? 1/11 Archie - Let him keep bouncing or stop insulin?

Discussion in 'Lantus / Levemir / Biosimilars' started by cmb, Jan 12, 2018.

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  1. cmb

    cmb Member

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    Dec 29, 2017
    Hi,

    I'm so frustrated by Archie's numbers. I'm seriously thinking that him spending so much time in crazy high numbers might be worse than not give him insulin and therefore not drop at all. He lost weight again and is down to 9 lbs (from 12 lbs) in October. He was diagnosed at the vet with 374 - after two weeks of insulin I'm GLAD to see a 300 number from time to time. Is this normal?
     
  2. Carol in Chicago

    Carol in Chicago Member

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    Apr 5, 2017
    He has responded well to insulin, so please don't stop. I know you are frustrated and worried about high numbers, but if he needs insulin and doesn't get it, it would be worse.

    Do you need help with the dose to continue?
     
  3. cmb

    cmb Member

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    Dec 29, 2017
    We reduced it to 0.75 after he showed the 87 on 1/9 - but I'm just worried about his bounces. They take up most of the time - so what it comes down to is him spending more time in higher numbers than if he wasn't on insulin. That's crazy. When do the bounces stop?
     
  4. LizzieInTexas

    LizzieInTexas Well-Known Member

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    Jul 25, 2016
    Did you skip that AM shot (01/09)?

    :bighug:

    I know it is frustrating but just keep on.
     
  5. Tracey&Jones (GA)

    Tracey&Jones (GA) Well-Known Member

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    Dec 12, 2016
    That 1 unit seemed to get him to some nice blues.

    Are you following the TR or SLGS?

    Those bounces are his body's response to lower numbers. It is trying to learn what is needed. Some cat's are just bouncy. And yeah, those bounces get frustrating as they can take up to 6 cycles to come back down. Unfortunately, that is just part of the journey with some cats. As Archie spends more time in the lower numbers hopefully his body will get used to that and bounce less.

    The motto it is a marathon and not a race is very correct....
     
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  6. cmb

    cmb Member

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    Dec 29, 2017
    Yes, he was so low (131) that we didn't give that shot. I think the SLGS protocol says not to shoot below 200 and our vet said not to shoot below 250.
     
  7. cmb

    cmb Member

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    I thought we should follow SLGS, but someone said we're actually testing enough to follow TR. However, my husband is out of town this week and I don't get as many tests in as usual. I like the shorter wait times for dosage adjustments in TR though and we finally got the half-unit syringes.
     
  8. cmb

    cmb Member

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    Dec 29, 2017
    Technically this is how it should work, yes. But in reality and when I look at the spreadsheet, he is spending more(!) time in higher numbers(!) due to the bounces. How will he get used to the lower numbers then?
     
  9. Tracey&Jones (GA)

    Tracey&Jones (GA) Well-Known Member

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    Dec 12, 2016
    By pushing him lower in a gradual manner until his liver quits being a Panicky Pete and dumping excess glucose. I have found, looking at a many spreadsheets, in the higher numbers the bounces seem more extreme but as the cat's body begins to be more comfortable with regulation/regular numbers the bounces are not as extreme and don't tend to last as long. Think of it like conditioning for muscles - you keep upping the weights until you can leg press 200lbs - you don't start off there. Trust me, there was many sessions and sore recoveries before I got there.

    You are testing enough and even with DH away - you only need 4 tests. PS and one before bed and one out the door/just in the door during the AM cycle. No other health issues and no dry -if you can work it I would suggest TR.

    If using TR he didn't earn that reduction however that 87 would of just skimmed him under SLGS.

    For now, you are 6 cycle into .75u so you next move is based upon whether you are using TR or SLGS.
     
    Last edited: Jan 12, 2018
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  10. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    The SLGS method (not a protocol) says that in the beginning, not to shoot below 150. Between 150 and 200 there are options such as a reduced dose, skip, or shoot later when he's up higher. As you gather data on Archie, you'll be able to shoot as low as 90. You are starting to gather enough data so that if you are home and you can monitor, you can shoot lower numbers. Every time you skip or reduce the dose, you deplete the depot, which means numbers will be higher until the depot is back in play. That can take 6 cycles. Today is cycle six. Hopefully the depot is about full and he'll be over the bounce from that green he saw on the 9th. So he should be getting back to lower numbers soon. :bighug: Feline diabetes is a game of patience. Never my strong suit.:oops:

    Many vets still think in terms of the old in and out insulins, where you decide what dose give based on the preshot value, hence the suggestion to not shoot below 250. With Lantus, we dose based on the nadir or low point in the middle, so don't make dosing decisions based on the preshot.
     
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  11. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Hi Archie's Mom! We all know how frustrating the bouncing is but we have a saying around here, "they bounce till they stop" As Carol said, as they get use to being in lower numbers the bouncing will get less. Archie is very new to the Feline Diabetic Dance and his body hasn't learned to work with the insulin yet. But, he will......

    If you can test pre shots, mid cycle and before you go to bed at night ( lots of cats go lower in the PM cycle ) then you can follow the TR protocol and as you said, you can move the dose faster according to the protocol.

    Try to put on the patience pants with the bouncing and next time he is below 90 at pre shot, try stalling for 30 minutes to see if he comes up to 90 so you can shoot and keep up the momentum.
     
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  12. cmb

    cmb Member

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    Dec 29, 2017
    Thanks everyone, I'll put my patience pants on and will follow the TR method.
     
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  13. cmb

    cmb Member

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    So should I go back up to 1Unit if we're following the TR method?
     
  14. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    If it were my kitty and you follow the TR protocol , I would go back up. This is the 6th cycle since the reduction. Unless he takes a swam dive into the PM cycle and pops a green, I would increase.
     
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  15. cmb

    cmb Member

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    Dec 29, 2017
    Argh, after reading the TR protocol - It might be too much. We can't do +3, +6 tests. Also, those 20-30 numbers look very scary.
    What would you do it if we follow the SLGS method?
     
  16. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    You don't have to do the +3 and +6 tests all the time, just at the beginning. You are past that now. Just get a preshot test and one other per cycle, more if they are going lower. I got an average of 5-6 tests per day. The goal is to avoid the 20's and 30's! Reductions are at 50 with TR.

    If you decide to stay with SLGS, hold the dose a week, so three more days after today, then evaluate the dose and decide if you need to increase. You would increase at that point if you hadn't seen anything below 150. The goal is to find a dose where the low points are between 90 and 150.
     
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