i'm new here- increase dose????

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Re: i'm new here and i could use some help.

that is satan in my avatar :)

i am going to leave the insulin at 2 units, he might be over compensating but i only got the one low blood sugar test, and that was when he was on 4 units of insulin. so i already halved it, tonight and tomorrow ill get as much data as i can. i need to be more patient. when i have my human patients who are diabetic on lantus. it's different. sliding scales and such. cats are different. ahhh.

and someone asked - kitty is very thirsty. which he wasn't when he was on 4 units bid. which is why i was thinking it's not enough insulin. but i will wait and get more numbers. but he's not lethargic, or not acting any differently than usual. he ran around outside for 15 minutes. now he's stalking his food bowl.

i think? i fixed the spreadsheet. i'm sorry i'm not so great at this yet. and i also can't for the life of me get the colors on my numbers to work? i'd do it manually even if i could. i know it should just fill in but won't.

i'm working on getting ketones but he will only use the litter box in private. i set a second one up with nosorb stuff from the vet for that purpose but so far he wont use it either. (which i'm surprised about- he's used this setup in the past)

i'm about to try and get the pm preshot and i'll be up till at least midnight so ill get a reading before then as well.

thank you all again
 
Re: i'm new here and i could use some help.

dollsinmyeyes said:
so i'm working on a spread sheet. i am much less tech savvy than i thought i was . i don't think my colors are showing up right in the spread sheet to highlight the doses. and how sad but i don't even have a clue how to make a signature on a message board

a lot of my shots are given off schedule. on the nights i work back to back i am only home for 9 hours. so i am trying to figure out how i should adjust those doses. but i am just kind of lost. i am off until friday night so ill be trying my best to keep him on a schedule.

i think satan needs more than 2 units of insulin? anyone else agree? or am i just totally wrong? do i need more data? tonight/tomorrow ill be doing as many tests as i can get kitty to let me. at least my testing skill is improving. tonight we got the test over in one prick.

at the moment i am getting very overwhelmed by this all.

think i figured out the signature at least. colors are still not showing up

https://docs.google.com/spreadsheet/pub ... utput=html
Click to expand...

Before you worry about a dose to give, you need to first sort out your work schedule because there lies your problem. Lantus works on a 12/12 shot schedule or very close to it. If you are shooting 2u at +5 and then again 2u 7hrs later, you are going to have nadirs clashing and no numbers are going to be true.

Change your subj in your first post to ask about help with Lantus 14/10 schedule. There are some people who work odd hours and so they may shot 2.5u at the start of the 14hrs, then shoot 1.5u at the start of the next 10hrs.
Get help with the scheduling first, once you know what times you can shoot, then you can figure out what to shoot am and pm.

As for the food, let him eat. When the diabetes is not regulated, their bodies can't extract what they need from the food. One of my cats was eating around 30oz/day but once regulated he was closer to maybe 10oz.

The colors on your ss you can do yourself; they don't need to be automatic. I add other info in the fields on my ss's so the colors don't work for me either. Just go to the field you want to color and select the color you want.
 
Re: i'm new here and i could use some help.

thank you gayle.

there was only one day when i gave him insulin that close together. and his sugar was too high not to give him anything i felt. and i had to go to work. and i had cut his dose in half the day before because of the low sugar. just to explain. i know it wasn't right. i just didn't know what else to do at that point, and it was before i knew about spreadsheets and how lantus was working exactly in cats. i know a little more now. i hope.
i can not do anything to change my work schedule unless i get a new career.

i will try asking about advice on a dosing schedule.... it makes sense, and when i was giving the 4 units. in retrospect, i was adjusting the dose to be a little higher when i left for work and lower when i came home. i have it all written on the fridge, but i wasn't testing his sugars, and,
honestly. i don't know why i didn't think about that when i lowered his dose and started checking his sugars. so thank you for reminding me i could do this. i clearly needed the reminder

and i will see about doing the colors. as i said. i apparently am way less tech savvy than i thought.


so if anyone has any dose scheduling advice. i leave for work at 7pm and get home between 945-10am most days. there is no one around i could get to come in to dose him early. i only work 3 nights a week. so 4 days a week i can do 12 hour dosing.

thank you!
 
Re: i'm new here and need help w dosing schedules!

What about sticking with a split schedule every day? It may be alot easier for you and your kitty to have a solid 15/9 routine. I wish I could help with it but I have no experience. I do know there are a few people on the board who have successfully made their routine work, and I am sure you can get a good one set up as well.

