I'm really confused again

[Melissa and Celle]

Can anyone make sense of these numbers? I'm afraid to go up any faster or in bigger increments than I am given my prior experience with Levemir and the recent experience in December on Lantus. Any thoughts on why the numbers are so high right now?

She could certainly have a UTI given her history, although previously we didn't notice a huge change in her numbers due to the infection. We haven't been able to get a sample at home to test lately because she has been going in the box, which seems like a good sign. So that's also why we've had no ketone tests lately as well.

Could it be the meter is out of whack? I haven't done a control test in a while, and I'm out of solution. How common is that?

Could the insulin be bad? This is the vial I started in August. Previously when things went bad I got new insulin and it didn't work, so I ended up just wasting money chasing one theory after another.

I'm starting to feel hopeless again. Anyone have an idea?

 

[MommaOfMuse]

Yeah there is a very good chance that your insulin has gone south if you are using a vial rather than the pens. I have never used the vials I have always used the Solostar pens, but I usually only get about 3 months max if that out of a pen, and that is if I haven't used it all up by then and I think the vials wear out in about 2 months..your's is over 5 months old...I don't think Lantus will last that long.

Mel, Maxwell, Musette & The Fur Gang

 

[Eva & Butters]

Hi, Melissa ~

You were getting such good numbers for Celle the last half of December into January and then started getting a string of higher numbers. Makes me wonder if it is your Lantus that's no longer effective. My husband and I still buy the vials, too, and we're only able to use them for about 60 days before we start seeing a difference in Butters' bg numbers. "Previously when things went bad I got new insulin and it didn't work, so I ended up just wasting money chasing one theory after another." -- I hear you on this. Wish there were a cheaper way to test for bad Lantus other than spending the money to buy another vial or the pens, Melissa. In those previous times you mentioned, how long were you using the same vial of Lantus before buying new?

So frustrating when things are going well for our kitties and then they aren't.

Hang in there,
Eva

 

[Eva & Butters]

P.S. Another thought: Looking at Celle's spreadsheet, it does appear that 3.75U was a breakthrough dose for her in mid-December. But the action with that dose happened after several days. Maybe hold your current 3.75U dose longer to see if it starts lowering Celle's numbers again. You've probably got some bounce going today off yesterday's blue and yellows.

Eva

 

[Melissa and Celle]

My husband and I still buy the vials, too, and we're only able to use them for about 60 days before we start seeing a difference in Butters' bg numbers.

That's really helpful to know. I had in my mind that people used them all up, but that's obviously not always true.

In those previous times you mentioned, how long were you using the same vial of Lantus before buying new?

This is probably the longest that I've used the same vial. I certainly think I'll try a new vial before raising the dose at all.

Thanks so much for the help!

 

[Libby and Lucy]

Hi Michelle,

You don't know me, but I have a couple of thoughts that might help.

Here's what I see:

It looks like the dose reduction to 3 units failed. No big deal, it happens a lot that a cat needs a reduction, you do the reduction, then for whatever reason the cat decides that's not enough insulin after all and you have to take the dose back up. Lucy did it to me several times - you can see the biggest example on her spreadsheet in October 08. You did good, you started increasing the dose again, and she should hit another breakthrough. Then she will probably need more dose reductions again.

I also see that her breakthrough dose on Lev was around 4u, and her breakthrough on Lantus before was around 3.75. It seems like often when a cat has to climb back up in dose, they end up having another breakthrough at approximately the same dose they had the previous breakthroughs (sometimes a tad bit more, depending on how long it takes to work back up to that dose). I think you are probably pretty close to good numbers again.

Finally, the ugly red numbers look like they are a bounce from whatever happened during the daytime cycle on 1/19. It's possible (and even likely) that she went green during that cycle. See how her numbers have gone straight up since the 189? That looks like a bounce to me. So my suggestion is that you wait until that bounce clears (that can take up to 72 hours, but you'll know it when you see it), get some spot checks while you wait so you can see how low she goes when the bounce does clear, and make your dosing decision from that. If you increase before the bounce clears and base the dose increase on the red numbers you're seeing now, you risk ending up on too high a dose when the dose *might* actually be good once the numbers settle out. Does that make sense?

PS: some people are able to use Lantus for up to 6 months if it is handled carefully. It might be going bad and if you're in doubt it can't hurt to replace it, but I wanted to point out that the numbers patterns you are seeing actually do make sense, so it might not be the insulin.

 

[Eva & Butters]

Hi, Michelle and Libby ~

Michelle, you might want to make only one change at a time to see if you can pinpoint where Celle's higher numbers are coming from. I'm bad about making several changes at once and then I haven't really learned what caused the problem I'm trying to fix . Libby's suggestion is a really good one: wait until the bounce clears and see where that 3.75 dose takes Celle before trying new Lantus. Of course, you're close to six months on that vial of Lantus anyway, but hold off changing to a new vial until you can see if that dose lowers Celle's numbers.

Very helpful posting, Libby. Thanks!

Eva

P.S. Wish we could keep a vial of Lantus effective for six months. :smile: