Wacky numbers: 8 weeks out and confused, worried

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Steph

Steph

Member Since 2013
I don't want to be needy here. You have all responded with superb help, and I've followed your directions.

So Stubbie (Mick) is on 2 IU of Lantus 2xday, and his numbers make no sense to me. (I helped another cat into remission with your help--he's on Friskies pate and no dry, and he's lost weight and he's doing great--three months out. He has no signs of diabetes, and Casey was in terrible shape.)

Take a look at Stubbie's 65 (average 2 tests back to back) I just got--I will not shoot tonight. And this morning, 265? Two days ago: 300, and the cat has lots in the mid to high 200s.

He is on Friskies pate, and he gets a minimal amount of the highest protein dry cat food made: Wysong Epigen 90: with 90% meat and no starch. No grain. It's bound with protein.
His food is the same every day. Nothing changed today.

I am fearful that in upping his dose--which I was considering--that with these sporadic low numbers I could have a hypo. Of course, Pet Plan doesn't insure him for diabetes, and this would be devastating in many ways--especially because he's doing so well: gained four pounds in eight weeks.

Tell me what you think? Could this be a pancreatic problem?
 
He could have some intermittent pancreatic function. Or it may take him more than 3 days to stabilize on a dose, or he might've not eaten enough, or he might've had a bit of a GI bug or ...

Have you read over the Lantus Tight Regulation protocol sticky? This might help you decide if you want to go for the Tight Regulation protocol which has been able to get many diabetics off insulin. It looks like you are testing enough that you might be able to follow this and eventually "shoot low to stay low". If you're not able to test frequently, or have irregular hours, or have an irregular cat, you may feel more comfortable in the Relaxed Lantus forum.

If you start seeing that about every 3-5 days, you have to skip a dose, he may actually need a slight reduction. Lantus is a depot insulin, which means its effects build up over time. After the first 5 days on it, any adjustments to dose may take roughly 3 full days (longer in some cats) to show the full effect. As you get data, you'll be able to see his pattern.

Looking at your spreadsheet, there are a couple of options. A "skinny" 2 units might work better. This is when you back off the the dose just below the 2 unit mark, but not as far as 1.75 units. Alternatively, you didn't give 1.75 units a full 3 days, ie 6 shot cycles, to see how it would do. You might do that, too.

For an analogy to help conceptualize this (which you may or may not need), imagine a funnel and pouring water through it. If you pour slowly enough, the water just runs right through. If you pour too fast, the funnel fills and overflows. If you pour a bit fast, then back off a tad, you'll have a pool of water in the funnel with water going in and out smoothly.

Another analogy is walking up a downward escalator. Go too slowly, and you're back at the bottom. Go too fast and you climb to the top and get off. Go a smidge fast and then slow down just a tad, and you'll be able to keep to a specific height on the escalator.
 
Wendy & Tiggy: I have gotten "a few" nighttime posts. I can do more, but they will need to be before I go to bed, say 10 p.m. after an 8 p.m. shot, or 6 a.m. before an 8 a.m. shot, ok?

IS THERE A CHANCE THAT ANOTHER INSULIN LIKE PROZINC WOULD WORK BETTER? IF I HAD SHOT HIM LAST NIGHT AT 63 WITHOUT CHECKING, THAT COULD HAVE BEEN FATAL, YES?
 
Those tests sound good,

Actually if you had shot last night it may well have been fine. We don't know... When you shot at 73 on October 18, he then increased.. That's why we ask for more nighttime tests, to get a better idea of what he typically does at nighttime. Maybe read this on shooting low. http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=147

The lantus looks like it's working great, the issue is you aren't able to get more tests in. Once you get some nighttime tests we will be able to see how he is doing. He could well need a dose decrease or be heading to remission. What I am looking for is if he is dropping under 50.. That would mean the dose is too high.
 
What to do this morning??? (Semi-urgent?)

His number was 50 at 8 .m. PST. I upped his does .25 last night from 2.0 to 2.25.

What should I do?

I wonder how he could be headed into remission with numbers recently in the high 200s?
 
You've got to give it a chance to work, making increases according to the protocol you're following. He didn't become diabetic overnight, nor will he be regulated overnight.

Hold that increase at least 3 full days, then check the mid-cycle numbers and adjust again.

Nad grit you teeth and have patience. It you increase too much, you may miss his best dose, plus you increase the risk of hypo between shots.
 
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