New here, please help

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Thanks for the SS update.

With that high number, if the PMPS is high also, you would be safe to give the 0.5U that you have been giving.

With that low 190 from this morning, it's likely that Maggy has been going lower overnight. Would you be able to get what we call a 'before bed test'? A BG test before you go to bed for the night. It will give us more data to work with.

Many cats drop lower overnight. Maggy may be doing that.

Since you skipped the shot this morning, the numbers will be higher for a bit. The insulin depot needs to build back up.

I'd like to see at least 3 days on a dose without any skipping if possible. You do need to gather some more test data, especially for those mid-cycle numbers. We really only have yesterdays 6/22 tests to show us some idea of when Maggy's nadir is. Looks like it's somewhere after +3 and before +6.

Looking at the SS, based on the curve yesterday AM cycle, it looks like a dose increase may be due or some more bouncing going on. Hard to tell which. That 190 this morning leads me to believe that Maggy dropped much lower overnight. That tells me the dose may be ok or too much. Hard to tell.

For now, I'd like to see the dose stay the same and get a few more test numbers.
 
Ok, my pmps was 367. This cat is crazy. Why did it go down?

Anywho, I will do a before bed test tonight.. and then I'll try and get some random ones. Its just hard since I leave for work at around 8:30 and come home around 4:30 or 5 every day (besides weekends).
 
If you get home from work a few hours before you take the PMPS test, that is an opportunity to get a test then. Only after you have said hello to the family of course.

Why did the number go down? No way to tell for sure.
 
Before bed test at +3 was 243.

I'll do morning tomorrow, and then when I get home from work as well. Any thoughts on threshold for shot/no shot for tomorrow morning.. still 200 ?
 
rowley978 said:
Before bed test at +3 was 243.

I'll do morning tomorrow, and then when I get home from work as well. Any thoughts on threshold for shot/no shot for tomorrow morning.. still 200 ?
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Yes, I still think 200 for shoot/no shoot threshold. Over on the Insulin Support Group Lantus TR forum, the shoot/no shoot threshold is 150. I think you need to gather a bit more data before you are ready for that.

Have you read this topic on shooting low numbers? http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=147 It talks about gathering data to prepare yourself for shooting those low numbers.

We have 2 forums geared specifically for Lantus users. Insulin Support Groups (ISG) for Lantus TR and Relaxed Lantus. You always have the option to post over there for advice on the insulin you are using. Before you make your decision, I suggest going over to one of these forums and seeing how things are done. Read a few posts, read the Sticky topics at the beginning of the posts. Get a feel for if you think you would be comfortable in an ISG. It's up to you weather you want to post here in Health or over in one of the ISG's.
 
That is a tremendous amt. of information. ... I feel like I need to go back to college for some of that stuff.

Anyways, I did a "when I get home" test, and what not. .. I'm updating my ss. I'll get a before bed one again tonight, and some more tomorrow... trying to add to my collection of data.

Thanks
 
rowley978 said:
That is a tremendous amt. of information. ... I feel like I need to go back to college for some of that stuff.
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Yes, I've compared this to a crash course, college master's degree level in managing feline diabetes. It's a lot to learn but we can help you with a lot of it. Take it slow and easy. It's a pass/fail degree and when you have learned one lesson, you move on to the next.

Anyways, I did a "when I get home" test, and what not. .. I'm updating my ss. I'll get a before bed one again tonight, and some more tomorrow... trying to add to my collection of data.
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Thanks for those few extra tests. Keep getting more data when you can and adding it to the spreadsheet. It all helps, especially at the beginning when we are trying to find the nadir.
 
Look on the bright side, you will be able to educate your vet, and its good to challenge your brain in new directions...

Lots of yellow today.. Come on maggy I want some blue!!
 
Hey all

So I did a test when I arrived home from work today and Maggy was 150. I just did his PMPS and he's 115 now. Should I feed, or hold him off for an hour and retest?



EDIT : Also, could my cats lack of appetite (all 3 of them) because of the high heat and humidity have something to do with it? And/or could they be getting sick of the pate? Nobody finished the can I put out this morning at 8am. I threw away probably half of it. Its very hot and humid here this week.
 
