? High numbers...

[Scratches123]

Scratches has been very high for a while. She had some real good numbers in the past and I think I jumped the gun and lowered her dose too quickly when I saw she dipped to 70 and 90 a couple times. Now I can't seem to get on track again. Perhaps her insulin has gone bad? I've had it over two months. And her vet (we don't see this vet anymore) basically told me all the wrong things. Like, it's perfectly okay to inject insulin back into the pen to get air bubbles out. Which I was doing for a couple weeks before I found out that wasn't true. I also dropped the pen a couple times. There isn't that much left in it anyways, so I wouldn't feel terrible about getting a new one just to be on the safe side. Now I'm worried that if I raise her dose with this current insulin, then when it runs out I'll be using the same dose with the new insulin. And what if the old one has gone bad and I use a high dose with the new one. Wouldn't that over dose her? I'm sorry if I'm asking stupid questions. I think too much

 

[Sonia & Leo]

Good morning, sorry I can't help you with dosing but let's get your thread bumped up so more eyes are on it and you get a quicker response.
Putting a "?" in your thread title will help also.

 

[Sonia & Leo]

Bump

 

[AmandaE]

I have a feeling that it isn’t your insulin that is the problem, I think it might be the amount of insulin... I believe Scratches needs more.

With SLGS you typically hold the dose 7 days, do a curve and then based on the nadir value, you increase or decrease. I see you’ve been on this dose for about 14 days and even though you haven’t gotten a full curve, I do think that you have somewhat of a spread of data.

If it were me, based on the numbers you have, I would increase by 0.25u tonight and try to do a curve early on in the weekend if possible. Do you think you would be able to do a full curve this weekend?

 

[Scratches123]

I have a feeling that it isn’t your insulin that is the problem, I think it might be the amount of insulin... I believe Scratches needs more.

With SLGS you typically hold the dose 7 days, do a curve and then based on the nadir value, you increase or decrease. I see you’ve been on this dose for about 14 days and even though you haven’t gotten a full curve, I do think that you have somewhat of a spread of data.

If it were me, based on the numbers you have, I would increase by 0.25u tonight and try to do a curve early on in the weekend if possible. Do you think you would be able to do a full curve this weekend?

I could do that, yes. Scratches just switched vets last month and we absolutely love her new one, and she wanted us to stick with the doses for two weeks for now, and to email her the spreadsheet and she will give advice. So based on her advice and everyone's advice through this forum and Facebook, I'm trying to make decisions based on everyone's advice. I will email my vet today. I think I'll have time to do a full curve this weekend. I do the best I can, it's just me at home and I work full time and no one else is around to help and it's nearly impossible for me to be home all day to do a full curve so I try to get as many readings throughout the day as I can. I'm sure her vet will also want me to increase. The more I'm reading, I'm seeing that lantus isn't that delicate where some air bubble will ruin it. Thank you!!

 

[AmandaE]

I could do that, yes. Scratches just switched vets last month and we absolutely love her new one, and she wanted us to stick with the doses for two weeks for now, and to email her the spreadsheet and she will give advice. So based on her advice and everyone's advice through this forum and Facebook, I'm trying to make decisions based on everyone's advice. I will email my vet today. I think I'll have time to do a full curve this weekend. I do the best I can, it's just me at home and I work full time and no one else is around to help and it's nearly impossible for me to be home all day to do a full curve so I try to get as many readings throughout the day as I can. I'm sure her vet will also want me to increase. The more I'm reading, I'm seeing that lantus isn't that delicate where some air bubble will ruin it. Thank you!!

Oh Awesome! I’m so glad for you that you found a vet that you love! No pressure to strictly follow some of the strategy’s here, especially if you trust your vet. It’s really encouraging that she likes the spreadsheet and that you can consult with her about increases. I think it would be smart to write her and mention you’re worried about such high numbers and let her know you’d like to increase.

I think even though you haven’t had a chance to do a curve that you have done an awesome job getting tests in. I know it isn’t easy! I think you’re doing just great! Scratches is just so lucky to have you

 

[Scratches123]

Oh Awesome! I’m so glad for you that you found a vet that you love! No pressure to strictly follow some of the strategy’s here, especially if you trust your vet. It’s really encouraging that she likes the spreadsheet and that you can consult with her about increases. I think it would be smart to write her and mention you’re worried about such high numbers and let her know you’d like to increase.

