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Wendy&Tiggy(GA)
Member Since 2011
Yep let's hold the 0.5 for 3-5 days unless he drops below 50.
A before bed test would be good .. If its less than the preshot then you also might want to set your alarm for a +6..
Wendy
A before bed test would be good .. If its less than the preshot then you also might want to set your alarm for a +6..
Wendy
Wendy&Tiggy(GA)
Member Since 2011
Looks like a bounce. Normally I wold say you would be fine to go to bed but the other day he suddenly dropped at PMPS+5 so if I were you I might set the alarm for another test then.
Wendy
Wendy
Wendy&Tiggy(GA)
Member Since 2011
Make sure you get a test at +2 so you dont get any surprises about which way he is going. At +2 any food will have worn off so you will get a clear picture of his plans.
This dose is still building up in his system ( takes 2-3 days) so we will see soon how its going to work.
Wendy
This dose is still building up in his system ( takes 2-3 days) so we will see soon how its going to work.
Wendy
Wendy&Tiggy said:
Hi Wendy,
Unfortunately, I was already on my way to work when he would have been at +2. I tested him when I got home, which would have been about +8, and he was at 123. The PMPS will be the next test about 7pm.
Now if I understand this correctly, if he is high like he was yesterday, above 200, than he can get the shot. If he is low, I should wait to feed and test again in 30mins, to see if he is going up or down.
Deb & Wink
Member Since 2013
Yes, wait 30 minutes, hold the food, post here with the number.
Wendy&Tiggy(GA)
Member Since 2011
Yes if it doesnt throw you off schedule ...
Otherwise you can skip this shot - or - give a reduced dose ie 0.25 but make sure you get a before bed test in a couple of hours and be ready with syrup etc if he does drop low.
Wendy
Otherwise you can skip this shot - or - give a reduced dose ie 0.25 but make sure you get a before bed test in a couple of hours and be ready with syrup etc if he does drop low.
Wendy
Wendy&Tiggy said:
Thank you for your help!
He typically does not eat later than 7:30, so we are only a little off schedule. I just tested him again and he is at 84. I will skip this shot tonight, since I do not think I would measure .25 accurately.
I am having trouble finding syringes with 1/2 unit measurements. The smallest measurement on my syringe is 1 unit.
Wendy&Tiggy(GA)
Member Since 2011
They should have 1/2 unit syringes in pharmacies.. ask for U-100 syringes 3/10 cc, half-unit marked, short needle, 30-31 gauge
ie Relion 3/10cc 30 & 31 gauge short (Walmart brand)
BD Ultra fine 3/10cc short
Terumo Thinpro Insulin Syringe 31G 3/10cc
Would be good to have them as I think he might be on 0.25 soon. I am loving these numbers and hope he keeps it up so his pancreas can heal.
Wendy
ie Relion 3/10cc 30 & 31 gauge short (Walmart brand)
BD Ultra fine 3/10cc short
Terumo Thinpro Insulin Syringe 31G 3/10cc
Would be good to have them as I think he might be on 0.25 soon. I am loving these numbers and hope he keeps it up so his pancreas can heal.
Wendy
Wendy&Tiggy(GA)
Member Since 2011
Did you ask at the pharmacy section? They quite often keep them behind the counter.
Hi Wendy,
I did ask the pharmacists and they all said what I had was smallest.
I was reading more about the Tight Protocol when I saw the pics with the 1/2 units measurements.
Since Lucky's PMPS was low last night, he did not get any insulin, but I woke up this morning @ 2am to spot check and he was at 364. I didn't want to risk him going any higher before his regular shot at 7:00 so I gave him .5 units. This morning at 7, I tested as usual and he was at 262.
Would it have been better if I had just waiting until 7 to check him again and then give him insulin?
I did ask the pharmacists and they all said what I had was smallest.
I was reading more about the Tight Protocol when I saw the pics with the 1/2 units measurements.
Since Lucky's PMPS was low last night, he did not get any insulin, but I woke up this morning @ 2am to spot check and he was at 364. I didn't want to risk him going any higher before his regular shot at 7:00 so I gave him .5 units. This morning at 7, I tested as usual and he was at 262.
Would it have been better if I had just waiting until 7 to check him again and then give him insulin?
