27/8 Jai Jai - AMPS: 400-ish | PMPS: 427, +2: 428; +4: 436; +11: 445

Yesterday’s Condo: http://www.felinediabetes.com/FDMB/...ng-hypo-pmps-400-2-437-4-497-10-5-407.143334/


My Active Thread on the Main Forum: http://www.felinediabetes.com/FDMB/threads/jai-jai-update-and-discussion.143333/#post-1485314


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Hi, everyone. Jai Jai was on 0.5 units twice a day starting from this morning.


No surprise, his BGs all went up all red. His curve was flat, and I assume that he did not swing today.


He is a decent cat when he was sent back home. His picture at the clinic might tell you how moody he was.

 

I'm going to be honest - it's too much to wade through an ongoing thread that is several days old to try to figure out what is current information. It simply takes too much time to figure out if there is even a question or advice needed. Some people on Main Health board do that, but here on Lantus/Lev ISG, everyone is asked to start a new thread every day. From the "New to the Group?" sticky:

*** Daily Threads & Posting Instructions ***

• Please use one thread for all your comments and questions you have that day. This will keep all your questions, comments, and replies together.

• Start your thread with the date, kitty's name, and AMPS

• Your thread will be bumped to the top of the list when you or anyone else posts on your thread.

​

I'm looking at Jai Jai's spreadsheet and seeing that string of hours at 20ish the night of 8/25. Is that correct - not world mmol numbers, but US mg 20's? Bounces can last up to 3 days or so - if I were you, I'd be testing to try to catch what happens when the bounce clears. You can't assume that Jai Jai would be flat today. I would've expected him to clear the bounce today.

I haven't read through everything to see how you got to a 0.5u dose, but that's 1/3 of the dose that got him into the 20's. While I'd have made a significant reduction as well, I'd probably have just dropped to 1.0u. That was a huge reduction in dose, but since you're there, you'll want to be vigilant to test for ketones while he's high, and I'd make sure and get at least one mid-cycle test every cycle so you know how to adjust the dose.

Did you make a decision about what dosing protocol you are using? The Start Low Go Slow or Tight Regulation Protocol?

 

Hi, @julie & punkin (ga) I posted Jai Jai's situation on 28/8 here (http://www.felinediabetes.com/FDMB/...4-2-254-possibly-an-error-3-382-4-367.143416/). This thread does not have new replies, and it sank down to the bottom.

If you would like to take a look at how Jai Jai's going on, you may wish to visit my thread on the main forum (http://www.felinediabetes.com/FDMB/threads/jai-jai-update-and-discussion.143333/). I summarize Jai Jai's case at #2, and connect his daily condo at #3.

I am doing whatever I can to manage Jai Jai's DB. I have little experience in adjusting the dose, but everyone here is so kind to help and peer review one's suggestion. However, I am unable to test his every mid-cycle as no body is in the apartment in day-time.

Regarding the protocol, I intend to go for TR, but I will hold Jai Jai's dose for more days (>6 cycles) considering his hypo incidents so far.

 

I'm with Julie, I started trying to read through Jai Jais stuff yesterday but gave it up as being too hard to work out what's going on. Since you're using Lantus and this is where the lantus experts are I would stick to posting here for dose advice and use the health board just for other issues. The well meaning advice given on health often isn't right for lantus.

He is a very gorgeous boy

 

Hi, @Vyktors Mum . I don't know what I can do further to help you, Julie or others grasp Jai Jai's situation more easily. If you have any idea, please do let me know.

While I get the attention from the main forum most often, I keep posting here to report his daily BGs. Like what you have suggested, I want the experts to chip in Jai Jai's case, but most of the time people are asking me to follow the rules that I seem not violating.

I don't know what I have done wrong, and I don't know why the attention is drawn to the previous thread, but not the latest. I just cannot explain, but it is not what I intend to do.

If it is related to the language, I am sorry that I am not a native. I am unable to use English as natural as you all do.

Thank you for dropping by and trying to know more about Jai Jai. If it gives you a hard time of reading the pieces and bits, I am sorry for all the inconvenience.

