Hello Again! An update from Bob.

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Gummers

Member Since 2013
Well, despite the impatience in my earlier threads about Bob, I ended up waiting a bit before starting insulin. I kept testing, though I didn't mark on his SS because his readings seemed to be pretty consistently between 330-390 regardless of time of day or meals. In addition to the tests, Bob's diet has also been going great. He has lost 150g... which is lower than the 2% I could go for but I'm trying to be cautious since diabetics sometimes can't process food correctly.

I finally started up a few days ago at the very low dose of 0.5 of lantus. Its been pretty successful I think - I've been getting blood and giving shots with no complications or stress for Bob.

Anyway, after only 4 days I got a 166 on this morning's test and based on the advice in this forum of newbies not shooting below 200, I skipped the morning shot. Is that the right course of action? I'm pretty pleased that he has dipped low so easily and I'm hoping his obesity and neuropathy are treatable with similar ease... I'm sure his numbers will go up again because he's currently chowing down like there is no tomorrow.

When a cat tests lower than 200, when should I test again?

Thanks!
 
You made the right call! I dont use Lantus so I cant answer any of your other questions but I can tell you that if he is below 200 you dont shoot. Someone else like Deb and Wink or Sue and Oliver will be along soon and can answer the rest of your questions. You are doing a great job!! \M/
 
Hi, Deb & Wink here.

You were perfectly safe to skip the shot today.

There are 3 options when the BG is below your shoot/no-shoot threshold, which is currently 200, when you are just starting out with insulin.
1. skip the shot. Skipping the shot is always safe if you are unsure what to do.
2. reduce the dose. Reducing the dose is a possibility, 1/2 normal amount if you know how your cat reacts at those lower numbers. Maybe an option if you will be home to test and give more food.
3. stall. Stalling is waiting and retesting without giving food. Do not feed, do not give insulin and post here for advice. While waiting, get another test in 30 minutes. We want to see if that is a rising or a falling number without a food influence. Stalling may give you the option to shoot the full dose.

Do you have your hypo toolkit made up?

IN CASE OF EMERGENCY - YOUR HYPO KIT

Put together NOW the following items and put in an easily accessible place!
•Phone number of your vet
•Phone number, address and map/directions to your nearest emergency vet (or phone number of the cab company and some cash/credit card)
•Karo syrup, honey or corn syrup
•High carb canned food with gravy – 2-3 cans
•Some favourite treats
•Spare pack of 25 blood glucose strips
•Coffee for you ;)
Click to expand...

What you do depends on how long you have been giving the insulin, if you are home testing, how much test data you have on your SS (spreadsheet), if you are going to be home to monitor, if you have supplies on hand to manage those low numbers and support your cat. Some of the folks on the West Coast are night owls and were probably up last night when you posted. Health forum tends to get quite in the wee hours of the night. You might want to post over in Insulin Support Group Lantus TR if there are not many people here in the Health forum. You can tell who is in the forum by looking at the bottom of the page.

For future reference, we like people to post on the board if they get a low number so we can guide them and help you make your decision. Without that insulin this morning, we can expect Bob to bounce to high numbers. We'll get him back on track.

Next time, please put something like "Help! Dosing advice needed asap" to get more attention on your post and use the question mark post icon.

Here are 2 posts to read and printout for reference, about low numbers and how to handle.

http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=46003
http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=147
 
So, I just gave Bob his PM shot... his bg was 273 which is high but still a lot lower than the numbers I was getting before I started insulin, and lower than I was expecting without a morning shot.

What's going on? I expected #s in the mid 300s. The cat is currently 8.3kgs and is only getting 0.5units.

btw: Yes, I've had a hypo kit prepped since he was first diagnosed.
 
Well, one scenario for what is going on with Bob's BG numbers is that his pancreas is healing and helping out a bit.

It does look like Bob dropped lower overnight last night.

Would you be able to get a test before you head off to bed tonight? It can give us some good clues as to what is going on with him at night.

Then, I notice your morning shot time is 8-8:30 local time. Are you up much earlier than that time? Maybe take a test in the morning as soon as you get up?
 
A test at midnight would be great. I think that would be a +4 if I calculated correctly. Is that correct?
 
Just took a test at +4 (midnight) and got 264. Not much change.

I'm hitting the hay! Night folks, and thanks for the good work you do!
 
He is probbaly bouncing. Nice to see the insulin is working though.

