Duncan +7 375, +9 357, +8 340, PMPS 347

Status
Not open for further replies.
SaraM2261

SaraM2261

Member Since 2011
Hi, I am wondering what an average time is to fill the shed on Lantus. I know, I know ECID...
Just looking for a range, or really any # of cycles or days on Lantus etc...

I have Duncan, in his 4th cycle. Still not seeing a number lower than 271 when he is peaking on it at 6+ or 7+. He stays for about 2-3 hours and then the numbers go back up to the high 300's 350's and 370's, got a 390 something once. (New and have not had time to create a spread sheet yet, but I will get working on that when I have a free moment.)

Like all newly diagnosed cat mommas I just want to know when I will see his number start to get better. :)

Also can't seem to find a stickie anywhere with a BG numbers explanation on the whole range such as 0-100 = pretty low or hypo and what to do, 100-200 = common mid-range numbers going up or down during the cycle etc... 200-300 pretty high...300-400 un-regulated etc.... Is there something like that around here??

Thank you!
 
Re: How many cycles to fill the shed?

SaraM2261 said:
Hi, I am wondering what an average time is to fill the shed on Lantus. I know, I know ECID...
Just looking for a range, or really any # of cycles or days on Lantus etc...

I have Duncan, in his 4th cycle. Still not seeing a number lower than 271 when he is peaking on it at 6+ or 7+. He stays for about 2-3 hours and then the numbers go back up to the high 300's 350's and 370's, got a 390 something once. (New and have not had time to create a spread sheet yet, but I will get working on that when I have a free moment.)

Like all newly diagnosed cat mommas I just want to know when I will see his number start to get better. :)

Also can't seem to find a stickie anywhere with a BG numbers explanation on the whole range such as 0-100 = pretty low or hypo and what to do, 100-200 = common mid-range numbers going up or down during the cycle etc... 200-300 pretty high...300-400 un-regulated etc.... Is there something like that around here??

Thank you!
Click to expand...

How long to fill the shed? It's different for each cat but it's been found that 4 cycles is enough for most cats. That also means some like my Shadoe may be filled after 2 or 3 shots, but my Oliver used to take up to 6shots.

Following the general guidelines of the protocol will work.... everyone wants to know when will you see better numbrers..... the answer is You will see better numbers when you are approaching or reached your cat's needs.

"General" Guidelines:
--- Hold the initial starting dose for 5 - 7 days (10 - 14 cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 cycles).
--- Each subsequent dose is held for a minimum of 3 days (6 cycles) unless kitty earns a reduction (See: Reducing the dose...).
--- Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

Increasing the dose...
--- Hold the dose for 3 - 5 days (6 - 10 cycles) if nadirs are less than 200 before increasing the dose.
--- After 3 consecutive days (6 cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
--- After 3 consecutive days (6 cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

Reducing the dose...
--- If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.

--- If an attempted reduction fails, go right back up to the last good dose.
--- Try to go from 0.25u to 0.1u before stopping insulin completely.

Random Notes...
Because of the cumulative nature of Lantus and Levemir:
An early shot = a dose increase.
A late shot = a dose reduction.

A "cycle" refers to the period of time between shots. There are 2 cycles in one day when shooting twice a day.

Sometimes a dose will need to be "fine tuned" by adding some "fat" or "skinny-ing up" the dose.

You start at the first dose and take a week to fill the shed. Then, following the above, if nadir is above 200 and under 300, like your 271, then up you go with the dose by .25u. if nadir is over 300, go up .5u. You hold the new dose for 4 shots and then look to the nadir.

You can't tell at the start how long it will take your cat as you don't know your cat's dose. If you hold dose for 2days then go up, then hold for 2days, then go up, well.that's the pattern until you reach YOU cat's does.

For your cat you want numbers around 50 and for sure under 250. if you get under 50, then you will reduce on the next shot.
 
Re: How many cycles to fill the shed?

hi sara! your goal is to get numbers between 50 & 120 - that's the range of BG for a non-diabetic healthy cat. it's very much a dance and they go up and down in dose and numbers on the way there.

i'd encourage you to open a condo (thread) here in lantus land daily and we'll teach you how to help Duncan. it takes a while to get to better numbers. we joke often about needing patience pants here - but there's a lot to learn on how to read the cat's responses to insulin.

and welcome to Lantus Land!
 