It's like 6 of one, and half a dozen of the other; I think you will need to talk to the others if it's worth it to have a 15/9 for 3days, then switch to 12/12 for 4days. I think I'd want to stick with the same routine every day.
 
Re: i'm new here and i could use some help.

dollsinmyeyes said:
so if anyone has any dose scheduling advice. i leave for work at 7pm and get home between 945-10am most days. there is no one around i could get to come in to dose him early. i only work 3 nights a week. so 4 days a week i can do 12 hour dosing.

thank you!
Click to expand...

Hi again, Melissa. Gayle asked me to check in because of my experience with a wacky work schedule and arranging shot times.

Is this schedule a 3 day in a row thing? If you can explain each day of the week in terms of when you leave for work and when you come home that would be help us help you with a schedule because how much insulin depends on what the shot schedule was the day before as well.

My experience with schedule changing due to work requirements is with Levemir insulin. I feel Lantus and Levemir are similar enough insulins that what I have done should work with Lantus, but it may take some time and experience to develop a shot schedule that works for Satan. We say Every Cat Is Different or ECID. If you are willing to learn, we can help with this.

I will just ask because sometimes people don't think of these things - is there anyone you trust who could come in and get a BG test and give shot closer to 12/12 schedule? Even a vet tech at a clinic is worth asking, they might live close enough to be able to do it for a small fee. Some petsitters will also give shots, but again there would be an extra fee and I don't know your financial situation. If someone could come in about 7AM and do his BG test, shot and food, that would help you out a lot and might well be worth the cost.

And Mel "MommaofMuse" is right - he could be getting too much insulin even at 2U. She has good advice on that. Not having a reliable dose is a bit of a problem when doing unusual shot schedules, but our main goal is to keep Satan safe.
 
Re: i'm new here and need help w dosing schedules!

Thank you for chiming in, i was thinking about pming you on Gayles suggestion

If i could start this all over I'd have never given him 4 units bid. he might be in some horrible rebound thing, but my gut feeling is that he's not on enough insulin right now because he's thirsty and peeing a lot more again. but i don't know. i'm willing to just try and wait it out a few days,

i think i want to just feed him how he wants to be fed as long as it wasn't more than he was eating pre-diabetes (or when i think he became diabetic, or symptomatic) until i get a feel for how his sugars are on the 2 units of lantus, unless someone strongly strongly feels its too much insulin. it might be. i clearly do not know enough about this.
but i need more data, and the more i read, and look at others spreadsheets the more i think i am learning.

my schedule is erratic, my 3 days in a row are not the same, for example i am off work now until friday night, leave at 7pm and come home 930 saturday am off saturday / sunday, work monday night 7pm-10am tuesday (takes longer to get home on weekday mornings). and than i am off 2nights, than on 2 nights in a row, sometimes i work 3 nights in a row but it is rare, because it is hard on me to do. my schedule changes every week, and i really don't have much control over it aside from requesting 4 specific nights off a month

occasionally, very infrequently, i get sucked into staying late. due to the nature of being a nurse,

satan gets his vet care so far at a clinic in my town, with some volunteer techs, but they are mostly all teenagers and i would be reluctant to let them into my home at 7am, my mom and sisters live out of reach for coming in, and the only neighbor i really know is an elderly lady who would probably do this if she could. i'm pretty sure wrestling my cat and doing blood glucose checks, or even giving him a shot is beyond her. especially at 7am.... but i'll keep my eyes and ears about it...... theres another lady i talk to occasionally whos dog loves my yard, but she doesn't usually walk lily until 9 or 10 am, and than she's usually half asleep in her pjs. i do live in a friendly neighborhood. but i feel like its a really big task to ask of any of these people. i'm wrestling the cat to do the ear pokes currently. but we're getting them over faster now at least. and as many people report. one ear gives lots of blood now. poor bruised ear. :sad: but he likes getting his turkey treat :)

sorry if i wrote a lot.
 
Re: i'm new here and need help w dosing schedules!

