I guess I need to forget everything I thought I knew... and start over

[Sieden]

I was told to come over here and get myself some help. I should have done this a long time ago because I'm all over the place. There was a time when I worked closely with someone and we had things under control but then I went off on my own and lost control because I have a hard time sticking to a schedule. Anyway, yes I'm an adult and I'm admitting that I need help. I think that the guy that I was working with never took the time to explain to me how Lantus works and he would see the numbers and give me a set dose to use but he never explained why. So here we are and I still don't understand what Lantus really does and maybe that's why I'm having a hard time adjusting Peanut's dose on my own.

Thanks,
Erika

 

[rhiannon and shadow (GA)]

here's a link to yesterday

today's action and numbers look great.

If you post daily, we can help, and we can especially explain why to the suggestions made.....


You don't need to withhold food when getting a curve....

diabetics do better with several smaller meals a day..... it helps to keep the sugar levels more level.
The only time we ask you to not feed is the two hour window before shot time.....
that is so you don't have a food influenced pre shot number.

I hope that you can start testing more freuently, especially if the numbers call for monitoring.

I have a feeling he might earn a reduction soon ( needs to go below 50) unless you are doing the slow method in which case
he did earn a reduction.

 

[Wendy&Neko]

Hello and welcome. What's past is past, so we'll help you help Peanut going forward. First, take a read of the Sticky Notes at the top of this forum. There is a lot (overwhelming at first) of information, but we love answering questions and helping. There are two methods for dosing we use here, and people chose one or the other based on their personal circumstances. You'll see that both of them figure out what dose to give based on how low it takes kitty, and both stick with consistent dosing unless he earns a reduction, or the dose isn't enough and needs to be increased. And we hold the same dose for at least six cycles after an increase to build the depot. The nice thing about having the dosing methods, Tight Regulation or Start Low Go Slow Method, is that they give you pretty straight forward guidelines to follow. And just ask if you aren't sure what to do.

When was Peanut first diagnosed with diabetes?

 

[Sieden]

here's a link to yesterday

today's action and numbers look great.

If you post daily, we can help, and we can especially explain why to the suggestions made.....


You don't need to withhold food when getting a curve....

diabetics do better with several smaller meals a day..... it helps to keep the sugar levels more level.
The only time we ask you to not feed is the two hour window before shot time.....
that is so you don't have a food influenced pre shot number.

I hope that you can start testing more freuently, especially if the numbers call for monitoring.

I have a feeling he might earn a reduction soon ( needs to go below 50) unless you are doing the slow method in which case
he did earn a reduction.

Today was a smack in the face and a wake up call for me that's why I'm here. I've never dealt with an emergency before and I panicked. Poor Peanut did not appreciate the rush of honey in his mouth either lol.

I will try to post daily for help understanding.

I was not aware that food was not to be withheld during a curve until today. I was feeding them 4 times a day and then went to twice a day because I switched to raw food and that's just a pain in the ass but at the time I was only leaving the food out for 2 hours because that's what the package says and now I know better. I will leave it out for up to 6 hours at a time. In the wild, cats munch on dead animals for hours and even days at a time and they are fine. I get my food from Primal and they test it for pathogens so I don't worry about it. Anyway, usually during the night I pick up the food and then during the day I will leave the food out with the exception of the pre-testing 2 hour window.

I plan to start testing more often to get a bigger picture of what is really going on and I'm also taking him to the vet on Monday for a full blood workup.

 

[Sieden]

Hello and welcome. What's past is past, so we'll help you help Peanut going forward. First, take a read of the Sticky Notes at the top of this forum. There is a lot (overwhelming at first) of information, but we love answering questions and helping. There are two methods for dosing we use here, and people chose one or the other based on their personal circumstances. You'll see that both of them figure out what dose to give based on how low it takes kitty, and both stick with consistent dosing unless he earns a reduction, or the dose isn't enough and needs to be increased. And we hold the same dose for at least six cycles after an increase to build the depot. The nice thing about having the dosing methods, Tight Regulation or Start Low Go Slow Method, is that they give you pretty straight forward guidelines to follow. And just ask if you aren't sure what to do.

When was Peanut first diagnosed with diabetes?

When I worked with someone before I used the Tight Regulation method so I'm quite familiar with it and I'll be choosing that method for now. I haven't have time to read every sticky but I'll finish up with them tomorrow. My main goals are to get them all read, to keep up with posting Peanut's results and to stay on somewhat of a schedule. I'm bad about it but I'm going to try my best to stick close to it and to test often.