I think even though you haven’t had a chance to do a curve that you have done an awesome job getting tests in. I know it isn’t easy! I think you’re doing just great! Scratches is just so lucky to have you

I am really fortunate to have her as a vet. Her last vet almost killed her. She had her on two units and didn't tell me how important it was for diet change and home testing. She dropped in the 40s one night shortly after I started home testing. I noticed she was acting very sluggish and seemed really weak for a couple weeks after starting her insulin. If I hasn't found this forum my cat would probably be dead. I am really grateful for everyone here and her new vet. I know a lot of people struggle with their vets. I just emailed her telling her my concerns with the insulin and maybe she needs an increase. Scratches first appointment I sent the spreadsheet over and when we first met her the first thing she said was how much she loved the spreadsheet

 

[Gill & George]

As long as your insulin still looks clear and no 'floaties' it's probably good. We try to be careful with it to make sure it lasts as long as possible and we can use every last drop.

You're doing a great job of getting tests in. It does appear as though Scratches needs more insulin, though on SLGS it's recommended you do a full curve before taken her up, in your case you it seems you have sufficient data to support an increase.

I'm glad that you like your new vet and you feel that you can work with her. I'm glad she likes the SS. Hopefully she'll be receptive to your input and you can develop a good working relationship. I'm sorry you had such a bad experience with your first vet.

I'm not liking the idea of holding onto a dose that is not getting a kitty into good numbers for 2 weeks though, this can lead to Glucose Toxicity and ultimately you will be 'chasing' the BG and will struggle to get BG down into normal range, if I'm honest, that's one of the main reasons I chose TR over SLGS. I mention it because you are testing enough to do TR should you want to. You can always hold on to the dose a little longer if you are unsure, increasing when you know you can monitor.

I've linked a post that has some interesting reading and describes the effects of Glucose Toxicity.

 

[Olive & Paula]

Your doing great. Since vet wants you to hold dose for 14 days, would she compromise with you and agree to hold for 10 days?

 

[Scratches123]

As long as your insulin still looks clear and no 'floaties' it's probably good. We try to be careful with it to make sure it lasts as long as possible and we can use every last drop.

You're doing a great job of getting tests in. It does appear as though Scratches needs more insulin, though on SLGS it's recommended you do a full curve before taken her up, in your case you it seems you have sufficient data to support an increase.

I'm glad that you like your new vet and you feel that you can work with her. I'm glad she likes the SS. Hopefully she'll be receptive to your input and you can develop a good working relationship. I'm sorry you had such a bad experience with your first vet.

I'm not liking the idea of holding onto a dose that is not getting a kitty into good numbers for 2 weeks though, this can lead to Glucose Toxicity and ultimately you will be 'chasing' the BG and will struggle to get BG down into normal range, if I'm honest, that's one of the main reasons I chose TR over SLGS. I mention it because you are testing enough to do TR should you want to. You can always hold on to the dose a little longer if you are unsure, increasing when you know you can monitor.

I've linked a post that has some interesting reading and describes the effects of Glucose Toxicity.

I will look more into TR. It just worries me bc I'm not home during the day. I can come home to test her on lunch though. I wasn't thinking there was such bad co

As long as your insulin still looks clear and no 'floaties' it's probably good. We try to be careful with it to make sure it lasts as long as possible and we can use every last drop.

You're doing a great job of getting tests in. It does appear as though Scratches needs more insulin, though on SLGS it's recommended you do a full curve before taken her up, in your case you it seems you have sufficient data to support an increase.

I'm glad that you like your new vet and you feel that you can work with her. I'm glad she likes the SS. Hopefully she'll be receptive to your input and you can develop a good working relationship. I'm sorry you had such a bad experience with your first vet.

I'm not liking the idea of holding onto a dose that is not getting a kitty into good numbers for 2 weeks though, this can lead to Glucose Toxicity and ultimately you will be 'chasing' the BG and will struggle to get BG down into normal range, if I'm honest, that's one of the main reasons I chose TR over SLGS. I mention it because you are testing enough to do TR should you want to. You can always hold on to the dose a little longer if you are unsure, increasing when you know you can monitor.

I've linked a post that has some interesting reading and describes the effects of Glucose Toxicity.

I will look more into TR. It just worries me bc I'm not home during the day. I can come home to test her on lunch though. I wasn't thinking there was such bad consequences to leaving her at high numbers for a couple weeks before increasing dose. I will start to email the vet the spreadsheet earlier than two weeks from now on.

 

[Scratches123]

Your doing great. Since vet wants you to hold dose for 14 days, would she compromise with you and agree to hold for 10 days?

Yes I wasn't even thinking long term effects when she recommended two weeks. I will email the spreadsheet sooner than two weeks from now on.

 

[Gill & George]

I wasn't thinking there was such bad consequences to leaving her at high numbers for a couple weeks before increasing dose.

Some cats are more prone to glucose toxicity than others. But yes, it can make it harder to regulate and ultimately get them to remission.

