Teo
Member Since 2020
Done! I got 134 mg/dL, which I think is fine, right? (I've been eating until recently.)
Changing diet, fighting neuropathy
- Thread starter Teo
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Done! I got 134 mg/dL, which I think is fine, right? (I've been eating until recently.)
Deb & Wink
Member Since 2013
Teo
Member Since 2020
We got a new insulin pen on Wednesday last week, and also started a new set test strips for our meter some days ago. But there were no changes in this last three days when the BG readings started to get lower, nothing that could explain this change directly. Note that I have also checked the test strips with the test solution provided with our meter.
I had made this questions to myself too.
Yesterday we still had some higher values, and I took that as a sign that the change could be legit.
I had made this questions to myself too.
Yesterday we still had some higher values, and I took that as a sign that the change could be legit.
Deb & Wink
Member Since 2013
How old was the insulin pen you were using before?
Do you store the insulin in the refrigerator?
Did you insert the code chip into the code chip slot when you started using the new vial of test strips?
Do you store the insulin in the refrigerator?
Did you insert the code chip into the code chip slot when you started using the new vial of test strips?
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Deb & Wink
Member Since 2013
Test again please, but first make sure you inserted the code chip in the code chip slot when you started using the new vial of test strips.
More of a concerned if the meter said LOW or LO.
You feed at +8 in the morning (AM) so that can make the BG's rise.
More of a concerned if the meter said LOW or LO.
You feed at +8 in the morning (AM) so that can make the BG's rise.
Deb & Wink
Member Since 2013
You feed at +8 in the morning (AM) so that can make the BG's rise.
We have discovered that Viamo can get a very fast increase in BG readings after he eats.
How much did you feed Viamo? Was that the +8 feeding?
We have discovered that Viamo can get a very fast increase in BG readings after he eats.
How much did you feed Viamo? Was that the +8 feeding?
Teo
Member Since 2020
Definitely. Sorry for the fuzz, but I had never gotten the "HI" value with Viamo.
He ate something like a quarter of a can, an hour ago. Not much.
What does this imply for the treatment? I'm baffled, I did not expect this.
Teo
Member Since 2020
The pen we were using before was something like two months old.
We always do.
Yes, and quite shure because we've only used two different test strip vials.
Deb & Wink
Member Since 2013
Thanks for confirming code chip used with new vial of test strips, storing insulin pen in the refrigerator, pen only 2 months old. Insulin pens can often be used until the last drop.
Are you only feeding Viamo the beef flavor of the Vitalcan Complete or are you also feeding the chicken flavor?
Trying to check everything I can think of.
Are you only feeding Viamo the beef flavor of the Vitalcan Complete or are you also feeding the chicken flavor?
Trying to check everything I can think of.
Deb & Wink
Member Since 2013
Do you remember which flavor he got this morning? +3 +8 today?
Track it on the SS for each meal?
Track it on the SS for each meal?
Deb & Wink
Member Since 2013
Teo
Member Since 2020
What I don't get about this is that he had already eaten at +4 AM and we did not see this fast glucose increase.
Deb & Wink
Member Since 2013
Feeding later in the insulin cycle with lantus insulin can cause the BG levels to spike (go higher) as the insulin wears off a bit.
There are ways to 'manage the curve' but you are leaving at the end of the week and I did not want to have you do too many changes before you left and had your cat sitter come in. Especially with no testing and cat sitter being there less to observe.
I'd rather wait to have you do food changes related to WHEN you feed in the 12 hour cycle until after you come back.
Teo
Member Since 2020
Then it might actually be a good thing that our cat sitter won't be at home for most of the day cycle. He will mostly feed at the time of each injection and a little after, but certainly not at the times late in the cycle when we usually still do it.
By the way, he is coming home in a minute to talk about his chores as a diabetic cat caretaker. If there are suggestions regarding the time of feeding, it is a good moment to tell him.
Deb & Wink
Member Since 2013
Have the cat sitter feed first.
Give the shot.
Take care of other things that need to be done.
Leave more food for Viamo.
How long will your cat sitter be staying for each visit?
Change Viamo now to the feeding schedule your cat sitter will be using.
Give the shot.
Take care of other things that need to be done.
Leave more food for Viamo.
How long will your cat sitter be staying for each visit?
Change Viamo now to the feeding schedule your cat sitter will be using.
Teo
Member Since 2020
I have a question.
We were with our sitter teaching him how to give the insulin injection just now, but when he pressed the button in the pen Viamo flinched for a second, our friend got scared and he pulled the needle out of his skin too early. We all saw a big drop on the end of the syringe, so we are pretty shure some insulin got inside him, but most probably not all 4 units.