Thanks for the warm welcome

 

[Wendy&Neko]

It'll help us if you put TR for Tight Regulation in your signature. Glad you have some familiarity with it.

 

[Bobbie And Bubba]

Good to see that you came over to L & L. We will help you all we can. Ask all the questions you need to . That is how we all learned. Also, I found it helpful to read others condos each day and I learned a lot that too.

 

[Kris & Teasel]

Welcome to the L&L forum! We discussed vets on your other thread. Did you find one that appears to be "user friendly"?

 

[Judy and Boomer]

Welcome to L&LL!
Don't hesitate to ask any questions you may have! Lantus/diabetes does have a bit of a learning curve to it but the members of this board will help you!

 

[Sienne and Gabby (GA)]

Unfortunately, there are a few people who invite people off of the Board with the promise of providing individualized attention. I'm glad you came back!

First, while I can appreciate your being nervous seeing that 51 yesterday, looking over some of the data you provided from about a year ago, there's a pretty good likelihood that Peanut was seeing low mid-cycle numbers. If you were being coached that you didn't need to get spot checks, that's really not the case with Lantus or Lev. With a depot-type of insulin such as these, dosing is based on the lowest number in the cycle. Hopefully, that sounds familiar if you've been following TR.

The other important factor with Lantus is consistency. I know you said keeping to a schedule is hard for you. However, you will get the best results if you shoot at a consistent time twice a day. It's helpful to remember that an early shot acts like a dose increase whereas a late shot acts like a dose reduction. Moving to a drastically earlier shot time, especially if you're not going to be around to test, can be dangerous. If you need to adjust your shot time, we can help you with a strategy to get back on schedule that is less disruptive. In addition, if you keep moving the time, the depot doesn't stabilize and numbers can be all over the place.

Please let us know how we can help.

 

[Sieden]

It'll help us if you put TR for Tight Regulation in your signature. Glad you have some familiarity with it.

Last night I went back and read about both types TR and SLGS and it seems that I was probably doing something more of in between before. I'll have to read it again and try to make up my mind but now I'm leaning more toward the SLGS. We will see, I'm not ready to start clearly, I already F'd up by missing his morning dose. I'm really sick and just couldn't get up today.

 

[Sieden]

Welcome to the L&L forum! We discussed vets on your other thread. Did you find one that appears to be "user friendly"?

I did find one, it only took me 2 tries before I found her. Her name is Dr. Moran and she specializes in cats. She answered every one of the questions you guys gave me to ask her and she answered all of them correctly.

 

[Sieden]

Unfortunately, there are a few people who invite people off of the Board with the promise of providing individualized attention. I'm glad you came back!

First, while I can appreciate your being nervous seeing that 51 yesterday, looking over some of the data you provided from about a year ago, there's a pretty good likelihood that Peanut was seeing low mid-cycle numbers. If you were being coached that you didn't need to get spot checks, that's really not the case with Lantus or Lev. With a depot-type of insulin such as these, dosing is based on the lowest number in the cycle. Hopefully, that sounds familiar if you've been following TR.

The other important factor with Lantus is consistency. I know you said keeping to a schedule is hard for you. However, you will get the best results if you shoot at a consistent time twice a day. It's helpful to remember that an early shot acts like a dose increase whereas a late shot acts like a dose reduction. Moving to a drastically earlier shot time, especially if you're not going to be around to test, can be dangerous. If you need to adjust your shot time, we can help you with a strategy to get back on schedule that is less disruptive. In addition, if you keep moving the time, the depot doesn't stabilize and numbers can be all over the place.

Please let us know how we can help.

Just the word "depot" is foreign to me. I'm not certain that I was on a TR anymore after reading about the SLGS. The man who coached me did tell me to get a mid cycle reading every now and then for when he thought it was needed but he never stressed that it was needed daily or even often for that matter.

 

[Sieden]

Lastly thank you all for the warm welcome, I'm glad to be here. I'm sorry that I missed his AM shot today. I know that it certainly isn't a good way to kick things off. Yesterday I mentioned in my other thread that I was dealing with a pretty severe allergic reaction that I was having to grass because I got caught up in a "grass storm" as the lawn guys were here at my apartment complex yesterday and I had to go outside. I don't simply have "hay fever" or whatever, I'm actually allergic. As dumb luck would have it, I'm also allergic to cats lol. With all of the testing that I had to do yesterday I'm pretty sick today. I'll get his PM dose since I'm already awake and hopefully I'll be feeling better tomorrow.

