Chloe at 368 at +4, 340 at +8

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Roberta, I hope everything is ok. I'd like to offer some suggestions:
1) The TR protocol would call for a reduction anytime you get a number under 40. Period, full stop, even with long term diabetic kitties. You held 0.5u a number of times, and then actually increased to 1u on am Sept 21st, when the dose should have been 0.25u.
2) we dose based on nadirs, not preshots. Chloe has been telling you 0.5u was too much.
3) Lantus loves consistency, you've been changing the dose too much (in the wrong direction) and not following the protocol when reductions are earned. You need to give a dose 6 cycles to see what it can do.
4) we have a lot of experienced Lantus members, who don't come to health forum often. We'd love to help you get a handle on things, please consider posting there regularly so we can help you.

I'll end by how I started, I really hope everything is ok with Chloe, we worry when people stop responding.
 
Christie & Maverick said:
I'd test again, to be sure it isn't a wonky strip, but 30s deserve immediate attention. I'd be giving some syrup now, if that number is correct. You can give a couple of drops on her gums. Up you go Chloe.
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I made sure she is eating her dinner and will test again very soon. I also gave her a few treats.
 
Christie & Maverick said:
Roberta, I hope everything is ok. I'd like to offer some suggestions:
1) The TR protocol would call for a reduction anytime you get a number under 40. Period, full stop, even with long term diabetic kitties. You held 0.5u a number of times, and then actually increased to 1u on am Sept 21st, when the dose should have been 0.25u.
2) we dose based on nadirs, not preshots. Chloe has been telling you 0.5u was too much.
3) Lantus loves consistency, you've been changing the dose too much (in the wrong direction) and not following the protocol when reductions are earned. You need to give a dose 6 cycles to see what it can do.
4) we have a lot of experienced Lantus members, who don't come to health forum often. We'd love to help you get a handle on things, please consider posting there regularly so we can help you.

I'll end by how I started, I really hope everything is ok with Chloe, we worry when people stop responding.
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Well, there are several factors. One, I was using an old, but not expired, vial of Lantus when she was staying in the blues and greens. I bought a pen for the first time and found it difficult to get the correct dose with it because it kept sucking the insulin back in. (see my posts re the pen) Also, my vet has given me guidelines about dosages depending on BG numbers. I never give insulin if her BG is under 150. I'm going to test her again now.
 
Where is that in relation to your test @ +10 please? It is still too low, you'll be skipping again tonight, which is not ideal with past history or DKA. Are you able to check for ketones at home, either via meter or Ketostix? She needs additional higher carb, what you gave appears to have done nothing, syrup is still warranted. Let's get her up to safe numbers, then we can chat more about what you might want to consider doing going forward, okay?
 
Christie & Maverick said:
Where is that in relation to your test @ +10 please? It is still too low, you'll be skipping again tonight, which is not ideal with past history or DKA. Are you able to check for ketones at home, either via meter or Ketostix? She needs additional higher carb, what you gave appears to have done nothing. Let's get her up to safe numbers, then we can chat more about what you might want to consider doing going forward, okay?
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Okay, she ate a lot, but I'll give her a drop of honey. When I was using the old vial, I was giving only one injection per day for awhile and we thought she might be going into remission. The vet did a urine test a couple weeks ago and she was negative. Maybe she got a bacteria when they expressed the urine. I'll check her for ketones next time I see her peeing.
 
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Test again, another 20 Minutes, please. The syrup can wear off quickly. Keep the food down to a minimum now, she needs to be hungry if you need to continue to intervene. You need to keep checking until we are sure she is safe, please keep your SS and thread title updated, so we can help you, if necessary okay? Stay with me, and I'll stay with you, I'm here to help Chloe.
 
Christie & Maverick said:
Test again, another 20 Minutes, please. The syrup can wear off quickly. Keep the food down to a minimum now, she needs to be hungry if you need to continue to intervene. You need to keep checking until we are sure she is safe, please keep your SS and thread title updated, so we can help you, if necessary okay? Stay with me, and I'll stay with you, I'm here to help Chloe.
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She's at 40 now.
 
Again, I need help to understand what that number is compared to +10, are you at +11.5ish now? Syrup should have kicked in by now, she's not moving much, Is give her a couple more drops. This is why I worried about seeing 28 at preshot Sept 29th and preshots of 30s Sept 10th and 11th. You must see that goodness knows where she was at without intervention before those reset, earlier in the cycles previously?
 
