? 4/10/18/Ravan/+3 379/+6 353/pmps386/+3 258/+6 195/+7 237

http://www.felinediabetes.com/FDMB/...294-4-347-pmps289-2-314-5-5-201-7-424.193895/
Went from bg201 to bg424 in 1 1/2 hrs ? (Only had a tabls of raw chicken at 3am.)

 

I know it may not seem like it...but to me I see Raven's numbers starting to flatten. Instead of all the SS colours in a couple of days...we are seeing a drop to yellow up to pink then red.

Raven looks like he needs more juice but hold your course on the SLGS, and see where the next 6 cycles take you.

I don't think that increase was all food but part of a bounce.

 

Normally I would agree with you, Tracey, but there have been trace ketones in the picture a few times in the past week.

 

I know ther is a conversation on yesterday's post about ketones and doses, but I am going to reply on today's post to bump it up. I think you should increase by 0.25 units as soon as possible. You only increased by a half that amount last time. As I posted then, it works best to increase by 0.25 units at a time, at this point in Ravan's diabetes journey. That is what SLGS calls for. Smaller increases usually do nothing at this point. You test enough to know that it now safe to increase. With ketones in the picture, the "rules" get bent on waiting, especially since we know this dose is is not taking him low at all.

 

@Tracey&Jones

What you wrote is what I was planning on doing. But others feel I need to increase to 1.5 Today.

I was Happy to see more pinks & yellows. I was tweaking the insulin a tiny bit to see if it would bring his #'s down gradually. I just increased it to 1.25 4 days ago. It seems too soon for another increase to 1.5?

Do you have anymore advice for me on that?

It seems that most of the posts I read, people use Pharmaceuticals (drugs) for not eating & nausea. I'm new to this post but I've taken care of animals for over 50 yrs. I do have experience with Heart disease & cancer.

I use Slippery Elm for nausea which is often the reason they won't eat. It can heal stomach problems & in my experience works for nausea, vomiting (usually caused by Drugs) & for diarrhea. If you google it you will see that it's been used for a very long time,no known side effects & it's very healing. When my cat had cancer he stopped eating I read about CBD OIL. I gave him a few drops every day & he ate good till the day he died(cancer spread to his lungs)

If you'd be interested I could give you a good web site about Slippery Elm or CBD oil

 

Wendy&Neko,
Thank you for your advice.
I get overwhelmed sometimes with all the information.

 

From earlier:

There are two cycles per day, one per shot. The amount of the increase should be 0.25 units, at this point. Increasing slowly does not prevent bounces. Only time spent in normal numbers will do that - and even then at the cat's own speed. Basically, we can't control that.

Yes SLGS says to increase slowly, but when you are doing enough testing to know how low the dose is taking him, and you have ketones showing up - the "rules" go out the window.

There is a LOT to learn at first - but wthe experience members here can help you. We all remember what it was like to be new.

 

@Wendy&Neko,

I think it upsets a lot of people when I ask too many questions. In over 50 yrs of taking care of my animals I've learned I really need to be their advocate.

Just last year one of my cats died because I took the advice of an emergency Vet.I will NEVER give my animals any meds until I look it up online to read thoroughly the side effects.

Just because they went to Veterinary school doesn't mean they don't make mistakes. That goes for Human doctors also.

I'm giving Ravan & myself a break this evening,not testing. I really want to see his bg tonight pre shot. I'll most likely increase the dose to 1.5 so I'll be up all night checking.

The advice has been controversial so I'm still a bit confused.

I was getting some blues 10 days ago then the Fur shot threw it all off.

I'm a lot more comfortable taking it slow.

 

Don't be surprised if his numbers don't come down right after you increase his dosage. Lantus is a depot insulin and when you increase the dosage the depot has to "catch up". So you may not see lower numbers and you might actually see higher ones!

Edited to add: This is referred to as "New Dose Wonkiness" or NDW!

 

We have all been newbies and we all learned most of what we know through trial and error and mostly from the experience of the people on this board. It's a long learning curve! It's important to ask questions in order to understand!

 

@Judy and Boomer
Tracey&Jones wrote me at 10:37 am She felt I should wait till the SLGS cycle is further along to see what the lantus will do.I wrote to her & still haven't heard back.

I just increased his dose 4 days ago to 1.25 now another increase to 1.5 Doesn't feel right.

Do you agree I need to increase the dose 4 days after i already increased??

I was giving Ravan Ringers several times a week & his ketones were neg. Someone wrote & said it can cause heart problems so i stopped. A few days later he showed a trace of ketones.

I spoke to my Vet & he said he never heard of ringer causing heart problems. If a cat has heart trouble already you cannot give more fluid. I had a cat with heart disease so i know this.

As you can see I'm getting conflicting advice which can be very confusing!

Last year my cat died because i followed the advice of an Emergency VET!

Can you understand why I'm being Very Cautious?

