Insight into BG readings??

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Emily

Member Since 2014
Hi there Lantus experts-

Can anyone take a look at Prince's SS and tell me what the heck is going on? He was at his lowest yet this morning, but not super low, so I gave him 2.0 units instead of 2.5. Now he is just rising and rising. I thought the nadir was supposed to be at +6. I have no idea what is going on with his cycle and I'm afraid I will never get him regulated! Why is his BG at the lowest in the mornings? What is my next step here to get him regulated? Should I have given him his usual 2.5?

Thank you!
 
Looks like he's bouncing from the blue numbers. Have you had a chance to go through the starred sticky's at the top of the Lantus forum. They are incredibly helpful. A bounce is the liver panicking about the lower numbers than it is used to. It just needs time to get used to the lower bg's as it has become accustomed to thinking the high numbers are normal. We all get the joy of bounces and they are frustrating but a part of the FD dance.
 
Hi Emily and Prince! i don't think i've "met" you yet. Glad to have you here!

Your sweet Prince is bouncing. Take a peek here to see what that's about: New Dose Wonkiness (NDW) and Bouncing

It's extremely common. It's a normal reaction by the body to a number lower than he was used to.

It was probably a good choice to reduce the dose this morning since you haven't shot that low before, but as you get more experience and data you'll want to go ahead with the shot when faced with 130's, as long as you can monitor. For now, however, great choice.

I hope you'll post daily so we can get to know you and Prince and help you get him regulated. and YES, he can get there.

On the Tight Regulation Protocol yellow starred sticky, go down about a paragraph and read the PDF on Management of a Diabetic Cat. It shows that there are very good chances that (90%) of cats who get immediately into the Tight Regulation Protocol soon after diagnosis can have their pancreas heal and they can become diet-controlled (no insulin injections.) We can teach you what you need to know to do that with Prince.

Ask any questions you have!
 
hi there :cool:

I just posted a reply to your post on health

Well Prince gave you a real eye opener this morning - glad to hear you are available to monitor today.

Good job on converting to all wet! It's the best foundation on which to build your FD treatment for Prince.
:?: Can you tell us when that happened?
Converting to all wet low carb can have a profound effect on BGs - there is a kitty here right now who recently made the conversion and went from 5u Lantus to zero within a few days.

Regarding using food to guide the numbers , should that be required, it's best to use high carb wet rather than dry. Dry will take longer to work and longer to clear the system as well.

It's important to try and determine nadir, however it can be a moving target. Looking at his ss I think his nadir may be later than +6 and he may be visiting lower numbers during the later half of the PM cycles .

Glad to see you here - it's the best place for Prince to be.
 
Thanks, everyone! So it's a bounce... What does that mean for tonight? Should I go ahead and give him his usual 2.5 or do I drop it down to 2.0 now?

I hope you'll post daily so we can get to know you and Prince and help you get him regulated.

Hi Julie and Punkin!
What should I post daily? Thanks for the welcome! Am I in the right place or should I be posting on the other Lantus board? This is all a little confusing :YMSIGH:
 
Post here daily. Format is date, kitty name, preshot number
Then link your previous condo to each days new topic by clicking the url button and pasting the address bar between the ][ of [url] Sandy's :?: is a great plac....5u were good, but let's see what they think.
 
i meant for you to post here in the TR support group. if you are interested in helping him work off of insulin, this is what the Tight Regulation Protocol is all about. The goal is to hold a cat "tightly regulated" in healing BG numbers (50-120) so that the pancreas can heal.

It helps for consistent advice if you post here daily. i saw Sandy's comment about Prince transitioning from dry to wet food - that's an essential piece of information that i'd have missed! You may (very likely) find he needs less insulin as the dry food carbs work their way out of his body. I'd probably hold the 2.0u dose, even though he didn't technically "earn" a dose reduction by going below 50. Usually we don't reduce the dose until we see a number below-50, but because he's not getting dry any longer and that can make a huge difference, i think sticking with the 2.0u makes some sense.

Let's see what others think about that.
 
