Joplin's Progress

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Cherylockholmes

Cherylockholmes

Member Since 2013
Original thread here: viewtopic.php?f=28&t=94334

Ok, I think I finally figured out this spreadsheet. I see now that when you enter the numbers, it automatically assigns it the color pertaining to that number. Pretty cool! Thanks for everyone's help in this journey. I appreciate everyone's insight and look forward to learning more :)
 
He is looking good. Are you still on Vetsulin? If so, this is very encouraging. . It is important to find out if he has a sudden drop or if he is surfing along in reasonable numbers. But a 206 after 12 hours is encouraging. I am a little nervous about giving one unit on a number so close to 200 (our no shoot number for newbies) because of the usual vetsulin patterns. Can you monitor today? Maybe get a +2/+4/+6. If not, please leave out some food so if he drops low, he can eat and bring himself up.

Can you go back to your signature and add Vetsulin. It makes a big difference in the dose advice you get. BTW, great job on the Spreadsheet!
 
Sue and Oliver (GA) said:
He is looking good. Are you still on Vetsulin? If so, this is very encouraging. . It is important to find out if he has a sudden drop or if he is surfing along in reasonable numbers. But a 206 after 12 hours is encouraging. I am a little nervous about giving one unit on a number so close to 200 (our no shoot number for newbies) because of the usual vetsulin patterns. Can you monitor today? Maybe get a +2/+4/+6. If not, please leave out some food so if he drops low, he can eat and bring himself up.

Can you go back to your signature and add Vetsulin. It makes a big difference in the dose advice you get. BTW, great job on the Spreadsheet!
Click to expand...

Added to my signature! I had to leave for work for a bit, and was planning on testing him again at +5, but came home to find my husband gave him some more wet food while I was out. Just tested him again at +5, after he ate about an hour and a half ago, and he is testing at 188. (added to spreadsheet!) So, I should test him again before dinner and not give a full unit if he is close to 200?
 
I would test again when you can before the next shot. He looks like he is not dropping after the shot but going down slowly. Why don't you collect the numbers you can and then post at preshot time for advice? If he is over 200, it looks like the insulin is working pretty well.
 
Maybe you could help me determine if this food I feed my other cats would be okay to feed him. I've been trying to feed him the Evo, but he's turning his nose up at it....he'll eat a little, then walks away. He really likes the DM food, but it's such crap that I really don't want to keep him on that. My other 6 cats eat Precise Holistic Complete Grain Free Flaked Chicken. It says it's: Crude Protein (min) 10%, Crude Fat (min) 4.5%, Crude Fiber (Max) 1.0%, Moisture (Max) 78%. I do notice that it has potato starch listed in the ingredients, but it seems to be far down the list. Any way of determining if this is a suitable option for him?
 
Food info in your other post. That Precise Holistic Flaked Chicken is 14% carbs, too high for a diabetic cat.

See your other post for a shortcut shopping list of foods to select from that are <10%, our recommended carb level for food.
 
Ok, I spoke with my vet and he is going to switch him to Lantus...yeah! After the most recent reading in my curve, 417, this Vetsulin is clearly no good for him.
 
You might want to go over to the Insulin Support Group forum for Lantus TR and read the stickies at the top of the posts. They all start with the word STICKY and give you a lot of information about Lantus.
 
Thank you again Deb...that was very helpful to read. So, I just got the Lantus ($155...OUCH!) The TR protocol says to give .25 IU/kg. Joplin is 12 lbs. so that equals 1.5 units if my math is correct....however, the vet only prescribed 1 unit. Do I listen to him, or follow this protocol? This is the same vet mind you, that I had to spell out the name of the drug for because he hadn't heard of it. :roll:
 
12 lbs /2.2 (kilos in a pound) = 5.45 kilos
5.45 kilos * .25U = 1.36U
1.36u rounded down to the closest 1/4 unit would be 1.25 as a starting dose by my calculation.

We tend to be more conservative on the dose. So rounding down to that 1U for a beginning dose of Lantus is a good idea.

