Funky numbers...

I feel like I'm reading Chinese trying to figure all this stuff out. I'm frustrated and confused. Today Jade went from 265 amps to 78 in just 3 and a half hours. Lowest she's gone so far. I panicked. Feed her treats and gravy food. I skipped last night shot because she was only at 120 pmps. I test, feed and shoot at 11 and 11. This morning I went a half an hour early, could that be why? I'm trying to get back to 11 and 11 asap. Tonight I tested, fed and shot at about 10:45 and hoping starting in the am I will be back to 11 and 11. Is this ok?

 

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No....because you didn't shoot last night.

IF you had shot last night at 11 and then shot at 10:20am this morning, that would have been 40 minutes early and could have (but not necessarily would have) caused a lower number. Early shots can act like a dose increase and late shots can act like a decrease in dose

Yes.....if you need to change your shot schedule, we recommend changes in 15 minute per cycle increments, so 10:45pm tonight would be fine for 11am tomorrow morning.

I think you meant 265-87

When's the first time you'll be able to run a curve on Jade? Testing every 2 hours for 12 hours?

 

Yes. That is what I meant. Thank you. I won’t be home for 12 hours straight anytime soon.
Maybe Monday I can do frequent testing, but not quite every 2 hours. I did do that last Monday tho!

 

Is there any way you can change your shot schedule so you'd be able to get a +2? I don't know your work schedule (but I seem to remember it's pretty nuts)

Other than that, just try to always get at least a +2 or +3 on the PM cycle (yes, we're all sleep deprived...LOL)

That may help us see what's going on better

TRY not to overreact if he's above 68....a little low carb food can usually help keep them from dropping without sending them to the moon

 

Yep! A +2 is pretty doable. Like now for instance. Staying up so I can test her again in a few minutes. That would be at 1pm and 1am which is pretty easy. I run a restaurant and am typically gone from 2:30-10-10:30pm.

 

Hi Jill, I just wanted to pop by and say welcome. You are in the right place. Like Chris suggested I would also encourage you to find a protocol you can stick with (TR or SLGS). I am new here by a few moths, and I found that copy pasting information from the stickies to a Word document, printing them out, and keeping them in a binder was helpful to me. I re-read them until I started remembering the info, and have it handy to reference. And don't worry about that 87 - that is a very healthy number. I think lots pf people here would love to see an 87 on one unit of Lantus! I am up to 7 units now, it has been a very overwhelming ride but you can tell by the color changes on my SS that Shmee is doing much better these days. Trust the process

 

That would be great....a lot of times that +2 can almost predict what's going to happen later in the cycle so if you can start trying to get that as often as possible, maybe we'll see what Jade is planning on doing later in the cycle

 

So her +2 is basically the same (320) is that normal??

 

Hi! Thank you for your response! I think because the Vet said that 100-300 is Jades desired range, the 87 freaked me out. That and thinking that she was headed down into that slippery slope of Hypoglycemia ( my biggest fear) . It’s the first time she’s been in the green. Usually I’d be at work at that time and the thought of not being home if that happened keeps me up at night. I just have to find a way to make sense of all of this. I should have paid more attention in school!! Lol! But true!
I’m happy to hear your fur baby is doing well!!

 

I gave you this info the other day (but I understand.....people had to explain the same thing to me 100 times before it started to "stick" in my brain!)

Now ECID of course, but we've seen these "rules" apply enough times to most cats that they're a good place to start

If the +2 is about the same as the PS, it's usually going to be a pretty normal cycle....gradually lower to nadir and then gradually back up to the next PS

If the +2 is higher than the PS, that's usually the sign that a bounce is starting and it's OK to take a pokey break (and get some sleep if possible!)

If the +2 is lower than the PS, that's your "early warning sign" that you better plan on getting more tests in later in the cycle.

Some cats do better with predicting at +3, but most seem to follow the "+2" pretty well.

