Hercules 10/08 I am wondering if his BG values have anything to do with insulin....

Hercule's mum

Hercule's mum

Member Since 2020
It has been a while, but I seem to have hit a brick wall and would welcome some advice/suggestions.

Hercules is now a "long-term" diabetic cat that is still unregulated! He's never been in a very high dose, and when I go above 0.5 he tends to need a lot oh HC support.

Not too long ago he was doing really well on a 0.2 dose. I dropped further and things spiralled out of control. This has happened before.

At the moment his numbers makes no sense to me, and most days we have a "mountain cycle", instead of flats or smiles. I am wondering if the insulin at this point is doing absolutely nothing and what I am seeing is just his response to food... Is it possible?

The simple answer is that I need to increase his dose, but I am back at work and cannot keep a close eye on him. Just yesterday he was in lime green towards the end of the cycle...

What do you guys reckon I should do?
 
Hi Karen, nice to see you after a long time :bighug: So sorry Hercules still doesn't find his dose, hope it will happen soon.

i have no idea how to manage FD and go to the office :( I am lucky Denis is still in HO. If i can add my 2 cents, i don't think Hercules needs a dose increase, just yesterday he reached 49 on this dose. Maybe just choose a dose and stick with it for longer, it has to be 0.2 or 0.18, in my opinion both were still bringing him to lower green values and the rest is just bouncing, as long as he reaches a lower green value here an there it still gives him the chance to regulate on that dose.

I will tag some experienced people to jump in and help with more constructive advice: @Bandit's Mom @tiffmaxee @Sienne and Gabby (GA) @Marje and Gracie

Good luck :bighug:
 
It looked to me like he has a late nadir but it also could be he needs more mini meals spread out later. By stopping food at +4 he’s going low by the latter quarter of the cycle. If anything I would feed more mini meals and a slightly higher carb to prevents the lows and eliminate the need for a lot of hc and then the bouncing.
 
Thanks both for your thoughts!

@tiffmaxee
Unfortunately I can't do minimeals anymore because I am no longer at home and there are two cats in the household (so automatic feeder does not work....). I'm giving him insulin at 5am, so I can get out of the door to work by +4.
I have tried feeding him 6 and 9% food, but his numbers just got higher. I supposed I can increase the % and the dose, but that may not prevent him goind down through the day...
I think he is quite carb sensitive, as you can see the huge jumps (as last night, from 92 to 256 after a meal of 2% carbs....). Perhaps give him a small portion at PS, and larger portions at +2 and +4?
 
I don’t think so. I think he needs food between +4 and whenever you get home from work. I don’t think the 2% raised the bg. It was a bounce from the 49. Can you lock him in a room with a feeder to see if it helps? I know that’s not ideal. One of mine hates closed doors so much I have locks on my doors. The other one eats my clothes if she gets a chance.
 
Thanks everyone!

I must say I am a bit confused about the suggestion to switch to lev....When I tought about it, was when he was diving at the begining of the cycle. How will lev help if he is having late nadirs? Or is the idea to try a different insulin?
 
Wendy is the big champion of Lev around here and she is on vacay, but from what I have heard said around here, Levemir is better at pulling high numbers lower and keeping them more steady. It's also recommended because it doesn't sting as much as Lantus at higher doses but that's not Hercules' problem. Here's a bit from the link at the top of the Insulin Care sticky:

"Levemir has demonstrated less variable, steadier blood glucose-lowering effects compared to both NPH insulin and Lantus. Comparing Levemir with Lantus when used with a fast-acting insulin in patients with type 1 diabetes, Levemir had a lower risk of major hypoglycemia and nocturnal hypoglycemia, but the risk of hypoglycemia overall was comparable."

@SashaV is very happy with Levemir, hopefully she will check in and give you her perspective.
 
Sorry for my late response!

Lev is not better at pulling numbers down, as I understand it. But many have better experience with it, especially when Lantus doesn't do the trick.
Nadir on Lev can be very late, or not even in the same cycle as given.

It's probably just me, but often I see Lev as the go-to when nothing else is working. I rarely see cats being SO flat as Ruby on lantus, but again it's probably just me. Maybe I'm seeing more Lev spreadsheets?

I really do think Herc could do better on it.
And if your vet is uncooperative let me know. I'm wasting a ton of juice of not hitting the right spot, no one would know the difference if a pen landed in the UK. On the tiny dose Herc is on, one pen would last you forever. So let me know!
 
Thanks Katherine and Sasha. Sasha you make me LOL! Indeed, I am still half way through the Lantus prescription I got last year.... I am very tempted to try!
 
Hercule's mum said:
Thanks Katherine and Sasha. Sasha you make me LOL! Indeed, I am still half way through the Lantus prescription I got last year.... I am very tempted to try!
Click to expand...
23rd of May and a few more day, then it's one pen for me. So just let me know! :bighug:
 
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