Melissa,

Here's a tentative schedule based on your working those hours on 3 consecutive days and staying with 2U.

regular shot schedule should be 10PM/10AM

Day 1 non-work day
2U at 10AM
2U at 10PM

Day 2 work day 7PM to 10AM
1.75U at 10AM
1.75U at 7PM before leave for work

Day 3 work day 7PM to 10AM
1.5U at 10AM
1.75U at 7PM before leave for work

Day 4 work day 7PM to 10AM
1.5U at 10AM
1.75U at 7PM before leave for work

Day 5 non-work day
2U at 10AM
2U at 10PM

Day 6 non-work day
2U at 10AM
2U at 10PM

Day 7 non-work day
2U at 10AM
2U at 10PM

Day 1 non-work day, start schedule over.

The reason to lower the dose twice during the work period is because of Lantus' accumulative effect that you may see referred to here as a "shed." I am afraid it might build up too much so I think it should be lowered prior to each +9 shot except for that first work day. Also, giving shots earlier than 12 hours since the previous shot is like a dose increase itself, so you have to lower the dose. The formula I had developed for Gandalf was based on my determining that a 12% decrease worked OK. If Satan's dose needs to be 2U that is very easy mathematically.

I will be honest that without knowing how effective 2U truly is for him, that makes this whole schedule kind of a guess. It is what I would suggest for a cat who was somewhat regulated on 2U. But at the first sign of 2U being too much, like another low, we need to rethink this schedule and dose. From what you're saying I feel OK about 2U for him at the present time.

I just read your newest post. The somewhat erratic schedule complicates things only a bit more. Basically you want to reduce not just the earlier shot but also the shot before that one. If you want to try it for yourself with next week's schedule, write it out like I just did and we can make sure it's OK. There really isn't much you can do to extend duration in this case because the very next shot after going 15 hours between has to be an earlier one.

I hope this gives you a little more control and helps you feel better about everything.
 
Re: i'm new here and need help w dosing schedules!

thank you so much vicky for your time and knowledge,

when i am a little more awake i will write out my time just like you did.
and what you say makes sense. and i guess it will take some experimenting, and maybe some trial and error.

i'm sorry i don't have better data yet. still figuring this all out

but you have made me feel like this is more manageable. and i really appreciate that. and satan does too. even if he thinks i'm torturing him still.

i overslept on the 9 hour test but i got a 10 hour test, of 216, which wasn't such a low drop, ill get the 11, and the amps.
i am realizing that the low usually comes at 5-9 hours for most cats, so i will try to get readings in that range today, and tomorrow if at all possible.
but it doesn't appear that most cat's go down that much lower than the 10 hour, but i don't have enough data to assume anything.

everyday this will get easier. that is my mantra, and that's what i keep telling the cat man
 
Re: i'm new here and need help w dosing schedules!

dollsinmyeyes said:
everyday this will get easier. that is my mantra, and that's what i keep telling the cat man
Click to expand...

And how right you are! You're doing great, so keep up the good work!
 
Re: i'm new here and need help w dosing schedules!

To add your picture, click on the blue upload attachment tab at the bottom of your post window that you're working on. Click choose file-->navigate to the file on your drive---> select it--->click add file---> add caption if you like---> position cursor where you want image---> click place inline. This works for me at least!
 
Re: i'm new here and need help w dosing schedules!

the picture upload thing isnt working, but ill try again sometime.

today went better than yesterday with regards to glucose numbers, nothing in the 500s, or even 400s

all wet food, most of it low carb, while going over binkys list in depth today, i discovered a lot of what he eats was low carb, so we're going to switch to the low carb friskies flavors, some DM mixed in to use up what i have left, we're going to start on wellness, for variety, because he seems to really like it.
http://www.petco.com/product/112955/Mer ... -Food.aspx anyone feeding their diabetic cat this?

i haven't gotten to type up the plan for the insulin shots, but i have an idea in my mind, and hopefully have a few minutes in the morning. its been a long day of errands and chasing kitty and i am falling asleep
 
Re: i'm new here and need help w dosing schedules!

Those numbers look better Melissa. And you've done a BG curve, go you! Or maybe half a one, I still don't know if they're meant to be 24 hours or if one cycle is enough. Anyway, good work. There's not a huge curve in them I notice. Most curves I've seen have more of a dip in them, in the middle somewhere. I wonder if a curve will appear as Satan settles down into 2U.
 