So, the question is, knowing that his values today were too high, that he really needed that insulin, and that the injection was unsuccessful: would it be totally unacceptable to give him one extra unit of insulin to compensate for the lost dose? Is it always better not to risk it?
We were with our sitter teaching him how to give the insulin injection just now, but when he pressed the button in the pen Viamo flinched for a second, our friend got scared and he pulled the needle out of his skin too early. We all saw a big drop on the end of the syringe, so we are pretty shure some insulin got inside him, but most probably not all 4 units.
So, the question is, knowing that his values today were too high, that he really needed that insulin, and that the injection was unsuccessful: would it be totally unacceptable to give him one extra unit of insulin to compensate for the lost dose? Is it always better not to risk it?
Deb & Wink
Member Since 2013
Always better to not risk giving more insulin if you think some or all of the insulin has not gone into your cat.
You can never tell how much actually got into Viamo.
Note on your spreadsheet that it was a partial shot.
That 'big drop' you saw on the end of the insulin pen needle could have been anything, from a couple of units to maybe only half a unit.
Lantus dosing is not based on the pre-shots. It's based on the lows and it can take 6 cycles or more to see changes in the insulin dose.
You can never tell how much actually got into Viamo.
Note on your spreadsheet that it was a partial shot.
That 'big drop' you saw on the end of the insulin pen needle could have been anything, from a couple of units to maybe only half a unit.
Lantus dosing is not based on the pre-shots. It's based on the lows and it can take 6 cycles or more to see changes in the insulin dose.
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Teo
Member Since 2020
This is interesting, what do you mean by pre-shots? And what do you mean by seeing changes on the insulin dose?
Anyway, do you still think it's a good night to make a curve? If you tell me, I do it tonight. If not, tomorrow.
Deb & Wink
Member Since 2013
Sorry. I did not explain that well at all. I used some words incorrectly. Let me try again.
1. The first test in a 12 hour cycle is the pre-shot test. The test you do at +0 (AMPS or PMPS). The test you do to see if your cat's Blood Glucose level is high enough to safely give insulin. For new members we usually set that safe Shoot/No shoot number at 200 mg/dl. So if the BG is above 200, then give insulin. That limit is set to keep your cat safer from hypoglycemia. As you test more and gather more data, that Shoot/No shoot limit can be modified to a lower number.
When you inject the insulin, it goes into a place we call "The Depot" which acts like a small storage area. That storage area takes time to fill completely and can affect up to 6 cycles. The time tends to be less when a cat is on a smaller dose, and more when a cat is on a larger dose. Other factors can apply as well, but using the generalization of 6 cycles is a good starting point until you have learned your particular cat's patterns.
After you inject lantus into your subcutaneous tissue, the acidic solution is neutralized by your body to a neutral pH. Because glargine is not soluble at a neutral pH, it precipitates out into a form that's not soluble in subcutaneous fat, and there forms a relatively insoluble depot. From that pool, or depot, of precipitated glargine in the tissues, small amounts slowly move back into solution over time and then to the bloodstream.
2. There are 2 dosing methods used here on the FDMB message board. They are Tight Regulation (TR) and Start Low, Go Slow (SLGS). You can read about them here http://www.felinediabetes.com/FDMB/...-low-go-slow-slgs-tight-regulation-tr.210110/
3. Random Notes:
NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus/Basaglar cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.
+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. Onset begins around +2 for most cats. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Often lower than the PreShot number.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Basaglar/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.
1. The first test in a 12 hour cycle is the pre-shot test. The test you do at +0 (AMPS or PMPS). The test you do to see if your cat's Blood Glucose level is high enough to safely give insulin. For new members we usually set that safe Shoot/No shoot number at 200 mg/dl. So if the BG is above 200, then give insulin. That limit is set to keep your cat safer from hypoglycemia. As you test more and gather more data, that Shoot/No shoot limit can be modified to a lower number.
When you inject the insulin, it goes into a place we call "The Depot" which acts like a small storage area. That storage area takes time to fill completely and can affect up to 6 cycles. The time tends to be less when a cat is on a smaller dose, and more when a cat is on a larger dose. Other factors can apply as well, but using the generalization of 6 cycles is a good starting point until you have learned your particular cat's patterns.
After you inject lantus into your subcutaneous tissue, the acidic solution is neutralized by your body to a neutral pH. Because glargine is not soluble at a neutral pH, it precipitates out into a form that's not soluble in subcutaneous fat, and there forms a relatively insoluble depot. From that pool, or depot, of precipitated glargine in the tissues, small amounts slowly move back into solution over time and then to the bloodstream.