 

You’re absolutely right! You did!
I’m sorry! I have now taken a screenshot of this and will refer to it often. So this is a good number and off to bed I go. Yaaaaa!! Thank you again for all your time, feedback and advice.

 

It is a bit lower, but about the same. I don’t wanna make a mistake here...

 

Should be a totally safe cycle.....when we look for "lower", we mean more than a few percentage points

Get some sleep!!….that's where I'm going!!

 

Goodnight, Chris ( and China)!

 

Jade says thank you as well

 

This morning amps is 159. I will always use the basic rule of thumb as far as the +2 number being higher ,same or lower. Thanks for everything!Happy Sunday!

 

I totally understand. Hypo is a very scary thought. The sticky about hypos is extremely helpful.
You will find that your vet might have some differing info than this forum. A good piece of advice that someone here told me in the beginning was to ask your vet how many diabetic cats they have gotten into remission. This seemed daunting to me at first, but if you're like me just having their answer in the back of my mind helped me gauge their advice. My vet had "very few". In comparison, this Lantus forum alone has helped 403 (I believe that is the latest number) cats go into remission since 2008. That is a lot considering most vets to not achieve many remission success stories. Most vets goal is your get to get your cat regulated, which is why they told you 100-300 is a good range. I think "renal threshold", where basically their organs are functioning properly, is under 280. This is probably the goal for your vet. I assume your long term goal is to get him into remission. That is our goal here. Your vet might also suggest a dose increase by a full unit. Mine did. We increase by .25 here, until you surpass 5 units like me, then increases are .5. There is not a .25 marker on the syringe and I really freaked out about that at first, but honestly it is just an eyeball estimate. Halfway between the full unit and a half and you got a .25. You can read over the LANTUS & LEVEMIR - TIGHT REGULATION: SHOOTING & HANDLING LOW NUMBERS sticky for more info and pictures for shooting .25. I hope that all makes sense. Like I said I know its so overwhelming at first! I love the name Jade and such a pretty kitty! Love her eyes

 

Also above everything - remember ECID (every cat is different). Like Shmee sometimes does not follow that +2 rule. It is still good to get though, and really any tests you can. Think of the SS like a puzzle, if you did not get a +3 today, get one tomorrow or the next few days. Same as in the middle of the night. Set an alarm for a random +5 or +6, just to get some data. Try to find her nadirs (lowest number of the cylcle) because this is how you are going to base your dosing in the future.

 

Thank you for all that info!! I will most definitely ask my Vet. I’ve only tweaked her dosage once ( from one unit to .5) when I thought her number seemed a bit low. That’s all very new to me.
And I named her Jade because of her stunning eyes!

 

I was given a general rule of thumb.
If the +2 (or +3) is higher or about the same as PS it should be a good cycle. Of its lower, I should be on alert.
Today the amps was 159 and +2 was 150. I opted to hold off on my plans and test again in about 15 minutes

 

Yes true, but not just lower, they say if the +2 is about 25% lower than the shot time than yes it should be an active cycle. So for a 159 AMPS, if he got down to around 119 at the +2 then it will probably be in active cycle. Since your +2 was 150, you should be good to go for a while if you have plans If this were me, I would probably get another test in two or three hours if I was able. For you since you want more data, if you are available to test in another two hours from when you got the 150 I would go from there.

 

Her +2 is 123. I think I’m going to stay around and continue to test throughout the day/ evening. Make this a curve day. Ideally, what time (ish) should I see the lowest number before she starts to rise? +6-+7?
Thank you for taking the time to help!!

 

No problem I try to help when I have time because I know it was very overwhelming for me in the beginning. I am just a newbie though, Chis and lots of others here are much more experienced but I can certainly try and help where I can.
Making this a curve day if you have time is great! I don't really think there is a right or wrong to when a nadir is, maybe others can give you more info on that, but most cats normally nadir around +4 to +7. Another valuable lesson just to keep in te back of your mind- their patterns can change.
I am off to try and take a nap now (see my SS I got like no sleep haha!), but others should hopefully be popping in here to help if you need it!