Re: i'm new here and need help w dosing schedules!

my gut instinct is that he needs more insulin but i will wait a little longer before doing a dose increase. maybe tomorrow,

I was going to get at least a 1 cycle curve if it killed me yesterday. part of being a nurse gets me very ocd about these things. and the ear pokes. we have a whole system already. i tackle the cat, one or two pokes a treat or some petting and we're good to go.

his 11+ is 412 now and he hasnt had anything to eat since i went to bed since he's gobbling up every crumb he can find, and than i catch him licking the empty bowl... he drank a lot of water yesterday too...i am trying to get him 2 decent sized meals and 2 snacks every day. plus the testing treats which have been turkey cold cuts or a nibble of his favorite food (some FF food that is pieces of fish. i forget what its called)

i will post in a few minutes my tentative work insulin schedule

i think i've decided that i will do my best to seperate the doses as much as possible before hand, with 15 minute changes.
when i have to give late doses that are due for a decrease i will give 1.75, early doses due for an increase i'm going to stay at 2, but maybe give a fat 2. am i right? am i wrong? lantus TR protocol says
"Random Notes:
Because of the cumulative nature of Lantus and Levemir:
An early shot = a dose increase.
A late shot = a dose reduction."

so last nights shot was given at 9:45 pm 2units
friday am: 9:30 2u
friday pm 7pm 2u (early dose increase?)

saturday am should be home by 930, 1.75u (late dose decrease)
saturday pm shot 7pm (have to go out- working on changing my plans so i can give the shot later) 2u

sunday am, shot, 12 hours post saturday night shot 7:!5am? 2u
sunday night 7:30 hours post, 2u

monday morning 12 hours post sunday night shot - aiming for this being at7:45 2u
monday night shot 7pm 2u

tuesday morning 9:45a 1.75u (late shot = dose decrease?)
tuesday night 9:30pm 2u on time shot.

wednesday morning 9:!5am 2units on time shot.
wednesday night: 7pm 2 units early shot - increase.

thursday am 9:45/10am 1.75 units late shot. decrease
thursday pm 7pm 2 early shot increase


friday am 9:55am 1.75 units? late shot decrease.
friday pm 7pm shot 2 units early
sat am shot 12 hours post friday night shot.



i have a good idea of what i am going to do....... i will use your dosing advice for now vicky, and try 12% changes when i need to increase or decrease, and ill ask for advice. i have a feeling his dose will need to increase, but today i am staying on the 2 units.

as long as i am interpreting the early increase, late decrease i think i am doing okay... but vicky had reduce reduce......

aaaah this is so stressful. i will jsut do the best i can do. and hopefully it will all settle down better. he will never be as well regulated as i want him to be i guess but what can i do. just keep checking his numbers?
 
Re: i'm new here and need help w dosing schedules!

i'm getting all stressed out now that maybe lantus is no good for satan because of my schedule. i don't know what would be better.
the vet didn't think my work hours mattered. i'm sure she'll think i'm getting far too involved in my cats diabetes. i just told my friend i have to come late to her birthday party because i have to stay home to give the cat a shot... i can only imagine the eye rolls going on over there.

le sighe.
 
Re: i'm new here and need help w dosing schedules!

Hi Melissa,

First off I think you might be confused about this:
Because of the cumulative nature of Lantus and Levemir:
An early shot = a dose increase.
A late shot = a dose reduction."
Click to expand...

It doesn't mean that you want to give a dose increase if the shot is earlier, it means that an early shot acts as if or is equal to giving an increase in dose.

"Early shot" means a shot given less than 12 hours after the previous shot. So if your last shot was at 9:30PM and you want to give the next shot at 7:30AM, that is an earlier shot and as such you need to DECREASE the dose at 7:30AM. You also need to have decreased the 9:30PM shot in my experience so you don't create too much "shed."

A "late shot" means you gave the last shot at 7:30PM and can't give the next shot till 9:30 AM a full 14 hours since the previous shot so the shed is being drained, but it isn't safe to give an increased dose in that case. You just have to be aware that the draining shed may cause higher BGs over the next couple cycles and not react to those by giving more insulin.
 
Re: i'm new here and need help w dosing schedules!

I can't help with dosing but I know people here feed their kitties Merrick Before Grain. If you look at the food lists, one of the flavors (maybe the quail? I can't remember) is high in phosphorus--bad for kidneys--but I know at least the turkey is considered pretty good, or was last time I checked.
 
Re: i'm new here and need help w dosing schedules!

thank you vicky,
and thank you for the food info. salmasmom!

learning learning learning.
 