2. There are 2 dosing methods used here on the FDMB message board. They are Tight Regulation (TR) and Start Low, Go Slow (SLGS). You can read about them here http://www.felinediabetes.com/FDMB/...-low-go-slow-slgs-tight-regulation-tr.210110/
3. Random Notes:
- In the case of a furshot, NEVER give another shot. There's no way of knowing how much of the first shot "got into" the cat.
- NEVER give a second shot because "numbers are too high" in a 12 hour cycle.
- Test often for ketones.
- Be consistent in timing and type of food.
- KNOW THY CAT. Shooting early or late is a practice best reserved for those who have a full understanding of the insulin used and it's effects on their kitty. Because of the cumulative nature of Lantus and Levemir, please be aware:
- Shooting an hour or two early *could* act like a slight dose increase.
- Shooting an hour or two late *could* act like a slight dose reduction. Please ask for guidance if you're unsure.
- A "cycle" refers to the period of time between shots. There are 2 cycles in every 24 hours when shooting on a 12/12 schedule.
NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus/Basaglar cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.
+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. Onset begins around +2 for most cats. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Often lower than the PreShot number.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Basaglar/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.
- Carryover - insulin effects lasting past the insulin's official duration
- Overlap - the period of time when the effect of one insulin shot is diminishing and the next insulin shot is taking effect
- Insulin Depot - a "spare tank" of insulin, which has yet to be used by the body
- Lantus, Basaglar & Levemir: What is the Insulin Depot?
- Bouncing - 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).
Teo
Member Since 2020
Good morning! That post was very informative. Thank you.
We finally did a curve yesterday night and I am still puzzled at what happened with his BG during the day compared with how it went after. Can you make sense of it? For the first time he had steady values in the ~250 range. That was until he ate at +8 AM, then his BG skyrocketed, and after the insulin it went slowly down. His AMPS was higher than the previous days. Now, 3 hours after his morning, he is in the "red zone" again.
The only explanation I can think of after reading your notes on Lantus insulin is that maybe this was a bounce. Is it possible?
We finally did a curve yesterday night and I am still puzzled at what happened with his BG during the day compared with how it went after. Can you make sense of it? For the first time he had steady values in the ~250 range. That was until he ate at +8 AM, then his BG skyrocketed, and after the insulin it went slowly down. His AMPS was higher than the previous days. Now, 3 hours after his morning, he is in the "red zone" again.
The only explanation I can think of after reading your notes on Lantus insulin is that maybe this was a bounce. Is it possible?
Deb & Wink
Member Since 2013
Sorry Teo. I forgot to say yes, please do a curve last night. Tired and I missed that last night. Happy to see you went ahead and did the curve last night.
Yes, I do think it was a bounce. Nothing you can do about that. You have to wait out those bounces. They can take up to 6 12 hour cycles to clear. It's a self protective mechanism that protects from lower BG levels than a cat is used to. Not necessarily dangerous low hypoglycemic BG numbers, but lower than the cat has been having. So even those 200+ range BG readings yesterday AM cycle were not something Viamo's body was used to and that was a bounce.
Keep with the same insulin dose for now. Keep feeding the same food for now. But change to the feeding schedule your pet sitter will be able to use.
There is a lot more information in the Lantus/levimir forum here if you are interested. It's all in English, so no idea how well google translate will do in making it understandable for you. Look at the "Sticky" posts at the top of the forum for more info.
Viamo is nowhere close to having a 'typical' Lantus cycle at this point. No where close to being regulated either. If we can get him better regulated, the neuropathy will improve. It all takes time.
You have changed his diet to a lower carb food. That's a big step.
You are home testing. That's the second big step.
You are giving him a good insulin for cats, with the lantus (glargine) insulin. That is the third big step.
You have a spreadsheet (SS) setup and we can look at that and see some of what is happening. That is the fourth big step.
Now it's fine tuning. Seeing what works best for Viamo and you.
We'll wait to make any more changes until you get back. Such as using an insulin syringe 3/10 cc 30 ml with 1/2 unit markings to draw the insulin from the pen (mini-cartridge of insulin) that you are using. That way you can change the dose in smaller increments. We usually do 0.5 or 0.25 unit changes at a time. The pen only allows you to change the dose in 1 unit increments and that can be too much or too little.
ECID. Which means both Every Cat is Different and Every Caregiver is Different.
Yes, I do think it was a bounce. Nothing you can do about that. You have to wait out those bounces. They can take up to 6 12 hour cycles to clear. It's a self protective mechanism that protects from lower BG levels than a cat is used to. Not necessarily dangerous low hypoglycemic BG numbers, but lower than the cat has been having. So even those 200+ range BG readings yesterday AM cycle were not something Viamo's body was used to and that was a bounce.
