What am i doing wrong?

[Chelipepper]

I have been following the guidelines of going a week with a starting low dosage of lantus and then increasing by .25 after each curve test if numbers are not around 300 by AM/PM shot and nadirs are higher than 90 during curve. I am currently at 2 units a day for Oliver and instead of his numbers getting better, they are actually going up.

His spreadsheet is current @ the link. (For his first week of lantus, I originally started off using it to "cover" his numbers...that data I deleted from the spreadsheet after I read the other info re depot and using a steady dosage instead of coverage. The numbers on the spreadsheet start with when I was administering the lantus correctly. Curves are on separate lines in spreadsheet -and the dates where u see an entry at the 10hr point are the days im working a 12 hr shift at work and so have to give him his shot 2 hrs early)

Thanks in advance to anyone who can help me .. I am losing my mind with this ..

 

[KelticAngel]

Do you remember what was going on around the 14th and 15th of this month?

There's a strange anomaly in his BGs where they were suddenly super high (510 from 383).

I have been following the guidelines of going a week with a starting low dosage of lantus and then increasing by .25 after each curve test if numbers are not around 300 by AM/PM shot and nadirs are higher than 90 during curve. I am currently at 2 units a day for Oliver and instead of his numbers getting better, they are actually going up.

His spreadsheet is current @ the link. (For his first week of lantus, I originally started off using it to "cover" his numbers...that data I deleted from the spreadsheet after I read the other info re depot and using a steady dosage instead of coverage. The numbers on the spreadsheet start with when I was administering the lantus correctly. Curves are on separate lines in spreadsheet -and the dates where u see an entry at the 10hr point are the days im working a 12 hr shift at work and so have to give him his shot 2 hrs early)

Thanks in advance to anyone who can help me .. I am losing my mind with this ..

 

[Lisa and Witn (GA)]

Is Oliver still eating dry food? If so, I think that may be part of the reason his numbers are high. How close are you to switching to all canned? Once you start feeding all canned you may need to lower his does. Dry food, even "low carb" food still can significantly increase BG levels.

 

[Bron and Sheba (GA)]

Hi
You are still very early in the FD journey and it will take time for your kitty to become regulated.
Are you able to get any more tests in during the cycles? During the past 11 days you have only 2 tests that were taken during the cycles. It is possible that Oliver is starting the cycle with a high number, dropping low during the cycle and then bouncing back up in time for the next shot. This is a common occurrence. The only way to tell if this is happening is to get some tests in during the cycle. Getting tests in around + 4 to +8 will give you an idea what is happening. You need to do this on several days as some of the days he could be bouncing. Bouncing can happen if kitty drops too low, drops too fast or drops lower than he has been used to and his body panics and dumps glucose and regulatory hormones into his blood stream and his BSL shoots up causing what we call a bounce. Bounces can last from 1 cycle up to 6 cycles. That is why you need to test more than just one cycle.
Also if you are able to get some tests in during the pm cycle that would be valuable data. Cats often drop lower at night. If you can get a before bed test each night it will tell you if Oliver is going to drop lower that night which will mean you will have to set your alarm to wake up and test him later in the cycle to ensure he is not dropping too low.
Do you leave food out for Oliver when you go to work?

It is hard and frustrating in the beginning but it gets easier. Keep asking lots of questions and we will help you.

 

[Chelipepper]

The only strange thing that happened over that time period is that I was ill and so overslept and didn't give him a dosage until much later on the 14th, but that actually happened after the high rise in his BG.

Do you remember what was going on around the 14th and 15th of this month?

There's a strange anomaly in his BGs where they were suddenly super high (510 from 383).

 

[Chelipepper]

I have 8 other kitties and they eat dry as well as canned. I have amped up the can giving, but my cats all have different eating styles eek ..so I cant just lift up the dry food or the cats I have that eat cat slowly -or dont really eat much can- and basically graze all day would not be eating. I have switched to a higher protein/low carb dry food but yes, I note that even the "best" dry cat food is not going to be as beneficial as canned food. Oliver eats more canned than anything else. I close him in with a dish of canned right after his AM and PM shot and he eats it all (between 3-5 oz, depending on his appetite), so he is getting the least dry food of anyone in the house. Unfortunately, I dont have a way of keeping him shut away from the dry food (we live in an apartment, so cant keep him on one floor while everyone else and dry food is on another)..he also doesn't like to be shut into a room away from everyone else -and I wouldn't want to do that to him on a 24/7 basis..no quality of life there for him. I do believe that food is actually playing at least a part in the numbers, tho ..I might add an additional time of feeding him canned. My dream would be all of them to be on canned and each of them to eat what they need to get in an alloted time each time I feed them..hows that for a dream? lol Thank u so much for taking the time to answer me and helping me to focus re the feeding. I appreciate it

Is Oliver still eating dry food? If so, I think that may be part of the reason his numbers are high. How close are you to switching to all canned? Once you start feeding all canned you may need to lower his does. Dry food, even "low carb" food still can significantly increase BG levels.

