unit in the a.m. and one unit in p.m. I tested him before I left this morning at 6:00 and he was 444. They gave him 2 units at 10:00 after his 9:45 reading was High. At 11:00 a.m. it read 422, 1:00 p.m. 361, 3:00 235, and 5:00 193. I tested again when I got home and it's 179 at 6:45. So you see it's still going down. I'm tested again every hour and then feeding him at 9:30 and then give 1 unit...unless it's too low.

 

I must have checked before you posted. Let’s see what the PMPS is.

 

It looks like the numbers are in the pm side of the spreadsheet. Also you didn’t Put in the dose of 2.

 

What time of day do you USUALLY give him insulin?

By giving him 2 units at 10 a.m. they've thrown your schedule way off...unless you were also giving it at about that time of day. Are you prepared to give him insulin at 10 p.m. tonight? IF there's a number that's shootable...and then stay up later to test?

 

It's is pm right? I just checked again and still going down. It's now 146. I'll check at 9 and then feed him. She said she needed to see when it would start going up and be out of his system...

I got off schedule the other night so it's now 10:00 every 12 hours. It's okay. I can deal with since I'm retired and a night owl.

What I didn't want them to do is give 2 units. I have been giving 1 unit. It's all so confusing. He's not moving much but maybe he's just exhausted from the day. I'm checking his BG again at 9 so hopefully it's not still going down. Last check was 146 from a reading of High.

 

Hi Again Patty...just wanted to let you know that I'm signing off for the evening...I'm an early riser due to work obligations - so I have to settle down for the night early...

I'd consider skipping this evening if he's still falling. That 2 units today was quite a bit and I wouldn't want you to have to deal with a hypo situation tonight - sometimes there are fewer people on the forums as the night goes on...

A lot of cats (mine included) come way down in the numbers after getting home from the vets - I don't know why, but it happens...

Please be sure to post his numbers on your SS in case there are those who are watching and don't shoot anymore insulin without posting for help/support. It may be a long night.

Have a good evening!

 

But the curve was during the day. You haven’t done the pmps test. Here what I think since he’s still coming down and it looks like +8 ? I’m worried about a hypo. If he were my cat I would skip and start over in the morning with 1 unit at whatever time you want to make his time.

 

I'm sorry, I might not be charting correctly. I should probably read that thread...
I thought the +8 was time??? If you look at it like time you'll see the numbers for today. I have another test at 9 and then I'll feed him. She wants to know when his BG starts going back up. I'm afraid it will stay low. She said if it's 250-300 15 minutes after he eats that I should give him 1 unit.

 

Your are misunderstanding. Your AMPS would be on the left side.Then numbers are hours after the preshot. So if their first test was at 12:00 that would be +2. The test before eating and insulin goes in tge AMPS box. Tonights’s test at 10:00 belongs in the PMPS box. So your curve numbers need to be moved to the left side. Make sense?

 

I agree 2 was a lot and I didn't want him to be given 2 units. He is still going down. If it gets lower I'm feeding and testing to see if it will start increasing again.

Have a good night and thanks for checking on us.

 

No, their first test was at 9:00 and second at 11:00. I think I might see what you mean...the +number is hours after shot?

 

Ok. When did he get insulin?

 

Ok. When did he get insulin? His bg before insulin goes in amps.

 

Ok. When did he get insulin? His bg before insulin goes in amps. The 444 goes in the amps box. The next test goes in the box for the number of hours after the insulin.

 

He got insulin at 10 but i tested him before I took him. So would I just use two lines for both days? Never mind, you just said i should put it in amps.

 

So what your your test result?

 

I am just about to take it again so will let you know. I think I corrected today's.
I'll be back after I test, feed and retest.

 

Yea. So he was at 146 eight hours after insulin,right? You fixed it.

 

The result you get will be +11 I think.

 

I think I have the SS corrected now but only for today. His BG has gone up to 237 but still not high enough for 1 unit. She said to give 1 unit if it was up to 250-300.,
What do you think? The BG didn't come up until 9:00 and was 164. I fed him and tested 15 minutes later and it was 237.