Keep with the same insulin dose for now. Keep feeding the same food for now. But change to the feeding schedule your pet sitter will be able to use.
- Did you change Viamo to the feeding schedule your cat sitter will be able to use?
- Did Viamo eat any people food or only his cat food?
- Are there any other pets in the house?
- Do you leave any food out on the kitchen counter or elsewhere and he may have sneaked up on the counter to eat some of that food? Bread? Anything?
- Does he open cabinets or drawers by himself? I had a cat that opened the cabinet where some dry food was and he chewed through the bag.
- Was any food dropped on the floor and maybe Viamo ate it without anyone noticing?
- Is someone else in your home sneaking food to Viamo? Family? Friends? Roommates? Because he is begging for food?
- What day do you leave?
- Want one more curve a couple of days before you leave. Wednesday? Thursday?
There is a lot more information in the Lantus/levimir forum here if you are interested. It's all in English, so no idea how well google translate will do in making it understandable for you. Look at the "Sticky" posts at the top of the forum for more info.
Viamo is nowhere close to having a 'typical' Lantus cycle at this point. No where close to being regulated either. If we can get him better regulated, the neuropathy will improve. It all takes time.
You have changed his diet to a lower carb food. That's a big step.
You are home testing. That's the second big step.
You are giving him a good insulin for cats, with the lantus (glargine) insulin. That is the third big step.
You have a spreadsheet (SS) setup and we can look at that and see some of what is happening. That is the fourth big step.
Now it's fine tuning. Seeing what works best for Viamo and you.
We'll wait to make any more changes until you get back. Such as using an insulin syringe 3/10 cc 30 ml with 1/2 unit markings to draw the insulin from the pen (mini-cartridge of insulin) that you are using. That way you can change the dose in smaller increments. We usually do 0.5 or 0.25 unit changes at a time. The pen only allows you to change the dose in 1 unit increments and that can be too much or too little.
ECID. Which means both Every Cat is Different and Every Caregiver is Different.
Teo
Member Since 2020
Hi Deb. Thank you, what you said cleared up some things for us.
First I'll try to briefly answer the questions you enumerated regarding Viamo's "bounce". Then I have a question.
1: We are trying to change the feeding schedule to adapt to our sitter's. This means not giving him food from 12 am to 18 pm. We are not doing this rigorously because Viamo is usually stimulated with smells when we use the kitchen, so he begs for food at the usual times. This will certainly not be the case when we're not home.
2-7: The other pets in the house are two other cats. They eat from a different plate which is at a height Viamo can't reach. The food is not accessible to any of them and no one is giving Viamo other types of food. The only disturbance to his diet is that, once in a while, he will find a cockroach and devour it completely. As far as we have seen, this has happened two times in the last 10 days (its summer, insects abound), and he could also eat some at other times without us noticing.
8: We leave this very weekend. I'll leave on Friday and my mother on Sunday.
9: It'll be hard to have another night curve, but I'll do my best to manage it. It wouldn't be as good if it was only during the day cycle, right?
So, now Viamo seems to have gone back to yellow values. We also have some good news: we teached Viamo's sitter to make BG tests! So he will be testing each time before injections.
The question is: what should the sitter's "No Shoot Number" be during our absence? If Viamo keeps getting this low values, it is reasonable to think he might get some BG measurement under 200. In this case, should the sitter give insulin?
The question of what dose to give him is still open to debate, too.
First I'll try to briefly answer the questions you enumerated regarding Viamo's "bounce". Then I have a question.
1: We are trying to change the feeding schedule to adapt to our sitter's. This means not giving him food from 12 am to 18 pm. We are not doing this rigorously because Viamo is usually stimulated with smells when we use the kitchen, so he begs for food at the usual times. This will certainly not be the case when we're not home.
2-7: The other pets in the house are two other cats. They eat from a different plate which is at a height Viamo can't reach. The food is not accessible to any of them and no one is giving Viamo other types of food. The only disturbance to his diet is that, once in a while, he will find a cockroach and devour it completely. As far as we have seen, this has happened two times in the last 10 days (its summer, insects abound), and he could also eat some at other times without us noticing.
8: We leave this very weekend. I'll leave on Friday and my mother on Sunday.
9: It'll be hard to have another night curve, but I'll do my best to manage it. It wouldn't be as good if it was only during the day cycle, right?
So, now Viamo seems to have gone back to yellow values. We also have some good news: we teached Viamo's sitter to make BG tests! So he will be testing each time before injections.
