? Could this be regulation beginning?

Discussion in 'Lantus / Levemir / Biosimilars' started by Idjit's mom, Apr 20, 2018.

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  1. Idjit's mom

    Idjit's mom Well-Known Member

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    Idjit has been below 150 for 3 days. He's in the blues, except for his dip on Wednesday. I have not been giving insulin 2 days now. He's eating well, being his usual self (bopping on our heads at 5:30 am, cause it's light out and time to get up an eat!) I don't know what to think, perhaps all wet, low carb diet is working? Your thoughts please.
     
    Last edited: Apr 20, 2018
  2. Amanda & Shmee

    Amanda & Shmee Well-Known Member

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    Great numbers! I think a reduction is supposed to be done gradually, but I am super new to this so I am curious what others input will be. I would add a question mark prefix to your title.
     
  3. Stacy & Asia

    Stacy & Asia Well-Known Member

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    Can you remind me, you had diet switch in here too, right?
     
  4. Idjit's mom

    Idjit's mom Well-Known Member

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    Apr 3, 2018
    Idjit DX, 4/3, began Lantus 1 U next day. Vet did not tell us to test AMPS, we got AphaTrak , 1st test on 4/6. Vet said to test @ +6 daily. Began eliminating dry food to all wet food diet. Curve at clinic 4/11, vet instructions to shoot 1U AM, test @ +6 Mondays and Thursdays. Learned here should never shoot w/o testing, and should be on 12 hour, not 24 hour shots. All wet food diet for 1 1/2 weeks.
    Called vet last Tuesday, she maintained 24 hour schedule works, said ok to test, then if -200 no shoot, it 200-250 repeat BG in 2 hours if 250 give 1/2 U. If +300 give 1 U Advised here sliding scale is no good for Lantus SLGS.
    So, I messed up on Wednesday, scared the crap out of us, and have just been testing, feeding and watching.
     
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  5. Idjit's mom

    Idjit's mom Well-Known Member

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    You are probably right about reduction, I am very new too. I was getting conflicting information and trying to take care of him.
     
  6. Sandy and Black Kitty

    Sandy and Black Kitty Well-Known Member

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    Hi there :cool:

    Amazing what a difference proper diet can make.
    How did you discover Idjit was diabetic? What was his BG at the time of diagnosis?

    In general it's a good idea to taper insulin use down incrementally - from .5u to .25u to .1u.
    Reductions are earned either by dipping below 50 (TR) or below 90 (SLGS) on any given dose, or by maintaining BG in the normal range for a solid week.
    To help ensure a strong remission, before cutting off insulin completely you want to see mostly green numbers (under 100) with only a few random blue numbers between 100 - 120
    (the above numbers are based on human glucometer readings)

    Assuming the AMBG and PMBG numbers are 12 hours apart, at which "plus hours"do you feed him? It would be interesting and valuable to see BG just before feeding, 1 hour later, 2 hours later and 3 hours later. You would not need to get 3 consecutive tests after one meal, you could spread them out, for example 1 hour after breakfast, 2 hours after dinner, 3 hours after a mid day meal. The data would help you know if a it may be a good idea to offer a little insulin support for a while longer, to be sure his pancreas is healed enough to resume full time insulin producing duty.
     
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  7. Idjit's mom

    Idjit's mom Well-Known Member

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    Idjit was drinking more water, he urinated on the floor, it dried a bit and was sticky, he started vomiting. I believe his DX BG was 386. He had lost close to 2 pounds since his check up in January. We now test, then feed at 6am, usually, test & feed @ +6, again @ +12 now. I give him a bit less at +12, then a little around 8:30 - 9:00 pm, in hope of him not bouncing on us at 5am with the get up dance. He does not like testing, it takes both of us to get it done, but it's getting better. I was following vet advice and not shooting below 200. I worry I have messed him up. It appears our attending vet is not as knowledgeable as desired, since never advised testing before shooting, or more than 1x day.
     
  8. Sandy and Black Kitty

    Sandy and Black Kitty Well-Known Member

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    It does get easier. Most of us here, myself included, started out the very same way. The day will come when you will be able to test 'solo'
    Sadly most vets, being general practitioners, are not as knowledgeable as desired.
    You have not messed him up.

    How about getting those post meal tests on different, consecutive cycles? For example, along with the AMBG test, get second test 1 hour after breakfast.Then after the PMBG test get another 2 hours after his meal and after the next days AMBG and breakfast test 3 hours later?