 

No problems at all with your English

Just keeping posting his numbers here daily and any other pertinent info about behaviour, eating etc all in one place with the link to your previous day's post. Now that you've decided on following the TR protocol can you add that to your signature as that lets us know what the appropriate dosing advice will be. For TR you haven't been following 'the rules' but no worries now that you have decided that's what you want to do we know which rules to help you follow.

Please also make sure that you always take the PS test, I see that you've skipped a few, so you know that it's safe to shoot. Chances are Jai Jai will need an increase in the next few cycles but I'd like to see a little more data first, e.g. We don't know anything about what happened in the last two days (before today)

No need to apologise, it's all very confusing to start off with but its very obvious how much you love Jai Jai and that you're willing to do everything you can to help him and we are more than willing to help you do that. Deep breaths, I promise that the more you learn the easier it will get

 

I have updated my signature per your suggestion. I did not know the distinction between SLGS and TR, I still do not. There are several differences but I find it hard remembering the details.

But, for the best possibility of remission, TR is the choice. Due to Jai Jai's hypo incidents (five times in these two months), I will change the dose in a more cautious way.

I skipped the PSs because I did the +11. I start feeding Jai Jai after the +11 test. I assume the PS figures will be affected by the food which people tell me this is not desirable. And since Jai Jai is still on high side, I did not test again within the 1 hour time. If Jai Jai's numbers start going down, I will be more cautious about the PS values. And I hope the day is coming real soon.

Bear with me if I do not include as much information as you want. I have quite a demanding job, and I can only squeeze some of my lunch time to type the messages. Anyway, I keep doing the best I can, and I really understand how difficult it is to follow when there has been a lot of things happened in a short period of time. I myself also felt overwhelmed and have problems to clear my mind.

Thank you again for the hugs and care. Sending my hugs and love to you and Vyktor. Cheers.

 

no one is meaning to criticize you, hollis! so don't worry about that! Your English is fine and easy to understand.

Hopefully holding the 0.5u for now will let things settle down.

I would test his urine for ketones once a day for now.

Can I suggest that instead of getting a +11 and feeding him then, you wait to test and feed until +12? Then it is clear what his blood sugar is when you are giving him insulin.

 

Julie, I don't mean that either. I am trying to find out a way that works for me, also for the experienced Lantus users. I need the help so desperately as I was fired by the vet - the vet politely "referred" me to other vets but she assumed that I knocked their doors by myself.

I have to feed Jai Jai after +11 test because he is a grazer and he does not finish his meal in one sitting. He does want to eat but it will take at least 1.5 hours to complete. I cannot leave his plate while going out for work, because other cats will eat up all the leftover.

It will be more understandable to present my daily schedule to you:

5:45am Get up
6:00am Test/Feed (40g)
6:30am Feed (50g)
7:00am Shoot
7:00am Feed (20g)
7:30am Go out for work
6:50pm Return home
7:00pm Test/Feed (40g)
7:15pm Feed (50g)
7:30pm Shoot
7:30pm Feed (20g)

If Jai Jai always has good appetite, I feel fine with test/feed/shoot approach. Sometimes, Jai Jai does not keen on his food, he ate half of the normal portion and then stopped. Or, he needs even more time to finish his meal. This morning took me 2.5 hours. If I do not start earlier, he may not eat enough before my going out and I end up worrying him getting hypo during the day.

If you have some good ideas for sharing, please do let me know. Wish you a nice weekend.

 

Hollis --

I think the glitch is that most Lantus and Lev users post here. This board is typically very active -- more active than the Health board. Members who are very experienced with Lantus/Lev generally hang out here, not on Health. Frankly, I rarely venture over to the Health board and I'm among the most experienced people here. New members are encouraged to get settled using the basics (e.g., home testing, what to feed) and then move over to one of the insulin-specific forums. On the Health board, they encourage one thread. Here, we encourage a daily thread so we don't have to wade through days and days of information. (We link the threads together so we can page back but the most important info is in today's post.)