The question is: what should the sitter's "No Shoot Number" be during our absence? If Viamo keeps getting this low values, it is reasonable to think he might get some BG measurement under 200. In this case, should the sitter give insulin?
The question of what dose to give him is still open to debate, too.
Deb & Wink
Member Since 2013
Yellow values are good!! Glad to see that Viamo is doing better again.
- No shoot number should be set at 200 for your pet sitter. If <200, do not give the insulin. No tests will be done except the pre-shot tests. Since cats usually have lower BG readings in the middle of the cycle, but we won't know what they are, it's better to skip the dose then to risk hypoglycemia.
- If pet sitter can not get a successful test, reduce dose by 1U so the new dose would be 2U. Either 3U or 2U is what I've been thinking for the reduced dose when you pet sitter was caring for Viamo.
- Another curve in the daytime would be fine. Would like one more curve if possible.
- If another curve is not possible, that's ok. I already know I want the dose reduced to 3U while your pet sitter is taking care of Viamo. Thought would be safer when your pet sitter was unable to test at all.
Deb & Wink
Member Since 2013
Have a good vacation in Montreal.
Veronica & Babu-chiri
Member Since 2016
Hi have a good vacation, Viamo's numbers are already looking better !!
If necessary do you think your sitter could post in the forum if he/she needs help?
If necessary do you think your sitter could post in the forum if he/she needs help?
Teo
Member Since 2020
Hi, thank you! Yes, his numbers are slowly going more and more into a better range.
Not directly, because I'm the only one who can write fluently im english, but he will keep us informed of any irregularity or doubt that he may have, and I will try to write here if anything importan occurs.
I won't post as often from tomorrow on, but I'll keep an eye on the forum. And certainly on Viamo
Not directly, because I'm the only one who can write fluently im english, but he will keep us informed of any irregularity or doubt that he may have, and I will try to write here if anything importan occurs.
I won't post as often from tomorrow on, but I'll keep an eye on the forum. And certainly on Viamo
Deb & Wink
Member Since 2013
OK.
Yellow values are good!! Glad to see that Viamo is doing better again.
Yellow values are good!! Glad to see that Viamo is doing better again.
- No shoot number should be set at 200 for your pet sitter. If <200, do not give the insulin. No tests will be done except the pre-shot tests. Since cats usually have lower BG readings in the middle of the cycle, but we won't know what they are, it's better to skip the dose then to risk hypoglycemia.
- If pet sitter can not get a successful test, reduce dose by 1U so the new dose would be 2U. Either 3U or 2U is what I've been thinking for the reduced dose when you pet sitter was caring for Viamo.
- Another curve in the daytime would be fine. Would like one more curve if possible.
- If another curve is not possible, that's ok. I already know I want the dose reduced to 3U while your pet sitter is taking care of Viamo. Thought would be safer when your pet sitter was unable to test at all.
Deb & Wink
Member Since 2013
Viamo is still bouncing I see. That will probably keep happening for at least 6 cycles. You have to be patient and wait it out, and not increase the dose.
Veronica & Babu-chiri
Member Since 2016
Tell him to private message me in Spanish if he needs some helpHi, thank you! Yes, his numbers are slowly going more and more into a better range.
Not directly, because I'm the only one who can write fluently im english, but he will keep us informed of any irregularity or doubt that he may have, and I will try to write here if anything importan occurs.
I won't post as often from tomorrow on, but I'll keep an eye on the forum. And certainly on Viamo
Teo
Member Since 2020
Hi! Yesterday my mother starting giving Viamo 3 units each time. Today he hit the black range again. She asks if she should go back to the original 4 units.
I understand this, but I'm not shure if you meant it for the new dose (3U) or the original one (4U).
I understand this, but I'm not shure if you meant it for the new dose (3U) or the original one (4U).
Deb & Wink
Member Since 2013
I meant it for the new (3U) dose.
Lantus dosing is based on the nadir or lowest point in the insulin cycle.
We have no idea how far down in BG level the 3U dose took Viamo.
I suggested you lower the dose because your pet sitter will only be there 2 times a day.
Your pet sitter will not be testing during the middle of the cycle.
Viamo will likely run a bit higher in BG readings at that lower 3U dose.
I thought that reduction to the 3U dose was safer than keeping Viamo at the higher (4U) dose while you are away.
You can monitor more often when you get back home.
The choice is yours. To keep Viamo at the higher dose of 4 U or keep him at the 3U dose.
@Veronica & Babu-chiri also said you could PM her. To do that, go to the top of the screen, click on your user name, click on Conversations. Start a New conversation with Veronica. I won't be able to see what you say to her, unless you click on the check box to
- Allow anyone in the conversation to invite others
Deb & Wink
Member Since 2013
First blue number?!!!!!! Just saw this for 22/1/20.