     
  9. Idjit's mom

    Idjit's mom Well-Known Member

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    I just conveyed your suggestions to my husband, I want to clarify test AM, feed, test +1, skip +6 test, test +12, feed, test 2 hours later. Second day test AM feed, test +3, test +12. Is that correct?
     
  10. Idjit's mom

    Idjit's mom Well-Known Member

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    It makes me very angry about our vet's instructions, we could have done irreparable harm in our ignorance. They diagnose, prescribe, and then treat FD without proper knowledge. Why????? Do they treat infections, injuries and other diseases as casually?
     
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  11. Idjit's mom

    Idjit's mom Well-Known Member

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    The only way to be able to test solo, will be to use magic wand to momentarily "sleepify" , ala Harry Potter.
     
  12. PussCatPrince - GA

    PussCatPrince - GA Well-Known Member

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    Made me laugh:cat:

    It is no consolation now, but the testing will get better
     
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  13. Steph & Quintus & L & O

    Steph & Quintus & L & O Well-Known Member

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    Honestly, if you're having numbers like this on an Alphatrack with no insulin, he could very well be going off it. ("Remission", not "regulation" -- regulation is when you're giving insulin and it is helping stay in good numbers.)

    "normal" values for a cat are around 70-120 or even 150 (with a pet meter). I'd continue monitoring him, stick to the low carb diet, and if you start seeing values above 150, think about starting insulin. Otherwise, I wouldn't.

    ETA: if you do start insulin because the numbers are still a bit high, start with 0.25 (or even a drop/0.1) twice a day and monitor closely. Even a drop can make a big difference -- look at Quintus's spreadsheet, the last day he got insulin. It was 0.1 and it sent him right into the lime greens. (1st Jan 2018)
     
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  14. Sandy and Black Kitty

    Sandy and Black Kitty Well-Known Member

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    Correct - assuming you are not shooting any insulin. This will help you figure out what, if any , bump up his BG gets after a meal and if so whether his pancreas can produce insulin as needed to bring BG back down. If you can manage any other additional tests it will help further sharpen the picture.
    That is the $64k question. Most of us here have had similar experiences.

    On the bright side, the universe brought you here - the very best place a diabetic kitty can be. We have been living and breathing FD for more that 10 years.
    I never imagined I could test my Black Kitty solo. He was a 5 year old stray intact male we took in off the streets...and he had BIG teeth...
    However perseverance prevailed :cool:

    Do you give him a treat after every poke?
     
  15. Idjit's mom

    Idjit's mom Well-Known Member

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    He gets treat after every poke, successful or not. I had purchased 4 lb bag Hill's DM, ($$!!) so I give 4-6 pieces. Since we have been testing before meals, then he gets his wet food, which he loves.
     
  16. Idjit's mom

    Idjit's mom Well-Known Member

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    Apr 3, 2018
    The idea of 0.25 and "a drop" makes me quake in my boots. Old eyes here, the lines on the regular syringe are quite close enough. I have located several magnifying glasses, and dusted off the magnifying craft lamp. If necessary, I will certainly try.
     
  17. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Great advice for you here! :smuggrin:
     
  18. Stacy & Asia

    Stacy & Asia Well-Known Member

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    A drop is super easy to measure, and no acute vision needed, really. To get a drop, you depress the plunger on an empty syringe hard, hold it that way as you insert into the vial or pen, release the plunger and voila! There’s a drop of insulin in there. You can try it and then squeeze the drop back out so you can see, but it works.
     
  19. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    You've been doing great -- and so has Idjit!

    A couple of thoughts to add to Sandy's and Stacy's comments.

    Your vet was suggesting to test at around +6 probably because the assumption was that this would be the lowest point in the cycle. Unfortunately, there's no guarantee that the lowest point in the cycle (nadir) is reliably at mid-cycle. Nadir can and does move around and some cats have their nadir either early or late. For example, my kitty's nadir was usually at around +3, except when it wasn't. Getting tests at various points will help you to get a better feel for when insulin onset and nadir occur.

    It is very important to get some tests during the PM cycle. Many cats' numbers drop in the evening. Without PM tests, you don't know if Idjit has earned a dose reduction and you don't know if his numbers are dropping to a point where you need to intervene. It helps to remember that testing is your most valuable tool when it comes to keeping your kitty safe.

