Julius #'s are all over the place

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Kitties Momma

Member Since 2011
Hello all
Julius seems to be doing quite well, however his #'s are all over and I was hoping for some general feedback. I have not had time to figure out the template so bear with me: here is just the last few days
3/6
7:38am 165 gave .5u
7:13pm 218 gave 1u
3/7
7:38am 215 gave 1u
7:31pm 264 gave 1u
3/8
7:23am 64
gave no insulin
my vet said that if he is over 200 give him 1u and if he is between 150 and 200 give.5 if he is under 150 no insulin. We have only been on insulin about a month now. Considering he got 2u total yesterday I am not totally surprised his #'s were so low.... he has not been over 300 in a while. He seems to bounce between 160's to 260's, though he has days where he is at 100 or 115.... At this stage is that normal? Do you give your shots based on the glucose reading and not just an arbitrary schedule? up until Saturday we were doing 1u in the AM and .5u in the PM. But on Friday morning he was 100 and I didn't think it was a good idea to give him his shot, so I called the vet and they concurred. I have been testing him before he eats, however I started testing after because for his PM shot I was testing at 4:30pm and he was getting his shot at 7:30pm. The vet asked me to test closer to his shot, so for consistency I feed him when I get home from work (4:15pm) , test him (12hrs after his AM shot, usually around 7:30pm) then give his shot based on his results ... what do you think? I do not get home from work until 4:15pm so I can't feed him at 3pm as some have suggested. I also understand that he should be on a consistent dose of 1u or .5u but not either or, my concern is that my husband and I work during the day and there is no one who can come and watch him to prevent him going into shock or seizure if his #'s went to low. It seems to me that this is early on in the process and we are learning more and moving in the right direction..... I wish I could just be here and test him/ feed him every few hours but that is not realistic... I am hoping someone out there who works and understands that can give me some feedback. I am going away to a trade show in a few weeks and my husband will be here to take care of Julius, however if he got stuck at work and didn't get here till 7:30-7:45pm then what?? Life happens sometimes and I am worried that once in a while we may not be here at the exact 12hr interval.... albeit extremely rare it might happen.... is 13hrs ok once in a blue moon?
 
The information you provided doesn't really give us much insight into what's going on with Julius' cycle. Lantus dosing is not based on the pre-shot numbers -- it's based on the lowest number in the cycle. Usually, but not always, this is somewhere in the middle of the 12-hour period. Having tests just at pre-shot times, doesn't tell you a great deal nor does it give you the information necessary to adjust a dose. For example, It is very likely that Julius' numbers were running low last night which is why you had a low pre-shot number this morning. The problem is you don't know how low.

I would strongly encourage you to read the starred, sticky notes at the top of the Board. They will provide you with a wealth of information about dosing, handling your insulin, key concepts, etc.
  • Tight Regulation Protocol: This sticky contains the dosing protocol that we use here. There are also links to the more formal versions -- the Tilly Protocol developed by the counterpart of this group in German and the Queensland/Rand protocol developed by Jacqui Rand, DVM and published in one of the top vet journals.
  • New to the Group: Everything you wanted to know about this forum and more. Info on our slang, FAQs, links to sites on feline nutrition and to food charts containing carb counts, how to do a curve and the components to look for, important aspects of diabetes such as ketones, DKA, and neuropathy, and most important, info on hypoglycemia.
  • Handling Lantus: how to get the maximum use from your insulin and what to not do with it!
  • Lantus depot/shed: This is an important concept for understanding how Lantus works.
  • Becoming Data Ready: What data you need in order to be able to work toward remission or tight regulation.

We are very numbers driven here. If you are having problems with getting the spreadsheet up and running, please post in the Tech Support center. Someone will be able to give you a hand.
 
I have posted in the tech forum several times about not being able to download the template, and have yet to get it working. I appreciate what you are saying, however I don't really know how all of you can work and test your cat every 3 hrs. I work, I am not home in the middle of the day to test him. I wish I could but I can't. I test him in the AM and when I get home. My vet said to test him before his shot in the AM and PM. I have done a curve on him already here at home. Is there someone out there that works who can give me some feedback??
 
if you're giving him his pm shot at 7pm, say, could you do a few tests while you're home then? like as soon as you get home, then a couple of hours after his dinner/shot and before you go to bed? that would at least give some ideas of other times.
 
