Scared newbie needing help

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Ok. He was fine last night. Not sure how long the insulin lasts for? I looked at his numbers over the whole weekend and he drops into blues mid cycle. PMPS is usually ok but AMPS consistently high. I thought it was supposed to last 12 hrs? My vet will probably tell me to increase again when she sees this but I won't this time.
 
He's preshots are consistently high right now because he is dropping so quickly after you shoot. The insulin does last 12 hours plus some. He is also dropping into unfamiliar territory for his body right now. And both those steep drops and going into blues when his liver is still use to running in the reds and pinks is what is triggering the higher preshots.

What is worrying all of us with experience here is that his mid-cycles keep getting lower and lower and you can't be there to monitor him during the day. Personally, if he was mine and I couldn't be with him all day I would back off his dose to 1.75 at the very least. But I also understand that you want to give your vet's advice a go as well. So this is your call.

Mel and The Fur Gang
 
KittyMom777 said:
PMPS is usually ok but AMPS consistently high. I thought it was supposed to last 12 hrs?
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Remember that Lantus is a depot insulin with substantial overlap between doses. Adjustments are based on the NADIR, not the pre-shot or any bouncing numbers. Basing dosage on how low Silver goes during a cycle helps keep him safe. For example, Saoirse sometimes gets fasting spikes of 2-3 mmol/L at AMPS (plus a possible dawn phenomenon influence). If I were to base her dosage on those values I would be putting her in danger because the dose would be too high.

KittyMom777 said:
My vet will probably tell me to increase again when she sees this ...
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Is your vet very familiar with Lantus or does she normally prescribe other insulins for cats? Some vets may be more used to in-out insulins like Caninsulin (aka Vetsulin) and sometimes give dosage recommendations based on preshot values for Lantus. This is incorrect and unsafe. Period.

I am in complete agreement with Mel here. If Silver were my cat, I would either stay at home and monitor very closely - around the clock - or I would reduce the dose.
 
Juliet

I'm going to show you two pictures and yes, they are both the same cat...lol



This is my Cassanova when I first adopted him, yes he really is standing up, or at least standing up as much as he could back then.
His dose was being based off vet run spot checks not even a full curve at the vet's just random spot checks. His previous own still had him on dry DM and wasn't testing him at home. He was on 11u BID of Levemir. He was 37 LBS! He had neuropathy, his coat was dull and thin. in short he looked like hell warmed over after 2 years of treatment under vet supervision. He didn't have a bad vet, in fact I've spoken with him on many occasions since adopting Cassanova, he just didn't understand a depot insulin as he normally uses N or Prozinc with most of his clients. Now he is learning from me how Lantus and Levemir work.



Same cat 8 months later following the protocol here and was OTJ until I had to use a salve on his feet that contained a mild steroid, he's already back to .25u for a dose after starting him back at 1u. And this morning's preshot was 161. In a couple more weeks he'll probably go right back to OTJ once the steroids clear his system again.

He's a completely different cat. In fact he's not even the same color anymore. He really is that much oranger in real life as he is in the pictures that's not a trick of the lighting.

Mel and The Fur Gang
 

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so happy he's doing well today. when you have a chance, can you edit your original post and click none so the 911 icon goes away. since he is safe now, we all still get nervous seeing the 911 help icon. thanks alot.
 
MommaOfMuse said:
Juliet

I'm going to show you two pictures and yes, they are both the same cat...lol



This is my Cassanova when I first adopted him, yes he really is standing up, or at least standing up as much as he could back then.
His dose was being based off vet run spot checks not even a full curve at the vet's just random spot checks. His previous own still had him on dry DM and wasn't testing him at home. He was on 11u BID of Levemir. He was 37 LBS! He had neuropathy, his coat was dull and thin. in short he looked like hell warmed over after 2 years of treatment under vet supervision. He didn't have a bad vet, in fact I've spoken with him on many occasions since adopting Cassanova, he just didn't understand a depot insulin as he normally uses N or Prozinc with most of his clients. Now he is learning from me how Lantus and Levemir work.



Same cat 8 months later following the protocol here and was OTJ until I had to use a salve on his feet that contained a mild steroid, he's already back to .25u for a dose after starting him back at 1u. And this morning's preshot was 161. In a couple more weeks he'll probably go right back to OTJ once the steroids clear his system again.

He's a completely different cat. In fact he's not even the same color anymore. He really is that much oranger in real life as he is in the pictures that's not a trick of the lighting.

Mel and The Fur Gang
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Hey, I thought I WAS following the Start Low Go Slow protocol? It said on here that if lowest point of the nadir was between 5 and 8.2 to keep the dose the same. http://www.felinediabetes.com/start-low-go-slow.htm The blues aren't new territory - its just I am seeing them for the first time because its the first time I've been home during the day to run a curve. Back in first week of November when the vet did the curve - he was in the blues for most of the mid point time at around the same level as he is now - 5 to 6. He does drop fast but doesn't go down to dangerous levels - not even in the green. I am going to send the SS to the vet this afternoon.
 
hi Juliet
that's great that Silver is doing well. good luck with the vet.
hope you can get some sleep tonight .
 
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