THOUGHTS ON TIGGER

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syndyz

Member Since 2012
Hello....I have been following TR on another website, but rarely get help or answers from their message board. It looks like this board is a lot more active.

Tigger is 13 years old and diagnosed 2 weeks ago. I am giving him Lantus every 10 hours and checking numbers every couple of hours. I need to transisition him, if possible to 2 shots per day, every 12 hours.

Please look at his numbers below and give me your thoughts & advice:

Thank you so much in advance, Cindy D. & Tigger


DATE 6/6

7:20AM .........................GAVE .5U LANTUS

9:15Am.......+2..........BG 258

11:15.........+4.........BG 239

1:15..........+6........BG 226 Nadir=226 + 6

5:00pm........+10.......BG 375......5U Lantus

6:30 PM.......+1.5 ......BG 305

8:30 pm.......+3.5.......BG 209

10:30 PM......+5.5.......BG 242


DATE 6/7


3:00 AM....+10.....BG 323... .5U LANTUS

7:45 AM....+4.75...BG 237

9:00 AM....+6.....BG 243

.............................ATE QUITE A BIT OF FF CHICKEN CLASSIC

11:00 AM.....+8....BG 218 Nadir = 218 +8

.......................................Ketones : slight

1:00 PM.....+10....BG 329....5U LANTUS

6PM........ +5.....BG 256

7:00PM.......+6.......239

9:00PM.......+8.......237 Nadir = 237 + 8

11:00........+10......356..... 1U PER NEW SCALE BELOW!!

LANTUS BG
US ( mg/dl) -------- Metric (mmol/L) ---- Dose
150 - 250 ---------- 8.3 - 13.9 -------- 0.75u
251 - 400 ---------- 14.0 - 22.2 ------- 1.00u
400 + -------------- 22.2 + ------------ 1.25u

Date 6/8

5:00AM.......+6........110 !! Nadir = 110 + 6

8:00AM.......+8........276....KETONES NEGATIVE

10:00 AM......10.......458... gave 1.25U Lantus

2:00 PM........+4......357

.........................Snack of dried chicken breast

4PM..........+6........280 Nadir = 280 + 6

6PM..........+8........291

.........................ate 1/2 can FF

8:00PM.......+10.......304....1U Lantus

10:00PM......+2........285.....neg. ketones

Date 6/9


6:00AM.......+10.......293 GAVE 1U LANTUS

10:00AM......+4........50 FED 2-3 TABLESPOONS FD CHICKEN

11:00AM......+5.......140 nadir = 140 + 5

12:20pm......+6.3......320

2:00PM.......+8........581 Neg.Ketones


4PM............+10......534 GAVE 1.25U LANTUS



8PM........... +4........216



10PM...........+6 .......130



DATE 6/10



12AM........+8..........134



2AM.........+10........238 GAVE .75 LANTUS



8AM.........+6..........291



10AM.......+8..........263
 
Hi and welcome to the group!

I think you will find the help you need here to help get Tigger into just the routine you want. For tight control, Lantus is used every 12 hours so that will work out perfectly. We also tend to stick with a dose until some very specific signs tell us it is time go go up, or hopefully, down.

Each person here (sometimes referred to as a bean which confused me at first!) sets up a daily "condo" for his or her kitty. There, they report the kitty's BG values for the day. You will find some of the very experienced and helpful people here will come and read this thread and advise you about how to proceed.

I came here one dark day in December 2009 with a kitty on Lantus whose numbers were all over the place. I followed the advice I was given here, and by March 4, 2010, he went into remission and has been there since. I am back around again because his BG numbers seem maybe to be creeping up and I want to stay on top of the situation.

So, get ready for the ride. You will find, I think, that with the support of the great folks here, it can be a satisfying and enlightening adventure.
 
I just created Tigger's spread sheet and attached it to my signature below....what a wonderful help!!
 
Hi, Cindy and welcome to our version of Lantus Land. If you've been posting on the Your Diabetic Cat website, I think you will find that this board is very different. There is no one "expert" and we use a protocol that was specifically developed and researched for use with Lantus and Levemir. While some of us spend a good deal of our time volunteering here, all of our feed back is up front for everyone in the Lantus community and FDMB to respond to. This is a very active board and there's someone hanging around almost 24/7. We're here to lend a hand when and if you need one. We welcome your questions and want you to become active in our community.