I do work. I arrange my shot times so I can get several tests before I leave (since my cat dives early). If I get home more than an hour before shot time, I test when I walk in the door. I do get tests in during the evening cycle and on weekends and/or days off. Many people here do work. It can be challenging but because Lantus dosing is based on the lowest point of the cycle, getting as many spot checks as you reasonably can is important. Unfortunately, with just the pre-shot information you provided, I can't draw any legitimate conclusions about Julius' dose other than to suggest his numbers dropped over night on 3/7. Having some additional tests that evening would have been helpful.

Please take a look at the protocol we use. It is a well research protocol and encourages spot checks. Unfortunately, your vet may not be familiar with how Lantus dosing is done.
 
Julius' Mom said:
I have posted in the tech forum several times about not being able to download the template, and have yet to get it working. I appreciate what you are saying, however I don't really know how all of you can work and test your cat every 3 hrs. I work, I am not home in the middle of the day to test him. I wish I could but I can't. I test him in the AM and when I get home. My vet said to test him before his shot in the AM and PM. I have done a curve on him already here at home. Is there someone out there that works who can give me some feedback??

The simple answer is to adjust your shot times to allow for easier, more frequent testing. Get in tests whenever you can as often as you can. It will only help you and Julius in the long run. And as far as Vets go, listen to what they have to say, then do your own research. Unfortunately, I had a great vet that I lost confidence in about this. Then the vet I switched to wasn't as versed on Lantus as PZI, so LL is my guide. Do your best, but the more knowledgeable you are from testing and reading, the better off both of you will be.
 
We're new to this, too, and it does take some getting used to. For the first few weeks that Trixie was on Lantus, we only tested once a week at +6, so you're already way ahead of where we were! Her third +6, 3 weeks in, was a 55, and that was the wake up call that propelled us into frequent-testing action. I also have her shots sheduled so that I can squeeze an extra test in before I leave for work. I'm fortunate in that I own my own business, and I work just a mile away from home, so I can sometimes scoot home at lunchtime for a test, too. I test as soon as I walk in the door in the evening, as well as PMPS, and at least one before hitting the sack. On my days off and weekends, we do more, just to help get a feel for her trends. We're still so new at this whole frequent testing thing (and diabetes), that we really don't even have enough data to see exactly what her trends are just yet anyway, although we're finally starting to get a feel.

Your also one step ahead, since your vet encouraged you to test to begin with. You just need a few more tests here and there, so you can really start to see what's happening.

With your work schedule, it sounds like evenings will be your prime testing time. While it's no "fun" for any of us, to does become somewhat of a ritual that you adjust to. After Trixie's first test, if you told me she would automatically come running when she hears the lancet device clicking, I never in a million years would have believed you! But that is exactly how it is now, just a few weeks in. And now it's seems like something we've been doing forever...it's part of our routine. Also, does your husband help with testing? If he doesn't, maybe he can start doing it, too...that will help ease the burden on you having to do it all alone.

Hopefully you can get the spreadsheet up and running soon. It is sooo helpful to see the numbers charted out and color-coded. For me, it gives me tremendous piece of mind to see where things are at all times.

Good luck with all of it. The stress really does settle down...

Amy

PS - Julius is very handsome!!
 
Good afternoon and sorry to hear you are having some minor issues with your spreadsheet, etc. If you can create a google account, then try these instructions after you have the account created:

1) sign into your google account, and click on one of the template links
2) click on ONE of these template links. if you are in the United States, please use the first one. If you do not, please click on the second one.

USA (mg readings): click on this link:US Template
Outside of USA (mmol readings) click here: World Template

3) Click on "USE THIS TEMPLATE"
4) A copy of the spreadsheet will appear. Click on "File" then choose "Rename..."
5) Call your spreadsheet whatever you like.
6) on the upper right, click on the arrow next to "Settings" and left click on "Google Account Settings". You'll see a section that says "Personal Settings" and then one below it that says "My Products". Under that is a section entitled "Docs". That is where your SS should be if you saved it correctly.
7) then to publish it so we can all see it, bring the SS up, in the upper right corner of the page above the SS, left click on the arrow by "Share" and then click on "publish as a web page". At the bottom in a big white square, you'll see an https address. Highlight and copy the entire thing. Then go back to the main FDMB page and click on "User Control Panel", click on "profile", click on "edit signature" and then paste the SS address into the white box. You will need to add a few qualifiers so in the end, it should look like this:

kitty's name Spreadsheet

Hope that helps.
 