Wendy&Tiggy(GA)
Member Since 2011
yes because now your schedule is totally off as the next shot needs to be 12 hours later. We need to tweak your sheet a little to reflect this -the 364 you got at 2am really should go in the AMPS column for today now instead and 0.5 beside it in the dose column.
What it does show you is that last night if you had waited a little longer we probably would have seen his BG shoot up and you would have been able to shoot.
Ignoring what the pharmacists actually said, did they not have the syringes i listed? those should have 1/2 unit markings on them.
Wendy
What it does show you is that last night if you had waited a little longer we probably would have seen his BG shoot up and you would have been able to shoot.
Ignoring what the pharmacists actually said, did they not have the syringes i listed? those should have 1/2 unit markings on them.
Wendy
Deb & Wink
Member Since 2013
Wal-Mart has 3/10 cc insulin syringes with 1/2 unit markings.
Wendy&Tiggy(GA)
Member Since 2011
Yep those are the relions I mentioned. The staff there dont seem to always know that the syringes have the half unit markings on them though.
Wendy&Tiggy said:
Thank you again for your help.
I knew I should have posted again after I got the third reading to get recommendations before I fed him. He was just so hungry and crying a lot, I felt terrible.
I am going to go back to Walmart tomorrow and ask her to show me the 3/10cc's they have. You may be right, they may not realize they have 1/2 unit markings on them.
Unfortunately, my internet at home is completely down 
I got the 1/2 unit syringes at Walmart after all! I started using them last night with his evening shot, and I think he may have been getting a little more when I was using the old syringes without the 1/2 markings?
He was kind of high this morning so I am concerned, but I know it will take time to see how this new dose will work out. Planning to do another curve very soon.
Thank you!
I got the 1/2 unit syringes at Walmart after all! I started using them last night with his evening shot, and I think he may have been getting a little more when I was using the old syringes without the 1/2 markings?
He was kind of high this morning so I am concerned, but I know it will take time to see how this new dose will work out. Planning to do another curve very soon.
Thank you!
Deb & Wink
Member Since 2013
Glad you were able to get those 3/10cc syringes with the 1/2 unit markings. They make it so much easier to give those tiny doses.
Wendy&Tiggy(GA)
Member Since 2011
Hold the dose for a few days and if we dont see greens etc again we can increase back to 0.75.. however it looks like he might be clearing a bounce so you might see some later today.
However I am thinking you might want to post on the lantus board.That board has lots of very experienced dosing members on it and is a great sense of community.Since you are now up to speed with testing etc I think they will really be able to advise you better on dosing etc. I post there myself every day or two to get their eyes on my cats.
http://www.felinediabetes.com/FDMB/viewforum.php?f=9
Here’s how to post:
Every day ( or as often as you can) you open a new thread/post. We call them "condos" (short for condition report, or the home you live in and the cat trees some people have)
Subject line: The subject has the date/cats name and BG readings ie 08/17 Lucky AMPS 400 +2 333 + 5 224. You add a ? icon if you have a question. You should update your subject line in the very first post for the day as you get a reading, or whenever you have a question. For your first post put "newbie" also in your subject so everyone can welcome you!
Contents: The contents of your post have a quick update on how your cat is feeling as regards the 5Ps ( peeing. pooing, preening, playing and purring) and any questions and a link to your previous post ie : Today Lucky was in a good mood, playing and eating well. But he is peeing a lot and his BG is really high. Should I increase the dose?
There is no rush to post there. I like to suggest that people go over to their insulin specific support group and check it out. Read the Stickies at the top of the Topics section. Read a few condos posted by other members. Get a feel for how the forum works. See if you think it would be a good fit for you.
But you are always welcome to post here in the Feline Health forum for as long as you want.
Wendy
However I am thinking you might want to post on the lantus board.That board has lots of very experienced dosing members on it and is a great sense of community.Since you are now up to speed with testing etc I think they will really be able to advise you better on dosing etc. I post there myself every day or two to get their eyes on my cats.
http://www.felinediabetes.com/FDMB/viewforum.php?f=9
Here’s how to post:
Every day ( or as often as you can) you open a new thread/post. We call them "condos" (short for condition report, or the home you live in and the cat trees some people have)
Subject line: The subject has the date/cats name and BG readings ie 08/17 Lucky AMPS 400 +2 333 + 5 224. You add a ? icon if you have a question. You should update your subject line in the very first post for the day as you get a reading, or whenever you have a question. For your first post put "newbie" also in your subject so everyone can welcome you!