Re: i'm new here and need help w dosing schedules!

dollsinmyeyes said:
i'm getting all stressed out now that maybe lantus is no good for satan because of my schedule. i don't know what would be better.
the vet didn't think my work hours mattered. i'm sure she'll think i'm getting far too involved in my cats diabetes. i just told my friend i have to come late to her birthday party because i have to stay home to give the cat a shot... i can only imagine the eye rolls going on over there.
le sighe.
Click to expand...
Yesterday I left a birthday drinks gathering for a friend early because I had to get home and test my cat. Its a bit like that isn't it. And today I'm starting him on five meals a day but I have no automatic feeder, so we are arriving a bit late for my great-nephew-in-law's first birthday party, and leaving a bit early. I don't know how this will work for the future but at the moment it actually suits me, I have a big deadline for my phd and so I needed an excuse to get home, one that other people can't tell me to reschedule.
 
Re: i'm new here and need help w dosing schedules!

i guess everyone else will just cope.
i'm part of a young active social circle in nyc. and i live outside nyc. so its going to take some adjusting of my schedule less going out. but thats okay i'll deal


here is my update/corrected
cat insulin schedule the timing is kind of off, i put my goal shot times from getting home from work, sometimes it'll be 9:45-9:50am. but i fugre the closer i can stay to 12 the better?

friday am: gave 2, should have been 1.75
friday 7pm 1.75u
sat 9:30am 1.5 u
sat _pm 2 u 1.75 if early
sun _am 2 u 12 hours post last
sun _pm 2 u 12 hours post last
mon _am 2 un 12 hours post last (goal to have this one be at 7:15 or 7:30)
mon 7pm 1.75 units
tue 9:30 am 1.5u
tue 9:30pm 2units
wed 9:30am 1.75 units
wed 7pm 1.75
Thur 9:30 1.5
thur 7pm 1.75
fri 9:30 a 1.5
fri 9:30pm 2
 
Re: i'm new here and need help w dosing schedules!

sooo maybe this wasn't the right thing to do wiht lantus sheds and everything but i gave 1.75units instead of 1.5 units. because satans amps was 561 after 14 hours post his last insulin shot.
i'll do 1.5 or 1.75 if the next shot has to be a little bit early. this scheduling is so tricky. and stressful. and maybe i am just venting...... satan seems okay at all these different blood glucose levels. but they make me nuts.

his numbers are overall too high for my comfort level..... how do i get his numbers down!

is it time for an increase? do i just need to be patient?

i want to pull my hair out. i'm going to try and pay my little sister to come and maybe do 10pm shots for me when i am at work but she is reluctant.
(THIS WAS HER TEENAGED YEARS CAT- that i got given responsibility for when i moved out)
 
It's been a lot of years since Patriot and I did the insulin dance. He's a wonky cat and we got creative to deal with it. Sounds to me like you are doing just fine and as time passes and you have more testing data you will be better able to assess potential tweaks to your dosing routine.

I was admonished not to micro manage but for me that is what worked, I was a testing and tracking-aholic. In retrospect I wouldn't change my style but I would change my stress level and concern I could be doing more or better. Just by changing diet to wet only and administering insulin you have addressed the two major components to kitty feeling better.

Patriot was the type of diabetic that experienced large swings in glucose level and it was a trick and half to figure out what we needed to do. I think they feel better if the drop and rise in a cycle is not too extreme so even if the numbers are a bit higher than you like, working toward a smoother curve is just as important as reducing overall BG.

I'm hoping you have completely gotten away from leaving any dry down when you have to be away at work and wanted to point out that you can put extra wet food down and it is fine to sit there all day. I would also freeze wet food and put the frozen out as well so there is a fresher food supply.

You are doing well and you have lots of experienced Lantus users to help you make adjustments as time goes on and you have variables under control and trends noted from testing. Good luck!
 
hey cheri
thanks for checking in

ive been freezing food in ice cube trays and leaving that out when i go to work. no more dry food. i gave it all to my mom who will feed it to her cat regardless if its bad for tabs

i will let him settle into this dose longer. i am impatient. must learn patience with regards to this

satan seems good. the peeing too much has settled back down.

thanks again everyone!
 
good to hear the last bit. Sneakers started peeing less in her last week on the humalin. It started up a bit more when we switched to PZI but has decreased by another 25% since then- almost 2 weeks.

I, too, have two late nights but not as bad as yours. And, no, it isn't bad that you leave to go give satan a shot- I did that a lot today and the response I got the most was "Cats can get diabetes? Who knew!" And anyone who is a diabetic knows it is important whether the person is a two leg or a four leg.

GOOD LUCK!!!
 
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