Oh and as for what to post, well your whole cat report (5P's) is he purring, peeing, pooping, preening and playful. Also ask your questions as they come up. Go ahead and check out some of the other posts here to see what people write. We very quickly become a family, as you will soon see. We care about each other and their kitties and we stay in touch. Even if time only allows a few brief words.
Welcome officially to LantusLand! :-D So happy you and Prince are here!
 
just to encourage you, Kim, who has been helping you, just helped Twice go off of insulin after a brief flirt with diabetes. He's a poster cat for how to get with following the TR protocol, heal and go off of insulin. He's now diet-controlled.

go twice, go!
 
It's true. Twice went off the juse and is now living a fine life as a diet controlled kitty :-D But it was WE and not me :-D . You're in a good place Emily. There are so many experienced people here that will help guide you and support you. Sadly not every kitty goes OTJ (off the juice), but they all get to be healthy, well maintained and we get to have many more years of happiness with them.
And being here definitely increases the odds of kitty going OTJ. The number one goal, keep kitty safe at all times :-D
 
Ok-so I don't know if I should be here or in the "relaxed" group...I am still really new to this and very wary of hypoglycemia. We'd love for him to be OTJ, but I also just really want him to get better and be back to his "normal" self. I don't know if I should be in the relaxed group and then transition to this group?

We rescued Prince about 2 years ago at the age of 7. He was overweight and we put him on a diet, providing him with what we thought was quality food (grain free Blue Buffalo dry) and wet food 2x a day. Then, he got really sick and Prince was diagnosed with diabetes, hepatic lipidosis, and liver inflammation on 2/14/14. Here is his story:

I brought him to the vet when I noticed that he suddenly seemed a lot thinner; I realized that I could feel his spine. He had also suddenly lost his appetite. Our vet told us he had lost about 3 lbs over 2 months! I felt terrible for not realizing he had gotten so thin. The vet did an xray and noticed inflammation around the liver. He asked us to come back later for an ultrasound (he had to call in an ultrasound technician). Meanwhile, over that weekend, Prince stopped eating and seemed very ill. We rushed him to the hospital, where they said he was very dehydrated. He was diagnosed with diabetes, hepatic lipidosis, and liver inflammation. After 2 nights, we brought him home and gave him the dry and wet prescription food that the vet had prescribed. We had to syringe feed for a few days. Then, I discovered this message board, looked at different resources, and then realized he should be off of dry. I switched to Innova cat/kitten wet food, which Prince and my 3 other kitties are currently eating.

The vet has him on an appetite stimulant, tumil-k, B-12, and denosyl and he has had 2 rounds of antibiotics. The vet is trying to help us figure out what the liver inflammation is. She thought maybe hepatitis, which is what the antibiotics were for. Prince also has been having diarrhea since this all started. If the diarrhea does not clear up, he may have irritable bowel disease, and that would likely be the cause of inflammation.

Prince has always had tummy issues...months ago, we had brought him in for really severe gas, but it seemed to go away.

All of this is extremely overwhelming and I just want to get him better. I am doing my best with the insulin, but I'm not sure if I am giving him the right food. On one hand, I want to keep the food the same to see if the food change caused the diarrhea, but on the other hand, if it is the food that is causing it, of course I don't want to keep him on it. I also want to get the BG controlled as soon as possible, so switching the food just adds one more factor.

Sorry this is so long, but I REALLY appreciate the advice!! This board has been so helpful!

PS-our regular vet kind of abandoned us in the middle of this crisis-never called back with results of bloodwork or to set us up for an ultrasound. He never returned our calls. Not sure what that was about but it was very upsetting and we had previously really trusted and like him. So right now all we have is the vet that took care of Prince at the emergency hospital.
 