I'm ok with strips, but I don't have high carb wet food, or high carb any food. I have honey and I have ice cream? Does that count ? He loves ice cream... or, used to love it when I was able to let him have a few licks.

Staying up, not really an option tonight. I'm running on fumes as it is this week... but I'll do it if I have to .
 
ok then - if he doesnt go up to over 150 I would skip.. or maybe give 1/4 unit. I hate to see him losing momentum but we do what we can.. it will happen again.

Next time you go shopping, pick up a few cans of a gravy cat food for these situations. Syrup will work in a pinch but gravy food is better.

Wendy
 
Yes, the heat may reduce appetite - less active = less calorie use.

With the heat, you may want to use a thick ceramic plate and chill it in the fridge or freezer to help keep the food cool while its down. Some folks will freeze part of the meal so that it may be nibbled as it thaws. Or place some freezer packs under a plate.
 
Yep sounds good. Get a test in 2-3 hours if you can though,, let's see when he starts to shoot up.. He will probably be high again tomorrow am.
 
So maggy was 391 on yesterday morning when I hadn't given him the shot the previous night. Last night he was 279, so I gave a shot. This AMPS he is 174. I'm waiting a half hour and retesting to see what direction he's going. I am not going to be home today.. Still half shot, or 1/4 shot? Thoughts (if anyone is around ). Thank you.

** He went up to 180 at 1/2 hour after the AMPS.

I gave him 1/2 shot
 
Hi,
I see you're looking for dosing advice. I don't give advice, but if you add this: "? dosing advice" to your subject line (go all the way to your first post to change it) then click the "?" icon, I am sure someone will help you :-D
 
When you say you gave 1/2 shot - is that 1/2 unit or 1/4 unit?

174 is within meter error of 180 so he was kinda flat. However he did this same thing on the 26th and then started to increase a few hours later so probably will do the same. Are you around to test today to see?

Wendy
 
Great to see some mid cycle tests...

Any chance of a before bed or mid cycle night test? am wondering if you need to sneak the dose up a little ie to 0.75 ... but am very wary about that in case he is dropping low at night..

Wendy
 
Maggy is doing well. I went away for a week earlier this month and had someone come give his shots to him. He was alright when I got back, so thats good. His tests are still all in the high 100s, 200s, and up to the mid 300s, so, I guess thats where I'm at! I'm still having a hard time getting mid cycle shots. Just too busy.
 
Ok good cos I was a little worried. Maybe you want to do a curve once a week ( every 3 hours or so through the day) just to make sure he isnt dropping too low or staying too high.

I still think he is dropping low some nights - you gotta wonder when you see a blue preshot, how low he went the cycle before.

Wendy
 
Well, it's undoubtedly time for a dose change, but without some mid-cycle tests, it's impossible to gauge how much.

I'm not comfortable suggesting a dose change amount without some of those mid-cycle tests. Catch-22 situation here.

You've been giving this same dose for more than a month. Even the SLGS (start low, go slow) protocol does not usually hold doses for more than a week at a time.

We need at least a consistent 'last test before you go to bed at night' test. And a couple of weekend mid-cycle tests.

I remember you said you have a full time job, long commute, 2 young children and probably a lot of other life complicating responsibilities. But Maggy needs your care too. How can we help you to help Maggy better?
 
Hi Steve,
First time posting to you, so a belated "welcome to the board" to you and Maggy. I happened to notice that Kat "dropped my name" a few weeks back...

I personally should get a trophy (and recognition :-D for the "FDMB Basket Case of the Year" because I was a total mess the first few months' of Gobbles diagnosis. (Carl--feel free to thrown a trophy together for me, and let Steve know how mental I was about Gobbles :lol: :lol: :lol: I kept ya'll on your toes, huh?)
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And you've progressed way past "newbie basket case" for sure. Yes, Kat wins the award hands-down! Dude, she was having issues with one of her cats having "runny poos", and she set up a "Deer Cam" hidden camera in the basement in order to find the offender! (relax, Kat, you're still my favorite "basket case" :lol: ).

