? Need a little help as to what these recent numbers mean

Scratches123

Scratches123

Member Since 2019
These past few weeks, scratches has been doing great. Acting like her old self again. I think her body is kicking it back into gear and is starting to work correctly again. I hope! Anyway. For the last week or so, I've been skipping many shots bc her pre shot has been too low. Normally she will spike way back up again before her next shot time and stay night for a week or so. Her numbers seem to be leveling out, or whatever you'd want to call it, even with missing doses. I understand I shouldn't be skipping doses. But I can't give her insulin when she's way below normal bc I have a demanding work schedule and can't stay home to monitor her. I shot her 202 tonight and she's now (+2.5) at 111. Which is fricken fantastic!!! She has access to her food, and I will check again in an hour to make sure she isn't dropping too low. But what do you all think about these recent numbers? And how do I handle her doses since I'm skipping so many shots? Reduce maybe? She usually fails reductions...she went from one to .75 so we'll see what happens! So far so good.
 
Have you decided if you are following Tight Regulation or Start Low Go Slow as your dosing method? If so, please put TR or SLGS in the signature. If not, please read the dosing methods sticky note and see which suits you best.

Also, do you mind dragging the 2020 tab on the spreadsheet so it's the first one. Thanks!
 
I think I would try .50 and see if you can shoot every cycle. I know people who work follow TR but if I had been working when Max became diabetic I would have followed SLGS. That’s just my opinion.
 
Hi there,

Just wondering why you think the 0.75 dose was too low ? Your SS says SLGS and I don't see where she dropped below (90) on that dose...or (100) even ? I'd try the 0.75 again, but I'm fairly new here.
In the evening for some of the doses that you have skipped...would you be able to withhold food, stall and retest to see if the numbers have come up to a threshold where you feel comfortable giving the dose? If you try the 0.5 again, have you decided what numbers you will feel comfortable shooting? It looks like you have skipped PS numbers as high as 180s-190s on that dose?

If you are still following SLGS- you probably know all this but for reference :

Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
For lower than usual PS numbers- skipping doses etc.
  • Below 150 mg/dl (8.3 mmol/L), don't give insuin.
  • Between 150 and 200 (8.3-11.1 mmol/L), you have three options:
    • a.) give nothing
    • b.) give a token dose (10-25% of the usual dose)
    • c.) feed as usual, test in a couple of hours, and make a decision based on that value
  • Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
  • In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.
  • Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.
 
My kitty was diagnosed at the end of September 2019 and what I found really helpful to try and understand my cat's little body was posting her numbers in a new thread everyday or at least every second day. By doing this, experienced members on this board got to get to know Freckles and see her patterns. I am following a protocol to the T and before I do something like increase, decrease, skip, hold the dose etc., I always ask for advice. The experienced people/moderators on this board who give dosing advice have a ton of experience and have been guiding newcomers for a long time. They are EXTREMELY generous with their time and knowledge While the experienced people are getting to know my cat and her cycles, I'm learning more by reading the stickies and looking at a ton of spreadsheets.

Although, I'm relatively new at this, it's hard to see what is happening with your kitty's body because since Lantus is a depot insulin, the depot is constantly getting filled and then drained when the dosage keeps getting changed or you don't shoot. With Lantus, the nadir (lowest number in your cat's cycle) is just as important as your pre-shot numbers.

I really encourage you to decide on a protocol (either Tight Regulation or Start Low and Go Slow) and stick to it, post every day and ask a lot of questions. The experienced people need to have solid data of either TR or SLGS on your spreadsheet to help you help Scratches and give you the best advice possible to keep your little one safe. :)
 
tiffmaxee said:
I think she’s afraid to shoot and leave for work. That’s why I suggested that she find a dose she can shoot every cycle and then follow a method. The skipping of doses is messing up the depot. That’s why I suggested perhaps a decrease even though one hadn’t been earned. Am I right Scratches’s mom?
Click to expand...