I would prefer to see you start at the 1U that your vet recommended. It's easy to increase the dose as needed, after the depot fills. It's much harder to take the insulin out or deal with a hypo episode.

Hold that starting dose of Lantus for 5-7 days to allow the depot to fill. Test at every pre-shot. It is suggested to test at +3, +6, +9 for the first couple of days to see how things are going.

Keep your eyes out for hypo symptoms.

We like a shoot/no shoot threshold here on Health of 200. If the BG pre-shot test is <200, Do not shoot or feed, retest in 30 minutes and in the meantime, post here for help on how to proceed.

We will have you stall, skip, or reduce the dose depending on the number and your circumstances.
 
Well shoot...not used to these new syringes (much shorter), and Joplin squirmed and I'm not sure if I actually got any of the insulin into his system or if it just squirted out into his fur :oops:
 
Feel the area where you injected. Does it feel wet?

Smell the injection area? Does it smell like bandaids? (Some people have described Lantus as smelling like bandaids, medicinal smell)

Note on your SS possible fur shot and test to see how the numbers go, up or down.

Never give a second shot if you think you missed with the insulin. You could overdose Joplin.

"Better too high for a day, than too low for a minute."
 
It's such a small amount and he's long haired, so it doesn't feel wet but that doesn't mean anything. Yes, I did smell band-aids, but I had over-drawn a little bit and pushed a little bit out before attempting the shot, so that could have been what I was smelling. Oh well, guess I'll keep an eye on it. I'm wondering something though....is it common for cats to become more aggressive when their BG is high? Joplin used to be the cat all the other cats would pick on, but for the last week or so, he has been going after my other cats...not like he's intentionally trying to harm them, but dominance behavior like mounting and biting their necks! He is also peeing outside of the litter box...not every time, but here and there. Today I noticed a spot on the rug, and I know it was him because when I blotted it up, it was almost clear and barely had any scent...and since he's drinking so much, it has to be from him. Sigh. I hope this Lantus gets everything under control. :sad:
 
Well, Day 3 of Lantus and I'm really not seeing any measurable difference yet :( To me, the numbers seem similar to what he had on Vetsulin, and in fact I just recorded one of his highest readings ever pre-shot (414), when only 3 hours ago he was at 262. I don't get it!! Very frustrating. He's peeing all over the house, and I can just tell he's feeling crappy. How long until I can try upping his dose...if that's even the answer? Now he's getting only 1 unit. I know there are a couple figures missing from the last few days on my spreadsheet...I've been out of the house working a lot and haven't been home to test every 3 hours.
 
It can take more than 3 days to see a good response with Lantus. I would wait till 5 days are up and see what happens. A dose increase might be in order.
 
There is a possibility that he may be 'bouncing'.

When the glucose drops rapidly or when it drops a lot or when it drops to a very inaccustomed level, the body may react by releasing compensatory hormones. These hormones act to release glycogen stored in the liver. The glycogen is broken down quickly to provide glucose ... and zoom! Up goes the glucose.

Getting tests in the +5 to +7 hours after the shot will identify how low he is going and by how much. Testing around +2 hours after the shot may warn you if he is dropping fast.
 
I've decided to increase Joplin's dose. Given his numbers, would increasing it to 2 units be a good idea, or is there a good reason for only increasing it to 1.5? I increased it to 1.5 this morning....so far, as of the latest reading, there is no reaction to the additional .5 dose. I hate having his numbers so high for this long. Thanks.
 
The insulin depot will need to build up again to that higher 1.5U dose. Remember, part of the shot on an increased dose goes to the Lantus storage depot, part of it goes to work right away.

You want to hold that increased 1.5U dose for a minimum of 3 days before you can see how Joplin is reacting to it.

If he goes below 50, you would decrease the dose by 0.25U.

If you increase the dose too rapidly, you have a greater chance of bypassing an appropriate dose and never seeing low numbers.
 