Re: How many cycles to fill the shed?

Hi,
I just did a test at 7.5+ and Duncan is at 375. His pre-shot BG this morning was 279.
He is a larger cat and doing 1u 2x per day. It's only his 4th cycle, but I was really hoping it would have some impact by now. :(
I need to do more tests I guess and see what the heck is going on here...

What would you guys do if his number is at 375 and it's on it's way up already?? It's 2:45pm here and he is at 7.5+ and he will get his next shot in 4.5 or 4.75 more hours. (I had to shoot early last night because we went out, but only by about 45 minutes so I am creeping it back to it's normal time at 8pm about 10 minutes each cycle.) I know that can have an effect too, but I have not seen a low number from him yet, although the signs of DKA are gone now and I can tell he feels *much* better than before. I am frustrated an worried and scared that these numbers are not coming down.

Shouldn't the pre-shot BG be the highest since the previous shot is wearing off?? Why would he be so high when he should be at least a little controlled and at his peek? You know I am thinking now and previous days I was doing 6+ checks and it was in the 270's...could he peak and start back up within 1-2 hours?? (I need a spread sheet, I know.)

I am thinking maybe he had a food spike and ate some dry...should have given him his wet before I went to the store. :(

I am feeling very sad an anxious...
 
Re: How many cycles to fill the shed?

Welcome, Sara.

In general, it takes 5 - 7 days for a cat's numbers to start responding. Unlike some of the other types of insulin that are shorter acting and very potent (i.e., they yank numbers down), Lantus has longer duration. You end up sacrificing some of the potency for an insulin that is gentler and safer and longer lasting.

In response to your question about what to do, I would keep doing what you're doing. Increasing the dose is not a great idea at this point. What you could do that would still be safe and may help with numbers just a bit, is to move your shot time back by 30 min. You can adjust shot times by up to 30 min. per day or 15 min. per shot. The effect should be minimal.

I hope you will continue to post here. The people on this Board are very generous with their time and expertise. It would help us to lend you a hand if you can put together a spreadsheet that keeps track of your cat's test data. I included a link to the template we use.

Please let us know if you have questions or how we can help.
 
Re: How many cycles to fill the shed?

Sara,
By testing in the beginning, you will learn where your cat's nadir is, what his curve is like.
I have 2 cats and each has a diff curve.
Shadoe has nadir around +5 and her curve looks like a valley.
Oliver has nadir around +10-+11 and his curve looks more like a mountain, so his numbers at mid cycle are most times higher than his ps.

The more data you gather, the more clear you will see what's going on.
With each day, the picture will be more visible, but it'll take some time.
 
Re: How many cycles to fill the shed?

Ok, no increases, promise.
Just going to do more testing and get a clearer picture. Thanks for sharing about how different a chart can be for a different cat.
Just hearing stories from friends who have lost cats to diabetic shock and feeling sad and panicky.
 
Re: How many cycles to fill the shed?

I'm sorry to hear about your friends' losses. Diabetes can be a tough disease to manage. I would guess, though, that your friends may not have been home testing and/or were not using Lantus. Home testing is the best possible way you can keep your cat safe. It's why we are always pushing people to test -- safety is the one non-negotiable. Other types of insulin, like Humulin N which many vets still prescribe for cats, can be dangerous to use if you're not home testing. While no insulin is 100% safe, Lantus is gentle and safer than most.

It looks like you added a link to Duncan's SS in your signature. However, you need to fix the link. Here's what's in your signature:
In order for the link to be active, you need to include the http:// location. If you go to your SS and copy the info in the location line on your browser, you then want to paste it in the first URL bracket --. Hopefully, if you've set the access parameters correctly, we'll be able to link to your cat's SS.
 
Re: How many cycles to fill the shed?

Sara - very first, a BIG LOOOONG HUG! I remember the day I sat right where you are right now....sad, discouraged, convinced I couldn't do it right for my baby, sad that the numbers were still high and nothing was working, reading about people losing their babies especially to hypoglycemia and terrified that would be me, afraid I was going to kill my cat instead of help him, poking him for tests, feeling I was the reason it wasn't happening. After all, if I take an aspirin, my headaches goes away - WHY, OH WHY, OH WHY is this 'medicine' not helping him? If I give him antibiotics, he gets well....WHY, OH WHY, OH WHY.....I just wanted to sit in the closet by myself and cry.

