? Increased dose, how often to test?

[Summers Mom]

Good Morning everyone! Summer was on .5 units 2 x a day of lantus for 7 days but i increased her .25 this morning. She is now taking .75 units 2 x a day of lantus. I tested her 14 times yesterday! I know it may be over kill but was just trying to watch when her nadir was and how long she stayed there. i know, poor summer but she is a good girl and she doesn't mind the poking! Thank God! Its the shots she is a little squirmy with but all in all she is getting better and she is a very good girl. My question to you all is when increasing an amount of insulin, how often do you guys check and at what +times? I don't think i am going to test her every hour today like yesterday but just wanted to her you guys input. Thank you all for your great advice and help. Summer and i really appreciate it so much!

 

[Gill & George]

I'd probably start with grabbing a +2,
What you do next, depends on that +2, it's not set in stone.

So if she was higher @+2 then I'd give her a break and catch a test at +4 or even +5, if the +4/+5 saw her still in yellows then I'd let her be grabbing a test later in the cycle maybe +8/+9/+10 somewhere in there. Grabbing 3 tests in that cycle would give you an excellent idea of how she is doing on the insulin.

If however she was dropping at +2, that would indicate that the cycle is going to be active (you are likely to see some downward movement), depending on the number you get at +2 you would want to get a +3 or a +4, for example, if she was 150 at +2, I'd want to test no later than +3, as that would be a pretty big drop, if on the other hand she was 200, you could leave it till +4. The bigger the drop you see at +2 the more you need to pay attention.
If were to have an active cycle let the numbers be your guide on how often to test.


Looking at yesterday, when she came up to 261 at +6 after hitting 196 at +5, you could have stopped testing every hour, and maybe got another test in late in the cycle at around +10. If you look at how often I tested George, I didn't do this, I was home and George doesn't mind the tests, so I tested quite frequently even when he was high (pink and red), I think a part of me was just hoping that he would show some response to the insulin, and I was frightened that he would drop suddenly, but with hindsight it really wasn't necessary.

Its the shots she is a little squirmy with but all in all she is getting better and she is a very good girl

George was also a bit fidgety when it came to shots, he didn't mind the ear pokes. Sienne suggested shooting him while he had his face in the bowl, he loves his food soooo much that this turned out to be a great strategy for me, most times he never even looked up.

 

[Sienne and Gabby (GA)]

Overkill with testing? What's that? (Look at Gabby's SS.) You are among friends if you find you're a testaholic!!

There isn't an easy answer to your question regarding how often and when to test. Early on in the process, it's important to get enough tests that you have a feel for Summer's pattern. Given that the first week of using Lantus is when you're kitty is building the depot, patterns may be atypical. What you're looking to learn is when Lantus onset and nadir occur as well as how much duration you're getting from the insulin. The explanation of these terms is in the New to the Group sticky.

You're also looking to be "data ready" in order to follow the Lantus/Lev maxim: Shoot low to stay low. Basically, this means that you need the basic information about onset, nadir, and duration in order to have a comfort level if you have a lower than expected pre-shot test. That comfort level takes a bit of time to develop and no one will expect you to shoot a 50 at this point in you're managing Summer's FD.

I generally suggest that people get a test at +2 or +3. If numbers are going to drop, you may see a lower than pre-shot test at that point. (The bump up from the pre-shot meal is likely to have worn off and numbers may be dropping. If you look at Gabby's SS you'll see that I tested a lot early in the cycle since she had an early nadir and was capable of dropping like a rock.) I'd also suggest getting a test toward the middle of the cycle. Barring any drama, it may be helpful for you to test ever 3 hours to see what's going on.

Also, if Summer is food motivated, will she squirm less if you are able to shoot while she's eating?

 

[Gill & George]

Yesterday you ended up with two threads, usually we only have one thread (condo) per day, it will make it easier and keep all info for the day in one post, it can get really confusing for everyone.

What we usually do if a new question arrises during the course of the day, we update the thread title, by selecting edit thread, and selecting the edit title tab (top right of the screen), you can then ask a new question, update BG numbers you are getting as the day progresses, experienced members will look at the titles and pop in if they see something going on.

here's a link to a thread that Tricia put together to give you some tips on how to make the most of using the board.

http://www.felinediabetes.com/FDMB/threads/updated-tips-for-new-members.173572/

Overkill with testing? What's that? (Look at Gabby's SS.) You are among friends if you find you're a testaholic!!

LOL

 

[Summers Mom]

Yesterday you ended up with two threads, usually we only have one thread (condo) per day, it will make it easier and keep all info for the day in one post, it can get really confusing for everyone.

What we usually do if a new question arrises during the course of the day, we update the thread title, by selecting edit thread, and selecting the edit title tab (top right of the screen), you can then ask a new question, update BG numbers you are getting as the day progresses, experienced members will look at the titles and pop in if they see something going on.

here's a link to a thread that Tricia put together to give you some tips on how to make the most of using the board.

http://www.felinediabetes.com/FDMB/threads/updated-tips-for-new-members.173572/



LOL

Thank you for informing me on the different threads. I'm sorry. I didn't even think about editing the title and asking on the same thread. Who am i kidding? I can't seem to think straight since Summer's diagnosis and flooding all this info into my brain!! lol

 

[Summers Mom]

Overkill with testing? What's that? (Look at Gabby's SS.) You are among friends if you find you're a testaholic!!