Contents: The contents of your post have a quick update on how your cat is feeling as regards the 5Ps ( peeing. pooing, preening, playing and purring) and any questions and a link to your previous post ie : Today Lucky was in a good mood, playing and eating well. But he is peeing a lot and his BG is really high. Should I increase the dose?
There is no rush to post there. I like to suggest that people go over to their insulin specific support group and check it out. Read the Stickies at the top of the Topics section. Read a few condos posted by other members. Get a feel for how the forum works. See if you think it would be a good fit for you.
But you are always welcome to post here in the Feline Health forum for as long as you want.
Wendy
Wendy&Tiggy said:
Thank you again Wendy! I will check out the new forum ASAP!
Lucky's PMPS was 171, so since he is below 200, we are waiting 30 mins so I can test him again before he eats. If his BG is rising, I know I can give him his shot but If he is continuing to drop, would you recommend just skipping the dose for tonight? He is doing some serious crying right now so I know he is super hungry already.
Wendy&Tiggy(GA)
Member Since 2011
Lets see where he is, if he isn't rising you could skip but be prepared for a big number tomorrow. I think it wold be better to shoot though as you want to maintain momentum if you can.. Plus you have shot low before now, anything over 150 and a promise of a test at +2 and you are good to go.
Wendy&Tiggy(GA)
Member Since 2011
Got another test yet?
Wendy&Tiggy(GA)
Member Since 2011
Ok good, get a +2 just to be safe.if its lower then you might want to set the alarm for a mid cycle as it usually means an active cycle..
Wendy&Tiggy(GA)
Member Since 2011
Hows things going? I saw you jumped the dose up - and back down. I dont know if he was ready for a dose increase - did the tight regulation board or your vet recommend it to you?
Heres normal protocol which tells me I would have held the dose for 5 days before increasing.. See bold. I would take him back to 0.5 and hold the dose longer to see
Wendy
Heres normal protocol which tells me I would have held the dose for 5 days before increasing.. See bold. I would take him back to 0.5 and hold the dose longer to see
Wendy
Wendy&Tiggy said:
Hi Wendy,
Thank you for your help as always.
I have not been able to get online at home for days, but I kept his sheet updated when I could get WiFi in random places.
It was suggested that I increase his dose earlier this week, so I thought it would be a good idea to test him last night since I didn't have to work this morning.
He did not get very low last night at all, but he seems to still be dropping right now. His AMPS was 199 so I waited 30mins and he dropped down to 99. We are off schdule by 1.5hrs now, but I thought I should wait another 30 and see what's happening and he went up to 195.
Would you sitll recommend reducing his dose back to .5? Or holding .75 for a few more days?
Wendy&Tiggy(GA)
Member Since 2011
I would hold the 0.75 for now - since he is rising you are fine to shoot - just maybe get a +2
Wendy
Wendy
Wendy&Tiggy said:
Hi Wendy,
I think I am going to post on the Lantus board as was suggested, but I am so confused by his numbers right now. It seems as though he is all over the place?
Also, he has been getting 0.5ml since I switched to the new 1/2 unit syringes on 8/19. I am an idiot, and I was not measuring correctly. The last time that I did a curve was on 8/23 and his nadir were greater than 200, but less than 300 which would mean an increase, but that was only after a few days of getting 0.5ml.
As of today, he has been getting this dose for 10 days, so I am wondering if I should do another curve before increasing? Or just increase to .75?
Wendy&Tiggy(GA)
Member Since 2011
I think you need to get more data before making an increase, it looks to me like he is bouncing up and down and I want to know how low he is going that is triggering the bounce.
0.5 might even be too much. Can you get some more mid cycle tests in? This morning he was high but I bet its a bounce and he will come down soon, so I would get a +6 and maybe every 2-3hours after that if he is dropping.
If you can get a +6 today let me know and I can say when I think the next test should be . If we do that for a few days we might catch the low.. Deal?
Wendy
0.5 might even be too much. Can you get some more mid cycle tests in? This morning he was high but I bet its a bounce and he will come down soon, so I would get a +6 and maybe every 2-3hours after that if he is dropping.
If you can get a +6 today let me know and I can say when I think the next test should be . If we do that for a few days we might catch the low.. Deal?