 

[Kris & Teasel]

I did find one, it only took me 2 tries before I found her. Her name is Dr. Moran and she specializes in cats. She answered every one of the questions you guys gave me to ask her and she answered all of them correctly.

This is great news!!

 

[Chris/China (GA)/Garfield]

Just the word "depot" is foreign to me

Think of the depot as a "timed release" medication.....this isn't exactly how it works, but it'll give you the idea of the concept of the "depot"

You give a shot....some of it goes to work and the rest goes "into the depot" (is stored in the subQ layer)....as the day goes on, the depot releases the insulin back into the bloodstream to go to work.

Once the depot is "full", you will start to see the full effect of that dose......but each time you change the dose, it can take up to 6 cycles for the depot to "stabilize" and release the correct amount.....that's another reason why frequent dose changes aren't good when you're using Lantus....the depot never gets a chance to stabilize and release the correct amount.

 

[Wendy&Neko]

There is a Sticky Note on the depot that is a good read.

As for choosing TR or SLGS, you can always pick one and switch later if you want.

 

[Sieden]

Thanks for explaining, I read the sticky on it too and I understand it now. I did make a choice on the method I'm going to use. I am choosing TR and I put it into my signature.

 

[Sieden]

I feel that last night went well. I'm going to keep it at the 1u for now even though I hate seeing the numbers so high but he's not on his regular food right now. When I go get his raw stuff on Monday it will drop the carbs and that should induce a change and I want to give it a little time to see what happens before I mess with the dose. I will do my best to continue with testing like I did last night depending on if I'm awake during the day or night.

 

[Gill & George]

Hello and welcome to LL,
I'm glad you and Peanut have found your way here.

Since you have gone with 1u and with the recent skipped shots and changed doses, I would try to shoot that 1u consistently now for at least 6 consecutive cycles before changing, (unless Peanut earns a reduction with a drop below 50) that should give the depot time to 'stabilise' and you will be able to see what this dose is really doing for him.
You may be seeing some bouncing from the drop into 51 the other day, though again with the skipped shot and dose changes things could be wonky at the moment, but give it a few cycles and the picture should become clearer. So for now hold that 1u, and see if some consistent dosing gets Peanut into some nice numbers.

Below is an explanation of bouncing taken from the new to the group sticky.

• Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

 

[Sieden]

Thank you for the explanation on the bouncing, that helped to clear it up a little bit for me. I did plan to stick with the 1u for a bit, I had a feeling that it was the right thing to do. I feel good about being here in the LL forum too, thanks for the support.

 

[rhiannon and shadow (GA)]

just a little request....
put NS for no shot in yesterday mornings slot....
you can put in the comments.... was too sick or something.... otherwise, someone will likely ask....

i understand the allergies thing....
mine are so bad that the bones in my ears have eroded. I have to get allergy shots for the rest of my life.

 

[Sieden]

just a little request....
put NS for no shot in yesterday mornings slot....
you can put in the comments.... was too sick or something.... otherwise, someone will likely ask....

i understand the allergies thing....
mine are so bad that the bones in my ears have eroded. I have to get allergy shots for the rest of my life.

Did I put the NS in the correct place or should I move it one place over where I would normally put the 1.0 for 1u?
Also I did go out and get myself some Flonase and Zyrtec which I've never used before because they are so expensive. I was using generic allegra but it never helps.

 

[Gill & George]

Did I put the NS in the correct place or should I move it one place over where I would normally put the 1.0 for 1u?
Also I did go out and get myself some Flonase and Zyrtec which I've never used before because they are so expensive. I was using generic allegra but it never helps.

Pop it where you would right 1u.

Any reason you didn't get any spot checks today?

With TR you want to get at least one test midcycle even if they are high at ps.

If you are up a few hours before you shoot in the morning, perhaps get a +9/+10, or grab a test just before heading to bed.

 

[Sieden]

Pop it where you would right 1u.

Any reason you didn't get any spot checks today?

With TR you want to get at least one test midcycle even if they are high at ps.

If you are up a few hours before you shoot in the morning, perhaps get a +9/+10, or grab a test just before heading to bed.

