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Brandy & Max

Brandy & Max

Member Since 2020
Can anyone take a look at Max's spreadsheet to see what I may be doing wrong? I am getting discouraged. I also sprinkled imuquin on his ff pate this morning and I am wondering if this contributed to the high sugar? I could not find anything in the list of ingredients but I may be wrong.

Thanks
 
JanetNJ said:
I’m curious why you skipped insulin yesterday and why you only gave 1 this morning?[/QUOTE

The emergency vet told me if it was under a certain number to hold it and call them. So i did so....smh...which I see wasn't the right thing to do. So when I gave the insulin last night and checked him it kind of scared me that he dropped that much in two hours and then in four hours. And then when i dropped to the 109 i got a little nervous and thought he would bottom out why i was sleep so I gave one this morning. now i feel like i am back to square one. and he has to go until 630 before I give insulin again. sure i will try. i am new to this, and just joined this week.
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Just want to add, I know it’s scary to see those lower numbers when you’re used to the high ones but the 200’s is where you want him to be for the preshots so I wouldn’t have skipped yesterday am and even the numbers at night were good. Blues and greens are a great place to be. Only give a token dose if you get a Preshot number between 150-200. If it’s under 150 then you’ll skip for now because you’re still learning how your cat reacts. Minnie was at 185 at this am preshot but I still gave her her dose because I know I have some leeway with her during the day. If this had been a night when she eats less, I might have given a token dose. During the cycle, you really only have to worry if it’s under 50 that’s you’re red alert number and if you get an under 90 at any point in time you’ll reduce the dose by .25 starting with the next shot. Does this help?
 
Aleluia Grugru & Minnie said:
Just want to add, I know it’s scary to see those lower numbers when you’re used to the high ones but the 200’s is where you want him to be for the preshots so I wouldn’t have skipped yesterday am and even the numbers at night were good. Blues and greens are a great place to be. Only give a token dose if you get a Preshot number between 150-200. If it’s under 150 then you’ll skip for now because you’re still learning how your cat reacts. Minnie was at 185 at this am preshot but I still gave her her dose because I know I have some leeway with her during the day. If this had been a night when she eats less, I might have given a token dose. During the cycle, you really only have to worry if it’s under 50 that’s you’re red alert number and if you get an under 90 at any point in time you’ll reduce the dose by .25 starting with the next shot. Does this help?
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:banghead::(It doesn't help that I am an ICU nurse myself. I always look at everything that "could" happen..... I think it makes it much harder in that patient's with blood sugars = to my Max's would be on insulin drips and every hour blood glucose monitoring and I feel like I am just sitting "twiddling my thumbs" if you will not treating it....
 
Brandy & Max said:
Is there somewhere that explains the token dose?
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Check out the link I just posted but here’s the gist of it. Token dose should be 10-25% of regular dose:

Until you collect enough data to know how your cat will react, we suggest following the guidelines in the FDMB's FAQ Q4.4:
Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?
A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.
  • Below 150 mg/dl (8.3 mmol/L), don't give insulin.
  • Between 150 and 200 (8.3-11.1 mmol/L), you have three options:
    • a.) give nothing
    • b.) give a token dose (10-25% of the usual dose)
    • c.) feed as usual, test in a couple of hours, and make a decision based on that value
  • Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
  • In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.
  • Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.
 
Brandy & Max said:
:banghead::(It doesn't help that I am an ICU nurse myself. I always look at everything that "could" happen..... I think it makes it much harder in that patient's with blood sugars = to my Max's would be on insulin drips and every hour blood glucose monitoring and I feel like I am just sitting "twiddling my thumbs" if you will not treating it....
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You just have to remind yourself, different species = different metabolisms and different reactions to illness and treatments :)
 
Aleluia Grugru & Minnie said:
Sorry but why would you go down to 1.5? That’s not a token dose and he didn’t earn a reduction, right? If he did and you were decreasing, he should go down to 1.75 not 1.5...
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Probably because she is new and hasnt digested all this information...If you are asking me its because I shouldnt stick my stupid nose in on a dosing question.:p
 