We utilize the Tight Regulation Protocol developed by Roomp & Rand (and Marshall) from the University of Queensland. The starred, sticky note at the top of the board describes the slight modifications we've made as well as provides links to the protocol that was published in a leading veterinary journal. Based on the research, we encourage you to stick with the protocol and shoot every 12 hours. I also think shooting every 12 hrs. will be much easier on your schedule.

In addition, and again, based on the research, using a sliding scale for dosing Lantus often results in wonky numbers. Lantus is a depot-type of medication. Every time you adjust a dose, it has an effect on the insulin depot. Think of changing the dose as if you were throwing a rock into pool of water. There are ripples which need time to settle. If you change the dose at every shot, you're not just creating ripples, you could be creating waves. Doses need time to settle. You will get much better results if you shoot consistently both respect to the amount of your dose and when you're shooting (i.e., every 12 hrs.).

I would also suggest you pick a dose and stick with it for 3 days/6 cycles. If this were my cat, I would probably stick with 1.0u of Lantus and see how that dose works once it settles.

Please let us know if you have questions or if there's any way in which we can help. The people here are incredibly generous with their time and information. Again, welcome and I hope you will be posting often.
 
Thanks! I have already read all the protocol and Stickys....constructing the spread sheet really helped put Tigger's numbers into a format that makes it so much easier to understand! After looking over all the info and his new SS, I have to say I agree about dosing 1U for 3 days at 12 hour invervals! My only question is transitioning him from shots every 10 hours (so hard on our beauty sleep! :) ) to the 12 hours....his last dose was just at 12 noon today....my thought is to give the shot 1 hour early until I can get him to 9 am & 9 pm....since an early shot == a dose increase, should I go with the 1U or ???

It is also sooo encouraging to be able to look at other diabetic cats' SS and see how they went from reds, blacks & pinks....to greens and blues!!

Thanks for your help and how wonderful there is this board when we newbies need help or have questions!

Cindy D. & Tigger
 
Hi Syndyz, welcome to Lantus Land!

I was on that "other board" before coming to FDMB and yes, the 10 hour routine was exhausting and wasn't working for Cini Mini.

As for adjusting Tigger's shot time from every 10 hours to every 12 hours, if I remember correctly I moved the time out by 30 minutes each day. (i.e. 10 hours apart on day 1, 10.5 hours apart on day 2, etc.) till I got to a 12 hour interval.

The other issue you face is that your shot times are going to be Noon and Midnight. Is that a good schedule for you?

Any suggestions from the more experienced shooters?
 
Moving the shot times by an hour, can be dicey if Tigger is in lower numbers. Another member was asking about early shots and Jill wrote out an excellent response that I linked.

The other option is to skip a shot and then start at 9:00 when the next shot would be due. As long as ketones aren't an issue and you can grit your teeth through some higher than you like numbers, this may be simplest. Otherwise, the alternative is to move the time by 15 min. every shot or 30 min. per day. You will end up needing almost a week to get to your preferred schedule. This option will have the least impact on Tigger's numbers.
 
Hi Lydia,

If the last shot was at Noon and she gives another at 9pm then that's 9 hours apart. :shock: Which means the previous injection at Noon will overlap with the new injection at 9pm by 3 hours. This could be dangerous, especially if kitty has an early onset.

I think Sienne's suggestion of skipping tonight's shot at Midnight and then give the next at 9am tomorrow morning might be the safer alternative.
 
I have deleted the above message because I misread the whole situation and thought the last shot was actually at 10am. I have to stop reading this site on my iPod.

Apologies. Pretend I am not here!
 
If I am reading it correctly the chart says the last injection was at 2am and the last BG reading was at 10am.

I was looking at this in Cindy's follow-up post:

syndyz said:
....his last dose was just at 12 noon today....
Click to expand...

I would say a schedule of 15 mins earlier each shot time till she gets back to 9am/pm would be best. Not ideal by any means because it will take a few days.

I'm not a big fan of skipping doses if it can be helped, but in this case since Tigger's numbers are on the high end it may not matter as much.
 