 

[Chelipepper]

Thank u so much for taking the time to give me a thorough and insiteful answer. The problem with timing is that I work overnights on nursing and often have odd shifts hour-wise ..I work 2/8 hr shifts and 2/12 hr shifts and get called in for a lot of extra. The 12 hr shift nights particularly worry me because on those nights, Oliver is getting his lantus 2 hrs early on the insulin schedule. Another issue is I normally dont get 2 days off in a row except every other weekend..it makes it difficult for the testing because it means that day I basically dont get sleep as the goal is to test him every 2 hrs. (The Reason for the spotty testing on my curve days-with autoimmune, I would be literally making myself sick on the days I have to wake up every 2 hrs to test. I try to get 4 hrs of sleep in on those days and then test as close to the 2 hrs on the remaining time left to the curve before I head to work again.) Working the overnight also means Im not home to test him at night, but I CAN do some extra overnight testing on the days im off-and I will.

Thanks to your suggestion, I will definitely add more full curve testing in to see what is going on. I think what I will do is continue to try to do the once a week curve testing on my single day off closest to that 7 day period ..and then also add another curve test on one weekend day of the weekend I am off -no matter how close to the 7 day period I am. (If that makes sense) ..it will give more data.

Yes, dry food is left down all day-Oliver is currently getting 2 feeding times for canned food -right after his shot-in which he normally consumes 3-5oz of canned. .. I posted on another reply that I am also going to add another canned feeding time in for him to try to get him to eat even less of the dry food he might be "snacking" on. Lifting food is not an option, unfortunately as I have 8 other cats..some of whom eat slowly with canned or dont like canned and eat less than the others during their canned feeding time.

Hi
You are still very early in the FD journey and it will take time for your kitty to become regulated.
Are you able to get any more tests in during the cycles? During the past 11 days you have only 2 tests that were taken during the cycles. It is possible that Oliver is starting the cycle with a high number, dropping low during the cycle and then bouncing back up in time for the next shot. This is a common occurrence. The only way to tell if this is happening is to get some tests in during the cycle. Getting tests in around + 4 to +8 will give you an idea what is happening. You need to do this on several days as some of the days he could be bouncing. Bouncing can happen if kitty drops too low, drops too fast or drops lower than he has been used to and his body panics and dumps glucose and regulatory hormones into his blood stream and his BSL shoots up causing what we call a bounce. Bounces can last from 1 cycle up to 6 cycles. That is why you need to test more than just one cycle.
Also if you are able to get some tests in during the pm cycle that would be valuable data. Cats often drop lower at night. If you can get a before bed test each night it will tell you if Oliver is going to drop lower that night which will mean you will have to set your alarm to wake up and test him later in the cycle to ensure he is not dropping too low.
Do you leave food out for Oliver when you go to work?

It is hard and frustrating in the beginning but it gets easier. Keep asking lots of questions and we will help you.

 

[Chelipepper]

Thank u for the answers provided, each of u helped me to focus on my plan with Oliver.

Going forward, I will add more curve testings and also do some overnight tests on the nights im off (ill update the spreadsheet as I go along) I am also going to give Oliver one additional canned feeding time during the day to make him less likely to snack on dry food that is left down for the others in supplementation of their canned food.

Thanks again ! I am also open to still getting "answers" from anyone else who would like to reply as well as any information is appreciated and thrown into my mental stew pot

Oliver and I both thank u!

 

[KelticAngel]

Wow, you have a complicated situation!! You can be proud of yourself for the work you're putting in for dear Oliver. I think all of those things you are planning on doing are great ideas, and will give you a lot of valuable information.

The only other thing I can see that you might need to consider is those days when he's getting his Lantus 2 hours early - that can sometimes act like a dose increase. Lantus needs to be on as much of a 12-hr cycle as possible. That means if his usual dose time is 7am/7pm and you need to dose him early (5am) because of work, then his schedule should now be bumped to a 5am/5pm rotation.

