First skipped shot questions

[TravisM]

I apologize I still don't have Beeb's ss set up yet, but his preshot numbers have been pretty consistently in the 190 + to mid 250 range and I give him his full 2 unit dose at 9/9 . This is with the exception of one preshot number on Dec 2nd that was 134, then 40 minutes later 147 and 20 minutes later at 159 when I gave him 1.5 units of insulin.

I have been generally trying for the most part to be giving him his insulin at 9 and 9, and when ever we get off the schedule time wise , I have read your notes on how to get back on schedule and followed it as much as possible.

Today his preshot was 110 at 9:20 am, 128 at 9:52 am , and 136 at 10:31 am. Since his numbers are rising but still below 150 and it is pretty much an hour and half past his shot time, I decided to skip this dose and get him back hopefully this evening at 9 pm.

I have been giving him any food he will eat since the inital 9:20 reading today trying to get that number up so I can give him his insulin and also because I start getting very nervous when I see readings from him that are that low. I normally try to get a good meal in him a couple hours prior to his preshot test/injection so his numbers are good enough to give him his insulin.

Any comments on what I could have or should have done instead of with holding the shot this morning or what to possibly expect this evening for a preshot reading ?

 

[Sienne and Gabby (GA)]

Just to make sure I'm understanding, you do not want to feed Beeb in the 2-hour window prior to his shot time. If you are stalling to see where numbers are heading, you should not give any food since the food will raise numbers and you won't know if it's truly safe to give a shot.

When you're stalling, the insulin from the previous dose is wearing off. In addition, even when you do shoot, it takes about 2 hours for Lantus onset to occur. That said, it takes a while for the caregiver to get comfortable with shooting lower numbers. I suggest that you think about where you would be comfortable shooting and gradually work your way down to shooting lower numbers.

Can we offer you some help with getting Beeb's spreadsheet set up? Personally, I'm not a fan of offering any suggestions without the benefit of seeing a cat's spreadsheet. I'm tagging Bhooma (@Bandit's Mom) and she can lend a hand with the set-up.

 

[TravisM]

I don't mean to sound argumentive, but I don't really understand. Aren't his numbers going to be falling if he has not eaten in 2 or more hours ? I thought you want to give the insulin after eating so it " has something to work on"? And if his numbers are falling and below 200 already, don't I want to be doing something at that stage to bring them back up a bit? ( I really don't feel comfortable with him much below 200 at this point in time - especially when it is a preshot reading - maybe if I can get him further along in his disease stages I will, but I don't now- so I guess around 175 would be about my minimum comfort level for insulin shots - this is really nerve racking for me and is pretty much consuming my life when things are not going well like this morning. He is becoming more and more finicky and getting tougher to get to eat. For example this morning he had a small bowl of kibble about 3 am when he normally gets me up to eat and then I got up at 7 am and got him to eat another small bowl of kibble maybe a small bowl and a quarter. ( I measured out what I mean by small bowl and it is at most 1 1/2 tablespoons of food.) In order to get him to eat his kibble these days I am needing to sprinkle and mix in a couple of crushed cat treats like Friskies party mix and actively encourage him as well. I gave him a 1/4 of a cerenia yesterday and did a few days ago as well to help in case he is nauseated or generally not feeling well from his triaditis or what ever else may be making him ill. I just feel like anytime I can get him to eat it is a good thing ?

Marje and Gracie has already graciously told me she would help me set up a ss for Beeb- I just need to get her the information she needs to do it so there is no need for Bandit's Mom to work on it, thank you for asking her though.

 

[Sienne and Gabby (GA)]

You're not being argumentative in the least. We want you to ask questions so you understand what we're basing our input on..

First, consider the nature of cats. They do not like to be predictable. Your correct in that logic would dictate that a cat's numbers should be falling by the end of the cycle due to insulin wearing off and your cat not having been fed for several hours. However, I suspect there are days when you are ravenous at breakfast and days when you're not interested in eating. Appetite can vary. With respect to insulin, while there are certainly times when numbers are rising, what I saw with my own cat and with other kitties here is that rising numbers are not always the case. There are times when numbers are dropping at pre-shot times. It is entirely counterintuitive. It's also why we strongly push for pre-shot tests.

Numbers may be dropping and what you're not factoring in is the depot. There are times when the action of the depot throws you a curve. If you've not seen this post, it provides information on the depot.

No one would expect you to be shooting low numbers at this point in your managing Beeb's diabetes. My suggestion was more to get you to start thinking in those terms. One of the basic principles of using Lantus is, "Shoot low to stay low." If you look at some of the spreadsheets on the Lantus forum, you'll see members shooting what are normal blood glucose numbers. You'll also see a lot of green on those spreadsheets.

Are you feeding Beeb his usual kibble? If you've switched over to a diabetic kibble, chances are he doesn't like it or he's gotten tired of it. It's also likely to be high in carbs. There may be better alternatives.

 

[TravisM]

I am feeding his usual prescribed kibble for his triaditis and another combo triaditis/CKD. He has been on the first for about 3 years and the second (which doesnt look very appetizing to me) for about 6-9 months - I can't blame him for getting tired of them. The vet told me that if I switch to a diabetic kibble one of the other two diseases may come roaring back instead- the triaditis almost killed him with a bad bout 3 years ago so I think I am sticking with the lesser of the possible evils, if I can keep him interested enough to keep eating it.

Beeb just tested at 197. I thought he would test much higher or at least in the mid 200's, but I felt comfortable to give him his regular 2 unit shot. I have read the article on the glargine insulin type depot a couple times- I still don't fully understand the chemistry/mechanics involved but maybe this is just what today was about. See what the morning brings.

Thank you for your help and support Sienne. It is much appreciated during a tough time. I tend to second and third and fourth guess everything involving my pets health.