I will look more into TR. It just worries me bc I'm not home during the day.

I can understand that I had the luxury of being at home. We have had numerous members that have followed TR successfully with demanding work schedules though.

The following TR with a full time job link below, will give you an idea of strategies that some used to be able to follow it safely.
Let us know if you have any questions. It's worth considering

http://www.felinediabetes.com/FDMB/...ion-possible-with-a-full-time-job-yes.129378/

 

[Scratches123]

Some cats are more prone to glucose toxicity than others. But yes, it can make it harder to regulate and ultimately get them to remission.

I can understand that I had the luxury of being at home. We have had numerous members that have followed TR successfully with demanding work schedules though.

The following TR with a full time job link below, will give you an idea of strategies that some used to be able to follow it safely.
Let us know if you have any questions. It's worth considering

http://www.felinediabetes.com/FDMB/...ion-possible-with-a-full-time-job-yes.129378/

There are a bunch of terms I'm still not familiar with when im doing my research. Like "running down the dosing scale"

Stuff like that.

 

[Gill & George]

There are a bunch of terms I'm still not familiar with when im doing my research. Like "running down the dosing scale"

Stuff like that.

Running down the dosing scale, is when they earn reductions fairly quickly and they need less and less insulin.
There's a LL dictionary for some of the slang we use, here's the link
http://www.felinediabetes.com/FDMB/threads/lantus-basaglar-levemir-isg-slang-dictionary.1903/

 

[Penelope and Mačka]

Like, it's perfectly okay to inject insulin back into the pen to get air bubbles out. Which I was doing for a couple weeks before I found out that wasn't true. I also dropped the pen a couple times. There isn't that much left in it anyways, so I wouldn't feel terrible about getting a new one just to be on the safe side. Now I'm worried that if I raise her dose with this current insulin, then when it runs out I'll be using the same dose with the new insulin. And what if the old one has gone bad and I use a high dose with the new one. Wouldn't that over dose her? I'm sorry if I'm asking stupid questions.

I had the same worries.
Macka's numbers were consistently (still are a little) too high and I blamed it on the insulin. After 6 months with the SAME vial, he finally goes into better numbers. I will probably finish this vial within the next couple of days, to the last drop. At the beginning, I injected air bubbles every time, as I did not know. I left the vial on the counter, etc... Looks like this insulin is more solid than we think.

 

[Scratches123]

I had the same worries.
Macka's numbers were consistently (still are a little) too high and I blamed it on the insulin. After 6 months with the SAME vial, he finally goes into better numbers. I will probably finish this vial within the next couple of days, to the last drop. At the beginning, I injected air bubbles every time, as I did not know. I left the vial on the counter, etc... Looks like this insulin is more solid than we think.

Okay, phew. I tend to think too much at times and having anxiety doesn't help, haha. I'll start giving her 1.25 units tonight and see if that helps in a few days.

 

[Sue and Luci]

You're doing a great job with Scratches! Plenty of testing...and I agree with above posters, it's definitely time for an increase.

Often vets, although trying to be helpful and supportive are not as up to date on all things Feline Diabetes as the people in this forum. I know it may seem confusing as you try to sort out who's advice to take - but you can certainly believe that your vet is seeing many types of animals and animal problems and hence her knowledge of FD is diluted. The people on here - especially the commenters above have their focus on feline diabetes and have much experience and knowledge of that subject. I hope that helps you with your decisions somewhat.

You're doing the right thing by increasing now.

And now for a bit of housekeeping: Could you please edit your title and set it up like this: 11/18 Scratches AMPS 286 - ? High Numbers...

That'll help us all keep things straight as there are many posts on the forum; and when you post tomorrow you'll want to do the same sort of thing: 11/19 Scratches AMPS ### ...

Looking forward to seeing you here daily with good news about scratches Welcome!

It's helpful if you have posted previously to put that as your first line so we can look back at your history. Just copy and paste the url from that post into this one - you can get fancy with it later

 

[Sienne and Gabby (GA)]

I'm one of those members who followed TR, work full time, and I was the only person managing Gabby's diabetes. TR is possible with a full time job. One advantage of TR is that the protocol was published in a leading veterinary journal. I've attached the journal article should you want to share it with your vet.

With either of the dosing methods we use, Start Low Go Slow (SLGS) or Tight Regulation, the dose isn't held as long as you've been holding Scratches dose. With TR, doses are evaluated every 3 - 5 days whereas with SLGS, you evaluate every 7 days unless a dose reduction is warranted. As Gill noted, holding a dose that's not bringing your cat into better numbers can cause glucose toxicity to develop. The term sounds worse than it really is. Basically, your cat's body acclimates to the higher numbers and treats them like the new "normal."