There's more info on how to adjust scheduling here.

 

[Lisa and Witn (GA)]

I understand about trying to change all of your cats over to canned. I have been there myself and know the challenge. I had 8 cats at that time also. One trick that helped me was to start mixing the canned food in with their dry. I started with only a small spoonful and gradually increased it while reducing the dry. It took several weeks before all of them were eating canned. Towards the end I was only adding a few pieces of dry on top of their canned food.

 

[Chelipepper]

My issue with the early dosage is not that I have to move time for workschedule as much as if im working a 12 hr shift and have an hour and a half commute to get there, , there is literally no way possible for me to give him his dosage on time. Our 12 hour shifts run 7p-730a and then 7a-730p. If I get off of work at 730a, im home at almost 845ish.i give him his insulin after testing his BG its now almost 9a.. I have to be at work at 7p, with the commute I have to be out the door at 5:30p .. so hes getting his insulin at 5:25p. There is no room for me timewise to bump back or forth. Thankfully ..I only work 2 12 hr shifts a week, but even when im working an 8 hr shift, my end time is 730am, so not home til 845. No problem on the days I start at 11pm ..but on the days I have to be there at 7p, his meds are going to be early

Wow, you have a complicated situation!! You can be proud of yourself for the work you're putting in for dear Oliver. I think all of those things you are planning on doing are great ideas, and will give you a lot of valuable information.

The only other thing I can see that you might need to consider is those days when he's getting his Lantus 2 hours early - that can sometimes act like a dose increase. Lantus needs to be on as much of a 12-hr cycle as possible. That means if his usual dose time is 7am/7pm and you need to dose him early (5am) because of work, then his schedule should now be bumped to a 5am/5pm rotation.

There's more info on how to adjust scheduling here.

 

[KelticAngel]

Wow!!
That's super complicated. Yikes.

Have you tried other types of insulin? Lantus is specifically designed for that consistency and won't work very well if it doesn't have it. It's one of those ones that will bring the BG down and keep it down nice and smooth. It's one of the least flexible of insulin options, from what I've been told... It's magic is in the consistency.

My issue with the early dosage is not that I have to move time for workschedule as much as if im working a 12 hr shift and have an hour and a half commute to get there, , there is literally no way possible for me to give him his dosage on time. Our 12 hour shifts run 7p-730a and then 7a-730p. If I get off of work at 730a, im home at almost 845ish.i give him his insulin after testing his BG its now almost 9a.. I have to be at work at 7p, with the commute I have to be out the door at 5:30p .. so hes getting his insulin at 5:25p. There is no room for me timewise to bump back or forth. Thankfully ..I only work 2 12 hr shifts a week, but even when im working an 8 hr shift, my end time is 730am, so not home til 845. No problem on the days I start at 11pm ..but on the days I have to be there at 7p, his meds are going to be early

 

[Chelipepper]

I will run Oliver thru a few more weeks of the lantus and see how he does. (I have a nurse friend who works straight 12s and her kitty does ok with the lantus, even tho its not a 12/12 for him the days of the week that she works .. her cat went almost seamlessly into Lantus tho with perfect BGs of 275ish preshot after the first week . Oliver is not going to be like that, apparently ..soo.. we might need to consider a conversation with the vet in a few.

Wow!!
That's super complicated. Yikes.

Have you tried other types of insulin? Lantus is specifically designed for that consistency and won't work very well if it doesn't have it. It's one of those ones that will bring the BG down and keep it down nice and smooth. It's one of the least flexible of insulin options, from what I've been told... It's magic is in the consistency.

 

[Chelipepper]

I feel your pain ...what did u do about the 'different eaters'? ..I have some that eat 3 oz within 10 mins in one sitting ..I have some that eat a few crumbs and then want to come back 10 mins later , eat a few more crumbs and then want to come back ..and then I have one whos a vacuum cleaner and who wants to eat his, the crumbeater's and everyone elses lol

I understand about trying to change all of your cats over to canned. I have been there myself and know the challenge. I had 8 cats at that time also. One trick that helped me was to start mixing the canned food in with their dry. I started with only a small spoonful and gradually increased it while reducing the dry. It took several weeks before all of them were eating canned. Towards the end I was only adding a few pieces of dry on top of their canned food.