Looks like your cat sitter did not give insulin, which was good. Please enter 0 in the units column for yesterday, 1/22/2020 if the dose was skipped.
Would you please give me the date you are back in Argentina? Thanks.
Looks like your cat sitter did not give insulin, which was good. Please enter 0 in the units column for yesterday, 1/22/2020 if the dose was skipped.
Would you please give me the date you are back in Argentina? Thanks.
Teo
Member Since 2020
Hi, sorry for the late reply.
It seems like we did have our first blue number! Viamo's sitter checked two times to make sure, so he was confident not to give insulin. Still, his values at the times of the injection are high. Higher than before, when we were giving him 4 units, I think. Our sitter will hopefully be doing a curve tomorrow. That should give us more data to understand what's going on.
My mother will be back on february the first.
It seems like we did have our first blue number! Viamo's sitter checked two times to make sure, so he was confident not to give insulin. Still, his values at the times of the injection are high. Higher than before, when we were giving him 4 units, I think. Our sitter will hopefully be doing a curve tomorrow. That should give us more data to understand what's going on.
My mother will be back on february the first.
Deb & Wink
Member Since 2013
Safer to skip the shot when you are in the blue numbers and can't monitor as much. Shoot/no shoot BG reading for Viamo is still at 200, so your cat sitter did exactly what he should have done. I had you set that number a bit higher than normal, since your pet sitter was not going to be around as much.
Viamo is bouncing again. His body is reacting to those lower BG (blood glucose) readings by using a self protection mechanism. It doesn't have to be really low, simply lower than Viamo's body is used to that causes that self-protection mechanism to kick into gear. We sometimes call it 'liver panic'.
Remember this? "Bouncing - 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 glucagon, 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)."
Those higher red and black BG (blood glucose) readings are from the reaction to the bounce. Need to wait at least 3 days for those higher numbers to subside.
A curve tomorrow 1/26/20 would be fine. That will be the 3 day wait (6 cycles) for the 'bounce' to clear and get a realistic look at what the 3 Unit dose is doing for Viamo.
You don't change the dose for lantus based on the pre-shot numbers. You change the dose based on the nadir or lowest BG (blood glucose) reading the insulin has taken your cat.
Hope you are having a great time in Montreal.
Viamo is bouncing again. His body is reacting to those lower BG (blood glucose) readings by using a self protection mechanism. It doesn't have to be really low, simply lower than Viamo's body is used to that causes that self-protection mechanism to kick into gear. We sometimes call it 'liver panic'.
Remember this? "Bouncing - 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 glucagon, 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)."
Those higher red and black BG (blood glucose) readings are from the reaction to the bounce. Need to wait at least 3 days for those higher numbers to subside.
A curve tomorrow 1/26/20 would be fine. That will be the 3 day wait (6 cycles) for the 'bounce' to clear and get a realistic look at what the 3 Unit dose is doing for Viamo.
You don't change the dose for lantus based on the pre-shot numbers. You change the dose based on the nadir or lowest BG (blood glucose) reading the insulin has taken your cat.
Hope you are having a great time in Montreal.
Deb & Wink
Member Since 2013
Looks like high flat numbers in that BG curve done on 1/26/20.
Could mean too much insulin, too little insulin or bouncing. Yes, too many possibilities to know what to do here.
A typical difficult curve when you first begin regulating is high and flat, between 300 and 500. This can indicate either not enough insulin, or too much insulin and bouncing. It may also indicate insulin resistance due to glucose toxicity. Telling the difference is difficult, and requires looking at a full dosage and curve history. The best method is to avoid bouncing rebound by starting low and going slow.
Could mean too much insulin, too little insulin or bouncing. Yes, too many possibilities to know what to do here.
A typical difficult curve when you first begin regulating is high and flat, between 300 and 500. This can indicate either not enough insulin, or too much insulin and bouncing. It may also indicate insulin resistance due to glucose toxicity. Telling the difference is difficult, and requires looking at a full dosage and curve history. The best method is to avoid bouncing rebound by starting low and going slow.
Deb & Wink
Member Since 2013
Sienne and Gabby (GA) has suggested that there are many more experienced users of Lantus on the Lantus ISG. You may want to think about posting over there.
Lantus / Basaglar (glargine) and Levemir (detemir)
Lantus / Basaglar (glargine) and Levemir (detemir)
Teo
Member Since 2020
Hi Deb. I'm writing you at the beginning of the last week of my trip. My mother has already arrived back home, and she is measuring Viamo herself again. He seems to be doing allright, not much has changed. He often gives values over 500, but every once in a while he is starting to get pretty low numbers.
