New to the Relaxed board, could use help interpreting #'s...

[Shonna and Neko]

Hi there! I've posted a couple of times to the main forum, but I am new to posting on this board.

Neko was diagnosed diabetic in September, and we still can’t seem to get her regulated. I’m not sure how long it takes, but without much instruction from our vet, my husband and I feel like we are sort of just guessing at what we should be doing.

We’ve been keeping track of her AMPS and PMPS on the SS, and last weekend we did a curve to get a better idea of how the insulin was working. What seems to be happening, though, is that the more BG tests we do, the more confused we get...

I’ve read a lot about bouncing, and maybe that’s her issue, but I am confused about what that really is and how to counteract it. It seems like it would be a never-ending cycle.

We both work during the day, so it is difficult to get numbers other than the AMPS, but as I am home this afternoon, I was able to get a +7, which is good since her AMPS was low. I’m going to try on a regular basis to get a mid-point test after the PMPS, since that time of night is more doable.

In the meantime, I would really appreciate if more experienced people could look over Neko’s SS and try to interpret what’s happening, give us some feedback.

Couple of things to note:
• Neko is currently receiving 1.5 units of Lantus twice a day.
• Her Lantus is past the 28-day mark now (got it in September). We are refilling her script tonight. Might that be affecting her numbers?
• Neko eats 1 can of Fancy Feast Classics Beef or Chicken, twice a day, with .5 can in between if she seems hungry. She’s unable to have ideal free feeding as we have a kitten in the house that will eat anything left out. Neko also gets treats of boiled chicken after her BG tests. I get confused though, how to interpret midday BG tests when she is snacking or eating treats. Wouldn’t they be skewed? (She doesn’t get anything 2 hours before AMPS/PMPS)
• Neko’s behavior does not seem to change at all, regardless of her BG – high, low, etc. She acts pretty much the same. However, she was diagnosed diabetic after going into Ketoacidosis and spending a weekend in the vet urgent care, so we know what that looks like, and would really like to never do that again!

Thanks in advance!
- Shonna

 

[phlika29]

Re: New to the Relaxed board, could use help interpreting #'

Hi shonna

I am not experienced enough to give you any advice but just wanted to pop in and say hi and welcome. I would definitely recommend getting as many blood glucose readings as possible. Even the +1 and +2 and +10 and +11 provide helpful information. Before I go to work I try to get a +1 reading or a +2 then at the weekends I try to get a few more. The same in the evenings.

Again I don't want to advise and please don't follow anything I say but wanted to comment that you are getting some low preshot readings and some red pre shot readings. If big drops occur in any one cycle the liver can release some compensatory glucose?? That means a cat's readings can get higher in the next cycle. See how badly I explained that :shock: I wonder if the dose is a little high and you may be better taking Neko back by 0.25 and seeing if the numbers level out more. Again see what other members suggest.

Have you read this info on lantus? viewtopic.php?f=9&t=18139
This thread tells you about storage and handling. Done correctly the lantus should last longer than 28 days viewtopic.php?f=9&t=151

How much does Neko weigh, this can be used to calculate the dose, it is often much lower than a vet advises.

Best wishes

Sarah

 

[MommaOfMuse]

Re: New to the Relaxed board, could use help interpreting #'

Okay first off her dose is way too high which is why you are seeing the bouncing. Anytime a cat that is newly diagnosed gets a reading under 50 regardless where that happens in a cycle (the period of time between one shot to the next) that earns them an automatic dose reduction of .25u Neko has had several of those over the last few days so I would at the very least drop her back to 1.25u if not back to 1u twice a day. You can always raise the dose if it isn't high enough but you can't get it out of the cat once it's shot.

Okay now to explain just exactly what a bounce is...Think of taking a long road trip, you pull out on to the highway and start cruising right along at 75 mph, at first that seems really fast but as the trip wears on your body adjust to the speed and it feels very comfortable and normal, then you come to a construction site and you immediately have to slow down to 45 mph now you know you are still traveling at a fast rate of speed but to your body that is now use to 75 mph it feels like you are just crawling along...Right?

