New Here - It's Official :(

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Looks like that prior reading was correct. I would give him a rest for a few hours or maybe even wait to see where he is tomorrow morning.
 
You are feedin a low carb canned right? What type/brand?

If his pancreas is working, it will kick in and the blood sugar drops after a meal.

How do you normally feed ie before diagnosis?

Wendy
 
Its the friskies special diet...one tht was recommended...I had fed him 1/2 of the can around 4:15 after I tested this afternoon...about an hour earlier than normal.

There isnt much left..maybe a couple of tblspns

I always feed before I dose...within 15 minutes..

Hes been grazing since about then
 
What flavours? Most are ok except the sliced chicken in gravy..

I would feed him on his normal schedule. If you don't he will get hungry and eat more at the next meal which will also spike his blood. Personally I prefer to give mini meals through the day to try and keep the blood levels more stable..
 
This is the pate...Friskies Special Diet Turkey & Giblet Dinner, Classic Pate

He's been eating like mini meals really. I'll put out 1/2 a can...based on how I did it before...but he wont eat it all at once...he eats it over several hours.
 
Ok that's perfect.

Anyway let's see how it goes for now, maybe if he keeps going up on monday you restart the lantus but at only 0.5units or even 0.25.

Wendy
 
Thats pretty much what the vet said...if he goes to 350 to dose him, but I'll still test him a few times during the day..just in case

Thanks
 
Just did AMBG and came in at 361. Feeding him now...I know I have to dose...vet said if over 350 I should give 1 unit.

Gave him 1 unit after he finished.
 
Do you have syringes with half unit markings? Those are quite helpful with Lantus when you're getting into low doses.
 
No, I'd have to eyeball it...its sooo tiny lol but I think I can. Just going to test him throughout the day...and see how its going. Tomorrow vet wants me to do a curve for her
 
By "watch" I mean "test" ;)

So I would test at +3 to start and depending where he is ,get more tests in.

For example at +3, if he is high yellow or pink I would wait 2-3 hours before another test.
But if he is low yellow, blue or green I would test hourly until you see two readings increasing in a row.

Trying to see how low he goes. i will be around though and can guide you depending on his readings.

Wendy
 
Ok cool - he is slowly coming down. I would get another test in a couple of hours. Also it might take a few doses of this to see any effect... like last time you didnt see the effect and greens for a couple of cycles because of the way Lantus slowly builds up in the cats system.
 
So is the possibility of him dropping too fast not a possibility anymore? I'm guessing I'm still in the "regulating" stage since I just started him on Lantus Wed night...so that puts us just past the 3 days...and we even skipped a few doses

I have to run to the store...will be back in about an hour...his next test is at 11:55 am CST...will update then

Thanks
 
He could but looking at these numbers it seems unlikely.

So what happens is that when you give Lantus it slowly builds up in the cats system over a few days like in a sort of "Depot".So you dont really see the true impact of a dose immediately. If you skip a dose then you drain the depot a bit. So in order to know how a dose is working you need to give it consistently, every 12 hours, for a few days... unless the cat drops low (under 50) in which case you drop the dose by 1/4unit.

For example on the 24th morning and night you gave 1 unit. The depot started to build up with each of those doses, so much that the morning of the 25th he was green and you had to skip. And the depot wasnt even properly full to match the 1 unit dose. This tells me that there is a good chance that 1unit is too much.

We need to find a dose you can give every 12hours to keep the blood in a better range.
 
I'm starting to understand...will test again in about 15 min and post.

Test 11:55 am is 227. which is +5...and he's wanting to eat ugh...maybe a tspn or 2?
 
Are you willing and around to do a +7? This might give us a better idea of Nadir, since you have a +5 already. Most cats nadir around +5 to +7.
 
Would you be willing to add a location to your user control panel, profile, edit profile, location field? This would give us some better idea of what your time zone is and when the +7 will occur.

What time will that be by the way? :-D
 
Ok he bounced from the low numbers yesterday. he probably will continue to drop. Keep watching. You may have a low PMPS too

Wendy
 
Definition of a bounce:

When a cat is first diagnosed, the blood glucose has probably been high for a while. As the insulin starts to take effect and numbers start to come down, the liver has to learn to adjust to the lower numbers. We call this "liver training school". But before it relearns that low numbers are ok, when the BG drops to a number lower than the liver is accustomed, or if BGs drop low, or if the BG drops suddenly, the liver”panics” and reacts by releasing counterregulatory hormones and glucagon. This drives the BG back up. This is what we call a "bounce".