I know that response is a bit old now, but we have seen more low numbers since. This situation is confusing me now, because the range of values his BG is taking is really big: yesterday he got his first value under 100!
So, do you suggest I move to the Lantus forum?
I know that response is a bit old now, but we have seen more low numbers since. This situation is confusing me now, because the range of values his BG is taking is really big: yesterday he got his first value under 100!
So, do you suggest I move to the Lantus forum?
Deb & Wink
Member Since 2013
Hi Teo! Glad to hear from you.
Yes, please go to the Lantus ISG (Insulin Support Group) forum to post about Viamo. Seeing the first green blood glucose number is fantastic, very exciting. But scary too. There are lots of nice people over there in the Lantus/Basaglar (glargine) and Levemir (detemir) forum to guide you and your mom.
Here is that forum
Lantus / Basaglar (glargine) and Levemir (detemir)
Start a new thread over there, link this post into that one, at the very top of the post. And then explain what is going on. Brief explanation for now would be enough. People will ask you questions.
I'm very glad your mom knew to skip the dose last night, February 1st. That PMPS of 71 is too low to give 3 units of Lantus. If you can, please change your signature to indicate the food you are now feeding. The Vitalcan, not the Royal Canin Diatetic.
Also let people know you are in Argentina, your primary language is Spanish, your mom is testing, and that you are away on vacation. Let them know you understand some English, but may need google translate to understand.
Explain that you use an insulin pen and do not have U100 insulin syringes to use right now. Let people know that your insulin pen only allows you to change the dose in 1 Unit increments.
You or your mom should try to get some U100 insulin syringes. Have your mom look for 3/10 cc (volume) U100 insulin syringes with 1/2 unit markings on the barrel. You may not be able to find any syringes with the 1/2 unit markings. It's more important that you obtain the smaller volume insulin syringes that are also U100.
I'll watch out for you for a bit, over in the Lantus forum. More to give people some background information than what to do about the changing the insulin dose.
Yes, please go to the Lantus ISG (Insulin Support Group) forum to post about Viamo. Seeing the first green blood glucose number is fantastic, very exciting. But scary too. There are lots of nice people over there in the Lantus/Basaglar (glargine) and Levemir (detemir) forum to guide you and your mom.
Here is that forum
Lantus / Basaglar (glargine) and Levemir (detemir)
Start a new thread over there, link this post into that one, at the very top of the post. And then explain what is going on. Brief explanation for now would be enough. People will ask you questions.
I'm very glad your mom knew to skip the dose last night, February 1st. That PMPS of 71 is too low to give 3 units of Lantus. If you can, please change your signature to indicate the food you are now feeding. The Vitalcan, not the Royal Canin Diatetic.
Also let people know you are in Argentina, your primary language is Spanish, your mom is testing, and that you are away on vacation. Let them know you understand some English, but may need google translate to understand.
Explain that you use an insulin pen and do not have U100 insulin syringes to use right now. Let people know that your insulin pen only allows you to change the dose in 1 Unit increments.
You or your mom should try to get some U100 insulin syringes. Have your mom look for 3/10 cc (volume) U100 insulin syringes with 1/2 unit markings on the barrel. You may not be able to find any syringes with the 1/2 unit markings. It's more important that you obtain the smaller volume insulin syringes that are also U100.
I'll watch out for you for a bit, over in the Lantus forum. More to give people some background information than what to do about the changing the insulin dose.
Deb & Wink
Member Since 2013
Teo, You do not have to post on the Lantus forum if you do not want to.
The reason I suggested you post a new thread there, is because there are many more people over in that Insulin Support Group that are able to help you.
They know much more about Lantus and the nuances of using it and adjusting doses than I do.
They have some guidelines to use if you think you might want to post there for help. Please read this link to get some good information.
The Basics: New to the Group? Start here!
It's your choice. To stay here in the Welcome and Main Forum or post over in the Insulin Support Group.
The reason I suggested you post a new thread there, is because there are many more people over in that Insulin Support Group that are able to help you.
They know much more about Lantus and the nuances of using it and adjusting doses than I do.
They have some guidelines to use if you think you might want to post there for help. Please read this link to get some good information.
The Basics: New to the Group? Start here!
It's your choice. To stay here in the Welcome and Main Forum or post over in the Insulin Support Group.
Deb & Wink
Member Since 2013
Hi Teo,
I checked Viamo's SS (spreadsheet) this morning.
Viamo has been in the good yellow range with his blood glucose (BG) numbers since your mom arrived back home.