Well that is what happens to a diabetic cat, they have been diabetic long before you realized anything was wrong, their bodies have gotten use to that 400 BG range and it feels pretty normal to them, then we find out they are diabetic, and we start giving insulin. The insulin slams on the brakes and they drop back into normal numbers again or even just lower numbers than what they have become use to, the liver reacts as if they are going into hypo and throws out counter-regulatory hormones and stored glucose to drive the numbers back up again. But just like when driving if you keep driving at 45 mph it begins to feel normal again and 75 mph becomes fast feeling again. So will a cat's body the longer we can hold them in normal numbers the more they relearn what normal feels like and the liver stops freaking out when they feel them.

Two things can cause a bounce, one can be corrected by dropping the dose, the other they just have to bounce until they stop. The first is what Neko is doing right now, she is dropping too low and her body reacts to save her life by throwing her back into the higher numbers and she is dropping at a steep rate. Overall you don't want them dropping much more than about 100 pts in a cycle. She is also hitting numbers lower than her body is use to so that is freaking it out as well. Now part of it we can fix by rolling her dose back and letting her come down smoother and gentler which is those steep free fall drops. The rest which is her hitting numbers that her little body hasn't seen in awhile....well....just got to pray she has a really smart liver and it's a quick learner. :YMSIGH:

As far as the ravenous appetite well again that can be coming from two sources, either being too high because she isn't using the food she is eating properly when she is sky high so she's hunger, and when she is dropping into the 40s and I think I even saw a 30 something on there, then she is voracious because her instinct is to eat to counteract the low drops. Once she levels out she will go back to eating like a normal kitty and 2 cans of Fancy Feast will be enough for her to stay satisfied on. Unless of course she is part lion...lol.

Hope that helps. Sorry I wasn't around to welcome you properly today, as I usually am, but we just moved to a new house this summer and I was trying to get the Fur Gang's new playroom painted before the snow flies here, which in Nebraska even though it was 80 yesterday could be as early as Halloween. :roll: Such a joy at times living in a state with bi-polar weather patterns.. :lol:

Anyhow, I'm looking forward to getting to know you and Neko better and Welcome to the Relaxed Lantus family. Most of the time we are the busiest around here first thing in the morning and then again in the evening although usually when not covered in paint I do try to monitor this forum pretty often and I do have an alert set on my phone to tell me when there is a new post here so I can pop in..Just unfortunately not today.

Mel and The Fur Gang

 

[tibbs5]

Re: New to the Relaxed board, could use help interpreting #'

hi Shonna and Neko
just wanted to say welcome. i see you already got advice from some of our resident experts. i am also new to this sugar dance and this group is so helpful. they will really help you. welcome.
Nadine & Tibbs my sugar cat

 

[Shonna and Neko]

Re: New to the Relaxed board, could use help interpreting #'

Thanks for the quick replies! We were thinking her dose might be too high. The vet had her up to 3 units twice a day not too long ago, which we didn't think was right, so we chose, without his input, to take her back down to a smaller dose. We'll try going down just a bit further, to see how she handles it. Is going from 1.5 to 1 unit too fast, should we go to 1.25 for a few days first?

By the way, Neko weighs 12.5 pounds. She's a Maine Coon mix, so she should be a bit husky
We also picked up some new Lantus tonight. This time we got the cartridges instead of the vial, so we don't waste so much. We've had the vial for about 60 days, and still only used maybe half...

Thanks!
- Shonna

 

[doombuggy]

Re: New to the Relaxed board, could use help interpreting #'

Shonna, are you keeping that vial in the fridge? I see you got the cartridge/pens now, I would still keep them in the fridge.
it also keeps the pet away from something to play with. :lol: Can you tell we have a curious kitten in the house?