Skinny consistent 300's

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tsteinbarth

tsteinbarth

Member Since 2014
Skinny isn't having any really low numbers any more and even with the random day when I or my son can't get to him within the 12 hours, he seems to be riding higher numbers. I'm suspecting that those numbers were mis-readings since he seems consistent with the 300's.

Is now a good time to up his dose a touch?
 
Here is the protocol for upping the dose.
Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit..
 
Actually, I do see that Skinny hit 181 at PMPS last night...were you able to get any tests after that? If he dropped low, this morning's high yellow AMPS might be the result of a bounce, and without knowing that for sure, it could be dangerous to increase.
 
Amy:

I was thinking his 181 from last night was due to the fact that I didn't get home from work until 9 pm and he was 2 hrs overdue for his shot. I actually expected his number to be lower. And I didn't test between 9 pm and 6 am. I've been pretty exhausted and bedtime last night was 10 pm.

It's hard to get doses at .25 level on the needles I'm using especially between 0 and 1u. Do most needles come without the .25 marking?
 
It's possible that Skinny was low from his food being late, or he could have been low from the insulin doing it's thing...it's hard to say, and that's where the tests give us the answers.

When you shot this morning, did you shoot 12 hours from when you shot last night?

I've never seen needles with .25U markings, but most of us do use needles with .5U markings. These are the syringes I used to use, but many here prefer Terumos:
Monoject half-unit_

There are people here who use calipers, too, to really fine-tune a dose.
 
Hi Toni:

I agree with Amy. Due to your schedule, you need to be extra careful about increasing Skinny's dose. Maybe on a weekend when you will be around to monitor more closely?

Usually a late shot results in a higher PMPS - more time without insulin generally makes them go up. If the 181 was at +14, Skinny may very well have been much lower during the day.

Am I understanding you're using needles that don't have 1/2 unit markings? If so, you can get some that do at Walmart. Terumo also makes one that a lot of people here use. No syringes have the 1/4 unit markings - how I wish they did!!! The ones with the 1/2 unit markings make it a little easier to figure out the 1/4 unit dose.
 
Usually a late shot results in a higher PMPS - more time without insulin generally makes them go up. If the 181 was at +14, Skinny may very well have been much lower during the day.
Click to expand...

I'm confused by the above? If I am logging his number BEFORE he eats or given a shot for the PM how is that his number was lower throughout the day? His numbers seem to be riding in the 300's at the 12 hr mark between shots.

As for the needles, they only have the .5 and 1 marks and was wondering if others had needles with .25 marks :-D

When you shot this morning, did you shoot 12 hours from when you shot last night?
Click to expand...

The shot was less than 12 hrs because I wanted to put him back on "schedule". He got his shot at +10.
 
I think if I were you, after a 14 hour cycle and then a 10 hour cycle, combined with that pretty blue yesterday, i'd just hold the dose and get some nadir checks to see how low the dose is taking him. I don't think there's a hurry to increase his dose, and you want to know that he actually needs more before you increase. Cats can move their BGs crazy fast - we have kitties on here that can be 400 at amps and pmps, and hit 40 in between! :shock: That's why there is so much emphasis on the test mid-cycle. I understand you can't always get them - that's life! But without them, I'd just sit tight on the dose until you can.

I bumped up a post a couple of days ago for someone else called Should I Increase the Dose? that Jill wrote a while ago. Lots of good tips in it!
 
I'm pretty happy with how my little boy has been doing. I've stayed with .5u and have gotten back to our "routine" with shots and food after his hiatus without the "juice" that happened at the end of last month.

It's hard to say what his numbers were before I started monitoring but he seems even more "normal" than before so I am pleased.

FINALLY was able to coordinate a time to show my son how to test and he did that tonight for the first time so other than random times he forgets, I think I've got the basis covered to managed my crazy schedule. The auto feeders are being ordered this week. Too bad cats can't wear an insulin pump :lol:

Thanks again for the advice over the past 3 weeks. Can't even imagine what my anxiety level would of been like without being here let alone the courage to start monitoring.
 
Hi Toni! nice to see you and skinny!

Here's a spreadsheet for you to take a peek at: Gabby 2009. Take a look at 9/20, for example.

amps 307
+5 86
pmps 425

Scan down her spreadsheet and look for green nadirs, then look at what the amps and pmps are. She's one of the examples I was mentioning to you - a cat that can have most of her preshots at 300+, but have nadirs under 100. Because Lantus dosing is based upon how LOW the dose takes a cat, not upon the preshots, Sienne would've had a disaster if she'd been basing her dosing upon those preshot numbers.

Gabby isn't unique in this - We see many cats do this. Dyana's JD can go from 500-500 at preshots and still hit green numbers in between.

I just can't encourage you enough to have your son test Skinny, or you test skinny at some mid-points during the insulin cycle. As an experienced Lantus user, I've seen many cats that go low at night. I'm just being honest with you - I'm worried about his safety.
 
I have to agree with Julie about testing around +5-7. Max is one of those cats that drops at night. If I didn't know that he would have gotten way too much insulin and gone hypo.
 