Brandy try and stick to the same dose of Lantus. Lantus likes consistency and chopping and changing the dose will not let the depot settle and you will get wonky numbers.
Have a look at the two dosing methods below that I have linked and see if you want to follow the tight regulation or the Start Low Go Slow method. It makes a difference as to what we tell you. When you decide which methods, could you put it into your signature so we can see it please?
http://www.felinediabetes.com/FDMB/...-low-go-slow-slgs-tight-regulation-tr.210110/

When you stall with Lantus, you don’t feed and test again 20 minutes later to see if the number is rising. Post and ask for help if this happens. Always change the subject line in your thread so we can be alerted to the fact you need immediate help with the dose.

The 109 is a very safe number on the alphatrak meter. If you get a number below 68, that is when you need to take action and give honey or some high carb food to bring it up higher.
If you see a number around the 109 or a number that has dropped significantly from the last BG test, you can give some ordinary low carb snack and test again in 1/2 to 1 hour to see what the number is doing.
I can see that Max is bouncing now from the 109 as he is not used to the low numbers any more. Bouncing can happen if the cat drops too fast, too low or lower than he is used to. His body panics and he dumps stored glucose and regulatory hormones into his system and the BG shoots up. Bounces can last for up to 6 cycles and there is nothing you can do once it has happened but wait it out.

Are you feeding him at all during the cycles as well as before the shot?
We recommend giving a couple of snacks as well as the preshot meal during the first half of the cycles both am and pm cycles. Say at +2 and +5 or what ever suits you.
Keep asking questions, we are happy to help.
Bron
 
Thank you BRon. This makes sense. Yes bc he actually needs to put on a couple of pounds I have been feeding him a can Pre shot in the am. What he doesn’t eat I rewarm and offer again. Then feed him at lunch then again before pm shot and if he goes to dry food I will give him another Fancy Feast as I am trying to wean him from dry food. So today he ate a total of 2 and 1/2 but split up throughout the day. What do you consider snacks?lol. I think the SLGS would work best for him.
 
Just to clarify, what do you mean feeding pre shot? Do you mean after you test but before you shoot? Because you should not feed 2 hours prior to preshot testing because that could influence the BG levels. So test, feed then shoot. Is that what you’re doing?
 
Like this morning, I tested , them fed him, then shot but at the vet they were telling me test , feed, test then shoot. That seems like a lot of poking. With our boxer several years ago they told us to feed, then test them shoot. So you are saying I shouldn’t feed him anything at all 2 hour before I am going to check him. It will still influence it that much if the carbs and such are very Low? So pretty much if I am testing I. The morning and say I get 300 it would probably be save to get the 2 units bc it is going to go up a little more with him eating breakfast. Sorry for the misspelling. It’s much harder typing on a phone lol
 
Brandy & Max said:
So you are saying I shouldn’t feed him anything at all 2 hour before I am going to check him.
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For the AMPS and PMPS tests, you want those tests without the influence of food so you want to make sure he doesn't eat for the 2 hours immediately before shot times.

Then you Test, Feed, Shoot....most of us do the T/F/S in 5-10 minutes. Since Lantus doesn't usually start to "kick in" for 2-3 hours, as long as Max is willing to eat, he can take his time eating his main meals.

Brandy & Max said:
The morning and say I get 300 it would probably be save to get the 2 units bc it is going to go up a little more with him eating breakfast.
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We need to find a dose that you are willing to give every 12 hours. Consistency is very important with Lantus. You can't dose it based on the Pre-Shot number.

How about going with 1.5 and holding that dose for the next several cycles? We need to see how he does when the dose is consistent so the depot is working correctly.
 
Brandy --

You may want to consider posting on the Lantus forum. You're posting on Health which is where most people start out. Once you have your spreadsheet set up and are home testing, it's helpful to switch to posting on an active, insulin focused group board. Lantus/Levemir/Basaglar is very active and the members there are very knowledgeable about the use of Lantus.
 
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