It's because sometimes I sleep at night and sometimes I sleep during the day time. On 3/25 I was up all night long so that's why I was able to spot check so often and once I gave the dose at 10am on 3/26 I started heading to bed. Sometimes I will be able to get in a spot check before I head to bed and sometimes I definitely will not be able to. I have to take very heavy sedative medications in order for me to go to sleep. I know that MOST people will simply not be able to understand this but it's the way that I've had to sleep for most of my life because I have chronic insomnia which is why I'm up all night long on some nights. I have to time my medication properlly, I can't just take it and then hop into bed, it doesn't work that way. It takes at least an hour to even start to kick in but once it does, it come on fast or it could take several hours so if I start to feel myself getting sleepy very quickly then I know that I CANNOT even consider trying to test him, it's just not an option. I have literally fallen asleep while I was walking across my room and I caught myself while I was falling to the ground. It's very scary. On the other hand if my meds take several hours to kick in then I might take forever to fall asleep and thus won't be able to wake up the next day when it's time for his next dose. So while I understand that the spot checks are important, please understand that I know when I can do them and when I can't. I promise you and everyone else here that I'm going to do everything in my power to really, really try my best but I have to use caution for the sake of Peanut's health and safety. I know that you guys didn't know that I was medicated and that's okay. I'll add it to my signature so that might help for future confusion.

 

[Kris & Teasel]

This FD thing can be difficult to manage when you have your own health issues. All we can do is our best. Unfortunately, Lantus isn't as forgiving as the non depot insulins when it comes to dose timing so it'll be harder for you to get BG stability for Peanut. I know you're working hard to keep him safe.

If, over time, you find you're having difficulty getting better BG control with Lantus because your medical issues are forcing dose amount and timing changes, you could think about trying a non depot insulin like ProZinc. It's quite flexible in dose timing (+ or - an hour isn't an issue) and amount (can be changed at frequently as every 3 cycles once you have enough data).

 

[Gill & George]

We have a number of members that have to take meds for sleep disorders, most find a way to work with their limitations and FD, it can be done
Adding it to your signature would be helpful, it will stop us pestering. I hope you didn't mind me asking, as you are new to the board and to TR (as we do it here) I just wondered if the not testing was because you saw high numbers and just assumed that there was no point in testing.

Good Job getting the before bed last night. Looks like he is flat and yellow for now.

Grabbing tests as and when you can (ie anytime in the cycle) can really help you to understand how Peanut is doing on the dose, so if one day you can't get a before bed, but you can get a +10 say when you wake up, then just get it, the more data you gather the easier it will be for you to understand Peanuts patterns and make good decisions about dosing.
On this site our dosing decisions are very data driven, gathering that data so that over time you can increase/decrease the dose safely and effectively for Peanut, the goal being to get Peanut regulated as quickly as it is safe to do so.

If you are wanting to continue dosing using the TR protocol, a pre requisite is that you must be able to get at least one midcycle test in each cycle on a regular basis(it's no biggie if occasionally this can't happen due to your health, but you don't want it to be a regular occurrence), if you are not going to be able to do that with your health issues, then SLGS may be a better fit for you and Peanut. If you think that usually you will be able to get tests midcycle on each cycle then TR continues to be a good option for you.
(I am just mentioning the above as I know that you have been reading the stickies and trying to decide between protocols, I still remember how overwhelming trying to absorb all the info and weigh up the pros and cons was in the beginning)

 

[Sieden]

I appreciate the concern, the information, the help, I do. I know you're concerned but just know that I'm dealing with a lot for just right now, things won't be this out of whack in a month and half or 2 months down the road. I'm quite literally in the middle of a major break up and a move. The man that I've been with for almost 6 years lost his job and he's moving back home to Minnesota and I want to stay in Texas. I'm going to be moving in with one of my friends at the end of April. It's a huge 2 story house and there's another cat there. I think that it's going to be a sad separation but a good change for me and the cats. I am very aware that dealing with the Lantus and especially the TR is going to be difficult but I have gotten Peanut into remission before by using this method and in January of THIS YEAR I had him anywhere from around 70 to the low 100's at doses of .25 to .5 and I felt that I was on my way to getting him back into remission again but I messed up and didn't keep a schedule. I don't think that it's too late for him if I try and do my part. I'm hard headed and I'm sticking with the TR for right now. amazingly I have stuck to a schedule before lol, it just takes a lot of willpower so I'll try to do the same thing that I did before and see if it works. If it does work then that means that I will be able to get a spot check in before bed but it will probably be a +1 or +2 at the latest. I guess at the end of the day I have to suck it up and make it work but I know that it's going to be a bumpy road until I get settled into the new house because right now I'm packing, cleaning, moving things and the cats know that something is up, they always do when it comes time to move and even that could be affecting Peanut. I really don't expect to get him stabilized for a bit because he's got a whole new world ahead of him.