Bounces can take up to 72 hours to clear so we are generally careful about increasing doses during the bounce. Once the bounce clears, then you can see the "real" numbers.
 
Yes, I think a next test at PMPS is the next test you need to do.

Let's make sure the PMPS is over 200 before you give any insulin, ok? If it is not >200, then please delay feeding, delay giving insulin, test again in 30 minutes and post here for advice. This is called 'stalling'. You can mention that in your post tonight if necessary.
 
Its actually going to be longer because I slept in this morning...he didnt get his AM test til 6:45...so it will be the same tonight...in case I have to dose him...so less than 2 hours from now
 
ok so he hasnt eaten for 1.5 hours right?

The issue now is that he isnt likely going to be high enough for you to shoot. This tells me the 1 unit is too much. So likely you will be skipping again. I would like you to start tomorrow with 1/2unit. Which is what we said before... but I know its hard to trust an unknown person on the web compared to your vet ;)

But whatever you do -whether you trust me or not - dont shoot under 200 you dont know how Poe is going to behave and could be setting him up for a hypo.

Wendy
 
its been longer than 2.5 hours since hes eaten...and I wouldn't dose unless he was over 350, so below 200 and not dosing is not an issue.

My vet wants me to do a curve tomorrow...will that make any difference in the curve? is decreasing it safe? Can I feed him now? or Stall?
 
Wait till the PMPS just to see what he is doing. Then you can feed him because you arent planning to shoot under 350 anyway.

Tomorrows curve.. are you planning on 1 unit again?

The problem with the curve is that the vet isnt seeing the whole picture here. Lantus is supposed to be dosed twice a day and the 1 unit dose is just too high for that. the dose is causing Poe to go low and making you skip....and then because you skip, he is going too high!. The too high is damaging his pancreas and over time will make remission less likely. Somehow you need to communicate that to your vet. The fact the vet supports home testing is a good sign so I am hoping he is open to discussion.

I want the best chance at remission for Poe and I think he has an a good chance at that (with proper dosing its a 40% chance) so we dont want to mess around here. The window for remission is very short and then you end up with a diabetic cat for life.


Wendy
 
I did the PMPS test about 30 min earlier than the time i should have...so that is the number for it..the 130. I put that number in the PMPS column. I can see how his numbers are jumping and how I have to skip a dose...and since tomorrow is a holiday here I have no way to contact my vet. So Ima give him the .50 dose and do the curve...and I'll tell her...I talked to her on Friday...she was the one telling me to not dose below 350.

we are now at almost 30 min past the test...and I know hes hungry lol its really late for him..and since I'm not dosing, I will be starting tomorrow earlier like I was before.
 
ok cool so feed and skip the shot.

Tomorrow morning lets curve on 0.5IU. Now of course the depot isnt full so Lantus hasnt had a chance to build up in his system to its correct level so he may sit too high for a day or two but at least hopefully you will be able to shoot twice a day!

Wendy
 
Maybe get a +2 or +3 tonite too, more data is always good. lets see where he goes from here.

I am excited to see how the new dose works tomorrow!! :razz:
 
I would do a +2, and only because you dont have one yet for that time. Am trying to see if he continues to drop or goes back up. he probably will drop a little longer and then shoot up to a nice :( pink for tomorrow morning.

Wendy
 
PMBG +2 is at 127...he didnt eat much dinner but is eating now again..this is really tough. I thought for sure he'd be hungry right after the PMBG...
 
The lantus is hanging around a bit longer than the 12 hours. It can stay for 15-18 hours before it wears off entirely and he starts to go up. Also his pancreas may be working a little.
 
His appetite fluctuation is making it hard too. I'm afraid to dose him when I need to if he dont eat enough.

But he's playful and happy...and I'm looking forward to see how he does on 1/2 the original dose.
 
For his appetite, are you worried he's not eating enough throughout the day/night? If so, then yes, you want to see him eat with his shot time to make sure he doesn't drop too fast. But, if he's eating enough, with Lantus it's more important to eat around nadir/+5-7 hours after shot time than it is to eat at actual shot time.

For me, once I figured out how much on average Michelangelo needed to eat each day, I no longer worried about him eating at shot time. Both of my boys (8 months and 1 year and a month old) eat about 2 cans of Friskies one day and 5 cans the next and other variations. It all equals out to about 4 cans a day over the span of a week. So as long as I see him consuming "enough," I'm not too worried if his appetite fluctuates from day to day.
 
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