Opinions please. Am I just not patient enough?

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Sofia

Sofia

Member Since 2022
Good evening from Italy.. Could any of you more knowledgable people have a look at Thor’s spreadsheet please and tell me if you think it’s going ok or if something is still very off? I’m interested to know about our readings from June 25th, that’s when we switched from Caninsulin to Lantus.
• We did Lantus 1unit then curve on day 9
•Vet told me to double the dose to 2units, I did not, I increased to 1.5units from June 5th.
•On day 12 I did another curve and over the last couple of days been monitoring here and there.
I haven’t written to the vet yet, there are a couple of greens I’m not sure about.

Are these numbers an indication that I need to increase the dose, or rather that the dose is already slightly too high and he’s bouncing? He’s always back in the 400s for his PMPS.

Am I being too impatient in that I expected Lantus to level things out a bit more?

Thank you for reading!
 
I'm no expert at reading spreadsheets so I'll definitely let someone else chime in, but the one thing I did notice is I think it'd be good to get in more testing. There are several days with no mid-cycle tests at all; only preshot tests. With Lantus, the dosing is based on the nadir (the lowest point(s)) in their cycle. Need more evening tests too since cats can sometimes drop lower.
 
@Sofia
Hi Sofia first of all I'm jealous you live in Italy :p
I'm all Italian and I wish I could go there. Where in Italy do you live
I will tag some members for you to take a look at your SS
Do one thing in your signature can you add Lantus and the date started
Members might think Thor is still on Caninsulin
Tap on your name above then tap on signature and add that then tap Save
Can you also add SLGS to your signature I see it on your SS but it would be good to add it to your signature also


@tiffmaxee

@Wendy&Neko

@Bron and Sheba (GA)

@Bandit's Mom

Thanks ladies
 
Last edited:
If you are following SLGS you need to reduce the dose to 1.25 units twice a day as your kitty has dropped under 90.
Your kitty is bouncing which is giving you the high BGs.
Well done getting the tests in during the cycles. That is very good information for us.
If you get a much lower BG after the pre shot like you did on 16/7 when Thor went from 431 to 103, that is a big red flag that you need to test again as I suspect Thor dropped lower after the 103.
the same as when you tested today and got 79. Please test again an hour later to see the BG is rising not falling.
Are you feeding during the cycles as well as the pre shot meals?
Please feed when you see a low BG.
You are doing a great job. Keep up with those tests during the cycles as well as the pre shot BGs:)
 
It looks like Thor drops too low and then bounces. With SLGS a decrease is earned if the bg is under 90 and Thor was at 58. However when you get a low number with the LIBRE it’s good to double check with an ear prick. He might have gone even lower if accurate. Always get another reading 20+30 minutes after feeding a low bg to see if it’s coming up. There was another huge drop to 103 at +2 that night. Again I question the reading but if accurate that’s onset and an active cycle was very likely requiring another test at +3-4.
 
I have a few suggestions. It would be worthwhile to add a row also in your spreadsheet to separate when you started Lantus, and note "Started Lantus".

I thought I would quickly ask, you have switched the insulin syringes now from what you used with Caninsulin which are U40 to the ones we use with the L insulins which are U100, correct? Ideally you want the U100 syringes with 1/2 unit markings since we find most cats are very sensitive to small dose adjustments. Also, can you tell us what is your current feeding schedule like? Are you feeding small snacks or just at AMPS/PMPS?

As for the swing in numbers, you have some bouncing going on:

Bouncing - is simply a reaction to what the cat's system perceives as a BG value that is "too low". "too low" is relative. If a cat is used to BG in the 200s, 300s or higher for a long time, then even a BG of 150 can trigger a "bounce". Bouncing can also be triggered if the BG drops too low and/or too fast. The pancreas, then the liver release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream. *Usually* bounces clear within 3days (6 cycles).

That said, you have noted that you are following SLGS, so a few comments there. I see that Thor has had a couple of cycles where he was under 90 but you didn't take a reduction of 0.25u. With SLGS any time the cat falls below 90, it warrants an immediate reduction by 0.25u. It is often a new learning curve when starting with a different kind of insulin; Caninsulin is an in and out insulin, whereas Lantus is a depot insulin, which means they work differently in lowering BG levels. Your goal should be to try and gather data to determine how your cat responds to this new insulin, and by testing, you can get a feel for some of the basics:

From the basics sticky:
  • 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
  • How to do a Curve - a simple explanation
With Lantus, we often like the +2 because it can sometimes be a good indication of how the cycle will go. If the +2 is higher than preshot, it usually indicates that not much downward movement will occur in the blood glucose levels. If the +2 is the same and certainly significantly lower, then that could signal more testing is required as the numbers may drop a little more quickly. By taking additional tests, that will allow you to monitor and feed to help slow down the drop.

Here is a link to the dosing methods we follow here for more information:
Dosing methods
 
babyg said:
I'm no expert at reading spreadsheets so I'll definitely let someone else chime in, but the one thing I did notice is I think it'd be good to get in more testing. There are several days with no mid-cycle tests at all; only preshot tests. With Lantus, the dosing is based on the nadir (the lowest point(s)) in their cycle. Need more evening tests too since cats can sometimes drop lower.
Click to expand...
Thank you. When we switched to Lantus the vet told me not to test, I think they thought I was being a bit OTT with my testing previously, so I tried hard to resist! I will definitely be testing more again from now on.
 
