numbers still crazy!

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katlady1974

katlady1974

Member Since 2013
i tested Timber before his PM shot and he was only 205. he normally gets 2u of insulin but i was afraid to do that and send him into hypo. called the vet who said to feed him adn check him again in 45 mins and if it's gone up "a good amount" give him 1u. ugh. do you guys normally check BG after they eat? i usually check it, feed him, and then give him insulin while he's still eating- he hangs out eating for awhile so i wait a bit to make sure he's eaten a fair bit first. still confused!!!! :dizcat
 
205 is pretty close to the threshold for the 'don't shoot' number, for a newbie. Your ss shows numbers all over the place, as if maybe kitty is 'bouncing' ..... If you're uncomfortable completely skipping the shot, you could try a much reduced dose, although I can't really advise you on the amount, I personally would be looking at more like .5 or less rather than 1u in this situation, you really don't want to be dosing based on a food spike as your vet recommended.
 
Let me get an experinced person over here. Please keep checking . Meanwhile do you have lots of strips? Sugar syrup and high carb food? Are you able to get tests in tonite? If so this would be a good time to learn to shoot low.
 
When just starting out, yes the no shoot number is 200. However, as you accumulate data to show that the nadir doesn't go too low, you may slowly reduce your no shot limit.

Give me a minute to look @ the spreadsheet. Had to get on PC 'cause phone wouldn't show it.
 
My post went wonky here it is again...
While we wait, here is info on shooting low.. http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=147

Shooting low is something we all need to learn how to do at some point because as your cat gets regulated she will start to spend more and more time at lower numbers yet won't be quite ready for no insulin at all.. And it is ideal to shoot low to keep them low.

Problem here is that you fed her so you don't know for sure what's going on with her since the food could raise her numbers.. Then when her food wears off and the insulin kicks in you could find her dropping rapidly. That's why I have asked for more eyes in here.
 
You were over 200.
You've been on this dose 9 shot cycles.
The nadirs are above 150.

Its OK to shoot.

If nervous, go with 1 unit.
 
I see a note you are cutting back on dry food? As you do this, insulin needs do drop, as much as 100 points.

How much dry was fed today? If you've completely eliminated it, definitely drop to 1 unit.
 
i tested him again and he's now at 268 (45 mins after eating). he still gets some dry every day, but he really hasn't been eating much at all today. i have a dish of about 1/3 cup and between the 2 cats they haven't finished it yet today (about 1/3 of the dish still there). usually timber likes to chow down on that.

so would you suggest 1u at this point?
 
Unless you'd like to be up monitoring all night, I'd think I'd split the difference and go with 1.5 units.
 
Lantus is like steering an ocean liner. Changes don't tend to show up very fast unless they are drastic. Dropping half a unit is not drastic.

Your cat hasn't gone below 150 on the nadir.

We consider < 50 at nadir to be potential hypo territory and worth a dose reduction in a new diabetic.
BG < 40 is definitely hypo territory.

You're more than 100 points above that at nadir so far.
 
I agree with Wendy and BJM that it's safe to shoot. I would even go so far as to say it's safe to shoot the full 2u since he hasn't noticeably been falling too low on it and is even probably due for a dose increase if it weren't for the diet change. BJM is right that if you do decide to shoot the full dose, it may be a long night for you since this is the first time you've shot him that low.

You're the one holding the syringe. It's ultimately your decision with what you feel most comfortable: don't shoot, shoot 1u, 1.5u, or 2u and stay up monitoring.
 
If you are worried just give the 1IU but no matter what, definitely get a test at +2 (2 hours after shot) to see where he is going once the food wears off. Edited to add - I will check on you at +2 so please post so I dont worry!!!

I have asked Carl to come over and advise on his thoughts - he is very experienced. (many many posts)
 
vet said i could go ahead and give him 1u, but she would prefer i skipped tonight and tested him again in the morning- and call if i had any questions. i'm so confused!!!!!
 
Whatever you feel comfortable doing is fine.

If you skip, the numbers will be really high in the morning; thats to be expected.
 
Hi,
I have asked Carl to come over and advise on his thoughts - he is very experienced. (many many posts)
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Wendy sent me a PM and asked me to take a look. I'd qualify her kind words with "but Carl has no first hand experience using Lantus". My cat was on PZI, but I do read and post often in the Lantus forum, so I understand how it works.

The others are correct in saying that one adjusted dose isn't likely to have a big effect because of the way that Lantus works.

Your vet suggesting you feed first wasn't terrible advice, but the dose really isn't determined by the preshot numbers with Lantus. It's the "nadir" number that is used to determine the appropriate dose.

You could shoot 1u if that is what you are most comfortable with. And you could have technically gone with the 2u dose when you saw that 205 number because as BJ said, you haven't experienced really low numbers in the middle of the cycles to this point.

What it all comes down to with you or any other person holding the syringe is "what do you feel comfortable with"? You could go with 2u, 1u, or you could skip altogether tonight (although that would be my last choice). No matter what dose you give, if you can get a test around +3 hours after the shot, that would be a good time to test.
 