Well first off, the vet OWES you those results. You paid for them. If you have to get the ER vet to request them then do that. ARG :evil:
The food transitioning could definitely cause diarrhea. Some kitties are way more sensitive to food changes than others. If it was quick transitioning, that could have something to do with it. But medical issues are always a concern.
As for whether or not you should be here, I think it's a good place to be. But anywhere in FDMB is better than not :-D It sounds scary maybe or overwhelming but it's not. Here's my situation. I work 9-12 hour shifts underground in a mine, meaning I could not in any way get home earlier than a cage that is scheduled to bring us up. I work 5-7 days every week (usually 5 now). I have a multicat household as well as dogs and various rodents. This was still the perfect place for me. I was terrified of hypos, and in fact most kitties I noticed do end up at some time dropping into scary numbers (not just here ;-) ). But the fact was, there is so much support here and so much info. Because of the number of people here, there are very few hours of the day that you won't find someone to help. And I really didn't expect Twice to ever go OTJ, I just wanted him 'normal', healthy and with me for years to come. That was truly my only goal. We were fortunate that he went OTJ, but we didn't expect it.
The drops are manageable if you are prepared and doesn't mean the kitty is necessarily hypo. When caught right away and dealt with, you will help Prince from dropping too far. Tight regulation here
Read through the information and see what you think. A big thing is testing. And whether or not you are here, you want to be always testing.
You're here now so stick around for awhile and see what you think. At the very least you will be able to learn more than you ever thought you would need to know about FD!
 
I work 9-12 hour shifts underground in a mine, meaning I could not in any way get home earlier than a cage that is scheduled to bring us up. I work 5-7 days every week (usually 5 now).

The drops are manageable if you are prepared and doesn't mean the kitty is necessarily hypo. When caught right away and dealt with, you will help Prince from dropping too far.

How do you manage monitoring when you are away for that long? How can you "catch" the kitty before he/she drops too far if you are away? That is my worst fear. I have not left the house for more than 1 1/2 at a time. I happen to be home right now because I go to school at night, but soon I will be going back to work. How did you make tight regulation work?

As far as the blood work, they just took it again when I brought him to the hospital so they knew what they were dealing with right away.

PS I see you are from Canada:) I married a Canadian and lured him to the US :)
 
I married a Canadian and lured him to the US :)
:lol: Atta girl!

Well the testing isn't a tight reg thing only. Tight reg is more about shooting the low numbers after you get some experience and being maybe a little more aggressive with the treatment. Not everyone on our board is following TR. But they are there for the support.
All insulins and all protocol's should have a good testing regimen. So, I made it work. That meant waking up earlier than I wanted and not hitting the pub on the way home with the crew after work :lol: Seriously, the disease changes things, but not for the worst. For the better. You will hear everyone talk about the amazing bond that is formed very quickly with their kitties. A bond stronger than you ever believed would happen. AND the cats COME to their test spot on their own free will to be poked! Sounds like bull, but I lived it and it's true :lol:
I used to wake up at 4am to get ready for work. I started getting up between 3 and 330. That way I could get a +10 and +11 before the shot at 5am. I could not do a +1 so I would look at my numbers on the ss and with help from others figure out how Twice's cycle that day might go. IF it looked questionable but probably safe, I shot and left some medium carb food out for him to eat if he felt his bg dropping (usually this makes them hungry). If it looked safe, I only left out lc. And if it was too scary, I would skip altogether, or depending on that number and the pattern I would leave out HC and shoot.
At night I always got a +11 and ps. Then a +2 +4 +6 (if I was still awake). I also learned to test while sleeping. Set alarm, do a +6 or +8. This isn't TR. This is keeping the cat safe while on insulin. ANY insulin. ANY program.
I think it's part of the reason we all get so close on the board. Noone else in the world will understand your FD life like these people will ;-) And it's kinda reassuring at 2am to know that you're not the only fool stumbling around with a lancet in hand :lol:
It's great that you are home now and this happened when it did, because it gives you the opportunity to set up your schedule and figure out Prince and how he is going to be on insulin. Don't be scared Emily, just be informed. You are here because you love him and want to do the best for him, therefore you WILL do the best. And you are not alone.
 
Hello Emily and a welcome from me to you and your handsome boy Prince.