Diane Tyler's Mom said:
@Sofia
Hi Sofia first of all I'm jealous you live in Italy :p
I'm all Italian and I wish I could go there. Where in Italy do you live
I will tag some members for you to take a look at your SS
Do one thing in your signature can you add Lantus and the date started
Members might think Thor is still on Caninsulin
Tap on your name above then tap on signature and add that then tap Save
Can you also add SLGS to your signature I see it on your SS but it would be good to add it to your signature also


@tiffmaxee

@Wendy&Neko

@Bron and Sheba (GA)

@Bandit's Mom

Thanks ladies
Click to expand...
Thank you! Signature updated, I hadn’t thought about that. We’re in Tuscany, but I was actually born in Scotland
 
Sofia, would you mind putting a thick line through the SS where you swapped to Lantus please so that it is easy to see where the change over took place?
Ignore what the vet said about testing….please do test to keep Thor safe.
 
Bron and Sheba (GA) said:
If you are following SLGS you need to reduce the dose to 1.25 units twice a day as your kitty has dropped under 90.
Your kitty is bouncing which is giving you the high BGs.
Well done getting the tests in during the cycles. That is very good information for us.
If you get a much lower BG after the pre shot like you did on 16/7 when Thor went from 431 to 103, that is a big red flag that you need to test again as I suspect Thor dropped lower after the 103.
the same as when you tested today and got 79. Please test again an hour later to see the BG is rising not falling.
Are you feeding during the cycles as well as the pre shot meals?
Please feed when you see a low BG.
You are doing a great job. Keep up with those tests during the cycles as well as the pre shot BGs:)
Click to expand...
Thank you so much. I had a feeling I should be giving 1.25 units not 1.5… but since the vet told me to jump to 2 units which I didn’t like, I thought I’d go mid-way. Thor eats, various times throughout the day, really whenever he’s looking for food he’ll get. Should I be avoiding feeding in the 2 hours before test and shot?
 
Christie & Maverick said:
I have a few suggestions. It would be worthwhile to add a row also in your spreadsheet to separate when you started Lantus, and note "Started Lantus".

I thought I would quickly ask, you have switched the insulin syringes now from what you used with Caninsulin which are U40 to the ones we use with the L insulins which are U100, correct? Ideally you want the U100 syringes with 1/2 unit markings since we find most cats are very sensitive to small dose adjustments. Also, can you tell us what is your current feeding schedule like? Are you feeding small snacks or just at AMPS/PMPS?

As for the swing in numbers, you have some bouncing going on:

Bouncing - is simply a reaction to what the cat's system perceives as a BG value that is "too low". "too low" is relative. If a cat is used to BG in the 200s, 300s or higher for a long time, then even a BG of 150 can trigger a "bounce". Bouncing can also be triggered if the BG drops too low and/or too fast. The pancreas, then the liver release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream. *Usually* bounces clear within 3days (6 cycles).

That said, you have noted that you are following SLGS, so a few comments there. I see that Thor has had a couple of cycles where he was under 90 but you didn't take a reduction of 0.25u. With SLGS any time the cat falls below 90, it warrants an immediate reduction by 0.25u. It is often a new learning curve when starting with a different kind of insulin; Caninsulin is an in and out insulin, whereas Lantus is a depot insulin, which means they work differently in lowering BG levels. Your goal should be to try and gather data to determine how your cat responds to this new insulin, and by testing, you can get a feel for some of the basics:

From the basics sticky:
  • 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
  • How to do a Curve - a simple explanation
With Lantus, we often like the +2 because it can sometimes be a good indication of how the cycle will go. If the +2 is higher than preshot, it usually indicates that not much downward movement will occur in the blood glucose levels. If the +2 is the same and certainly significantly lower, then that could signal more testing is required as the numbers may drop a little more quickly. By taking additional tests, that will allow you to monitor and feed to help slow down the drop.

Here is a link to the dosing methods we follow here for more information:
Dosing methods
Click to expand...
Thank you very much! I changed syringes yes, U100 with 1/2 unit markings. He eats various small throughout the day, not only at shot time. The vet was very “by the book” about dosing, I was told basically that when we find the right dose, we stick to it.. there’s no testing and decreasing dosage if we see it low. This is why I’m so grateful I found this forum!
 
Sofia said:
The vet was very “by the book” about dosing!
Click to expand...

same story just about every single person who comes to this forum has. The problem with this is the "book" was written many years ago. It is hard to wrap your head around going rogue and deciding on a dose that is not what the vet says to give but the people here are far, far more knowledgeable about feline diabetes than almost any vet you can find. You are right that finding this forum is something to celebrate, it can change your life and save your cat.
 
Bron and Sheba (GA) said:
If you are following SLGS you need to reduce the dose to 1.25 units twice a day as your kitty has dropped under 90.
Your kitty is bouncing which is giving you the high BGs.
Click to expand...
I just wanted to add, and thank you again, just by decreasing 0.25 units today, tonight’s PMPS was already under 400, it’s been one of our better days so far.
 
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