 

No matter what it was I was hoping you would skip tonight. I also would shoot 1 unit in the morning no matter how high because it will be high from skipping. Do you have a hypo Kit? You need high carb food, karo or honey. You also need middle carb food in case a little propping up is necessary. You can shoot ant time you want in the morning. Try and pick a time that you think you will like. How does this sound?

 

Yes, I agree. I didn't plan on giving anymore tonight. I have honey that I can use. What would a middle carb food be? I think 1 unit as well but she thinks 2 in morning and 1 in evening but that just doesn't sound safe to me since it stayed in his system for so long.

 

Two different doses shows a lack of understanding of Lantus. Two doses one double of the other will just make him bounce around all the time. Since this is steroid induced diabetes it makes even less sense to me as I have seen some when the steroid wears off don’t need insulin. They become diet controlled. Some remain diabetic. There’s a food list. I’ll send the link.

 

Two different doses shows a lack of understanding of Lantus. Two doses one double of the other will just make him bounce around all the time. Since this is steroid induced diabetes it makes even less sense to me as I have seen some cats get off insulin after some time off tge steroid and when on a low carb diet. Not all but some as not all on steroids become diabetic so I suspect something in their genes puts them more at risk. Just my opinion. Here’s a food chart link. It was last updated in 2017 and foods do change so it gives you an idea. Chewy.com has all dietary info for the food they sell so you could see if the carb % matches.
https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

 

Lantus does best when it's given at a consistent dose both AM and PM so I'd stick with 1U for at least 6 cycles to see how he does.

Between 11-16%

Going forward, you always want to take food up for the 2 hours immediately before shot times....so if you want to shoot at 10, no food after 8. You want to do the Pre-shot tests without the influence of food. Then as soon as you get the PS test, you can feed and shoot. It's Test/Feed/Shoot...usually all in 5-10 minutes.

You Test to make sure they're high enough for insulin, Feed to make sure they're at least willing to eat and Shoot...usually while their head was in the bowl.

Lantus doesn't usually start to "kick in" for 2-3 hours after the shot, so as long as Blue is willing to eat, he's got those 2-3 hours to finish his "main meal".

If you get a Preshot under 150, you should Stall, don't feed and test again in 20-30 minutes. Use that time to post here with a clear subject line like "STALLING! NEED HELP!" (hey, it usually works!..lol)
Once you have someone's attention, you can edit the subject line and replace it with the usual format.

As you gain more experience and data, you gradually learn to shoot lower and lower numbers. I did Tight Regulation with China and eventually got to where I'd shoot if she was above 50 (you can see her spreadsheet...it worked well for us!)

 

Blue is eating some dry so needs to follow SLGS.

 

Could that be added to her signature? That there's still some dry in the picture? (or that she's decided to use SLGS)

 

I’m not sure she knows yet what she’s following. Patty please add the dry food to your signature.

 

I agree. I didn't want her to give him 2 units. I'll go back to 1 in the morning and start over. He's just to small for 2 units. He was looking sick when I checked and he was at his lowest. I was relieved it went up.
I'm already using Chewy so will check on another food to have on hand.
I'll be glad when I get Blue regulated...if that's even possible. Thank you for being here for us.

 

You will get him regulated. It just might not be fast. For high carb I liked fancy feast gravy lovers and Soulistic Triple Harmony if you have a Petco near you. Fancy feast pate is fine for low carb. What time do you think you will shoot in the morning?

 

Oh and will you add the dry food to your signature?

 

Maybe 8:30 or 9:00. I don't work so have that option. I do play tennis on 2 teams and although I’m not playing right now (COVID and knee surgery) I'm not sure what I'll do when I play in the morning. How do others handle this? I guess I could take him with me and teach him how to be a ball boy! JK Is it easy to change up times when you give insulin?

 

You can adjust shot times by 15 minutes per cycle or 30 minutes per day....so if you have tennis to go to, decide what times will work for you and give yourself a few days before to start moving your shot times.

We also play this game when clocks change for Daylights Savings Time (and the end of DST)

 

You can shoot 30 minutes early or late every 24 hours. When you need to make other changes it can be figured out at the time. Shooting earlier than that can act like an increase and later like a decrease.

 

@Chris & China (GA) We cross posted. Lol.