Are you still feeding that high carb Precise holistic food? It is likely the culprit keeping Joplins BG levels high. You might want to look at this list and see if you can find a different carb food you like better but with lower carbs ( under 10% calories from carbs column C ) http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf

The more you can do now to bring his BG down, the quicker he will get regulated. Also he is still within the window for remission - as many as 40 of cats go into remission within the first 6 months when given a good insulin like lantus and, critically, a low carb food. After that the chances drop signficantly as the pancreas is permanently damaged.

Wendy
 
No, I got him off of that as soon as I found out the carb level a couple months ago. I'm now feeding him Weruva, from off that list.
 
Ok great! Then maybe you just haven't reached a good dose. I would try and get a few spot checks at night after +3 though just to be sure he isn't dropping low then- you would be surprised how many cats do,.

Wendy
 
Would you please consider updating your signature with the food you are feeding? It would help us in the future when we are making our suggestions.
 
Argh!! I thought we were finally getting somewhere. He was in the 200's all day yesterday on day 4 of his new dose of 2 units and then this morning...BAM, 356! Is it normal for it to get such randomly high readings while in the process of regulating? Part of me thinks maybe it's that I'm using a crappy monitor, and the other part of me is just dumbfounded. I picked up the dry food (Wellness Core) that my other cats were munching on in between their being fed canned 2x per day, and nobody is happy. Everyone is screaming at me on and off all day, but I'm willing to do what I need to to get Joplin into remission. I am going on about 3 hours of sleep over the last 48 hours with the screaming. Sigh. Please tell me the feeding frenzy subsides once he's regulated!!!!!!!
 
Yes the crazy eating should subside.

The high this morning is within error of the other pinks so I wouldnt read too much into it. You may want to increase the dose again though i.e.

General" Guidelines:
Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Click to expand...
 
Deb & Wink said:
Would you please consider updating your signature with the food you are feeding? It would help us in the future when we are making our suggestions.
Click to expand...
Not sure if you missed this post or decided not to update the signature?

I'm now feeding him Weruva, from off that list
Click to expand...
Curious as to which specific Weruva flavors you are feeding. Some are higher in carbs than others. Maybe concentrating on feeding some of the lower carb ones would help Joplin's BG numbers. :idea:

Please tell me the feeding frenzy subsides once he's regulated!!!!!!!
Click to expand...
Yes, it does. But it takes time.

I picked up the dry food (Wellness Core) that my other cats were munching on in between their being fed canned 2x per day, and nobody is happy. Everyone is screaming at me on and off all day, but I'm willing to do what I need to get Joplin into remission.
Click to expand...
Sounds like we need to have you feed more than 2 times a day. Are you around long enough in the mornings to give two meals? An hour or so apart? And then the same thing in the evening? Feed everyone right after Joplin's test and shot and then again before you go to bed or head off to work?
 
:?: Do you know how to use the little icon next to your post to get to the first unread post in the thread? It's like a little piece of paper, colored orange or red. Click on that.

Here are some of my thoughts.

With your nadirs >200 but < 300, Protocol is to raise by 0.25U.You may have bypassed a good dose or may not be high enough yet. Food may be a factor. Lower carb then you are giving, don't know until you let us know what flavors of the Weruva you are feeding.

You had some nadirs in the 200-300 range when you went from 1U to 1.5U. You should only have increased by 0.25U. You did not hold that 1.5U dose long enough. Should have been for a minimum of 6 cycles, maybe longer.

What I am saying is that changes have been made a little too quickly to see what the right dose may be. We need to get Joplin back on track and figure out what the dose should be. The best way to do that I think, is to get more experienced eyes on you. At this point I think you need to be in Lantus TR forum, to get more eyes on you to get you good dosing advice and see what you should do about the dose.

If you are not comfortable with moving to TR, we can PM a couple people to come over to Health to take a look at Joplin's SS.

Which would you like to do? Move to TR if you feel ready? Or stay here on Health and have a couple of experienced people come over?
 
Deb & Wink said:
Deb & Wink said:
Would you please consider updating your signature with the food you are feeding? It would help us in the future when we are making our suggestions.
Click to expand...
Not sure if you missed this post or decided not to update the signature?