I just wanted to comment on the diarrhea thing - as others mentioned it can take a couple of weeks for kitties body to get used to an all wet food diet. I went one further and switched mine to a raw diet. One thing that can help out is adding some probiotics to the food. Fortiflora is one good option. You can get it on line or from your vet. Speaking of which, ugh on your vet experience!

I agree with Julie on sticking to 2.0U tonight. Safety is number one here and with the switch to all wet food it can make a huge difference. I was the one that sat up with the member who was shooting 5.5U of insulin the day after she switched to all wet food - it was not a pretty 36 hours. :shock:
 
Welcome to LantusLand! Your Prince is a very handsome guy, but I have a thing for black cats. :-D :-D :-D This is the best place for treating FD, the knowledge and expertise here are amazing. That is horrible what your vet did. Are you interested in filing a complaint? I don't know the procedure to do that but no one should be treated that way.
Liz
 
I am worried 2.0 units is too low...that was the dose he had this morning and he has had high numbers all day.
 
Prince is probably bouncing from low numbers last night. Bounces can take up to 6 cycles to clear out of the system. Given the big jump from his PS to last night, he probably went lower overnight than the 137 this morning. Prince is already starting to turn it around today. Changing food can make a huge difference. Take a look at Scooter's SS on the night of February 18th. That morning was the first day the house went off kibble.

And Lantus also likes consistency which means sticking to the same dose instead of changing doses frequently. The TR protocol calls for holding the dose 6-10 cycles if they are seeing blues. I would stick to the 2.0 units for a few more cycles yet, unless he goes under 50, to see the true effect of changing to an all low carb wet food diet.

The worst part of feline diabetes and Lantus is that you have to be patient for changes to happen. Few of us here are good at that. :oops: We want the best thing for our babies NOW!
 
This is kind of a weird concept but Lantus is a depot-type insulin, which means it forms microcrystals under the skin. So the effect of a shot is more than just a few hours, maybe even a couple of days. Plus the liver reacts to lower numbers than recently seen, causing a "bounce", and that can take 3 days to clear. We wear a lot of patience pants around here. :roll: :lol: Julie is a long-time member who gives excellent advice. If she recommends 2.0u, that's what I would do. I know you want to do something RIGHT NOW to bring down those numbers, but this is the best treatment for now.
Liz
 
And Lantus also likes consistency which means sticking to the same dose instead of changing doses frequently. The TR protocol calls for holding the dose 6-10 cycles if they are seeing blues. I would stick to the 2.0 units for a few more cycles yet, unless he goes under 50, to see the true effect of changing to an all low carb wet food diet.

He has been on 2.5 for a while now, I only just dropped down to 2.0 this morning, and we changed from dry to all wet on 2/14. Going from 2.5 to 2.0 would be switching, so is that ok? Also, wouldn't changes from going dry to wet have shown up by now?

I'm sorry, I'm not trying to be pesty :sad: . The vet said to stay on 2.5 to get some consistency, but if people here really think it would be better to drop down to 2.0 now even though his numbers are still high, I'll listen.
 
Although you switched to wet food on the 14th, he's still been getting some high carb food. I see W/D (25% carb) a couple of nights ago and some I/D (23% carb) last night. If Prince is going to get just low carb food (strictly less than 10% carbs) going forward, then a cautious approach is warranted.

I know there is a lot of reading to do here, but I'm also going to add the post on counting cycles. Every time there is a fur shot or a missed shot, the cycle count starts over.
 
I too would stay at the new 2.0u Emily. As mentioned the carb in the food can dramatically affect how they react to insulin. You would like to have him on the low carb only and that will make the insulin really do its job. You will want to hold that dose for about a week to see what he does. By posting each day with the numbers, the members will be able to help guide you with dosing. More is not necessarily better. Every cat is different (ECID) and you will want to see how the combination of 2u and low carb only food works out. Only change the dose early if Prince drops below 50.
FD is a marathon, not a race. And safety has to be #1. :-D
 
Ok, we'll stick with 2.0. Thank you for sending the dosing protocol. That was interesting to see and I didn't really understand how it worked before. We have been going with what the vet said and I feel bad not listening to what she says, but this seems to make sense and I do want him to be safe. I guess I can always raise it and a week won't do a lot of harm if he is high, right?

