New Member - bsg still in 400-500 range after 2 months. Help?

[Deb & Gus Elmo]

My cat, Gus Elmo is @11 years old. Diagnosed in mid- August. Using Lantus. Been seeing vet for bsg and fructosamine levels. Now has a freestyle libre on (since last Wed). Increased insulin to 4 units on Friday eve per vet. Initial drop that night was encouraging but scores were higher yesterday & today. Gus is 15.6 lbs but not overweight as he is a large cat. Has lost 3 lbs since diagnosed. Feeding mix of Royal Canin glycobalance canned & dry. Worried that he won't stabilize!

 

[Diane Tyler's Mom GA]

Hi Deb and Gus Elmo what dose of lantus was Gus Elmo started on ?
4 units seems too high of a dose , did the vet increase by whole units?
We don't base the dose on Pre Shots , we base them on how low the dose takes them
We adjust the dose by 0.25 units
Do you have U-100 syringes with the half unit markings? Make it easier to adjust the doses

If you can fill out what we call our signature that will be helpful,it's at the end of everyone's post in gray

To set up your signature which you will see is at the end of everyone's post in gray, click on your name up top and then tap on the word signature and add this information

• Add info we need to help you:
  • Caregiver & kitty's name
  • DX: Date
  • Name of Insulin (do not include dose or frequency)
  • Name of your meter
  • Diet: "LC wet" or "dry food" or "combo"
  • Dosing: TR or SLGS or Custom (if applicable)
  • DKA or other recent health issue (if applicable)
  • Acro, IAA, or Cushings (if applicable)
  • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
  • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.

Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

Take a look at mine


We also use a spreadsheet to track our cats BG so we know how the insulin is working and how low they are dropping so we know when to either increase or decrease the dose
We adjust the dose by 0.25 units at a time . We don't adjust the dose by going by the Pre Shots

About the spreadsheet
AMPS - means AM Pre Shot the first test you take in the AM ,you need to withhold food 2 hours before testing so it's not food influenced

Units is where you would put how much insulin you gave
+1 is one hour after giving insulin if you were to test then that's where you enter his _BG number
+2 two hours after giving insulin. ditto
+3 and so on until you get to PMPS - PM pre shot withhold food 2 hours before testing

+1 same as you do for AM cycle

We don't give times because we are all in different time zones that's why we use the + numbers
I'll give you the link to set it up , if you have trouble just ask and we have a member who will gladly do it for you


You can look at any members spreadsheet to see what it looks like, it's at the end of everyone's signature just tap on it


Royal Canin Glycobalance (both wet and dry) is too high in carbs for a diabetic cat. The wet is around 14% carbs You need not restrict yourself to prescription food. Any low carb canned food (or raw food) will do.
So if you switch to low carb food you need to definitely be monitoring him because the BG can drop by 100 points

Here is a list of wet foods, a lot of members feed Fancy Feast Pate or Friskies, or any other one you will see on the chart
We like to feed 6% carbs and under
Here is the food chart
https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/

 

[Sienne and Gabby (GA)]

Welcome to FDMB!

I'm providing a link to a post that has most of the information that Diane mentioned all in one place. We call it helping us to help you.

I have a strong suspicion that what is making it hard to get Gus Elmo regulated is the Royal Canin dry food. It's high in carbohydrate and probably keeping your kitty's numbers in a less than desirable range. It's about 30% carbohydrate. We consider low carb as under 10% and most of the caregivers here feed their cats in the 5% range.

Depending on how low Gus' numbers dropped, his higher numbers may be a response to his being in a number range his system isn't used to. Without being able to see those numbers, though, it's hard to know if that's the case. It's one of the reasons a spreadsheet is so helpful! If you need a hand with setting up your spreadsheet, I'm tagging @Bandit's Mom (Bhooma) and she can lend a hand.

Please let us know if you have questions.

 

[Deb & Gus Elmo]

Thanks for the information so far. Much appreciated.
I created the spreadsheet but we can't seem to link it to my signature. We get an error message. Can someone help me?

 

[Diane Tyler's Mom GA]

Thanks for the information so far. Much appreciated.
I created the spreadsheet but we can't seem to link it to my signature. We get an error message. Can someone help me?

