? Pumpkin-help with lower numbers

[KAC]

Also posting in Lantus forum...............
I went up to 15 U of Lantus with Pumpkin on 12/23. Had to get his numbers down to maybe help save his legs. I've also started him on the B vitamin to help with neuropathy. I've been able to get some more readings. There have been a couple of times he was in the double digit numbers. I'm kind of panicking because his numbers have been so uncontrolled for so long and now I hit the lower numbers. Like this morning.....I didn't know what to do......Any help and advice is welcome. Please take a look at his SS.

-Does it look like 15 is a good dose for him?
-What do I do when his number is in double digits, like this morning and on 12/26?
-Do I still give 15 U or reduce dose when he is in double digits? * I was too scared to give insulin this morning.

**I'm going back to work on Monday Jan. 4th so I won't be home to do additional readings then. Trying to figure this out before I have to go back.

 

[Larry and Kitties]

Your notes for 12/30 said "

threw up a little about 2:00p after coming in from outside: gave him spoonful of feed at 2:00a scared of dip" When did vomit? Could that have been the reason for the low 12/30 AMPS?
Are there reasons for the other abnormally low PS'? 15 units seems fine for a normal high PS and when Pumpkin eats normally. You might want to consider also giving a little of either R or N when you get a high PS and Pumpkin eats.

 

[KAC]

Your notes for 12/30 said "

threw up a little about 2:00p after coming in from outside: gave him spoonful of feed at 2:00a scared of dip" When did vomit? Could that have been the reason for the low 12/30 AMPS?
Are there reasons for the other abnormally low PS'? 15 units seems fine for a normal high PS and when Pumpkin eats normally. You might want to consider also giving a little of either R or N when you get a high PS and Pumpkin eats.

He threw up a mouthful of food that was left in pan and a blade of grass. Pretty sure he noshed on some greenery outside. Definitely not enough to cause the dip. What is R or N? Im not familiar with all the lingo yet.
Seems like 70's/80's is too low BG for him. He gets very still and quiet. wouldn't walk or flip his tail. 10:30 AM BG was up to 156. I just don't know what to do when he dips.

 

[cabreu]

He threw up a mouthful of food that was left in pan and a blade of grass. Pretty sure he noshed on some greenery outside. Definitely not enough to cause the dip. What is R or N? Im not familiar with all the lingo yet.
Seems like 70's/80's is too low BG for him. He gets very still and quiet. wouldn't walk or flip his tail. 10:30 AM BG was up to 156. I just don't know what to do when he dips.

Willow also got sick when reaching new lows. When she first dipped into the yellow, then later the blue, and then later the green-- all of those times made her sick (the last one was not long after starting cabergoline, so I'm not sure if it was a new low or the meds making her sick). But getting sick at the new lows didn't repeat itself when she reached those lows again. Have you looked into cabergoline for the acromegaly?

 

[KAC]

Willow also got sick when reaching new lows. When she first dipped into the yellow, then later the blue, and then later the green-- all of those times made her sick (the last one was not long after starting cabergoline, so I'm not sure if it was a new low or the meds making her sick). But getting sick at the new lows didn't repeat itself when she reached those lows again. Have you looked into cabergoline for the acromegaly?

Yes, i have cabergoline but he stopped eating completely when I gave it to him. So I stopped. Only had it a few days. Once I get him on the correct dose of insulin, I'm going to check into a different form. Maybe another form, other than the liquid I gave him with a syringe by mouth, would be better and not cause him to stop eating. I'm thinking that for him 70/80 BG number is too low. He is a big boy.

 

[cabreu]

Yes, i have cabergoline but he stopped eating completely when I gave it to him. So I stopped. Only had it a few days. Once I get him on the correct dose of insulin, I'm going to check into a different form. Maybe another form, other than the liquid I gave him with a syringe by mouth, would be better and not cause him to stop eating. I'm thinking that for him 70/80 BG number is too low. He is a big boy.

Willow is also big (long and tall) but I don't think that means her BG should be any different than the usual healthy range. Did you try squirting the cabergoline on his food instead of into his mouth?

 

[Wendy&Neko]

Have you given up on cabergoline? I see the spreadsheets says you stopped it. If you are still on it, that can make a huge difference to dosing. What I say below assumes you have stopped it.

Does it look like 15 is a good dose for him?

Since you are using the AT, and normally not able to monitor as well as you have been this last week, I would reduce the dose to either 14 or 14.5 units for Pumpkin's safety. He has been seeing safe green numbers, but it wouldn't take much to make them unsafe. And with you going back to work, that would be not a good dose. Below 68, if following Tight Regulation, we say to reduce the dose. Following Start Low Go Slow for dosing, we reduce below 90.

-What do I do when his number is in double digits, like this morning and on 12/26?
-Do I still give 15 U or reduce dose when he is in double digits? * I was too scared to give insulin this morning.

If you had the data to do so, and ability to monitor, you could give insulin. But you did not have much data on shooting lower. If you look at the Lantus forum, there are Sticky Notes that give suggestions on what to do for low numbers. One option is to stall, which is the NOT feed, wait 20-30 minutes, and see if he comes up to a number you feel comfortable shooting. A reduced dose or skipping are also options, depending on the circumstances. If you post for help when you see a number lower than you are used to, people may be around to help you weigh the options.

ETA: Under 90 if following SLGS, you do not shoot.

And by the way, when you saw those green numbers last night, you did the right thing by feeding him. Food is what helps him stay safe. Make sure you have some higher carb wet foods around, in case you ever see numbers under 68.

What is R or N?

They are both shorter acting insulins. And not good options in your situation for the amount of time you can test. They are powerful tools, but with that comes danger if not used properly.

Size doesn't impact dose. We've had small cats on large doses and large cats on small doses. The goal for all should be spending as much time as possible below renal threshold. Pumpkin is not used to normal numbers, so that's why he felt unwell in them. Neko hid under the bed during her first greens. Think of high blood sugar like coffee - they've been used to all that blood sugar and now you are reducing it with insulin.