Can you update your signature to include the Type of insulin you are using (lantus) and what food he is getting?
Thanks
Wendy
 
Wendy&Tiggy said:
;) i love the "Addicted to" bit of your signature!!

Hope he comes down from the bounce soon.. how late was that shot yesterday? Remember if you shoot more than 30 mins late you need to adjust the shot time of your subsequent shots.

Fancy doing a profile? We would love to learn more about Bob and it will help other members review and advise.. http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=79123
Click to expand...

I shot at 10pm instead of 8:00ish. :( Unfortunately, car troubles meant instead of being home at 8pm, I wasn't home until 9:30ish and didn't get the shot in until about 10pm. So I read that shooting 15 minutes earlier or later doesn't make a big difference, so I shot him around 9:45 today and I'll see if I can bump it up to 9:30 for tonight. My best time is to shoot around 8-8:30.

He had higher numbers today. I'm not worried, I assume it takes a while to find the right dose and establish a routine. His numbers are still lower than I was seeing pre-insulin, and I'm happy with any gains we make, no matter how small. I'll see about that profile.
 
So I read that shooting 15 minutes earlier or later doesn't make a big difference,
Click to expand...
With Lantus, you can move the shot 15 minutes twice a day or 30 minutes once a day to get back on schedule. Yes, 12/12 schedule is ideal but sometimes life and responsibilities and car problems interfere.

He had higher numbers today. I'm not worried, I assume it takes a while to find the right dose and establish a routine. His numbers are still lower than I was seeing pre-insulin, and I'm happy with any gains we make, no matter how small.
Click to expand...
It does take time to find the right dose and the 'right dose' needs to be adjusted and keeps changing.

Have you looked over at the Stickies in the Insulin Support Group Lantus TR forum? There is a lot of good information there.
 
Yes, I've read through every one of the lantus pages but there is a lot of info so I probably will read through again in the near future.
 
After 5-7 days on Lantus insulin, the depot should be filled. This is when we should start to see more of how Lantus will work for Bob.

In the early days on insulin, the more test data you get, the more helpful it will be. We still need some more data to pin down Bob's nadir. Just because typical nadir is around +5-7, doesn't mean that Bob's nadir will be in that time frame.

Because of the AM blue number you got on 20/6/13, I think Bob may be dropping low overnight. Think about what testing you can get overnight. It only happened once so far, but it is common for cats to drop lower overnight.
 
Bob gets most of his food during the night time. I give them 2/3 of their food so that they let me sleep. My other two cats are not enjoying being on a diet (they are obese also) so they will literally hit me in the face with their paw pads and meow while sitting on my pillow... which isn't a problem during the day but at night its awful.

Would Bob still go lower at night if that's when he gets most of his food?
 
Would Bob still go lower at night if that's when he gets most of his food?
Click to expand...

Maybe. It's not known all the reasons why cats do drop lower at night. Food intake is one factor. Exercise or activity level is another. If you are more active, you are burning more fuel.

Insulin decreases BG numbers.
Food increases BG numbers.

It's finding the balance between the two that is difficult.
 
Hey! I didn't put the candle icon on.. not intentionally.

Bob had a 400 today. :( I think its because when I woke up I caught him licking cheese and tomato sauce from lasagna out of a bowl on the counter... or it could be bouncing still? Not sure. I will try and do more tests today to see how low he is going.

He must be feeling pretty hungry since he isn't one to hop onto counters.
 
Danielle, That was me that goofed and accidently put a candle post icon on my reply. I did fix it on my post. I'd like to blame it on my sugarhunk Wink since he likes to step on the keys and start posting himself.

Lasagna with cheese and tomato sauce! :o That is yummy contraband food for your sugarkitty Bob. Could be the contraband or still bouncing as the probable causes of the BG spike. ohmygod_smile

Some tests in the +5-7 time frame are good to see when nadir is. Probably already told you that before.

Need ~O) ~O) ~O) this morning. Only problem is, I'm not a coffee drinker so none in the house. Thunderstorms at 3 am woke me up and I didn't get to bed until 1am because I was monitoring a member with low numbers. Then the cats woke me up at 5:30 for breakfast. Need a long nap today. My apologies for any incoherent replies and rambling on.
 
Lasagna! Bob was channeling Garfield! And given tomato sauce generally has sugar in it, it could well spike his BG.

If he is hungry, feed him more (as long as he isn't gaining weight). Unregulated diabetic cats can't process food properly and are starving so he may need more calories for now,
 
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