 

I shouldn’t panic unless I see her dip below 70... correct? And if that happens, Greenies and Gravy?

 

Did you read over / print out the stickies? The how to handle low numbers stickie I linked before explains what to do for lower numbers. First is always try not panic
Have you figured out if you are committing to TR or SLGL yet?
PS - your streak of blues and greens look wonderful today!!! If you are doing a curve, you don't have to do every hour, you can do every two hours. But if you want to do every hour more power to ya Do you have Neosporin for her ear? Every once in a while I would put Neosporin on her ear since we prick them so much. My Shmee actually ended up being allergic to it and some ear hair started to fall out. If that happens to you its ok, you can always try this stuff: Halo Healing Salve. It was recommended to me here and he has never broke out from it.

 

Hi!! Yes! Her numbers are lovely!!im going to
Now do every 2 hours. Just wanted to get an idea of the curve upwards. She’s on the rise so I can breathe and take a walk. I’m using the Neosporin. She has a bruise or two from the other day. Poor baby. But doesn’t seem to
Mind the pricks if I distract her. I rub them frequently to make sure she’s not sore. Thank you for checking in on me! Hope you had a nice, long nap!!

 

Thank you I did! We are lucky, Shmee doesn't mind pricks either
For reference, I follow TR and I do not give anything high carb until he gets down to 50 or below (and then I only give about a tablespoon of gravy HC food). If you are uncomfortable with something above 50 like 70 and you think she is going to keep going lower, you can give her her regular LC food. This will bump up her blood sugar a little and help her to "surf" the nice numbers and not go down too low. If you get down to 50-60, you can even do a "medium carb" mixture where you mix a little bit of HC food with your LC food, to try and get her to not go lower than 50. Again I follow TR though, I think SLGS may be different I am not sure. Like the last two nights - you can see on my SS he got down to the 60's and I gave him his regular LC food at those times to try and get him not to fall any lower.

 

She's using the AlphaTrak…..so on TR, reductions are below 68

On SLGS, reductions are done if they drop below 90 on either a pet or human meter

 

Right thank you Chris. Sorry I did not think of that.

 

Below 68 is your "time to act"

Stay away from the Greenies if you can. Dry food (and treats) take longer to break down and get into the bloodstream, so you're better off using the gravy off a "gravy lovers" type food. Most of us have a few cans of Fancy Feast Gravy Lovers in our "hypo kit".....pop the top off, put it back down on the can and "squeeze" the gravy into another bowl....most of the carbs are in the gravy part and just a teaspoon or two is usually enough to bring them up without sending them too high.

We also don't want to over-feed in case they do continue to drop and we need them to eat later....so a few teaspoons of just the gravy is usually enough to bring them up without risking them filling up

 

I have a few cans of Frisky’s with gravy, is that as good for a carb push? I went and bought all varieties of the treats ( orijen) and she only likes the ones with the arctic Char in em. So that’s whats she’s been getting. I think you’re the one that recommended them, thank you!

 

Probably.....anything over about 16% is high carb, so you can always compare on the food chart before you buy

 

ok...here's where I get confused..I just tested her and she's at 93(+9) which means she's going back down when I was under the impression that once she started going back up after nadir, she would slowly continue to do so until her pmps? Now I'm not feeling so confident. Is this normal?

 

Yes it can be.....Lantus is famous for a "double dip" sometimes where they drop again sometime after nadir (but not lower than they went at nadir)

 

What do I do if she drops below 91?

 

it would depend on how much lower and when

there's no pat answer

I'd just plan on getting a +11 tonight so that when you do your PMPS, you'll know if she's going up

 

She’s back up to 130. Hopefully by 11:00, she will be ready for her dinner and shot.

 

pmps is back down to 120...I just don't get it but am not comfortable with a shoot. Shes eating now. I hope I'm making the right call.
I feel defeated. FB sucks. I will check her again at +2 and hope its back up so we can both sleep.