 

[Sieden]

Good Job getting the before bed last night.

Anytime you see more than one check in the PM you can rest assured that I'm wide awake lol
I'm trying to spread the checks out so that I don't stick him to death, he's already hiding under the bed 24/7, I have to trick him out with the laser light

 

[Kris & Teasel]

Good luck as you navigate this difficult road ahead. Managing our kitty's FD when life throws a lot of !%##!@ at you is very difficult. I hope everything settles down for you as soon as possible.

 

[Sieden]

Good luck as you navigate this difficult road ahead. Managing our kitty's FD when life throws a lot of !%##!@ at you is very difficult. I hope everything settles down for you as soon as possible.

That gave me a giggle, thanks Kris

 

[Sieden]

I got an AM spot check in, it's probably the only spot check that I'll get in for this AM because I'm taking Peanut to the vet today so his numbers wouldn't be accurate anyway. I'll report back when I return.

 

[Sieden]

So we went to the vet today. Peanut got a comprehensive blood panel done, they are checking to see if he has anything going on with his kidney's and that's about it. The Dr. took a look at my SS, I explained about the forum and told her that I was doing TR. She said that I don't really need her for the FD because it looks like I know enough about what I'm doing and that I have it under control. What she meant was that, we already know that he has diabetes so we don't need a diagnosis or any curves done, she could see that I can handle him at home. She said that she's going to run tests to see how his kidneys are functioning and look at some blood levels but other than that it looks like I have plenty of support with the forum and that if I need her for anything that I can call. Finally after that we talked about cleaning his teeth and she said that they could do it with anesthesia and everything for 550.00 and they aren't a cheap place, I paid 350.00 just for today. I haven't gotten any news from them yet but I have good feeling about this place.
Here is the place that I took him to, the vet was Dr. Moran. http://www.felinemedcenter.com/

 

[Kris & Teasel]

So we went to the vet today. Peanut got a comprehensive blood panel done, they are checking to see if he has anything going on with his kidney's and that's about it. The Dr. took a look at my SS, I explained about the forum and told her that I was doing TR. She said that I don't really need her for the FD because it looks like I know enough about what I'm doing and that I have it under control. What she meant was that, we already know that he has diabetes so we don't need a diagnosis or any curves done, she could see that I can handle him at home. She said that she's going to run tests to see how his kidneys are functioning and look at some blood levels but other than that it looks like I have plenty of support with the forum and that if I need her for anything that I can call. Finally after that we talked about cleaning his teeth and she said that they could do it with anesthesia and everything for 550.00 and they aren't a cheap place, I paid 350.00 just for today. I haven't gotten any news from them yet but I have good feeling about this place.
Here is the place that I took him to, the vet was Dr. Moran. http://www.felinemedcenter.com/

She certainly sounds like a vet who will WORK WITH her clients, not dictate to them. Very important!

 

[Sieden]

She certainly sounds like a vet who will WORK WITH her clients, not dictate to them. Very important!

YES MA'AM and she was super nice. She listened! She never once told me that I needed to do this or that. She even liked the forum when I told her about it, how many vets out there would give that response? She just said that she would let me know the results of the tests and if there was anything wrong then we could create a plan and go from there. I loved those words "we can create a plan". When I told her about the sudden peeing in his brother's box and drinking a lot of water she said that it could be a UTI which is what you guys first said. Guess we'll find out.

 

[Kris & Teasel]

YES MA'AM and she was super nice. She listened! She never once told me that I needed to do this or that. She even liked the forum when I told her about it, how many vets out there would give that response? She just said that she would let me know the results of the tests and if there was anything wrong then we could create a plan and go from there. I loved those words "we can create a plan". When I told her about the sudden peeing in his brother's box and drinking a lot of water she said that it could be a UTI which is what you guys first said. Guess we'll find out.

She's a keeper!

 

[Sieden]

I don't know if I'm supposed to start a new thread for Peanut or what but I'm increasing his dose to 1.25u

 

[Kris & Teasel]

I don't know if I'm supposed to start a new thread for Peanut or what but I'm increasing his dose to 1.25u

We start a new thread every day here in Lantus Land and put a link to the previous day 's thread in the first post. Have a look at the BG number reporting format in other thread titles. That 's so people can scan the thread list to see who might need some help.