Wendy
Wendy&Tiggy said:
Hi Wendy,
His PMPS was high this evening, so I will try and get up and do a +6 tonight, which would be after midnight and see where he is. I can't do anything during the day because of work unfortunately.
I was not even considering a bounce.
Thank you!
Wendy&Tiggy(GA)
Member Since 2011
Every time you see a green or blue followed by a day or two of pinks and Reds you gotta wonder ..bounce.
Yesterday morning you got a 75 at preshot. Was that the lowest he went? Unlikely... unlikley that you happened to catch the low given the limited testing . So he probably went lower than that, maybe even below 50 and then bounced.
And then today I see two reds. Did he stay red all day or did he drop too low midday and bounce up again? Both scenarios are equally likely. A +6 might well show the low.. Or he could still be bouncing. We will see..
Wendy
Yesterday morning you got a 75 at preshot. Was that the lowest he went? Unlikely... unlikley that you happened to catch the low given the limited testing . So he probably went lower than that, maybe even below 50 and then bounced.
And then today I see two reds. Did he stay red all day or did he drop too low midday and bounce up again? Both scenarios are equally likely. A +6 might well show the low.. Or he could still be bouncing. We will see..
Wendy
Wendy&Tiggy said:
Hi Wendy,
Thank you again for all of your help.
I tested him twice last night after his shot. His PMPS was 448 and at +6 he was down to 209, and then rose to 295 at +8.
This morning his AMPS was 432. I have not been at this very long, but is it likely that he dropped low enough to cause a bounce from 295 around 4:00am to 432 by 7:00am?
Thank you for your help!
Wendy&Tiggy(GA)
Member Since 2011
If he dropped I actually suspect between PMPS and +6 because he started to rise after +6.
Wendy&Tiggy said:
Hi Wendy,
I wish I could test more during the day, instead of in the middle of the night so that I could get more feedback :-(
I just tested Lucky again, this time a little past +3 to see if he is dropping as low as we think and bouncing, but he is only at 372. His PMPS was 465.
Wendy&Tiggy(GA)
Member Since 2011
Any chance of some mid cycle tests the next few days? I am wondering if a dose change is needed or if Lucky is dropping low during the day..
Wendy
Wendy
Wendy&Tiggy said:
Hi Wendy,
I should have been posting this whole time andd getting feedback from you and the other members and I probably wouldnt be so unsure right now. After speaking with the vet and my mom (nurse and also has diabetes) I have to say I don't know what to do next.
Lucky was on .5ml for a while, and his numbers just seemed to stay high. There were a couple mornings where he was low, but I did a few midcycle tests (in the evenings) and he was not dropping low.
My vet is not pleased that I am not using AlphaTrak, and is concerned that I changed his dosage from 1ml, based on the human glucometer. But I know from everything I have learned on this board, that he was dropping much too low when he was getting 1ml.
He just started getting .75, and it has only been about 2 days, but his midcycle numbers made me nervous last night. He never got below 50, but he was still pretty low this morning so I didn't give him a shot.
My mother says he may need a different dose in the am and in the pm, but I know that does not fit with the Tight Protocol.
Wendy&Tiggy(GA)
Member Since 2011
I dont want to contradict your mother's experience but given he's dropping to 59 - and thats borderline too low- I would not increase the dose! Reason is that normal cats are 50-130 , anything under 50 puts him at serious risk of a hypo. Increasing the dose will push the lows even lower.
I have a few scientific published reports we can share with your mum that show why Lantus should be dosed consistently. Would you like me to send them?
Here is hypo information - http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=15887
His numbers the last few days on 0.75 looked quite good - lots of blues and greens - except for todays red but that was because you skipped the shot. So I would hold 0.75 for now unless he drops under 50 which means decrease by 0.25 units.
So we need to teach you what to do when you see a low preshot, so that you dont lose momentum by skipping the shot. I will do another post to explain.
Wendy
I have a few scientific published reports we can share with your mum that show why Lantus should be dosed consistently. Would you like me to send them?
Here is hypo information - http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=15887
His numbers the last few days on 0.75 looked quite good - lots of blues and greens - except for todays red but that was because you skipped the shot. So I would hold 0.75 for now unless he drops under 50 which means decrease by 0.25 units.
So we need to teach you what to do when you see a low preshot, so that you dont lose momentum by skipping the shot. I will do another post to explain.