 

You might want to consider dropping her dose to .75 if you're concerned about not shooting the lower Pre-shot numbers....at least until you get some experience shooting those lower numbers

 

Since it’s been an hour and a half, it too late. I did this once before and another time I gave her .5. Makes me uncomfortable playing with her dose. Poor Kitty. I hope she feels ok through all these peaks and valleys.

 

I'm not talking about changing her dose all the time......I'm talking about reducing it and holding it until you're a little more comfortable.

Lantus doesn't do well with frequent dose changes anyway, so we want to find a dose that you feel comfortable giving every 12 hours without having her drop too low for you to shoot

IF you were doing SLGS, she would have earned a reduction by dropping below 90 (which is another reason you need to decide on a dosing method...TR or SLGS.....so we know when to recommend reductions)

 

My syringes are only whole units.... but I think I can go a bit under the one unit line pretty easily. Do you think that’s ok?

 

She’s back up to 235 @ +2. Time for some sleep. I will check in the morning and follow any and all advice you have for me.
Thank you, Chris.

 

I'd suggest getting some syringes with half unit markings as soon as you can. WalMart has them for $12.58/100

The key will be keeping the dose consistent, not necessarily being exactly .75.....it might help to use some kind of colored liquid and pull up what you decide is .75 into a syringe and then you'll have something to compare to when you're doing the real thing.

I can't stay on any longer tonight anyway, so Goodnight!!!

 

Goodnight and thank you!

 

When you have a little time, you might want to read "Making the most of your Lantus Insulin support group experience"

If you look at how the rest of us post, there's a "formula" we all use so that it's easy for people scanning the forum to look at the Subject line and see how each cat is doing. That way if we see something concerning, we check those posts first.

Also you can use the ? prefix on the subject line if your post includes a question

 

I sure will. Go to sleep!!

 

Are those the correct ones?

 

No

All these syringes have half unit markings (very important when you're doing microdosing) and are the correct syringes for U100 insulin and are available from ADW online:
UtiCare
Monoject
Carepoint
Sure Comfort
B/D

They're also available at WalMart if you have one near you. Their Relion brand 3/10ml, 30 or 31 gauge, 6mm or 8mm insulin syringes all come with half unit markings and are only $12.58 for a box of 100 (although a lot of them don't realize they DO come with half unit markings!)

 

I wish there was a Walmart near me, but sadly there is not. I will order these today tho. Her +11 is 351 ( i expected a high number after skipping last night)
I should expect a lower number at +2 under the circumstances? Thank you for taking so much time for me, Chris. Makes me tear up when I think about how much I'd like to give you a hug!

 

Tried to order and they need a doctors ok. Don’t think that’s gonna be possible.

 

And Walmart doesn’t have them online.

 

Looks like IL requires a prescription for over 20 syringes.

 

That's what they said. Amazon shipped them with no problem tho....they don't seem to have the half unit ones tho. I'm gonna try Amazon again just to make sure. I'm guessing my Vet will say no to me tweaking her dose.

 

Found a Walmart! Wooooohoooooo!!

 

For 3 months Walmart has been out of Relion insulin syringes..switched to Easy Touch by pharmacist and then BD??? Is Walmart getting rid of Relion U-100, 31 gauge, 8 mm, one half unit markings? The pharmacist nor the main corporate office are sure what is going on....She said that they have to order them themselves now? I a not sure what this means but don't like switching syringes...or is it just my Walmart??

 

I haven't had any problem getting them and haven't seen anybody else having any long-term issues either.

I know occasionally someone says they can't get them, but it seems to be a short-term problem

 

They had them at mine also.

 

Thanks and sorry..may have jumped the gun. Frank got last 2 boxes today..Pharmacist ordered 3 additional for him BUT says "I don't know if I'll ever get them. Distributor stingy with us??" Maybe it's our store.