It looks like from your schedule, you need to shoot at 7:00. Since that's the case, in the morning, I would not be feeding Jai Jai earlier than your AM shot time. There can be a wide variation between your +11 test and a +12 test even without benefit of food. Further, feeding an hour before shot time can inflate your numbers or, if a diabetic cat's pancreas is working, it may cause numbers to drop. In any case, with insulin such as Lantus, onset is typically 2 hours after shot time so it's perfectly find to test-feed-shoot all at the same time. If your vet had told you to feed at least 30 to 60 min. before you were shooting, this information is based on shorter-acting insulin. It's not accurate information for long-acting insulin like Lantus and Lev. (Short-acting insulin has an almost immediate onset so food needs to be on board in advance of shooting.)

The other option may be to shoot at 6:30 AM so Jai Jai has time to graze a bit before you leave and then shoot as close to that time as you can in the PM. A difference of 30 min. is really not a big deal.

Another option is that there are now feeders that work on a microchip. Jai Jai would have a collar that has a chip that will open the feeder -- the other cats wouldn't be able to get in so he could graze without the other cats finishing his food. The only concern is that these feeders are expensive.

 

Hi, @Sienne and Gabby. Do I follow the rules of L&L? I think so, I posted daily after Jai Jai's hypo and hospitalization on the forum. I have more before his hypo, I just did not have the time to dig out all of them. Here are some of the links:

26/8 (Treated HYPO, Back Home)
27/8 (1st Day of 0.5 Dose, photo at clinic)
28/8 (Bald spot)

What I am doing on the main forum is to gather all the links, summarize the suggestions, and raise questions whenever I need. Regarding raising questions related to dose advice, I still post on the L&L forum. I welcome their replies either on the daily threads or the active thread, but I must have to say, I have got more responses on the main forum. If you were me, I think you would also sort out some solutions that work.

Don't get me wrong. I'm 100% sure that members on L&L are helpful, and it gathers most of the experienced people here. This is just I am not able to find out how I can get the most attention, like how I cannot manage Jai Jai's DB. I appreciate if you will take a look at Jai Jai's case here (http://www.felinediabetes.com/FDMB/threads/jai-jai-update-and-discussion.143333/#post-1484784). I have already summarized the advice given by other users.

Half of my day is away from home, and my job is quite demanding, and I am not attentive to the FDMB in day-time. I need a lot of time to compose a message, but I try not to be hindered by the language problems.

I take all of your points, and they are really useful and I am not aware the suggestions you made are actually presented somewhere on FDMB. I am considering getting an auto-feeder that is triggered by the microchip. As I said, I will do the best I can to manage Jai Jai's DB. I hope this is just the end of the tunnel and I will see some light soon. Thank you for your time, and I would love to have your help in Jai Jai's dose.

 

The Health board may be responsive but the level of experience with Lantus and Lev is generally far less than here. It's your choice where you post and where you feel like your getting the best guidance. Having looked through the posts when Jai Jai's numbers were in the 20s, there was a lot of activity on the thread because there was a clear emergency.

Your home situation is not all that different than mine. I leave the house at 7:30 AM. I shoot at 5:00 and get home in time for Gabby's PM shot. Most day's I don't have the luxury of logging in to the Board.

I don't know that I agree that your cat's dose was too high initially. What I think was more the issue is that you didn't know to get spot checks nor were you told to not shoot low numbers until you had sufficient data accumulated. Further, you weren't told to reduce the dose after seeing numbers like a 25 on 7/19 or an 18 on 7/25. I also suspect that no one suggested that you not give sub-q fluids immediately after shooting since fluids can potentially further lower BG numbers. The bottom line is that you haven't gotten a lot of information that would help you to better manage your kitty's FD and to keep him safe.

Like I said, it's up to you where you post. For me, I do not monitor the Health board with anywhere near the attention I give to this Board. It's largely the same for the other people experienced with using Lantus and Lev. Like you, we have to set our priorities with where we spend the time we have available for helping people. I choose to put my energy here.