 

At least we're both saying the same thing....LOL

 

Great information. Isn't 50 terribly low? I'll check your SS. So much to learn.

I had a China about 10 years ago. I lost her and her brother to FIP.

I need to read more on the site. It's just been busy around here. I need to look at the differences with TR and SLGS.

 

Oh, I never thought about DST. I have never been good with giving medicine on time. Must learn to do better since Blue has to have insulin. I can do this!

 

There's usually plenty of notice before it happens so don't worry too much about it right now

 

Not once you have enough experience, data and truly understand how lantus works....took me about 6 months before I was comfortable making dosing decisions for myself (and I still asked if I was making good decisions!!...LOL)

A "perfect" Lantus curve is basically a straight line without any big highs, dropping to lows and then back to high again.

We have a saying here "Shoot low to stay low"....You'll learn that later!

 

I ran out of room on the SS for the last test I ran but since it was 237 and I didn't give him any Lantus.
This morning I tested at 8 and it was 417 so I gave him 1 unit after I fed him. He is ravenous.

 

Good morning Patty. He’s going to be really hungry with the high glucose. I’m hoping keeping him on 1 unit consistently you will start to see better numbers. You dint need to test again for three hours.

 

You put the PMPS in the right place. In the next box put NS for no shot. We call that PMBG since you didn’t shoot.

 

WELL DONE PATTY! Elise and Chris too!

I dunno if that happened to me I'd be on the phone chewing someone out. I usually over react to stressing situations though

 

Hi Patty just checking in how are you and Blue doing today

 

Did you get another test?

 

I had PT so just got it. It's 400.

 

It’s to be expected due to skipping. No more tests needed until PMPS.

 

I just spoke to the vet and updated her on numbers. She agreed with 1 every 12 hours but only because of Blue’s reaction last night when he was at his lowest. He was immobile again and staring. I'm going to test every 2 hours again on Sunday to see where he is.
She liked the number clinically but not his reaction to it so I was happy she listened.

 

Well it took her long enough but maybe she will learn from you.

 

We're doing better today. I finally got some rest after all that has happened. Blue is so good with it all. If it were anyone but Blue it would be very hard.

 

Max was easy too. At home. At the vet when he had the curve after his first shot he was labeled aggressive. He was so laid back. My vet had to have another one take over. We both laughed. He said it was cage fever. Max was always the perfect patient.

 

It's back to high. I am feeding him and will give him 1 unit. Do you think I should check it again or not. I guess there's not much I can do if it's high. This is not too fun guys.

 

Yeahhhh it isnt fun...Its frustrating and confusing. We just have to keep them as safe as we can . So I usually say...you cant test too much. I'm sure not everyone feels this way but I have a natural curiosity and HAVE to know.

 

I like knowing too but I hate sticking him again. Poor baby is tired. I just gave him the shot and he left the room.

 

Awwwwwwwww
Tomorrow is another day!

 

The depot needs to build from the skipped shot. He was also lower than he has been which also creates a bounce. If you are awake I would get a +3 just to see if he’s coming down. Believe it or not some cats go from black to green in a cycle. It’s good to see if you can figure out when Lantus onsets as well. Maybe a +2.5? You don’t have to though.

 

I might try for a reading. I'd love to see where his number is now. I had a friend over for her birthday so have been out of pocket. Blue came and went....he's so sweet but he's definitely not himself.

 

We are starting over again with the 2 units and then the skipped shot. He will be feeling better before you know it. You will hear lots of talk about patience pants around here. They make the rounds. I’m glad you had some diversion with your friend. Have a nice night.

 

I went ahead and got it. It's 243 so I'm happy with that. Yay, makes me feel better.

 

Thanks. You see I tested and it's 243.

 

He’s cleared the bounce and made up for the skipped shot. That’s good news.

 

Yay

 

If you are still up or wake up I’d get another test.

 

I didn't get another test last night. Were you thinking it might get too low? I tested this morning and he's 416. He has eaten an I'm giving him 1 unit of Lantus.

 

Hi. I wasn’t worried about him getting too low but wanted to see how low he went. Normal numbers are 50-120 so he wasn’t in danger and I wasn’t concerned. I’d get a +3 this morning.