Wendy
Wendy&Tiggy(GA)
Member Since 2011
So as I said above, his numbers the last few days looked good except when you skipped the shot.He is bouncing into pink a little but thats totally normal and over time the bouncing stops and remission can occur. he is spending more time blue and green which is great!!
But you had to skip this morning because he was too low.. so how do you handle that? Well we have ways...
1. Stall. Remember you dont feed for 2 hours before a shot? Well this is why because now you know he doesnt have food in his system so any bloo dsugar changes are due to his body and not the food. So say you get this low preshot number.. wait 30 minutes and dont feed or shoot. And if the number goes up then you shoot. If its going down then see below. You can keep waiting as long as it takes for the BG to rise but remmeber the next shot has to be 12 hours after you shoot so it can impact your schedule.
AND/OR
2. Shoot a reduced dose - go with half the normal dose instead. just make sure you get a test in 2 hours to make sure he isnt dropping too fast
Read this but if in doubt - come onto the lantus board and we will help you through it - even stay up with you at night if need be: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=147
Wendy
But you had to skip this morning because he was too low.. so how do you handle that? Well we have ways...
1. Stall. Remember you dont feed for 2 hours before a shot? Well this is why because now you know he doesnt have food in his system so any bloo dsugar changes are due to his body and not the food. So say you get this low preshot number.. wait 30 minutes and dont feed or shoot. And if the number goes up then you shoot. If its going down then see below. You can keep waiting as long as it takes for the BG to rise but remmeber the next shot has to be 12 hours after you shoot so it can impact your schedule.
AND/OR
2. Shoot a reduced dose - go with half the normal dose instead. just make sure you get a test in 2 hours to make sure he isnt dropping too fast
Read this but if in doubt - come onto the lantus board and we will help you through it - even stay up with you at night if need be: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=147
Wendy
Wendy&Tiggy said:
Thank you Wendy.
I think my biggest issue with shooting low is that I am not able to stay home and test him/keep an eye on him. Except on the weekends where I have more time in the morning, I am not home long enough to test him 2 or 3 hours after the shot if his AMPS is low.
I did have my hypo kit out and ready last night, just in case, but thank you for the shooting low sticky, I think I forgot to bookmark that one.
I should go onto the Lantus board as you have suggested. I think I am just nervous since I am still kind of new at this and asking too many questions!
Wendy&Tiggy(GA)
Member Since 2011
There is no such thing as too many questions!! Ask away!
If you can't be home and he's low, then skip for now. But over time you will get enough data to know if you can shoot and go out, shoot a low dose, or have to skip. Unless he goes into remission before then if course. If we can get the dose right then that's always a possibility.. And this current dose is looking good.
I will be ready to welcome you on lantus land. Remember its pretty much everyone you have met here, and more!
Wendy
If you can't be home and he's low, then skip for now. But over time you will get enough data to know if you can shoot and go out, shoot a low dose, or have to skip. Unless he goes into remission before then if course. If we can get the dose right then that's always a possibility.. And this current dose is looking good.
I will be ready to welcome you on lantus land. Remember its pretty much everyone you have met here, and more!
Wendy
Wendy&Tiggy(GA)
Member Since 2011
I just love cats. Crazy cat lady. And I love when a cat goes into remission, or if not, when he feel better and perkier and we have added another member to the community..
Wendy
Wendy
Wendy&Tiggy said:
So I have yet ANOTHER questions Is it normal for cats with diabetes to have hairball issues? Since he started getting insulin he is sort of wheezing, which usually ends with a hairball but not always.
I got some hairball relief drops by Sentry, but I am not sure if they will really impact his BG levels? I figured it was better than getting the treats which I am sure are carb heavy.
Wendy&Tiggy(GA)
Member Since 2011
Maybe he is just feeling better - feeling better = grooming more = more hairballs.
Try a small dab of vaseline on the paw. He will lick it off and it will help her pass them. No carbs either!
Wendy
Try a small dab of vaseline on the paw. He will lick it off and it will help her pass them. No carbs either!
Wendy
BJM
Member Since 2010
Ceebats said:
I think you mean units, because 1 milliliter has 100 units of Lantus.
You might print out the reference values I posted previously for your vet. And unless the vet is planning to donate an AlphaTrak and all the strips you'll need, you use what will fit your budget.
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