Cindy --

You mention on Tigger's SS that he tested positive for slight ketones. Does Tigger have a history of DKA or of throwing ketones? This will make a difference with respect to skipping a shot. I would not want to put Tigger at risk for developing a problem with ketones if there's a history. We can re-think the strategy around dose and shot time if this is an issue.
 
Hi there....I am able to test for ketones often and he has always been negative.....except the one noted time when it was very, very slightly trace....

Here is my thought....I have been giving him his shots every 10 hours per the other board's TR....his next shot on that TR should then be at 10PM toninght (10 hours from his 12PM shot)....so my plan was to give the shot at 11Pm tonight...one hour after his normal shot, but one hour before this board's 12 hour plan.

If you look at his numbers from today on his SS, he is remaining nicely low, especially the last 3 BG's

Maybe I can skip tonight's shot? If not, what about the 11PM shot?

Either way, should I wake up and test during the night at all?

Thanks in advance for any advice.

Cindy D.
 
welcome to LL!

Are you home during the day so you have some flexibility with shot times for the next day or two? It looks like you are usually available to monitor during the day if needed, is that true?
 
syndyz said:
Here is my thought....I have been giving him his shots every 10 hours per the other board's TR....his next shot on that TR should then be at 10PM toninght (10 hours from his 12PM shot)....so my plan was to give the shot at 11Pm tonight...one hour after his normal shot, but one hour before this board's 12 hour plan.
Click to expand...


Now that may not be a bad idea, but here is my suggestion:

Give 10pm injection tonight (6/10)
Monday (6/11) - Give injection at 10am, then again at 9:30pm
Tuesday (6/12) - Give injection at 9:30am, then again at 9:00pm
Wednesday - You're on track with a 9:00 am/pm schedule :-D

We really don't like to make adjustments more than 30 minutes a day. (We're all hardwired like that here ;-) :lol: )
 
since Tigger is staying nice and blue, I would hate to see you skip a shot and probably lose that momentum. What if you shoot at +11 tonight (11:00) but stay with the 0.75u dose instead of going up to 1u right now?

We usually try not to do back-to-back early shots because that can create quite a bit of extra overlap, so I would shoot at 11:00 in the morning, then move tomorrow night's shot back 30 minutes or an hour, if numbers allow. Doing it that way will take a few days to move back to a 9:00 shot time, but should keep Tigger safe while you're doing it. One thing I would do, though, is if Tigger does bounce really high again, that would be a good cycle to go ahead and shoot early and make up some time.

What do you think?
 
Both ideas sound solid....(I am tempted to split the difference and go for 10:30 LOL!) since his last three BG's are so nice, I think I can do the 11PM tonight idea ...of course I will test before the shot....I am learning numbers can change very, very quickly.

Thanks for any and all input....this is all so new and confusing, but it is so great to be able to get help and advice!!

More in the morning!
 
I wouldn't shoot 2 whole hours early if he is still cruising in blue. I know you have been shooting at +10 in the past, but it also looks like you haven't given a shot at that low a number. Giving a shot at +10 would mean staying up to monitor tonight, definitely. One hour should be ok this one time, since it is a reduced dose. Then get maybe a +2 tonight (2 hours after the shot) to see if he is still surfing in that range or if he has started to go up. If he is still lowish at +2, then set an alarm for another spot check during the night. Don't be disappointed if he does start to rise fast - it is annoying but normal.
 
Cindy - You've gotten lots of great info so far, so I'm just stopping in to say "Welcome!". I'm not familiar with that "other site", but I can't imagine shooting every 10 hours - yikes!! I'm glad you found us...and that's a very nice +8.5 for Tigger!

Amy
 
Is your spreadsheet up to date? I didn't see the 99.

Just as a FYI, when you begin your shots for today, open a new thread. (We call them "condos.") We use a particular format for the day so we can easily see Tigger's test results -- especially if there's an issue that warrants attention. the format is:
today's date__cat's name__AMPS__test result
6/11 Tigger AMPS-###​
We also link the thread from the previous day to today's condo. That way, if you, or anyone else, want to go back and follow-up on some information, you don't have to do a massive search. To link the threads, you put the http info from your browser between the URL code. If you click on the URL button above the text box, it will insert the code . You then paste the http:// info between the brackets: http info here.
 
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