Thank you all for the encouragement.....I have a gmail account (that means I have a google account right??) anyway I went to my gmail account and typed in insulin template, found the template and tried the procedure to no avail. I really want to make it work so you all can help me more!! so....can it be emailed to me?? I am going to test Julius here in a minute and see where he is. I am also going to do my best to do a .75 instead of the 1.0 and the .5 the vet said. Now... if your kitty was at lets say 64-100 would you STILL give a shot?? I don't feel comfortable doing that and then leaving to do go to work, I work about 15 minutes from home and wish I could just leave and come home but I can't I work in retail and it isn't that easy... if only!! I don't want to come home and find him dead!! I have skipped his dose when he is at the level, though I have that boomerang (I know that's not the right word) but the effect of his skipping the dose. In this case what should I do? I am going to test him preshot, before I go to work, when I get home, pre shot PM and if I am not too pooped when I go to bed.... or hope the hubby can do that test....
 
The simple answer to your question about shooting low is that you don't yet have the data to shoot low. If you look at Gabby's condo from tonight, you'll see I shot an 87. I've shot lower but I have accumulated the data that allows me to shoot low and I know how to steer Gabby's numbers by using high carb (HC) food. The goal, once you have the data, is to shoot low. Once Julius is better regulated, shooting low will flatten out the curve and the cycle will stay in normal BG numbers. But, it takes time to get to the place where you have the data and you have the confidence to do this. Scan the Board tonight and you'll see any number of people who shot numbers in the 64 (or lower) - 100 range. We do not advise shooting below 50, however. Take a look at the "data ready" sticky for more information.
 
Julius' Mom said:
Thank you all for the encouragement.....I have a gmail account (that means I have a google account right??) anyway I went to my gmail account and typed in insulin template, found the template and tried the procedure to no avail. I really want to make it work so you all can help me more!! so....can it be emailed to me?? I am going to test Julius here in a minute and see where he is. I am also going to do my best to do a .75 instead of the 1.0 and the .5 the vet said. Now... if your kitty was at lets say 64-100 would you STILL give a shot?? I don't feel comfortable doing that and then leaving to do go to work, I work about 15 minutes from home and wish I could just leave and come home but I can't I work in retail and it isn't that easy... if only!! I don't want to come home and find him dead!! I have skipped his dose when he is at the level, though I have that boomerang (I know that's not the right word) but the effect of his skipping the dose. In this case what should I do? I am going to test him preshot, before I go to work, when I get home, pre shot PM and if I am not too pooped when I go to bed.... or hope the hubby can do that test....

I am no expert, but I can give you my experience. Whenever Gracie's numbers were lower than normal, I was usually scared to shoot, even if I was home. Every time I delayed or skipped, it through her off. The last time she was lower than normal, I shot and we had a breakthrough. At some pint, you will have to try it. That said, in the short term, lower numbers/hypos are way more dangerous than moderately higher numbers. I was supposed to go away tomorrow, but canceled because my wife doesn't test and with Gracie changing, I will not shoot blind. I would also not let my wife shoot a very low number. If you're not comfortable, don't do it. Through more testing and shooting a few low numbers when you'll be home so you can see how he reacts will eventually put you at ease.


Good luck!

Jason
 
Ok....so forget the link I sent you because that is for a US SS and I understand you need the world one. So let me see if I can get that going for you. Sorry...I didn't realize you were in Canada.

And FWIW, I would definitely listen to Sienne; you must have the data before you can shoot low. But one thing I will add is that Julius will do much better if you shoot a consistent DOSE. Lantus requires consistency....same dose, same shot times. You aren't doing him any favors by shooting one dose in the morning and a different one at night. So you need to find the ONE dose that will keep him in safe numbers considering your work schedule. And that is what is most important...keeping him safe. You may have to run his numbers a little higher at a SAFE dose until you can figure out, through collecting data on the weekends, what his patterns are. It's ok to start low and go slow...that's what we suggest here. I started my Gracie at .5u and then slowly increased per the protocol so I could see what she was doing and at what number she started coming down.

BRB on the link for the World SS...I hope :-D
 
I have nothing but feel what you are going through. My Enana was also diagnosed in February.
I work 30 minutes away so I cannot test during the day either. I moved my AMPS to 6:30 in the morning so I could have at least a +1, then leave for work.
I get home an hour before (or more) before PMPS, test at +10 or +11 or 1/2 times.
Then I test at +1, +2, +3 or depending on how her numbers are.

There are excellent people here to help.

Julius is gorgeous.
 
I tried Cyn's and it didn't work so try the one I sent you then please PM me your gmail address so I can transfer it over to you as the owner. Thanks!
 
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