need help

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terri1962

Member Since 2011
I just tested Lilly this evening and she is at 149. I just increased her to .50 recently. Should I decrease dosage this evening ot not give shot? Meant to get a mid day reading but had work man here today.

Terri
 
Will you be around to test tonight, and do you have sufficient supplies? If so, I think you should be okay... I see that you shot a 139 on the 16th, so this wouldn't be your lowest pre-shot.
 
If Lilly's numbers are rising, it's generally fine to shoot. Remember, Lantus onset isn't immediate. The insulin will start to work in approx. 2 - 3 hours and you will have food on board.

The big issue here is you have no spot checks. You don't actually know when Lilly's onset or nadir is. If you are at work during the week, then get some tests, the bare minimum is a test before you go to bed, at night. Get a "sleep" test (i.e., set an alarm, get up, test, and go back to bed). Given the sparsity of data, I don't know how to best advise you. If you shoot, you MUST test.
 
I am starting to wonder is maybe she should be on a different insulin. It always goes the same I increase her and she drops to much, I decrease and she rises and the doses are not high.
I will try to get a mid day reading tomorrow. I went ahead and only gave her .25. Frankly I don`t know what I am doing. I get no help from the vet at all, she told me to give 1 unit twice a day which probably would have hypo her by now for sure. I love this cat so much but can`t seem to do the right thing for her she is my favorite cat, I know your not supposed to have favorites but she is mine.

Terri
 
Since you shot, please get a +2. That will give you an idea of how tonight's cycle will go.

the best way to keep her safe is to get those spot checks whenever you can, so you will know how low the dose is taking her rather than having to guess. Then you will know for sure whether the dose is too much, too little, or just right.

You saw her numbers rising and responded by increasing the dose, but it is very possible that those higher preshot readings were actually bounces if she went lower than you realize she did during the cycle before. The good thing is that it is soooooo easy to know for sure, all you have to do is grab some random tests whenever you can and a before bed test each night. Even if you don't know how to interpret her patterns, once you have some data then lots of people here will be able to help you figure it out.
 
Terri --

You're basing your interpretation on pre-shot numbers only. With Lantus, that's not going to give you a good picture of what's going on. You really need the spot checks. With Lantus, dosing is based on the lowest number in the cycle. It's quite possible that Lilly's numbers are dropping low during the middle of the cycle. Without those tests, you'll never know. What you may be seeing at pre-shot is some bouncing. Again, there's no way to determine this if you don't get mid-cycle data. You need to do a curve -- testing every 2 or every 3 hours for a 12 hour period. This will tell you where Lantus onset begins and when the nadir occurs. We can't responsibly help you with dosing or help you to learn about dosing without your providing us with the data to do so.

Frankly, you have no way to keep Lilly safe, no matter which insulin you opt to use, if you don't get spot checks. By comparison with other types of insulin, Lantus is far more gentle.
 
yes I will try to get a +2 reading and put in the spreadsheet as well as a mid day reading tomorrow. I wish now I would have given her the full dose.
I will try to get more mid day readings from now on. She does seem to be feeling better and is coming out more often.

Terri
 
I think before you dump Lantus you may want to consider giving it a fair shake by following the protocol.
Those between shot numbers are a very big part of the whole picture with Lantus. There's just no two ways about it.

Vets just don't see and successfully treat much FD. Here in LL we live and breathe it.
I've lost count of how many LL kitties have got off the juice - I think perhaps 200 or so. . .

None of us knew what we were doing in the beginning. I never knew a cat could have diabetes - I was stunned at the diagnosis.
Thanks to FDMB and LL my BK is alive and off the juice.
 
Terri:

Don't worry that you didn't give her the full dose; her shed will not entirely drain and she'll be ok. You can get back to her normal dose tomorrow morning.

It's a common occurrence in LL that one dose seems like too much and another seems like too little. It's just fine tuning until you find the right dose and the testing helps you do that. Lantus is a great insulin
and it and levemir are safer than the other insulins out there; they also have higher rates of remission.

If you can get some tests tonight and tomorrow, that might help you see what Miss Lilly is doing so you can start fine tuning the dose.
 