Oh ok... I wasn't sure since there were AM and PM shots skipped. 0.5 might be better than for a little while, but having a no shot number that she is comfortable with and sticking to it would be good :) It's tricky stuff though
 
Si am cat mom said:
Hi there,

Just wondering why you think the 0.75 dose was too low ? Your SS says SLGS and I don't see where she dropped below (90) on that dose...or (100) even ? I'd try the 0.75 again, but I'm fairly new here.
In the evening for some of the doses that you have skipped...would you be able to withhold food, stall and retest to see if the numbers have come up to a threshold where you feel comfortable giving the dose? If you try the 0.5 again, have you decided what numbers you will feel comfortable shooting? It looks like you have skipped PS numbers as high as 180s-190s on that dose?

If you are still following SLGS- you probably know all this but for reference :

Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
For lower than usual PS numbers- skipping doses etc.
  • Below 150 mg/dl (8.3 mmol/L), don't give insuin.
  • Between 150 and 200 (8.3-11.1 mmol/L), you have three options:
    • a.) give nothing
    • b.) give a token dose (10-25% of the usual dose)
    • c.) feed as usual, test in a couple of hours, and make a decision based on that value
  • Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
  • In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.
  • Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.
Click to expand...
I try to follow slgs but I was told to try tr. When she goes low like that, she stays there for a long time. Over 12 hours.
 
i am following slgs. guess i didnt realize i wasnt doing such a great job...
:( anyway. im asking why when her numbers get to around or less than 100, why it stays like that until her next shot and doesnt raise so i can shoot her. was just wondering if her dose was too high. i am aware i need to shoot twice a day. i am aware i am draining the depot, i am aware of the methods. it is just me at home. just me. i work two jobs. i am literally never home, just for a second in the day to check her. i wake up every day at 430 to shoot her and leave for work. i am not "afraid" to shoot her. im wondering why her numbers have been staying at or around 100 this past week. i will have to start posting every day so everyone can get a feel for what im working with here. i am following slgs. not sure how else to go about it. if you cant tell what method im following even though i have it in my spreadsheet, then guess im really not doing a great job here. ill start posting her blood sugar here everyday and see if i can get some advice on what to do. every time i feel like things have started to turn around, i post here and find out im doing everything wrong. i know thats not what is intended with the replys. i am not perfect, i know many of you have help and can spend more time with your kitties. but i do the best i can

sorry for the no response last night. i posted this then fell right to sleep.
 
Si am cat mom said:
Oh ok... I wasn't sure since there were AM and PM shots skipped. 0.5 might be better than for a little while, but having a no shot number that she is comfortable with and sticking to it would be good :) It's tricky stuff though
Click to expand...
thats why idkk if i need to reduce for a bit. i understand i cant skip shots
 
tiffmaxee said:
I think she’s afraid to shoot and leave for work. That’s why I suggested that she find a dose she can shoot every cycle and then follow a method. The skipping of doses is messing up the depot. That’s why I suggested perhaps a decrease even though one hadn’t been earned. Am I right Scratches’s mom?
Click to expand...
thats why i was wondering if i need to reduce. she will fall to about 100 or less in the day then stay there until her next shot. i also free feed her so she gets food all day long and her sugar still stays around 100
 
Judy and Freckles said:
Hard to tell from the dosing on the SS as I don't think SLGS or TR is being followed.
Click to expand...
i am following slgs and am aware i cant be missing shots, she hasnt fell below 90 so i havent reduced. but shes gone below 100 so i havent increased. its exactly why im in the pickle im in and have to ask for help
 
I didnt realize i didn have slgs method in the signature. sorry about that. i havent been updating here as much as i should. i just started a new job a month ago and its been tough getting into the swing of things with my new schedule. i only have myself to blame for not keeping up with her spreadsheet and stuff.
 
Scratches123 said:
I try to follow slgs but I was told to try tr. When she goes low like that, she stays there for a long time. Over 12 hours.
Click to expand...
I thought .75 was too low bc her nadirs were over 150. Then when I increased to 1 is when she was at 109 and I couldn't shoot her pm.
 