 

I just got another reading and it's 418. Bummer

 

Bummers happen. It will get better.

 

He. Ugh the Bounce again from last night. No worries. I’d test again in a couple hours.

 

I didn't get another test until 8 and it's 438. Didn't go up a lot. He is eating again and I gave him 1u. He seemed to be feeling okay.

 

All good. I’d get a test around the time you did last night 2-3. If it a lot lower it means he could go down more. That’s about when the insult kicks in.

 

Yes, I can do that. He doesn't look like he feels that great now. It scares me. I'll check him again in an hour or so. Thx.

 

How so? What’s he doing or not doing?

 

Lethargy and just not moving around like normal. He just looks pitiful. I hate this for him. I wish I could get him regulated. He is still peeing huge amounts of urine. He is eating pretty well. I feel sad watching him....and scared.

 

They do drink and pee a lot at first. Many are ravenous. I diagnosed Max because on the pancreatitis board cats were becoming diabetic and I noticed Max drinking and urinating more. I was thinking it was his kidneys but bought test strips that showed sugar in his urine and saw my vet the next day. I caught it very early. As his numbers come down that will get better. Were any of his other labs off? Do you have a copy? I always get copies emailed to me. I’ve found things that vets miss or don’t think are important. With all that urinating he might have low potassium for example that is making him lethargic. Give him some time, a week, on 1 unit. If he doesn’t do well we will increase but in .25 increments, not by a unit. Do your insulin syringes have 1/2 unit markings? If not you will need to get some.

 

No, my syringes don't have that. I was reading something the other night that mentioned they should have. I'll get some new ones.
I don't have a copy of the blood workup but will ask for it. I thought he might have CRF when I took him to the vet. I've had two previous that had kidney failure so always think that's what it is. Diabetes made sense when they told me.
The new food regimen is causing 2 cats to have diarrhea again. I'd just got that under control. Yakkkkk it's always something.
I'm going to check BG in Blue soon.

 

It's 384 so has gone down a little. He seems like he feels better too.

 

Good. I don’t think you need any more tests. I hope the two with diarrhea adjust soon. I’ll check in tomorrow.

 

Thank you so much. Don't know what I would have done without you and others on this site.

 

365 this morning so it's gone down a little each day. I see a pattern.

 

Slow and steady goes the marathon!

 

Might be working. Don't want to get too excited. Might check early afternoon.

 

I'm like that too.

 

Nice start! The low for many is +5-7. Blue might just have a later nadir though.

 

Here’s some more reading and I think it’s time to start posting on the Lantus forum. I bet @jt and trouble (GA) will visit you there too.
https://www.felinediabetes.com/FDMB/threads/the-basics-new-to-the-group-start-here.18139/

 

Okay good. I'm graduating? Thank you.

 

I like that!

Every day CAN be a graduation day!

 

Start tomorrow.

 

I think I'm in love with your device's autocorrect function, Elise.


Mogs
.

 

I HATE it!B@critter mom

 

@tiffmaxee - Looking at it from over here, it's most entertaining! Of course, that's of no comfort to your good self.


.

 

I often type i for o and g for h when rushing. My iPad and phone think that’s what I want now. Lol.

 

OMG it's 95

 

Okay. Deep breaths. This is great. Remember normal is 50-120. Feed a little of his regular food and test in an hour.

 

I was so shocked. He seems fine. I will feed and retest. Thanks for being here.

 

Now you are beginning to see why I was so concerned when the vet had you shoot 2 units. You are seeing how consistent dosing really helps. If under 90 he will earn a reduction.

 

That's one of the perverse aspects of the sugar dance. For the longest time you despair of all the blacks, reds, and stinky pinks, yearning to see your little one in nice green, healthier numbers.

Then a green shows up - and scares the willies out of you.


Mogs
.

 

Yes, and she still thinks that but I'm thinking this will convince her.

 

I know. Wow, couldn't have been more shocked. YAY

 

He ate a small amount and then I retested just now and it's 163. Is that what it's supposed to do?

 

Supposed to do? Well...in a word yes. Food should always raise BG levels. How much& long is "cat dependent" You are doing fine.