? Trying to understand why Nermal's numbers are still so high?

Laura bb

Laura bb

Member Since 2018
I just tested Nermal at the +5 and it is still high at 361. I thought his numbers would be lower by now. Could this be because of me being such a scaredy-cat afraid of hypos when I first started and not having him regular and skipping a few doses. When he first started on a Friday(I wish it was a Monday) the next day I blindly gave him a shot like my vet told me. He was super tired all day and I could barely get him to wake up, it scared me so I decided to wait till Monday to talk to the vet before giving him more because I did not know what I was doing. I guess I screwed up big. I cannot go to a different vet, it is the cheapest, and she was nicer in person than on the phone which had me balling my eyes out.then She told me I was killing my cat for not giving him insulin and brought me to tears so I rushed him to the vet on October 8 and he tested at 420 which is the first time I actually saw him tested with my own eyes. so I came on here looking for answers. Last week or so I tested a preshot at 41 and did not give him a shot, I thought I had tested wrong because it was my first time using the meter. The insulin was bought and started October 5. I am so confused--I want him to be well, he has started looking better, walking taller and more energy then before he started this. Am I being too anxious about wanting his numbers to drop so early? Should I test at different times. I tried waiting to test him last night but unfortunately I fell asleep on the couch waiting. I go to vet Tuesday, I am afraid she will increase his dosage and he will never get off this. I cannot afford to switch vets because she I want remission-I know it does not happen for every cat. My spreadsheet looks horrible I am sure because of not testing from the start. I am still learning new things from this website everyday---I appreciate any advise.
 
I am not one of the experienced members here, and I can't give dosing advice. Please be patient for the moderators to come on line.

However, I can say that testing more is critical. Until you have a sense of when onset for the insulin develops, how low Nermal goes, and where he is preshot, advice is going to be limited. If you can, today, test roughly every 2 hours. It's not quite a curve, but it will provide better data.

And mostly, breathe. You've got this. Testing, feeding the appropriate food, and working with insulin will get Nermal through this. And you, too.

I have had some luck getting my current vet to come to this board and start reading about protocols and dosing methods. You might want to gently suggest it to your vet. That way, she can look at the spreadsheet and see how Nermal is doing and how you're working on the dosage.

Take care of yourself.

Are you on the TR protocol, or SLGS?
 
Thank you i am going to print off his spreadsheet for her. I wish I could test more today but my father is very ill and I must go see him today. The vet has like ten kitties that live there and roam around, which helped comfort Nermal when he came in. They also have pet birds in big cages in the exam room to keep kitties distracted. One of their kitties has diabetes too. This is the most recommended and cheapest cat vets in Norman, Oklahoma.
 
Hi. First sorry about your dad. My mom was in and out of the hospital and not doing well while Max was on lantus so I know how stressful your situation is it’s impossible Blends to know what is going on with your cat because your aren’t doing any mid cycle tests. Since lantus dosing is based on the lowest point the cycle, called the nadir, nobody will be able to give you advice until you determine what that is. At night get a test at +2-3 or before bed. Any extra tests you can get day or night will help. Most cats nadir between 4-7 hours after insulin but some are early and some late.
 
There are a few possibilities.

First, I'm sorry about your dad.

It is imperative that you test more. Lantus dosing is based on the nadir (lowest point in the cycle). By only testing at pre-shot, you have no idea whether numbers are lower at nadir. Often and especially early in this process, if a cat's numbers drop into a range their body is no longer used to, the numbers bounce back into a high range very quickly. Thus, you have no idea whether numbers have dropped dinning the cycle. As an example, my kitty started a cycle in the 400s, dropped into the 40s, and was back in the 400s by the beginning of the next cycle. If I hadn't been testing, I would have assumed I needed to increase my cat's dose versus needing to reduce the dose based on the numbers.

Obviously, the other possibility is that Nermal needs more insulin. However, I would not be comfortable suggesting that you increase your cat's dose without some spot checks.

 
In looking at your signature, Nermal has only been off the crunchy food for a few weeks. If you can start getting spot tests mid-cycle and before insulin, you may see the numbers starting to drop. That would be the carbs exiting his system. Keep feeding the Fancy Feast.

Could you update your signature to tell us which protocol you're using? SLGS or TR?
 
I dont know which one I am using I have just made the spreadsheet this weekend and just one unit twice daily i am too nervous to adjust but will show my vet my spreadsheet
 
Sienne and Gabby (GA) said:
There are a few possibilities.

First, I'm sorry about your dad.

It is imperative that you test more. Lantus dosing is based on the nadir (lowest point in the cycle). By only testing at pre-shot, you have no idea whether numbers are lower at nadir. Often and especially early in this process, if a cat's numbers drop into a range their body is no longer used to, the numbers bounce back into a high range very quickly. Thus, you have no idea whether numbers have dropped dinning the cycle. As an example, my kitty started a cycle in the 400s, dropped into the 40s, and was back in the 400s by the beginning of the next cycle. If I hadn't been testing, I would have assumed I needed to increase my cat's dose versus needing to reduce the dose based on the numbers.

Obviously, the other possibility is that Nermal needs more insulin. However, I would not be comfortable suggesting that you increase your cat's dose without some spot checks.
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Ok I have been wondering about that myself. In the begining I thought he kept getting low before I bought this relion comfirm. (guess I need a new one now that its discontinued). I am going to test more and more now before my vet visit. I do not want her to adjust his dose higher if he does not need
 
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