Tara & Buster - AMPS 353, +5 186, PMPS 100 new to TR forum

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Tara & Buster

Tara & Buster

Member Since 2012
Thank you for inviting me over to this forum - I feel better about that and I could sure use the help!

Brief history: DX 7/6/2012, immediately went on insulin. Switched food to W/D after about 1 week. Several curves done at the vet which I now know isn't really helpful due to stress. He didn't ever seem to be getting much better in that timeframe. Low weight, dandruff, frequent urination, very hungry. Shot blind up until a hypo episode last week (the day I had planned to pick up home testing supplies, oddly enough). When he went hypo, the ER people switched him over to M/D and advised to go 3u am and 2u pm...I did not do that.

I decided to basically start over. I switched to Wellness Turkey & Chicken flavors and dropped the dose down to .5. He has improved dramatically! BUT, we need to get him off the roller coaster he's on right now.

SS is posted in the sig - updated this morning. Dose has just been reduced to .25.

FYI, Buster was not overweight when DX, nor has he ever been on steriods. He was on Royal Canin SO for crystals he had when he was about 6yrs old. Up until DX he had been fed dry SO BID and substituted canned food for two feedings a week. He's not the typical profile for a diabetic. I guess just crappy food and he's around 12 or 13 now - things can change just because.
 
Re: Tara & Buster - AMPS 353 - new to TR forum

Hi Tara,

Welcome to Lantus Land! I just looked at your ss and it looks like you're only dosing .25u 1x a day now. Is that correct? You were right to bring him down and start from scratch. Good thinking! The only problem is that Lantus and Levemir need to be given every 12 hours. This is important because the insulin does not last longer than that. Right now he is going 12 hours with no insulin. You're doing great but need to give the .25u 12 hours apart and test at least once during the night as well. Great job in setting up your ss and switching food.

Melanie & Racci
 
Re: Tara & Buster - AMPS 353 - new to TR forum

Welcome to TR and FDMB in general! You will get some great help here. There are some people here who have been handling this for years and giving advice. They are a fabulous resource! I could not have helped my Max without them!

I see that you have been having to skip shots, and give insulin only once a day. You are really getting results fast from the insulin, and the learning curve is so steep with this process that I hope you will be able to rely on the experienced board members a lot to help you through. Meanwhile, please check out the Stickies at the top for a lot of important info to help you manage his low numbers.

By the way, feeding and testing at certain intervals have helped me to avoid hypos while Max has been low. The "Shooting and Handling Low Numbers" is important reading: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=147. However, it doesn't talk about feeding intervals. Knowing when Buster ate in the hours prior to the shot can help the members of the Board help you to know if giving a shot is safe. Some people do not feed for 6 hours prior to the shot, others only 4, and some only 2. It all depends on how your cat processes the food, and what sort of "food spike" he gets, if any. You may want to try all these different times starting with 6 hours, then 5, etc. to see what it does to your cat's BG number at the time you intend to shoot insulin. Feeding within 2 hours prior to the shot is not usually recommended (unless, of course, you see a low number at +10 and need to avoid a hypo.)

At first, what you are trying to avoid is seeing a number at shot time that is above what is safe to shoot only because Buster ate at +11 instead of because the insulin has worn off completely. Later, you may feel comfortable shooting a lower number, and this issue becomes even more important.

There are some links that I can't find right now about testing intervals that will help you figure out how your cat is using the insulin, when the onset begins, and when your cat's nadir might be -- about becoming data ready to shoot lower numbers. I can't find it at the moment. Hopefully someone else can, and will link it here for you.

However, see the Sticky - "New to the Group? - Please Read . . ." Here it is: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=18139 It has a lot of links in it, and under "Learn how YOUR Kitty is responding to Insulin" there are links about when the insulin shot starts to work, typically, when it's action peaks, typically, etc. These times are different for all cats on Lantus, and the list there is an example of the theoretical cat. So, we test to find out what OUR cats are doing with the insulin. This helps us to find out whether we can give a shot at the time we intend to, when in the cycle to be concerned enough to test, when we should not leave our cats alone, etc.

Most people test one hour after the shot (+1) and two hours after (+2). Others do it differently after they find out when the cat's nadir usually happens. For instance, I test one and a half hours after the shot (+1.5) and/or +2.5 and/or +3.5 because I know my cat should have nadir around +3.5 or +4.5. (This way I test 3x instead of 4x, and only 4x if the +3.5 was low -- it's easier on the ears.) Testing at +1 OR +1.5 tells me how far Max's BG has dropped from Pre-shot, and if it's a lot, I will need to pay very close attention until +3.5, at least.

Also, testing at +10 and/or +11 tells me what I need to know when I get the pre-shot test -- at pre-shot is his BG falling too much below the BG he had at +10 or +11? If so, shooting insulin might be dangerous.