And now Gobbles is off the juice!

I know there's been a lot of input about doses and numbers and tests at whatever times per day, etc. already. What I'd rather ask is "How is Maggy doing"? Forget the numbers and the meter. We like to see what we call the "Whole Cat Report" on occasion. There's a concept we call the "5 Ps" here. Purring, Preening, Pooping, Peeing and Playing would be the five of the P's.

Usually, cats have issues with most of those things just before, or just after they are diagnosed as diabetic. What we hope to see over time, as they get more regulated and better numbers overall, is an improvement in the things that were "not good" before you started giving insulin.

So how is Maggy doing? Were any of these things an obvious problem before, and have they improved since you began treating him?

My cat, Bob, for instance, was peeing buckets. He quit grooming himself, and had dandruff. He rarely showed any energy and just laid around most of the time. He was pretty much a mess. It took several weeks, but the difference was amazing. The last real sign with him was "Playing", but that was mostly due to his Potassium levels being way under "normal" and once that was fixed, he could jump up on the bed once again. He's still pretty lazy, but that's just "Bob being Bob" rather than a sign of illness.

Now about the dose and test stuff...

To me, it looks like, on paper, Maggy might be able to use a slight increase in dose. But I'm not certain of that. I should also say that Bob wasn't on Lantus, he was on PZI, and it's a different type of insulin completely. But that's what my vet used, and that's what worked for Bob. So any "advice" from me on your insulin, Lantus, should be taken with that in mind.

You don't have to test 10 times a day, or 5 times a day, every day, in order for this to "work". It's more a matter of "when" to make it logical based on the fact that you're using Lantus.

Others have told you that the dose with Lantus is based mostly on the "nadir" reading. That doesn't mean you need a test at every nadir every day. But that's the number, when it comes time to question "does he need a different dose?", that the answer is going to depend upon.

I know you have a life you have to schedule around. Looks like you're up early for work, work all day, and that makes mid-cycle tests during the week extremely difficult. And because you get up before the sun comes up, staying up all night really isn't an attractive option. So, we try to help you figure out what is possible, and we work with that.

Bottom line - Feline Diabetes doesn't take over our lives. Each of us does what we can do. "Us", the people who try to help when people ask for help? Our "job" is to try to explain what we believe is the best way to treat diabetes, while we also need to treat every cat and every new member in a unique way that takes into account that every cat is different, and every caregiver is different. "We" have to try our hardest to work with what "you" can do.

So, let me try by asking some questions:
What days is it possible for you to get a "nadir" test, whether that's during the AM cycle or the PM cycle?
Is there one day a week maybe that you would be able to get 3 or 4 tests in a 12 hour period?
How soon after the AM shot do you leave for work?
How soon after the PM shot would you go to bed (in a perfect world)?

If you can tell us that, then we'd be better equipped to give you any advice related to adjusting his dose.

Whatever you can do, we can work with.

And let us know how those "Five P's" are doing?

Carl

P.S. I grew up in MA.... how 'bout them Sox? :-D
 
Thanks Carl, and everyone, for the latest posts.

I'll answer Carls questions the best I can here.

In terms of getting tests and when I leave for work/get home.

I leave around 8:15 am.
I do Maggy's test/shot between 7:30 and 8 so I can get my final things together to leave.

I get home between 4:30 and 5:30 each weekday.

I go to bed between 9:45 and 10:30 each day.

The best chances I'd get to do more tests during a 12 hour period would be Saturday or Sunday, just not regularly. But maybe it could be EITHER saturday or sunday. I'm probably home for at least one of those days each weekend.

In terms of the 5 p's..... Let me look back.
Yeah, I'd say that before being diagnosed, Maggy pee'd A LOT. Otherwise, he was fine (besides weight loss and being REALLY HUNGRY). After diagnosis and staring on lantus, everything, besides his weight, which has stayed around 11 or 12 lbs from 15 or 16, has been totally fine. He started peeing a lot less, and wasnt as thirsty and hungry. He's always been playful when necessary (I have two other younger cats in the house). I hadn't seen anything really change. However, for the past month +, I'd say that the urination has crept back up again to being more, but nowhere near pre-diagnosis levels.