Scratches123 said:
I didnt realize i didn have slgs method in the signature. sorry about that. i havent been updating here as much as i should. i just started a new job a month ago and its been tough getting into the swing of things with my new schedule. i only have myself to blame for not keeping up with her spreadsheet and stuff.
Click to expand...

Wow, you have a lot of stuff going on in your life right now! You are exactly right that once things get to be a routine things get better and easier. Although you are blaming yourself, you shouldn't be. You are doing the best that can and the people on this forum will help you get things going on the right track. :bighug: I have a ton of confidence in the experienced people that offer dosing advise. I think it's a bit difficult to answer your 'why' questions right now as there are just too many variables. For some reason your spreadsheet link is missing from your signature line ... at least for me it is. Can you add it back in?

Everyday, start a new post and create a link to the previous day in that post. Ask all of your questions in that thread. I wish I could give you dosing advice, but I'm not experienced enough.
 
Please don't beat up on yourself. The learning curve for managing a cat's diabetes is huge. Working 2 jobs and managing Scratches' diabetes is challenging!

One thing that may help you to better understand the spreadsheet is that once numbers are better, a Lantus curve is flat. All of the peaks and valleys flatten out. Of course, if you need to shoot and run, that becomes rather challenging on your nerves! Do you have a timed feeder? If not, that may help. Your kitty will have access to food during the day.

Are there days when you're not working? It looks like you've been getting plenty of tests and only been skipping shots during the PM cycle. It may be that with lowering the dose a bit, you'll be able to shoot the same dose twice a day.
 
Sienne and Gabby (GA) said:
Please don't beat up on yourself. The learning curve for managing a cat's diabetes is huge. Working 2 jobs and managing Scratches' diabetes is challenging!

One thing that may help you to better understand the spreadsheet is that once numbers are better, a Lantus curve is flat. All of the peaks and valleys flatten out. Of course, if you need to shoot and run, that becomes rather challenging on your nerves! Do you have a timed feeder? If not, that may help. Your kitty will have access to food during the day.

Are there days when you're not working? It looks like you've been getting plenty of tests and only been skipping shots during the PM cycle. It may be that with lowering the dose a bit, you'll be able to shoot the same dose twice a day.
Click to expand...
I'm lucky enough to work close to home so I can go home a check her on my break. If she was real low one day I could go home more often to check her. She always has food left out for her. If she's low on food on my break I refill. I'm just really hoping she's starting to regulate a little bit. I gave her the reduced dose last night and this morning so I hope she does well.
 
Sienne and Gabby (GA) said:
I'm hoping you got another test during the PM cycle. If it were my kitty, I'd want to be sure she was staying in those blue numbers.
Click to expand...
I got two tests last night. Of course I did, I always do. If she fails her reduction, should I go back up to .75?? Should I wait a some cycles or just raise the dose? I'd like to start tr sometime in the near future just as a heads up.
(I just haven't had time to update her spread sheet, I jot everything down on paper then update throughout the day bc I'm so busy it's just quicker in the moment to write it down)
 
I don't mean this to sound snarky but if the information isn't on the spreadsheet I can't answer your question.

From what's on your SS, I'm not sure why you're wondering about a failed reduction.
 
I don't mean to ask stupid questions. I'm just trying to get informed. I've only been doing this four months and I'm super friggen busy so I try to ask questions in advance so I'm not struggling to get answers in a pinch for whatever reason. I apologize if that makes me sound like I have no idea what I'm doing, I just like to ask questions in advance bc like I said it seems when I post on here it takes a long time to get responses sometimes and I always feel in a pinch asking when it comes time to shoot and idk how much to give her.
 
I can try to do away with the pen and paper and just go right for the tablet and update her spreadsheet asap from now on. Ugh. Life with a diabetic cat and trying to work two jobs on my own is really a struggle. I also rescued a dog from the local shelter here about seven months ago and he needs attention too haha. Sorry if I came on with a bit of an attitude, if it seemed that way I'm sorry I did not intend that.
 
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