@Bandit's Mom

@Chris & China (GA)

 

[Deb & Gus Elmo]

Hi Deb and Gus Elmo what dose of lantus was Gus Elmo started on ?
4 units seems too high of a dose , did the vet increase by whole units?
We don't base the dose on Pre Shots , we base them on how low the dose takes them
We adjust the dose by 0.25 units
Do you have U-100 syringes with the half unit markings? Make it easier to adjust the doses

If you can fill out what we call our signature that will be helpful,it's at the end of everyone's post in gray

To set up your signature which you will see is at the end of everyone's post in gray, click on your name up top and then tap on the word signature and add this information

• Add info we need to help you:
  • Caregiver & kitty's name
  • DX: Date
  • Name of Insulin (do not include dose or frequency)
  • Name of your meter
  • Diet: "LC wet" or "dry food" or "combo"
  • Dosing: TR or SLGS or Custom (if applicable)
  • DKA or other recent health issue (if applicable)
  • Acro, IAA, or Cushings (if applicable)
  • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
  • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.

Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

Take a look at mine


We also use a spreadsheet to track our cats BG so we know how the insulin is working and how low they are dropping so we know when to either increase or decrease the dose
We adjust the dose by 0.25 units at a time . We don't adjust the dose by going by the Pre Shots

About the spreadsheet
AMPS - means AM Pre Shot the first test you take in the AM ,you need to withhold food 2 hours before testing so it's not food influenced

Units is where you would put how much insulin you gave
+1 is one hour after giving insulin if you were to test then that's where you enter his _BG number
+2 two hours after giving insulin. ditto
+3 and so on until you get to PMPS - PM pre shot withhold food 2 hours before testing

+1 same as you do for AM cycle

We don't give times because we are all in different time zones that's why we use the + numbers
I'll give you the link to set it up , if you have trouble just ask and we have a member who will gladly do it for you


You can look at any members spreadsheet to see what it looks like, it's at the end of everyone's signature just tap on it


Royal Canin Glycobalance (both wet and dry) is too high in carbs for a diabetic cat. The wet is around 14% carbs You need not restrict yourself to prescription food. Any low carb canned food (or raw food) will do.
So if you switch to low carb food you need to definitely be monitoring him because the BG can drop by 100 points

Here is a list of wet foods, a lot of members feed Fancy Feast Pate or Friskies, or any other one you will see on the chart
We like to feed 6% carbs and under
Here is the food chart
https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/

Thanks again!
The vet started him on .5 unit when he was 1st diagnosed in August. It has been increased by .5 units or 1 unit over the past 2 months at vet direction. He is currently on 4 units. He weighs 15.6 lbs.

I set up the signature and did a spreadsheet but have been unable to link it yet. I asked for help.

 

[James Passinos]

Royal Canin Glycobalance (both wet and dry) is too high in carbs for a diabetic cat. The wet is around 14% carbs You need not restrict yourself to prescription food. Any low carb canned food (or raw food) will do.
So if you switch to low carb food you need to definitely be monitoring him because the BG can drop by 100 points

can diet alone control the BG? if you could drop by 100 points would that be just as effective as Lantus?
We have just starting switching from Royal Glucose and Hills I/D to the low carbs on the list (Weruva, Tiki and Fancy Feast)

 

[Chris & China (GA)]

I set up the signature and did a spreadsheet but have been unable to link it yet. I asked for help.

Bhooma is on vacation and not on as much as usual but I'd be happy to help you if I can. I set up a lot of spreadsheets for others!

Just click on my name and choose "Start a conversation" so we can see if we can figure out what the problem is!

 

[Deb & Gus Elmo]

Royal Canin Glycobalance (both wet and dry) is too high in carbs for a diabetic cat. The wet is around 14% carbs You need not restrict yourself to prescription food. Any low carb canned food (or raw food) will do.
So if you switch to low carb food you need to definitely be monitoring him because the BG can drop by 100 points

can diet alone control the BG? if you could drop by 100 points would that be just as effective as Lantus?
We have just starting switching from Royal Glucose and Hills I/D to the low carbs on the list (Weruva, Tiki and Fancy Feast)

Bhooma is on vacation and not on as much as usual but I'd be happy to help you if I can. I set up a lot of spreadsheets for others!