You may not know what the numbers mean on your own, but if you keep tract of them for a couple of weeks, and then you keep up with posting the numbers you get at these different times in the cycle on the board, you can ask for help interpreting them. You will be able to keep your cat safe AND even give shots when you might otherwise have skipped.

I hope this makes sense, and that someone with a lot more experience will be along shortly to help you with your next shot!!! In the meantime, until you have enough data on your spreadsheet to know what sort of numbers are not safe to shoot, it appears you are aware that the general idea is that a reading of 200 to 150 are in the "too low to shoot" range.
Have a great day!
 
Re: Tara & Buster - AMPS 353, +5 186 - new to TR forum

A little history here everyone:
Sienne told her yesterday to go to .25 2x a day so she is just starting that now.


I suspect you know this but Lantus is typically dosed twice a day. A cat's metabolism is twice as fast as a human's. As a result, if you're dosing only once a day, the first 12 hours you'll see numbers come down and without insulin, the numbers will spike back up.

If Buster had a symptomatic hypo at the outset, there's a good chance he's sensitive to the effect of insulin.

Generally, if someone is having difficulty shooting twice a day because numbers are too low to shoot comfortably, one strategy is to lower the dose. You could drop Buster's dose to 0.25u and see if that will allow you to give a twice a day injection.

It's looking like this forum has not been terribly busy. You're welcome to post on the Lantus Tight Regulation board. There are a number of people who follow the Start Low Go Slow approach who post on the TR board. People are usually there almost 24/7.
Click to expand...


Here is the Lantus info that Dale (max&emmamommie) was referring to:

Learn how YOUR kitty is responding to insulin:
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

Example of a typical Lantus curve:
+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.
Click to expand...


So glad you decided to come over. All these eyes will have lots of help to offer. Ask questions.
And you can point out that you need answers by putting a question mark in your post or using the icon.
also the words "need eyes" can get attention sooner than later. :smile:
 
Re: Tara & Buster - AMPS 353, +5 186 - new to TR forum

Thanks for the history Rhiannon. What board was this?

Melanie & Racci
 
Re: Tara & Buster - AMPS 353, +5 186 - new to TR forum

Glad you made it over to this board Tara, with all the people over here you will get help faster and have more eyes looking at Busters numbers. The relaxed Lantus was just not busy enough for a newbie. Good luck!!!!! :thumbup
 
Re: Tara & Buster - AMPS 353, +5 186, PMPS 100 new to TR for

Welcome to Lantus Land!!

I know you didn't shoot tonight -- I suspect because of the low pre-shot. However, could you start to get some PM tests. Even when you don't shoot, it's helpful to know when Buster's numbers start to rise. This will help you have a better idea of what kind of duration you're getting with Lantus.

It's possible that even with reducing the dose, there's still insulin in the depot. I'd suggest shooting the same, 0.25u dose tomorrow morning and let's see what Buster's numbers look like before your PM shot time. If you could grab a test at AM +11 and post, we can help you to sort out the alternatives.
 
Re: Tara & Buster - AMPS 353, +5 186, PMPS 100 new to TR for

Hi, Tara,

I see you didn't give Buster a shot tonight with your PMPS of 100. If I were you I would go ahead and test him tonight until you see the numbers go down and then rise up above at least 70, and maybe I would want to see 100; I'm not sure. The issue is that Lantus forms a depot under the skin, and it can be used by the cat to lower BG even after you did not give a shot at the last shot time. We can't be sure he won't go low tonight. The last couple of nights he was in the Blues at PMPS and then up around 350 the next morning. This might mean that he went low during the night, and bounced -- when liver is activated to release glucose into the system due to a low BG to prevent a hypo.

Hope you see this and it helps!

Dale
 
Re: Tara & Buster - AMPS 353, +5 186, PMPS 100 new to TR for

Let's rewind a bit....

With a shot at AMPS, it's highly unlikely that numbers will drop much more overnight. To do so, would mean that Buster's Lantus has a duration of well over 12 hours. While anything is possible, it's unlikely. Rather, AM numbers are high because the insulin has run out. The pattern is that there are high numbers in the AM, Tara gives Buster his shot, his numbers come down, and he may or may not need another shot at PMPS. If Tara doesn't shoot, numbers are high again by AMPS because there's no insulin on board.

Another possibility is that Buster has a late nadir. However, we won't know this unless Tara is able to shoot twice a day.
 
Re: Tara & Buster - AMPS 353, +5 186, PMPS 100 new to TR for

Welcome to Lantus Land, the greatest place you never wanted to be. :lol: :lol: Buster is responding very well to Lantus. That's great! Sienne will help you get the dose sorted out and I imagine you will start to see more consistently low numbers. I sure hope so!
Liz, Zener's other mom
 
Re: Tara & Buster - AMPS 353, +5 186, PMPS 100 new to TR for

We wanted to stop by and welcome you! Sienne will have you fixed up in no time. You are in great company in LL. have a great night!
 
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