Sienne

I have never curved Lilly before. I frankly don`t know yet if she will let me. The vet has always done that hence the high dose of insulin from the vet stress that the vet wanted to put her on.
I do know I need to do it but you have to understand not every cat can be tested every two hours. They do it at the vet because she is caged.
There has to be people on this board who have difficult cats to test. I know not every cat on Lantus can be tested every two hours.
I am also by myself in the house and have no other help, so that means chasing from under beds, dressers. behind the couch get the picture?
I just need help from time to time thats why I usually don`t post here because you guys are so data driven and frankly I don`t have the data to give.
 
personally, I am not a fan of the every 2 hour curves. I feel that getting even one spot check at different times in every cycle (or almost every cycle) yields a lot more useful data over time than testing every 2 hours all in one cycle.

A curve can be great to do every now and then, but if you are having a hard time testing then I would rather see you grab tests just whenever. Before you head out the door for work one day might be +2, then as soon as you walk in the door another day would give you a +11, then when you get home from errands on Saturday might be +7, just whatever. I always, always, always suggest a test right before you fall into bed each night, though, because a lot of cats show more action at night than during the day. For me that is usually +3 or +4. It takes a while to start filling in the holes on the spreadsheet that way, but that is how most of us have to do it. Then when those spot checks start showing numbers that surprise you, then you would want to step up and do more testing to figure out what is going on. Make sense?
 
Terri --

There's a happy medium here. I couldn't agree more with what Libby posted. That's fine. If it takes a while to get Lilly acclimated to testing do what you need to do to make this easy for both of you. Just do what you can to start filling in the picture so you will know what's really going on with Lilly's numbers.

There will be times, though, that you will need to test frequently. Usually this is when you see that Lilly's numbers are dropping and you need to manage the curve with food. The more quickly you can help make this an easier process, the more confident you will be when it comes to steering the numbers. FWIW, I'm Gabby's sole caregiver. She's pretty motivated by food and by treats, so that helped to get her on board with theprocess.
 
Thanks Libby

I was able to grab her up real quick and get a + 2 of 177. I only gave her half her dose this evening will be going to bed soon so I don`t think I should have to worry about her this evening. If I had given her the full dose I should have maybe tried to test throughout the night. She seems to be okay.
Thank you all for the help. I will put her back up to her full dose in the morning if her numbers look good and get a mid day reading when I can tomorrow.

Terri
 
A +2 can be very informative as to where the cycle may be headed. Typically, a +2 is around the same as your pre-shot. If it's lower, it's a "pay attention" sign.
 
hi terri, i don't know if i told you when you started posting that i had to burrito-wrap punkin in a beach towel to test him for the first few weeks. i put the towel over my chest horizontally, grabbed him and sat down on a chair. his back was to the towel and the towel ends were hanging off either side. i pulled one end of the towel tight across his chest, then did the other side. he looked like a shrimp with a head sticking out when i got done with him. then he couldn't fight me with all those legs nicely tucked in.

i moved to the sofa where i already had the testing gear ready. sat down with his head on my lap and then i had time to get the test. the second i was done i said "let's get some chicken" and he ran for the fridge for his treat.

people told me he would learn to come for the test and i thought right - the same cat that i have to pull out from under the sofa, hoping i don't dislocate his arms and then wrap up . . . right. but they were right - now he asks to be tested. he never gets fed without a test first and food IS a great motivator.

hang in there - try something like this and stay with it. you can do it and you will be SO glad you persevered. Lantus has the best rate for cats to go OTJ, but you have to get those in between tests to know what the dose is doing. the preshot tests just don't tell you the whole picture.

hugs! it gets easier - especially with treats. and after lilly gets one, make sure you get something too!
 
Thanks to all of you for your help, I did sneak in a test at +7 today and she was at 94. My mother is in a nursing home so have to go take care of her dog who has decided he will not eat now. I gave her full dose this morning at .50. She is getting better with the testing than she was at the start, I let all the other cats go into the room with us when I take her in there for her tests.
I am still not real good at giving the shots and half of the time wonder if I actually gave her the shot. A couple times I must have hit muscle or something because she let out little meow and I wanted to cry.
So I went back again on the internet to reeducate myself on how to give the shot. I will try to get more tests in during the day when I can so I can post to the spreadsheet so those that know can help me if I have a problem.

Terri
 
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