Otherwise, its just a normal day here. The tests/shots are routine now, which I thought would have been impossible. But, thanks to everyone here, I've made it doing those.

Hope that info helps, and I'd love to see Maggy's numbers get/stay lower. Some of my high numbers are, what I believe, due to Maggy getting some dry food (diabetic) in close to his test and subsequent shot. One of my 3 cats refuses wet food, so I got one of those uber-expensive dry foods ..... gold bag, raw something something chicken. I know that he likes to snack on it here and there, and I think thats where the high numbers come from. In the morning, when he's been sleeping on my face all night, he hasn't eaten in probably 5 hours... and sometimes his numbers are below 200.

Thanks again!

Stephen
 
Ok then, with your life schedule, here are some possibilities for testing to give us some more data to work with.

1. a before bed test. this may be a +2 or a +3. I would suggest this one every night.
2. an in the door test. This may be a +9 or a +10
3. one weekend day. Try to get a couple of tests in the +5 to +7 timeframe. Your choice for which weekend day, no need for you to do both days, unless you really want to. :mrgreen:

There are other possibilities, but it would mean shifting your shot schedule earlier. I have no idea how feasible that might be for you.
 
your schedule is somewhat similar to mine. I get home a little later, but also stay up later (night person).

Here's what I do:

6:30-7:00 - wake up, test/feed/shoot

I leave at about 8:15, so I have time to do a +1 at 8:00 if he is low in the morning. I rarely need to but the time is built in just in case I need it.

Get home at around 6, 6:30-7:00 - test/feed/shoot

10:30 - +4 test.

If +4 is lower than expected or dropping fast, I will stay up for +5. If not, I usually start moving toward the bed around 11:30.

(my cat KK is on Levemir, and with Levemir +4 tends to be more useful than +3. With your cat on Lantus, +3 should be ok, then stay up til +4 if you are surprised by the +3 number).

Weekends I get tests whenever I can, but try to get something resembling a curve on at least one day each weekend. That might mean +4, +6, and +8 or 9. If I'm home both days on a weekend, I'll try to get different tests on the other day. It's not a big formal thing to me and it's not necessarily all planned out (KK is my third diabetic cat, so it's just part of the routine). If I'm going out to the store I'll grab a test before I leave and another when I get home. If I take a nap I'll test when I wake up. If he starts pestering for food more than usual, I'll grab a test in case he is trying to tell me he is dropping. He gets treats when he is tested, so when I am home he tends to ask for tests. :smile: So if he asks for a test, often he'll get one.

It takes a little while to put together data this way, but it's how it works for those of us who work outside the home. You'll figure out a plan you can stick with.

Welcome to FDMB!
 
Maggy status update.

I've been doing more tests in the last two days. See my ss if you are able to check it out. I did a before bed last night, and then every 2 hours today (though I missed the +10).

I'll do some random tests tomorrow.

I'll also try and get the before bed one each night.
 
That's interesting, what i see is that maggy was dropping really nice last night. I wonder how low she went.. Maybe even into green. Then today she bounced off the low.

I would hold the dose a day or two till you see blue again and then try and get more tests at a regular 1-2 hour interval till you see a yellow.(even at night sorry) Let's see if we can catch that low. If its under 50, we reduce dose.
 
he is coming back down again. I cant believe we are constantly missing the low :(

Anyway I am wondering about a slight fattening of the dose to say 0.75 ... if we cant catch that low soon .... but would like everyone else's thoughts. Its not the safest idea since we really arent getting enough tests in but we have rarely seen a green no matter what.
 
I feel that would be a good idea, but my only concern is that I'm starting it on a Monday (when I"ll be unable to do any spot tests and/or monitor his behavior. I'm feeling it would be better to do this on a Saturday morning (change in dosage) so I'm there for him? Or is .25 such a small amt. that it won't have that much bearing on it given his numbers and historical fluctuations?
 
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