Panic said:
I've mentioned this a few times already but Roberta, please stop increasing the dose when she's in yellows. You won't give insulin over 150 but you're fine overdosing her when she's bouncing. Please keep her safe and lower the dose and DONT increase anymore.
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Christie & Maverick said:
No, sorry, comments are best put in the column, since I have found our own "personal" comments in the way you are applying to SS don't come through.
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I don't see where you put the times on Mav's SS. Also, how can I rename the SS link that shows in my signature?
 
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Christie & Maverick said:
Don't need to, times are standard as they relate to the preshot, ie. +1, +2, etc. We have many members in different time zones, so the standardization of +1 etc from preshot makes us all on the same page, if that makes sense?
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Yes, so does that mean you always do the preshot at the same time every day?
 
Yup, twice a day, he gets insulin 12 hours apart. that is the general principle, with Lantus and Levemir since cats metabolize insulin differently than humans do. Not sure about dosing with other insulins, I try and keep my comments restricted to what I have experience with, some other insulins like Novolin act completely differently.
 
Pre shot means the time you test to see if it's safe to give insulin
EXAMPLE if you test her in the morning at
9:00 AM. That's the pre shot
Then 12 hours later you would test her again 9:00 PM That's the pre shot
+1 means 1 hour after you shot insulin
+2. 2 hours after you shot the insulin
+3. 3 hours after you shot the insulin
And So On

Same thing for her night time Pre Shot
We don't write times down like Christie said we are all in different Time
Zones
 
Roberta do you have any high carb food anything in gravy?

Such as

You should always have a few can of these on hand in case you need to bring up


Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs


Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy. 15% Med Carbs




Fancy Feast Gravy Lovers Turkey Feast in Gravy. 15% Med Carbs


Fancy Feast Gravy Lovers Chicken and Beef Feast in Gravy 15% Med Carbs
 
Diane Tyler's Mom said:
Roberta do you have any high carb food anything in gravy?

Such as

You should always have a few can of these on hand in case you need to bring his BG up and get some honey also
Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs


Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy. 15% Med Carbs




Fancy Feast Gravy Lovers Turkey Feast in Gravy. 15% Med Carbs


Fancy Feast Gravy Lovers Chicken and Beef Feast in Gravy 15% Med Carbs
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Diane Tyler's Mom said:
Roberta do you have any high carb food anything in gravy?

Such as

You should always have a few can of these on hand in case you need to bring up
Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs


Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy. 15% Med Carbs




Fancy Feast Gravy Lovers Turkey Feast in Gravy. 15% Med Carbs


Fancy Feast Gravy Lovers Chicken and Beef Feast in Gravy 15% Med Carbs
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Diane Tyler's Mom said:
Roberta do you have any high carb food anything in gravy?

Such as

You should always have a few can of these on hand in case you need to bring up


Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs


Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy. 15% Med Carbs




Fancy Feast Gravy Lovers Turkey Feast in Gravy. 15% Med Carbs


Fancy Feast Gravy Lovers Chicken and Beef Feast in Gravy 15% Med Carbs
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No, I have dry food, which she likes, but she spits it up after she eats it. I'll give her some of that and another drop of honey. I just noticed she's missing a bottom fang, which is probably why she eats sideways. When she heard me pouring the dry food for the other cats, she came running and ate a bit. Now she's back on the bed.
 
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Roberta I see in your signature you feed 9 lives, do you have any of it in Gravy?
I would pick some of high carb wet cat food whether it be Fancy Feast like I listed or 9 lives in gravy.You should always have these on hand
 
Roberta, have you seen any signs or symptoms of hypoglycaemia? You need to look for these...

https://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

I am growing a little concerned that she is not coming up even with honey. I can stay on a other hour or so, but I really want to see numbers above 50 by then. If we can't get her up with what you are currently doing, you may need to consider either calling an emergency vet and/or taking her to one. I'm not trying to frighten you but if you have been giving honey now for two hours, with not much effect, you may need vet assistance.
 
Christie & Maverick said:
If you don't have any high carb canned, time to also grab some high carb dry food, it goes into the blood stream just as quickly as canned, just takes longer to come out.
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I thought it also took longer to hit the bloodstream compared to wet?
Mixing karo and LC can make MC if I remember right perhaps?

Please pick up a few cans tomorrow, she's is hovering in low numbers too much to not have those on-hand. And lower the dose permanently please. I don't want to wake up one morning and see Chloe hypo'd the night before from overdosing.
 
Roberta and Chloe said:
She doesn't have any symptoms. She never does when she goes low. I'll give her more honey and test again in a few minutes.
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Can anyone run to a supermarket and pick up some food in Gravy
Roberta please listen to Panic and Christie and me stop raising her dose

EDIT. Roberta she even went to low on 9-21 at 0.5 units she dropped to 35 @+4
 
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