Both last night and this morning, Viamo had good pre-shot blood glucose test numbers.
Was your mom able to obtain some insulin syringes?
Is she able to get some more blood glucose tests than the pre-shot tests and the blood glucose test at +2?
Does Viamo let her test him? Or does he struggle and run away?
I think we may need to lower the dose for Viamo, but would like to see some more blood glucose numbers to see if that is true.
When we do lower the dose, it would be better to do that in 0.25 unit increments. You can't do that with the insulin pen you use.
There is a video here that shows how to withdraw insulin from an insulin pen using an insulin syringe. It's in English, but I don't know of one in Spanish.
I checked Viamo's SS (spreadsheet) this morning.
Viamo has been in the good yellow range with his blood glucose (BG) numbers since your mom arrived back home.
Both last night and this morning, Viamo had good pre-shot blood glucose test numbers.
Was your mom able to obtain some insulin syringes?
Is she able to get some more blood glucose tests than the pre-shot tests and the blood glucose test at +2?
Does Viamo let her test him? Or does he struggle and run away?
I think we may need to lower the dose for Viamo, but would like to see some more blood glucose numbers to see if that is true.
When we do lower the dose, it would be better to do that in 0.25 unit increments. You can't do that with the insulin pen you use.
There is a video here that shows how to withdraw insulin from an insulin pen using an insulin syringe. It's in English, but I don't know of one in Spanish.
- How to Draw Insulin from a Pen or Vial With a Syringe (Video from Julie & Punkin)
Deb & Wink
Member Since 2013
Hi Teo,
Saw that your mom was able to get a +6 and a +7 blood glucose test today, 2/3/2020.
I think you need to reduce the dose.
Was your mom able to obtain insulin syringes?
Saw that your mom was able to get a +6 and a +7 blood glucose test today, 2/3/2020.
I think you need to reduce the dose.
Was your mom able to obtain insulin syringes?
Deb & Wink
Member Since 2013
You need to reduce the insulin dose for Viamo by at LEAST 0.25U. Immediately. With the insulin dose for tonight, 2/3/2020.
If you do not have insulin syringes, then please reduce to 2 units for this evening.
Please let me know you have read this message.
Please let me know your mom has this information.
Using Start Low Go Slow (SLGS) dosing protocol.
"If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit"
"Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately."
I'm giving you a link to the lantus dosing protocols we use here. Look about halfway down in this document where it explains more about the START LOW, GO SLOW (SLGS) dosing method.
Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)
We want to keep your kitty safe while you are away.
If you do not have insulin syringes, then please reduce to 2 units for this evening.
Please let me know you have read this message.
Please let me know your mom has this information.
Using Start Low Go Slow (SLGS) dosing protocol.
"If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit"
"Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately."
I'm giving you a link to the lantus dosing protocols we use here. Look about halfway down in this document where it explains more about the START LOW, GO SLOW (SLGS) dosing method.
Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)
We want to keep your kitty safe while you are away.
Bobbie And Bubba
Member Since 2015
Hey there! Congratulations on earning a reduction!
How about moving to the Lantus Forum so that the experienced people with Lantus can help you and Vismo? You’ll have a lot of eyes on Viamo there.
The link is here:
http://www.felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/
Starting a new thread would be a good idea too as this one is getting very long.
Looking forward to seeing you over there.
How about moving to the Lantus Forum so that the experienced people with Lantus can help you and Vismo? You’ll have a lot of eyes on Viamo there.
The link is here:
http://www.felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/
Starting a new thread would be a good idea too as this one is getting very long.
Looking forward to seeing you over there.
Teo
Member Since 2020
Hi Deb, hi Bobbie!
I've read everything you've been answering to this thread, and so has my mother. She is at home, but I'm not. I'm abroad. My mother understands english but she is not comfortable writing it. So it is really difficult to get a fluid conversation until I come back on sunday.
We have some syringes but we have never used them, so we prefer not to risk usung them until I'm back home. So you think we should change to 2 units this night?
Also, I'll be glad to change to the other forum, I just don't have the time to write an introduction there right now. I may do it this week, but I'll certainly have my mind more set on Viamo and the forum when I'm back home.
I've read everything you've been answering to this thread, and so has my mother. She is at home, but I'm not. I'm abroad. My mother understands english but she is not comfortable writing it. So it is really difficult to get a fluid conversation until I come back on sunday.
We have some syringes but we have never used them, so we prefer not to risk usung them until I'm back home. So you think we should change to 2 units this night?
Also, I'll be glad to change to the other forum, I just don't have the time to write an introduction there right now. I may do it this week, but I'll certainly have my mind more set on Viamo and the forum when I'm back home.
- Status