 

Ravan has been in overly high numbers for most of the last two weeks. He's had trace ketones on the last few checks. You seem to be stuck on the SLGS rule of keeping a dose for a week at the risk of having Ravan's ketone level possibly go higher. One thing is merely a dosing guideline while the other is a definite risk. They aren't of equal importance. Giving the fluids might be flushing ketones but it's not a substitute for an adequate dose of insulin nor will it necessarily prevent them from building to dangerous levels.

You want to be cautious but undue caution in the situation you're in might well result in you needing to seek help from an emergency vet.
Please do raise his dose to 1.5 u. Check his BG before bed. It won't likely have dropped too low and you'll be one small step closer to improving his level of control.

 

Thanks Kris,
I am definitely considering the increase. I just want you all to know my reasons for hesitating.

 

SLGS was developed on this board, over time, by the experiences of many. It may throw you for a loop to know that SLGS was never meant to be rigid, it’s merely a set of guidelines to follow in the beginning, some parts may or may not work for your cat or circumstances. With time, testing and knowing your cat, you can (and most people do) adapt SLGS to fit their cat. They may lower the reduction number from 90 to 70, for example.

This may also ease your mind a bit, it’s official, it’s in the SLGS sticky, at the bottom:

I understand your fear and hesitation, you’re being asked to trust a bunch of strangers on the internet, I would be concerned if you didn’t question anything!

We’ve had a lot of ketone throwing and DKA cats here, there have been some very recently and a couple with tragic outcomes, unfortunately. Believe me when I say most people would not be suggesting you to increase if the numbers weren’t high enough and you weren’t testing frequently, the fact that you are testing is what will keep your kitty safe from low numbers becuase there is something to be done about them, but you have to catch them first.

 

@Kris&Teasel,
His pmps was 386 (too high) I followed your & the others advice & increased to 1.5 units.

Everyone tells me to check at +2 but if you look at his SS he seems to show a change at +3 And his low readings are usually between +7 - +9 ,not at +6

I'll be up all nite checking!

Something else that he did today. He usually gobbles up the FFeast all day. But today he was not eating it as much.

I bought red meat today & he ate a large amount. He was raised on mostly raw chicken so this surprised me.

Before his shot i offered him FF & he didn't eat any. I offered red meat & he ate about 3 tbls.

I didn't get a chance to check for ketones today. When I got back from the store he had already peed (Large puddle in the litter)

Sometimes it really seems he waits till either i go out or i'm sleeping!

I create a new thread tomorrow morning. I guess i shouldn't expect too much for a while. He usually does a bounce when I increase the dose.

Thank you Kris for your advice & Thank you to all the others that helped!

 

Joy, I can see you are struggling with all the feedback, so all I can say is please try and remember that this is a community of very caring people, who offer suggestions based on their own knowledge and experience. I have purposely stayed out of the latest discussion because I can't share any experience or suggestions on dose, nor given the presence of ketones.

You have done a great job in getting tests and looking for ketones, that have led others to suggest that it may be time to increase. I know you would rather pull back on the testing, but right now that is helping tremendously in seeing what your next steps should be.

We all go through the same process of confusion and doubt, the early stages are so hard! It gets better, and I still learn something new about feline diabetes every day, even when I think I've got things figured out. Sometimes you just need one day at a time with feline diabetes.

 

Stacy & Asia.
Thank you for your help. I did increase his dose to 1.5

 

@Christie & Maverick,

I appreciate everyone for stepping forward to help. I'm the kinda person that questions "Everything" always did. My mother used to ask, why are you so "different!"

Although I often get stressed out I really need to know as much as I can before I make an important decision.

Thank You!

 

See, here's a perfect example how you are learning how Ravan's cycles look like on insulin. Know Thy Cat is a saying here, and you are doing it. For what it's worth, +2 is a starting point, but doesn't work for all cats. I couldn't tell anything about Neko's cycle by her +2 either and her nadir on Lantus was more like +7 to +9.

 

Indeed, very true. I used to find +2s helped, but not so much anymore, especially if I see higher preshots.

 

@Wendy&Neko,

Thank you. It's always good to hear I'm do something right!

Yes, all our fur babies are different,Just like us!

I'll be up all night checking!

 

@Christie & Maverick,

Your help & advice are always appreciated! Thank You!

 

I would start with your normal +3. If it's about the same or not much lower than the PMPS, I would call it a night and go to sleep. Not all kitties show a reaction to an increase right away. My Neko only sometimes would. Darn cats, don't like being predictable.

 

Beautiful blue last night that’s awesome great job!!!

 

Yes - nice blue last night!

 

I'm hoping this increase is going to lower his bg into a lot of blues. I've seen more blues at 1 unit.
I'm trying to understand why the increase was needed in the first place? Does it mean his diabetes is getting worse?
I always thought with Lantus it's a low dose?

(I'm going to start a new thread for today.)