I am thoroughly confused by the concern. Until a month ago, I had no information on how Skinny was doing regarding BG because I wasn't testing. If Skinny has been going low during the day, he has been doing that for almost year because his feeding and insulin schedule is exactly the same as it was when he was diagnosed a year ago. Even on the weekends, I can't get mid readings consistently. A few random days here and there also didn't seem to enough in order to get accurate information, so why create the stress of re-arranging my schedule to make that happen a day here and there? My son doesn't live with me and there is no way for him to test during the day. Not sure what options I have other than considering a new home for him.

Given my schedule and Skinny being on insulin for a year (except for the short remission), I feel like he is doing OK with room for improvement.
 
"Concern" is what we do here in LantusLand. As Julie pointed out with Gabby's example, we've seen kitties do some pretty major drops into very low numbers in between some very high preshots. And, we've seen patterns fluctuate widely, where one day a kitty will drop significantly, and another day they will stay high and flat.

FD is just a frustratingly and frighteningly unpredictable disease, so we are obligated to inform all members of FDMB, new and old, of how every cat is different, every cycle is different, and what CAN happen at any given time.

Of course each caretaker assumes the ultimate responsibility of caring for their cat as best they can, given their circumstances, but we still have to express our concerns - especially since this is a public forum where anyone and everyone can read what is posted here. Not only does what we type here benefit/affect Skinny's situation, but it can also affect a lurker's situation as well.

Even though you can't consistently get mid-cycle readings, every little reading CAN truly help build a bigger picture of how Skinny is responding to insulin. I would still recommend getting extra readings whenever possible, because you just never know...
 
Hi Toni,

I think all across the board, you'll hear people encouraging others to test as often as possible. That's the best way to make sure a cat is safe since insulin needs - and insulin responses - can change so quickly. What worked a month ago or a week ago or even a day ago may not be what works today. Things can just change that quickly.

On the TR board, especially, I think you'll hear even more encouragement to test often because of the protocol that's followed. The protocol for TR states that you hold doses for 3 days, make dosing decisions based on nadirs, etc. To move as "quickly" as the protocol indicates, you have to get tests at pre-shots and also in between shots in every cycle. Lots of people can't follow the TR protocol for a lot of different reasons - work schedules, testing limitations, etc. Those people often find that they are more comfortable posting in the "Relaxed Lantus" forum rather than the TR forum. People who post on Relaxed Lantus may not test as much as we do on TR, they may not shoot as many low numbers as we do on TR, they may not post every day like many people here on TR do, they may hold doses longer than we do here on TR, etc. I just wanted to mention it in case the "Relaxed" approach might better fit your situation right now. So....if you're frustrated with the TR forum, consider trying the Relaxed forum instead. (Just remember that no matter which forum you decide to post in, testing really is the best way to keep our kitties safe.)

Please don't give up on FDMB altogether; we all have Skinny's best interests at heart and want to see him get better - just like we know you do. :-D

Shelly
 
I'm not giving up the forum. Just confused. I understand everyone has Skinny's best interest at heart... I'm sure alot of people are like me and do best with specific feedback and the forum provided me with great advice and specific help a couple weekends ago when I was unsure what to do because I knew I wasn't going to be able to get any numbers.

There are alot of things I can't change, Skinny having FD being one and my work schedule is another. I know I'm not the only one who has a crazy life so it's probably "preaching to the choir" LOL . . . Skinny doesn't do well with stress and change, so while it's an option to take him to my boyfriend's home when I'm there, I know my cat and he could barely handle the 5 min walk to the vet when we lived next door to the vet let alone a 10 mile car ride just so I can get numbers. It's distressing to see your cat foaming at the mouth and kinda gross when he shakes his head all over the car :lol:

No harm no foul all :) Honest feedback is honest feedback.
 
you had a good post early this morning with some good questions. why would there be an issue now after you've been giving him insulin for a year?

that's a great question!

what i've seen is that dogs seem to be able to do a curve at the vet's for a day, the vet figures out a dose, and then the dog gets that dose for the next 6 months to a year. If the dog has low numbers and shows symptoms, the person gives karo and the BGs rise. I personally know 3 people who've had diabetic dogs, never tested, just shoot and go.

but cats are different. they have the unique ability to have their pancreas heal. When that happens, the pancreas starts putting out insulin, and now you might have insulin coming from another source (pancreas) besides what you're injecting. So what was once the perfect dose now becomes too large of a dose. That's my concern with Skinny - that he may be putting out a bit of insulin himself. It's hard to know.

I know you can only do what you can do - and i didn't realize your son didn't live with you. having a 20 something son, i am glad for you that he lives elsewhere! ;-) i love my son, but happily he's living elsewhere!

So ways to work around the work schedule and the need to sleep (what? sleep?) - try to get more tests on the weekends or whenever you have days off, try to get a before-bed test every night when you can. Even a +1 can tell us if a bounce is starting.

Make a practice of having food available for skinny when you're working long days. Not every cat will eat if their blood sugar drops, but many will.

Probably in this situation, I would delay dose increases until i'd had at least one weekend curve - so go slower with the dose increases because you are less able to monitor. The goal is to keep the cute little guy as healthy as possible, while keeping him safe.

And keep on plugging. One step at a time. Keep asking questions. :-D
 
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