There isn't an easy answer to your question regarding how often and when to test. Early on in the process, it's important to get enough tests that you have a feel for Summer's pattern. Given that the first week of using Lantus is when you're kitty is building the depot, patterns may be atypical. What you're looking to learn is when Lantus onset and nadir occur as well as how much duration you're getting from the insulin. The explanation of these terms is in the New to the Group sticky.

You're also looking to be "data ready" in order to follow the Lantus/Lev maxim: Shoot low to stay low. Basically, this means that you need the basic information about onset, nadir, and duration in order to have a comfort level if you have a lower than expected pre-shot test. That comfort level takes a bit of time to develop and no one will expect you to shoot a 50 at this point in you're managing Summer's FD.

I generally suggest that people get a test at +2 or +3. If numbers are going to drop, you may see a lower than pre-shot test at that point. (The bump up from the pre-shot meal is likely to have worn off and numbers may be dropping. If you look at Gabby's SS you'll see that I tested a lot early in the cycle since she had an early nadir and was capable of dropping like a rock.) I'd also suggest getting a test toward the middle of the cycle. Barring any drama, it may be helpful for you to test ever 3 hours to see what's going on.

Also, if Summer is food motivated, will she squirm less if you are able to shoot while she's eating?

Thank you so much for the info!! And i will try to shoot Summer while she is eating. I tried before and she was ok with it but She gave me the stink eye! lol I shoot in the flank area and it is hard to see while she is eating/standing.

 

[Summers Mom]

I'd probably start with grabbing a +2,
What you do next, depends on that +2, it's not set in stone.

So if she was higher @+2 then I'd give her a break and catch a test at +4 or even +5, if the +4/+5 saw her still in yellows then I'd let her be grabbing a test later in the cycle maybe +8/+9/+10 somewhere in there. Grabbing 3 tests in that cycle would give you an excellent idea of how she is doing on the insulin.

If however she was dropping at +2, that would indicate that the cycle is going to be active (you are likely to see some downward movement), depending on the number you get at +2 you would want to get a +3 or a +4, for example, if she was 150 at +2, I'd want to test no later than +3, as that would be a pretty big drop, if on the other hand she was 200, you could leave it till +4. The bigger the drop you see at +2 the more you need to pay attention.
If were to have an active cycle let the numbers be your guide on how often to test.


Looking at yesterday, when she came up to 261 at +6 after hitting 196 at +5, you could have stopped testing every hour, and maybe got another test in late in the cycle at around +10. If you look at how often I tested George, I didn't do this, I was home and George doesn't mind the tests, so I tested quite frequently even when he was high (pink and red), I think a part of me was just hoping that he would show some response to the insulin, and I was frightened that he would drop suddenly, but with hindsight it really wasn't necessary.


George was also a bit fidgety when it came to shots, he didn't mind the ear pokes. Sienne suggested shooting him while he had his face in the bowl, he loves his food soooo much that this turned out to be a great strategy for me, most times he never even looked up.

Thank you for the info! I am holding off until the +5, +6 . That's where she has been dropping.

 

[Gill & George]

Thank you for informing me on the different threads. I'm sorry. I didn't even think about editing the title and asking on the same thread. Who am i kidding? I can't seem to think straight since Summer's diagnosis and flooding all this info into my brain!! lol

No worries, I think we have all done the same in the beginning, it's no biggie.

Thank you for the info! I am holding off until the +5, +6 . That's where she has been dropping.

She's looking quite flat with those numbers, doesn't look like she's planning anything too exciting for the time being. (BTW don't let her read that or she'll make me eat my words)

She gave me the stink eye! lol

They really know how to let us know what they think don't they

 

[Sienne and Gabby (GA)]

Gabby did not like flank shots. I always shot in the scruff, which was easy to do if she was eating.

 

[Summers Mom]

Gabby did not like flank shots. I always shot in the scruff, which was easy to do if she was eating.

I did shoot in the scruff a few times but read it wasn't recommended because of it not absorbing well and that steered me away from that area. That is also the area where summer had her surgery when her skin was tearing away from her body. it is shaved there still and would be a big help to me and i didn't go on the incision, just by it. i see alot of people shoot in the scruff. Have you ever compared bg numbers with the scruff to another area? Just wondering if anyone has ever done that.

 

[Sienne and Gabby (GA)]

I think some folks have compared areas and absorption. Given that Gabby's numbers would often drop like a rock early in the cycle, I didn't need the insulin to be absorbed more quickly! FWIW, I pretty much shot in the same general area for 6.5 years without a problem. Given the surgery, I probably wouldn't shoot there either until everything was adequately healed.

I'm concerned about your mentioning that Summer's skin was tearing. This is often a sign of Cushing's Disease. Did your vet get Summer tested?