Shoot whatever makes you comfortable - or skip - however if you do shoot get some tests in tonite. Not because I think he will hypo, but to get some good data as to how he behaves when you shoot at a lower number.. you will need this data for future. Even if you skip I would still get another test in a few hours to give you data on that too.

If you shoot now, tomorrow morning you are going to be off schedule since you shot late tonite. But you can shift it back by 15minutes each time or 30 minutes a day.

Also homework for you tomorrow is to read my link above on shooting low. We should chat tomorrow about how to handle this in future and I can answer all your questions - because it will hopefully happen again as Timber gets more regulated. The 200 number is what we advise for newbies. But as you get experienced, you will gradually shoot at lower and lower numbers as you get enough data to know how he will behave at those lower numbers - and as he drops into the normal range for a cat.

Wendy
 
i did read it wendy! my head is kind of spinning right now!! so, am i to assume that vets are not comfortable with the shooting low method? my partner knows a vet who lives several hours away and he also recommended skipping tonights shot.

i will definitely test him again tonight. i'm now 2 hours later than i normally shoot him and i'm not able to adjust that time in the morning- because of work and kids' school. so i guess i'll let it go for tonight. test him again in 2 hours to see where he is. and like you say, that will help for next time!

thanks so much to all of you!!!!!!!
 
Its a lot to master all at once, especially if you've never had any background in diabetes. I was lucky - as an epidemiologist, we study disease risks in populations, so I had a clue when Spitzer turned up diabetic.

See my signature link on learning tips for help in comprehending the content. (I knew that college studying class would come handy one day!)
 
i did read it wendy! my head is kind of spinning right now!! so, am i to assume that vets are not comfortable with the shooting low method? my partner knows a vet who lives several hours away and he also recommended skipping tonights shot.
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I think it really depends on how familiar a vet is with Lantus specifically, how many kitties they have treated, how often they see remission, and how familiar they are with the latest research and protocols specific to the insulin.

There's also some degree of the vets doing the CYA thing maybe? If they aren't completely comfortable with home testing, especially with a human meter, maybe they shy away from telling a client to do something at home that they might be okay with doing themselves at their clinics?

My vet, who was a hardcore PZI prescriber, had no problems telling me to "shoot low", which is sort of odd because PZI isn't an insulin where shooting low is the best idea.
 
thanks again!! i'll test again tonight and at least will be able to gather more numbers to see how he's responding.
 
Big numbers because you skipped.

Now for text time.. So you do the test and see a number under 200. You wait and don't shoot and don't feed and test again in 30mins. This will show you how his blood is behaving not influenced by food. If he is rising you can shoot and feed. If he is dropping you can wait another 30 and see, or shoot a lower dose. But come here and post and we can help,

Given his numbers were so high after you skipped, next time you know you should be fine to shoot a lower dose or even the regular dose if he is rising as I said above.
 
yes, i said to myself lastnight "i should have given him the insulin"! though, i was surprised to see it didn't go up that much further overnight. i figured t would be off the chart for sure. my meter only measures up to 599. so when i put in 599 it means it was higher but i didn't get an actual number- the meter only tells me it's a high level above 599.

but now i know for next time! thanks again for all of your help!!! :-D :-D :-D
 
Its definately a learning experience! So how do you feel about posting on the tight regulation board on a frequent basis? Its a real sense of community and they have some very experienced members over there that can help with all this.

Its a bit daunting at first since the posts look odd but you get used to it and there is a strong sense of community.
 
i did take a peek over there and yes, it was overwhelming to see all the numbers- still learning that. I'll try and post over there later on! :-D
 
Its actually not too bad. It works like this

subject line : Date/ cats name/ cats blood reading

so for yesterday your subject line would have been: 5/12 Timber AMPS 554 + 5 194 +11 205 PMBG 268 +3 532
You can use a ? icon here if you want to ask a question in the body. For the first time you post I woild add the words "new here" or something so people can welcome you! AMPS = Am preshot. PMBG = pm Blood Glucose cos you didnt shoot . Some update their subject lines with every reading, others wait till end of day.

Then your content would be : a brief update on Timber in terms of the 5 pees - peeing, purring, pooing , preening and playing and any questions ie.. today Timber was happy although he is still peeing a lot. He slept beside me while i was on the computer purring. Question - how do I shoot at low numbers? Plus a link to your prior post - we call each post a "condo". Many of us try to post daily.
 
my head is kind of spinning right now!!
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Just keep asking questions, reading other posts from new members. There may be something we have talked about with someone else that we have not talked about with you.

Sending big {{{{hugs}}}} to you. Take deep breaths, often, to help you to relax. And keep telling yourself you can do this.

katlady1974 said:
i did take a peek over there and yes, it was overwhelming to see all the numbers- still learning that. I'll try and post over there later on! :-D
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You have only been a member here for two weeks. Tight Regulation forum can be overwhelming. If you feel more comfortable staying over here in the Feline Health forum, that is ok too. Many options, your choice.

There is a lot of information to learn with this new sugardance you are learning. And the steps keep changing on you al the time. It's no wonder you feel overwhelmed.
 
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