I have him on Innova cat/kitten wet right now, which is about 8%. I would ideally do Wellness Core, but it is so expensive, and I have put my 3 other cats on an all-wet diet as well. What do you guys think about the Innova cat/kitten?
 
you've got a variety of factors that all play together - you've got a dose, the carb content of the food you give, the volume and/or timing of feeding (when in relationship to the Lantus dose), and the cat's body. Each of those things can raise or lower the blood sugar.

what we try to do is to control factors that we can, so that we can see what is doing what.

when the cat's food carbs drop dramatically, we know that can result in needing a lot less insulin. we've had people do little experiments with their cats where even as few as 3 or 4 kibbles will make their BGs rise and keep them there for another day or so. depends on how carb sensitive a particular cat is. that varies from cat to cat.

now that the dry food has gone away, if you're going to stick to low carb canned food only now, he will need less insulin. we'd rather have him be a little high for a day or so than have him go too low from too much insulin.

let me be the first to say that in spite of what liz is saying, i don't know all. :lol: i know some - from what i learned with punkin and what i've learned from other kitties here. there are plenty of people who know more than me - i'm not the most experienced person. so you can consider my advice, but the best thing is going to be if you listen to everyone that posts, and as you can, read up on feline diabetes. that's why we require that advice be given in posts so that they can be peer reviewed. it improves the quality of the advice you get and we all learn from it.

the learning curve is so steep at the beginning that we try to just tell new folks what we'd suggest they do, while explaining the why of it so that they can learn. it takes a while before anyone sees it on their own. i wrote the post on bouncing and admitted there that it literally took me 6 months to be able to spot a bounce. ohmygod_smile you think you should get it sooner, but i didn't.

Kim had an awesome explanation above. Many people here work. one of the best tools for a working person is a timed autofeeder. i was home for the first year that punkin was diabetic, then went back to work and the autofeeder gave me incredible peace of mind. it is absolutely possible to work around work. Prince is diabetic whether you're gone or not, so learning how to read what he's done before so that you can predict what might be coming in the next 12 hours becomes a huge asset in managing him safely. i'm going to guess that you'd also like a life still, and would like to be able to leave home for more than an hour at a time. you can absolutely learn ways to keep him safe while you are gone. we don't all sit and watch our cats all day!

given all of that, the choices are always yours. we'll try to explain the reasons behind what we suggest - he's your kitty, so you always are the one making the final decisions. and no one minds you asking yet more questions - that's the only way you gain confidence in understanding your own decisions. we expect it - we were in your shoes at one point too.

so ask away. :-D
 
oh, and i meant to say that because he's bouncing - ie, his high numbers are caused by hitting low numbers, not from a too-low dose, even if you'd given 2.5u this morning he would likely be getting the same numbers.

also, because he's high you really don't need to be testing every hour. give both of you a break and don't test again til the pmps. then if he's still high, i'd probably only get a +2 or a +3 tonight and, if he's still in the 300's, sleep well and test him again in the morning.

bounces can last up to 3 days. that means that he could very well stay in pink numbers, or bobble around between 200-500 until Tuesday. i'm sorry for that bad news, but it's just part of it. when he's back down into blue or green numbers, then you'll know he's cleared the bounce. it can happen before Tuesday - anytime between now and then, i'm just saying if he stays up there high try not to worry. he will come down.

in the meantime, we don't increase the dose. wait to see what numbers he's at when he clears the bounce, then we can figure out if he needs an increase.
 
There are a number of members who are from the Boston area and who can recommend vets. If you post both here and on the Health board asking for recommendations, you'll get the names of some good vets.

If you are close to Angell Memorial, Dr. Brum is excellent. Several people from this board have used him for their diabetic cats. He also treated my sister's cat who was not diabetic but had numerous health issues. He was wonderful.
 
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