I'm now feeding him Weruva, from off that list
Click to expand...
Curious as to which specific Weruva flavors you are feeding. Some are higher in carbs than others. Maybe concentrating on feeding some of the lower carb ones would help Joplin's BG numbers. :idea:

Please tell me the feeding frenzy subsides once he's regulated!!!!!!!
Click to expand...
Yes, it does. But it takes time.

I picked up the dry food (Wellness Core) that my other cats were munching on in between their being fed canned 2x per day, and nobody is happy. Everyone is screaming at me on and off all day, but I'm willing to do what I need to get Joplin into remission.
Click to expand...
Sounds like we need to have you feed more than 2 times a day. Are you around long enough in the mornings to give two meals? An hour or so apart? And then the same thing in the evening? Feed everyone right after Joplin's test and shot and then again before you go to bed or head off to work?
Click to expand...


Deb, no I didn't miss the post. I updated my sig. with the food I'm feeding that day in fact...not sure why you're not seeing it there. I feed Joplin about 8 times a day....literally almost every hour he cries for food. That is when I'm home, which is most days....there are days I do have to work though, and he's on his own! Also, I am feeding the Weruva that was listed with the lowest carb counts from that list you (or someone else here) provided me.
 
Deb, no I didn't miss the post. I updated my sig. with the food I'm feeding that day in fact...not sure why you're not seeing it there.
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Huuum??? Curious as to why it's missing. No food mentioned in the signature. Only the link to your SS and this
Cheryl, mom to Joplin, my 6 y.o. male "gingersnap" kitty who was diagnosed with Diabetes on 5/10/2013.
ReliOn Confirm/ Lantus
Click to expand...

When you make a change in the user control panel, did you submit to save the change? Only thing I can think of as to why it's not there. PITB.

Also, I am feeding the Weruva that was listed with the lowest carb counts from that list you (or someone else here) provided me.
Click to expand...
Well ,some of those Weruva foods are 3% carbs, some of them are 9% carbs. Some kitties are more carb sensitive than other kitties. You could do a food test for a few days, see how carb sensitive Joplin was. You would feed only a group of foods in one percentage range, say 3-5% and kept track of the numbers for a few days. Then another test where you fed only foods in the 8-9% range you might see a difference.

I feed Joplin about 8 times a day....literally almost every hour he cries for food.
Click to expand...
When I was talking about feeding Joplin more frequently, I was also suggesting that you feed your other cats more frequently also.
 
I'm not seeing either. You could put it in your spreadsheet notes column. That helps, too.
 
Wendy&Tiggy said:
Yes the crazy eating should subside.

The high this morning is within error of the other pinks so I wouldnt read too much into it. You may want to increase the dose again though i.e.

General" Guidelines:
Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Click to expand...
Click to expand...

Thank you. He just tested a 201 before dinner. General question....what is the "ideal" number for a normal cat? To consider a cat to be "in remission", what kind of numbers, and for how long do they need to be holding there?
 
Deb & Wink said:
:?: Do you know how to use the little icon next to your post to get to the first unread post in the thread? It's like a little piece of paper, colored orange or red. Click on that.

Here are some of my thoughts.

With your nadirs >200 but < 300, Protocol is to raise by 0.25U.You may have bypassed a good dose or may not be high enough yet. Food may be a factor. Lower carb then you are giving, don't know until you let us know what flavors of the Weruva you are feeding.

You had some nadirs in the 200-300 range when you went from 1U to 1.5U. You should only have increased by 0.25U. You did not hold that 1.5U dose long enough. Should have been for a minimum of 6 cycles, maybe longer.

What I am saying is that changes have been made a little too quickly to see what the right dose may be. We need to get Joplin back on track and figure out what the dose should be. The best way to do that I think, is to get more experienced eyes on you. At this point I think you need to be in Lantus TR forum, to get more eyes on you to get you good dosing advice and see what you should do about the dose.

If you are not comfortable with moving to TR, we can PM a couple people to come over to Health to take a look at Joplin's SS.

Which would you like to do? Move to TR if you feel ready? Or stay here on Health and have a couple of experienced people come over?
Click to expand...

I am going to post from now on in the Lantus TR group. Thanks.
 
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