....then....I wrote about it in MY condo....and people hugged me....gave me encouragement, kept giving me hugs...helped me realize that

* I was NOT killing my cat
* the tests were giving me information that HE couldn't tell me so those pokies are HIS voice
* BIGGEST THING - Insulin is NOT a 'medicine', it's a hormone that's missing in my cat's body and has been for a while.
* I'm providing the hormone that lets my cat get the right things out of his food. If I don't give him insulin, he'll eat until he literally starves as his body can't use the food.
* As long as I test, I can protect my cat from those unsuspected low drops
* I can control those low numbers if I SEE them

SO - TODAY - I give you

* BIG LOOOOONG HUGS,
* Remind you that if you weren't trying to help your baby, you wouldn't even BE here at FDMB
* Give you another big long hug
* and tell you YOU'RE DOING GOOD!!!!!

Hugs from all our furry feet including the ones in slippers!!!!
 
Re: How many cycles to fill the shed?

oh sara, we truly do all understand. you're doing the right thing right now - arming yourself with information from people who understand feline diabetes and how it works. the beginning is the hardest part, i think, because you only know enough to be scared. we're here to teach you how to see how duncan is responding to it.

i like to think of the spreadsheet as being like a jigsaw puzzle. the preshot numbers and the dose are like the edge pieces - they tell us some. the tests you get mid-cycle over the course of the coming days will help to fill out the picture. for now, holding the dose is the right thing to do - after 5-7 days have passed we'll be able to see where you go next. try to get at least 1 mid-cycle test in between each shot. it can be different times but collectively over days it will tell us a lot about Duncan.

yes, cats bodies respond differently to lantus. some will dip quickly and then bounce up into higher numbers. some will have a flat curve. at the beginning most cats are a little bouncy and the numbers will move high-low and not follow the "ideal" lantus curve.

the best thing you can do right now is ask us any questions that you have and read the information on the yellow starred stickies at the top of the lantus forum page. it takes a while to understand how the lantus works and to be able to understand how Duncan's body is responding to it. we don't mind if you don't understand and you ask the same questions again. it can be very confusing.

it'll come! big hugs from me too!
 
Re: How many cycles to fill the shed?

oh, btw, what are you feeding him? do you have him on canned low-carb foods from the Janet & Binky's list?

and your original question about the numbers:

LO on your meter - immediate action of syrup on the kitty's gums, possibly vet trip

under 30 - is a danger zone. we want to give high carb food (the gravy out of the can) and/or karo/pancake syrup to pull up the blood sugar

under 50 - time to give some high carb food to try to keep duncan from going significantly lower. anything under 50 needs attention (give high carbs) and the kitty needs to be retested again in 15-20 minutes to make sure they are staying safe. that 30-50 range isn't necessarily a crisis, just time to take action.

mid 40's-120ish - range of non-diabetic cat. these are ideal numbers

120-250 - good numbers - cats can begin to have organ damage with sustained blood glucose (BG) over 250's, but many of our cats are there daily. you can't prevent it entirely, but we do our best to try to keep under 250.

250-HI - BG changes throughout every day and every night. the protocol that gayle quoted above is our guideline for dose adjustments. none of us want numbers that are high but some cats are very bouncy - with experience people learn how to try to keep them flatter and control the range they go in. we simply can't control all of it. also, we would rather have a cat with sustained high numbers than a minute of too-low numbers, so always, we are watching to prevent our cats from becoming hypoglycemic.

we put our cat's BG numbers in the subject lines of our posts and edit them throughout the day. that lets experienced people be able to see immediately if someone is in trouble.

all cats coming in new like Duncan have higher range in BG's - don't let that over-worry you. it's part of it.

did you say that he has had DKA? if so, people will advise you a little more aggressively with dosing and encourage you to make sure you are testing for ketones regularly. do you have the test strips for testing urine for ketones?
 
Re: Duncan +7 375, +9 357, +8 340

Hi Sara,

Welcome to LantusLand! You'll never be alone on this journey. Some of us (like me) aren't experienced enough to give advice, but there are many incredibly knowledgable people here who are very generous with their time and are always watching to see if someone needs help. The rest of us will be here to cheer you on and share this trip through the world of feline diabetes with you.
 
Status
Not open for further replies.
Back
Top