Ongoing spreadsheet Midnight

Status
Not open for further replies.
T

TMR

Member Since 2013
If you haven't read my previous posts, you may not know that I have been struggling with the testing and food that is recommended her. That is, it has taken me a little while to make adjustments and follow the recommendations. I have switched to the lowest carb dry food I can find (cat is intolerant of wet). The issue now is adjusting her insulin dose. I am testing a lot more now than I was at first, but there are a lot of days coming up that I will be gone all day and unable to test other than at shot times. And I will be gone for a week soon. So I want to try to get things leveled out before then if possible. I am really short on time right now.

I have gone from 1 to 2 to 3 and back down to 1 unit lantus twice a day. It was recommended to me to give 0.5 unit twice a day for a week and then do a curve. Due to Midnight's high blood sugars lately, I have decided to stick with 1 unit for now. So I will do the curve this Wednesday, when I have a day off, and go from there. I appreciate all the advice and expertise, but I just decided that I would stick with the 1 unit for now. I just updated the spreadsheet.
 
Hey there, nice to see you - and I certainly understand about the not being home much...

The reason it was suggested for you to take the dose down to .5 was so that you would be able to give a consistent dose twice a day - Midnight had a tendency to be low enough preshot at times that you were having to skip shots.viewtopic.php?f=32&t=94470&p=1013284#p1013142

Lowering the dose does tend to raise the preshot numbers, yes. The consensus is that because of the way Lantus works, its important to try to keep a consistent shot amount/time if possible.....and it takes about three full days at a given dose to take full effect.

She's your cat and you know her better than anyone else - I'm not challenging or criticizing your decision - I just wanted to make sure you understood the why behind the suggestion.

And I'm rooting for both of you to get Midnight on track so you can enjoy your week away without worrying too much.

Em
 
The problem with going to 1u is that it consistently gives you an unshootable number at least once a cycle. Which is why I recommended you drop to .5u and give that dose consistently for a week and then run a curve.

Second problem is when you have raised her dose from 1u to 2u to 3u is that we never raise a dose by full units at a time. That type of raising of dosage works well in a human that weighs over 100lbs on average, in a cat that might weigh between 5-15lbs that is way too much of an increase at once. And overshoots the ideal dose 99% of the time. Usually a dose is increased or decreased with a feline by no more than .5u and more often than not by only .25u.

I understand the feeling that time is getting short on getting Midnight's insulin dose straightened out, but to be quite frank that isn't going to happen if you keep shooting a dose that causes you to have to keep skipping shots. By the mere nature of how Lantus works in the body it needs to given at a dose that allows you to shoot every 12 hours.

If you keep giving 1u on one shot and then having to skip the next you are never going to regulate Midnight's bgs. Insulin is a hormone that is something her body should be producing normally but in a diabetic for some reason the body is either not producing any of its own, or not enough to keep up with the food that is being eaten. It is not the same as a chemical brew that makes up a drug like say a pill for thyroid, therefore doesn't play by the same rules. Nor is finding an ideal does as easy as it has to be a balancing act between what the body produces itself, the food eaten, the activity level of the cat, and their own metabolic rate. Just because there are two cats that both weigh 9lbs, are of the same age and activity level, and eating the exact same thing doesn't mean that they will both take the exact same dose on insulin, so to find that ideal dose for each cat they need to have their doses adjusted based on their own BG readings and have the dose either raised or lowered according to the established protocol.

Mel, Maxwell, Autumn & The Fur Gang
 
The only problem with starting over, with a dose of 0.5 units, is that the next time I am off 2 nights in a row and able to do a curve is May 22, which is a week before my trip. And that is almost 3 weeks from now. So I can't put her on 0.5 units for just a week and then do a curve. So would you suggest doing the curve this Wednesday or waiting 3 weeks to do it? It just seems like if she is on 0.5 units for 3 weeks, her blood sugars could be extremely high for 3 weeks. That worries me and just doesn't seem logical to me, to intentionally give her a small dose for 3 weeks with the expectation that her blood sugars will be high that whole time. Plus there are several days coming up that I will be gone all day and only able to test pre-shot.
 
What do you think of this alternative suggestion.

The first night, you did a pre-shot test, an in the door test, a before bed test and set your alarm to wake you up 2 hours later for a test. Then BTB.

The second night, you could get a pre-shot test, an in the door test, before bed test and set your alarm to wake you up 4 hours later for a test. Then BTB.

The third night, you could get a pre-shot test, an in the door test, a before bed test and set your alarm to wake you up 6 hours later for a test. Then BTB.