Just click on my name and choose "Start a conversation" so we can see if we can figure out what the problem is![/QUOTE
Thanks I will contact you in the morning about the spreadsheet.
I am glad that he has the freestyle libre on. I switched to RC wet mixed with friskier pate and he did drop. Lowest BG yet of 201. Will talk to vet in am about decreasing insulin.

 

[Diane Tyler's Mom GA]

Thanks again!
The vet started him on .5 unit when he was 1st diagnosed in August. It has been increased by .5 units or 1 unit over the past 2 months at vet direction. He is currently on 4 units. He weighs 15.6 lbs.

I set up the signature and did a spreadsheet but have been unable to link it yet. I asked for help.

We increase or decrease by 0.25 units , We adjust the dose based on how low their BG is dropping not the Pre Shots.
Here is the link to read about Lantus and SLGS
Once you get your SS set up by Chris we can see what's happening
https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/


Part of that process is getting a feel for basic concepts:

• Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
• Peak/Nadir - the lowest point in the cycle
• Duration - the length of time insulin continues to lower blood glucose

Do you have the U-100 syringes with the half unit markings

 

[Deb & Gus Elmo]

We increase or decrease by 0.25 units , We adjust the dose based on how low their BG is dropping not the Pre Shots.
Here is the link to read about Lantus and SLGS
Once you get your SS set up by Chris we can see what's happening
https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/


Part of that process is getting a feel for basic concepts:

• Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
• Peak/Nadir - the lowest point in the cycle
• Duration - the length of time insulin continues to lower blood glucose

Do you have the U-100 syringes with the half unit markings

The .5 unit or 1 unit increases were based on the vet recommendations. She is adjusting based on all of the above, which is why she ran fructosamine assays and has Gus on a freestyle libre right now. Current plan is to keep him at 4 units of Lantus so that a full metabolism change occurs (paraphrasing her words here). She will remove this Libre this Thursday and then we will apply a new one in about 3 weeks so we can do another curve.
Overall I do like her and trust her. I hope to have the spreadsheet linked up soon.
Yes, we have U-100 syringes with half unit markings.

 

[Diane Tyler's Mom GA]

The .5 unit or 1 unit increases were based on the vet recommendations. She is adjusting based on all of the above, which is why she ran fructosamine assays and has Gus on a freestyle libre right now. Current plan is to keep him at 4 units of Lantus so that a full metabolism change occurs (paraphrasing her words here). She will remove this Libre this Thursday and then we will apply a new one in about 3 weeks so we can do another curve.
Overall I do like her and trust her. I hope to have the spreadsheet linked up soon.
Yes, we have U-100 syringes with half unit markings.

In post #8 from Chris and China she said she would set up the spreadsheet for you did you see it , post numbers are to the rightbp just start a conversation with her

 

[Deb & Gus Elmo]

I think that I got the spreadsheet linked now?

 

[Diane Tyler's Mom GA]

I think that I got the spreadsheet linked now?

We can't see your spreadsheet
You have to
To set spreadsheet sharing permission:
* At the top right of the spreadsheet screen click on Share.

* In the pop-up dialog box click on the Get Link section.

* Change link access from 'Restricted' to 'Anyone with the link' and make sure that the permission on the right hand side is set to 'Viewer'.

* Click Done to save the changes.

 

[Chris & China (GA)]

Hit "Share" in the top right, then this box pops up. Change it at the bottom to "anybody on the internet with the link can View"

But yes, you have it linked in your Signature now!

 

[Wendy&Neko]

I see in your spreadsheet notes that you've switched to only wet now, but the vet wants you to go three weeks without replacing the Libre. I think that might be a dangerous move. Moving to all wet food cause a drastic reduction down in dose needed. And it can be even more apparent in a couple days, now is not the time to stop monitoring. Tonight you have your lowest preshot value yet, which shows the power of going to all wet food. Make sure you scan the Libre again tonight before bed.