    As for the Hill's dry diabetic food, it is crazy high in carbs. It is truly not a "diabetic" food. Also, look at the ingredients: Chicken By-Product Meal, Corn Gluten Meal, Pork Fat, Brewers Rice, Wheat Gluten, Powdered Cellulose, Pork Protein Isolate, Chicken Liver Flavor, L-Lysine, Whole Grain Corn, Lactic Acid, Potassium Chloride. By-products are not muscle meat, which is what cat's need. Corn and wheat gluten are "alternative" protein sources that cat's can't digest and are often sources for allergy. Cat's can't digest rice, either. Cellulose is wood/plant fiber. Cat's are obligate carnivores. Their system is designed to digest protein that comes from animals, not plants. They also need moisture in their food since they have a very limited thirst drive. Dry food contains no moisture, making it hard on the kidneys. This is my long winded way of suggesting you ditch the dry food. If you're looking for a treat or a topper for Idjit's food, many of the cats here are big fans of freeze dried chicken.

     
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  20. Idjit's mom

    Idjit's mom Well-Known Member

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    Apr 3, 2018
    Thanks very much, very helpful and stress relieving info. You are a gem!
     
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  21. Idjit's mom

    Idjit's mom Well-Known Member

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    Apr 3, 2018
    I know now that the Hills dry is not good. I have been preoccupied with finding 1/2 unit syringes, finding proper canned food, learning to test, etc, etc, that I haven't found a good treat yet. We have purchased 2 boxes of wrong syringes/needles, returned one stuck with one, bought the stupid Hill's dry, just a series of goofs. Will look at the freeze dried chicken.
     
  22. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    I understand how overwhelming it is trying to master all of the details of managing Idjit's FD. Like I said, you're doing great and Idjit's numbers are very good!

    I always purchased by syringes online through ADW (adwdiabetes.com). They have a great selection of U100, 3/10cc syringes that are in half unit increments. You'll need to fax them a prescription from your vet for the first time since most states do require an Rx to purchase syringes.

    Another easy option for treats is to roast or poach chicken for your kitty. You can cook a chicken breast, chop it up and freeze some so it doesn't spoil (unless you're rally generous with treats!).

    I would see if you can return the Hill's. If you got it from the vet, let them know that your cat won't eat it. Ditto if you got it at a pet food store. In most cases, they will take a return.

     
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  23. Sandy and Black Kitty

    Sandy and Black Kitty Well-Known Member

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    Freeze dried chicken breast chunks work like a charm for treats after a poke- so much so that we jokingly refer to them as ‘kitty crack’. I recommend you ditch the dry altogether. Since he loves his wet food a half tsp of LC wet food is a better choice for a poke treat.

    So today started at 142 and 2 hours after you got an 86. Did he have breakfast right after the test? When was his last meal before the AMBG test? Please note meal times on the ss, either in the cell corresponding to the plus hour fed or in the remarks column. You will soon see a clearer picture of how food affects his BG.
     
  24. Idjit's mom

    Idjit's mom Well-Known Member

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    Apr 3, 2018
    I did give him some roasted chicken chunks with a smidge of fancy feast for his treat.Ditching dry. Amended ss per meals in comments.
     
  25. Idjit's mom

    Idjit's mom Well-Known Member

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    Apr 3, 2018
    Can't return Hill's it's been opened. Isn't ordering supplies online prohibitive because of shipping and handling? I ordered from DiabetesSupply, mailing almost cost of products. Husband mailed return yesterday, again almost the cost of product. I want off the hamster wheel.
     
  26. Steph & Quintus & L & O

    Steph & Quintus & L & O Well-Known Member

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    Dec 9, 2017
    So you mean he's throwing all those lovely numbers on no insulin and Hill's dry food? Keeper :)
     
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  27. Idjit's mom

    Idjit's mom Well-Known Member

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    Apr 3, 2018
    No, he gets F F and Friskies canned, -7 carbs plus cooked chicken breast sometimes. I was just using a few pieces of the dry as a great after pokes. He used to love his dry. He's a keeper anyway
     
  28. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Even if it's opened, you can return a bag of food. There's no way to know if the cat will eat it if you haven't tried to give into your cat. FYI - if you order from Chewy's (online), if your cat won't eat something or the package is damaged, they give you a refund and ask that you donate the food to a shelter. (And their prices on food are extremely competitive, even on the pricey foods. I've been ordering from them for years.)

    With ADW, there's free shipping for orders over $89. If you're ordering syringes and strips for your meter, it's pretty easy to make the minimum. I also found good prices on strips on Amazon. I would also call whoever you're buying from and ask about free shipping. With diabetes, there's some expectation that you will need to keep re-ordering. It's in their best interest to have good customer service.
     
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