You are doing a curve, but over several days, not all in one day. I have read of that being possible. Yes, the numbers will be different, but we should be able to see a pattern, a trend. On those days where you will be gone all day, if you can not do the in the door test and the before bed test then you can not do it. We are trying to find an alternative that will work with your life. Like the suggestion?, hate it?, indifferent?

Let's see what Mel thinks of this idea too.
 
It is a consideration but my sleeping is hard enough with working night shift so this would be very difficult. I only get 2 or 3 hours of sleep when I work, so on my nights off I try to get 6 or 8 uninterrupted hours. What do you mean by in the door?
 
Deb & Wink said:
What do you think of this alternative suggestion.

The first night, you did a pre-shot test, an in the door test, a before bed test and set your alarm to wake you up 2 hours later for a test. Then BTB.

The second night, you could get a pre-shot test, an in the door test, before bed test and set your alarm to wake you up 4 hours later for a test. Then BTB.

The third night, you could get a pre-shot test, an in the door test, a before bed test and set your alarm to wake you up 6 hours later for a test. Then BTB.

You are doing a curve, but over several days, not all in one day. I have read of that being possible. Yes, the numbers will be different, but we should be able to see a pattern, a trend. On those days where you will be gone all day, if you can not do the in the door test and the before bed test then you can not do it. We are trying to find an alternative that will work with your life. Like the suggestion?, hate it?, indifferent?

Let's see what Mel thinks of this idea too.
Click to expand...


Deb - she asked if she should run a full curve on Wednesday. "So would you suggest doing the curve this Wednesday or waiting 3 weeks to do it?"....are you answering that as a no - instead she should do a multiday curve?

Because I was going to tell her that anytime she could run a curve its helpful based on how I understood the Go Slow protocol......however if you feel it needs to be over several days rather than just on Wednesday, I defer to your experience. I just wanted to make sure you read her question properly.

Em
 
if she should run a full curve on Wednesday?
Click to expand...
Yes, definitely. If she can run the full curve on Wednesday, that is fine and I do think she should go ahead and do that.


Because I was going to tell her that anytime she could run a curve its helpful based on how I understood the Go Slow protocol
Click to expand...
Yes, anytime she can run a curve is great!

But a curve does not need to be done in a single day if the person's schedule does not allow it. We want people to be able to get some rest and take care of themselves most of all. If the care giver is sick, who will take care of the cat in need?

What I was trying to explain is that she does not need to wait until her next day off on 5/22 to run another curve. By using the multi-day curve approach, she can do a curve or even a couple of curves before that day off. Pick 3 nights and test at different times over those 3 days.

Make sense?
 
An "in the door" test is doing a BG test the minute you walk into your house/apartment/condo/dwelling.

ETA:
I only get 2 or 3 hours of sleep when I work, so on my nights off I try to get 6 or 8 uninterrupted hours
Click to expand...
So on those days that you work, you are working an entire 24 hour period or are offsite for 24 hours?

I did realize that you have those long, long shifts 12+ hours.
 
I am VERY VERY grateful for all the expertise, advice, and concern from people in this group. I just need to work things out the way they fit in with my life. I am going to do a curve tomorrow after 1 week of 1 unit twice a day. I only missed one dose, once, because her blood sugar was under 200. I will then go from there, and I will consider the multi-day curve for the future as well. I am still learning about feline diabetes!
 
I am going to do a curve tomorrow after 1 week of 1 unit twice a day.
Click to expand...
Looking forward to the curve on Wednesday. Hope it gives you and us some more clues to work with.

I just need to work things out the way they fit in with my life.
Click to expand...
We don't know your schedule and life responsibilities anywhere as clearly as you do. We have a few clues about some of the things going on in your life but we are not living it . You are, and that makes you the best judge of how to fit tasks in to your schedule.

We are simply suggesting alternatives to see if maybe they will fit with your life. If they don't please let us know and we'll try to come up with some other suggestions. We're not trying to make your life harder, we are trying to make your life easier. But we need your feedback to do that. If something will make your life harder, let us know.

I am still learning about feline diabetes!
Click to expand...
As are we all. It's a lifelong learning experience. I equate this to a college graduate level crash course to start with, then some follow-up independent study of selected modules to become familiar with more specific areas about this disease.
 
Thanks again. I ccannot tell you how grateful I am for the advice and expertise. I just have to work it all out in the best way it fits into my schedule and life. Thanks again.
 
Status
Not open for further replies.
Back
Top