Whaddaya make of these numbers?

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heatherh

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Thyroid blood tests tomorrow for Leko, so I tried to gather some more numbers today so I'll have more info for the vet. WTH? I'm so confused.

I didn't feel any moisture on his fur after the AM shot. He ate his food earlier in the day than he typically would. See notes in the spreadsheet...

Any thoughts?
 
Leko's last post

Just want to link your intro post - keeps you from having to answer the same questions you've already answered!

when you start Lantus, we hold the dose for 5-7 days. Lantus is a longer-acting insulin and it builds up in the system, then you start to see what it's doing. Leko is just hitting the 7 day mark, assuming your ss starts when he started lantus.

my guess from his numbers is that he's very likely to just not be getting enough insulin, but i'd like to suggest a change to your testing pattern. instead of testing every hour, which will ultimately make you feel like you're going through your bank account in no time, i'd encourage you to test something like +2 or +3, then give it maybe 2-3 hours til you test again. then make sure and get an evening test, right before you go to bed. for some unknown reason, cats often go lower at night, so we like to see cats checked before you go to bed.

i'd encourage you to post over in the Lantus TR forum so we can help you know better when to test and how to adjust doses. basically you want to test preshot, like you're doing, and then get a mid-cycle test in so you can see how low Leko is going. dosing with Lantus is based upon the low number of each cycle, which is why we're interested in the low point of each cycle.

I saw on your last post that Sienne gave you links to some good information on food. There are a lot of good posts at the top of the Lantus Tight Reg forum - here's a good place to start: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=18139

it's a lot to absorb - do you have any questions?
 
Leko has been on Lantus for over a month at .5u. Vet is hesitant to increase his dose, so I'm trying to gather more data. I started home testing because he is still symptomatic (lots of drinking and peeing) which would seem to indicate it's likely we need to increase his dose. Could also be thyroid.

I realize testing less often is good. Let me explain how the Jan 10 testing went... +1 and +2 because I'd like to nail down when the insulin starts to work and it was convenient today. +3, 4, 5 because I'd like to catch the nadir and holy crap earlier numbers seemed high. +10 was when I could get back to it, +11 because I wanted to make sure he was headed back up.

I'm going to try to get some night data tonight.

I went through all (most?) of the stuff at that link. Think I have a decent handle on it...

I think I'm mostly looking for a logical look at this so I can work it out with my vet. I'm worried she'll only see the low numbers on 1/7 and 1/8 and be afraid to up the dose.

So from here... you'd suggest AMPS, then one or two during the day spaced out, PMPS, and try for a post shot pre bed test. Reasonable.

Thanks!
 
Thanks to the couple of people who suggested getting night numbers. He just tested at 69 at +2.

He dropped down to 48, is headed back up at +3.
 
hi again heather!

when you drop below 50, we always reduce the dose by .25units. so you would give .25 units (that's 1/4 unit) as the new dose now. i'm a tiny bit confused because you mention 48 in the post above, but the spreadsheet shows a 51. either way, i think that's close enough in a newly diagnosed (and a month is still newly diagnosed) kitty to call for a reduction.

your 334 this morning was a bounce from that 48 last night. looks like it might already be clearing from the 141 you posted this morning.

you might just have a bouncy kitty - some cats do that. let's see how he is on a .25 dose and if the bouncing settles down. you can eyeball the syringe for that dose - or look on this link for an example of what it looks like. http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=18139
 
Hey Julie,

I just gave him .5u before I checked in here. I haven't tested at night much (we tend to dose before bed), but based on the data I do have, I'm thinking a few things...

1. His PMPS was the lowest I've seen. I'm thinking it's wise to wait for a higher number before giving him his shot. It's often much higher right before bed.

2. Related to that, he eats with less enthusiasm in the evening and his BG maybe is sensitive to what he eats. And more variable depending on how much he eats.

From here on out, we're planning to give him the beef flavor (higher carbs of his 2 current flavors), make a point of making it more enticing with warm water, and being sure to give him a little time to eat before PMPS and his shot.

He was totally asymptomatic, so it's possible he's been dipping that low at night. I was just trying to get some nighttime data as suggested here. I'm going to try to get more to work with - maybe that will help clarify the picture a bit.

The comment on my spreadsheet about the 48 was between the numbers on the chart - I was watching to see his numbers start to head back up before going to bed.
 
I usually give him shot while he eats. I'll be giving him more time to eat in the evening to make sure he eats enough first.
 
I test, then feed him while I give him his insulin. Exception will be evenings I'll feed first to make sure he eats enough before insulin.

For evenings, is it better to test before food?

Also, we leave his food out. So it's possible for him to eat in the last hour before testing, but usually he eats all his food earlier.
 
Ideally you don't want Leko eating in the 2 hours prior to his shot so you get a true number not one that is influenced by food. Food will take about 15 mins to affect the BG. Suggest you get test about 15 mins before shot time then give Leko food and then shoot.
 
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