http://www.felinediabetes.com/FDMB/threads/high-bg-numbers-and-todays-the-day.219514/#post-2448912 Good morning, everyone. This is my first official post with Quincy's numbers! I don't have many questions right now as the people from the other thread were very helpful. My main question was when will I see results from the depot building? I can do more testing on the weekends or even between 430 and 9 but after that I am unable to as I have my own health issues going on. I do know I will have to wake up at some point to do a nightly test but as of now, this is what I have on my SS. As stated in my previous thread, I am having difficulties with testing but I know eventually it will get better.
The continuous testing thru day and night is the only way to figure that out. The insulin responses vary greatly per cat hence the need to test frequently (as possible). Some react right away some could take up to a week. ECID thing. I never used Basaglar so tagging @Chris & China (GA) who had. Until she replies I would suggest you take a test 2 hours past injection. It is often, but not always an indicator for an upcoming BG lowering for Lantus users. It would be good starting point I think. It is your dose #7, the depot may be filled (and you'll see lower numbers today) or it's getting very near being filled. Take a few tests today to see how low the dose takes Quincy. @April & Quincy
Hello and thank you. Unfortunately, I can only test 2 hours past injection at night. I cannot do it in the morning as I am off to work. However, on weekends, I can definitely do that. And today of course, I have to stay at work until 8pm so frequent tests will not be happening today. It sucks that the weekends seem to be the only time for frequent tests but I guess it's better than nothing.
it certainly sucks.. but in that case just make sure he eats well before you left and do leave out food for him to at least snack thru the day. There is danger of Hypoglycemia as you are well aware I am sure. Have you read the Hypo sticky? It's at the top of Lantus/Basaglar/Lev Forum. Having food on board might prevent it whilst you are away.
I definitely have read the stickies, all the stickies , and I DEFINITELY leave food out for him throughout the day. It's unfortunate that my schedule is what it is but I am only one person and my partner's schedule is the same as mine. We're the only two there so we'll do our best. I am hoping the danger of hypo is low at this point since his numbers are so high but what do I know? I know if/when the numbers get lower and I can learn more over weekends, that I'll know to not inject if it seems too low. One thing I was thinking is that when I inject him at 7pm and give him a snack, I could give a check +2 before I go to bed, but then again he'll have food in his belly at that point so should I still do it?
That is great! You can also collect very useful data if you alternate the testing times like ALWAYS take preshot (PMPS) and then take either +1 or +2. Do not worry about food being in his tummy just make a note the remarks section in the SS what and how much he had eaten. This way you can learn what kind of food bump he gets from this particular meal (the BG spike 30-60 min past eating) - the +1 usually reveals that. The +2 test is more about figuring out the onset on the latest dose. Again, I never use Basaglar but it is similar to Lantus and Lantus often onsets around +2. Check it out with Q. If the +2 test lower than PMPS than you have reasons to test again later because he is going down already and the strongest insulin action is still ahead (the nadir). In case you see lower +2 and cannot stay up you can pfeed extra meal with higher carbs in it, make sure he ate and then leave out some more foods for overnight. I use Fancy Feast Gravy Lowers Chicken, 15% carbs, @Walmart ~$0.75. But mid night tests are important and highly recommended because cats often go lower at night naturally. Another thing to test minimally but get the most is to routinely check AMPS +11, then PMPS, AND then either +1 or +2. It may sound like a lot but in absence of mid daily tests I think it is good compromise. Have you seen the Sticky on handling the TR with the full time job? It's on top of LB&L Forum. You may review it for tips on testing times, feeding tricks, food brands, etc., something you may find useful for Q even though you are ETA: NOT on TR.
Great to see you posting April! Definitely the testing will get better . Now that you are posting regularly, Have you considered which dosing method you would like to follow? We use two: Start Low Go Slow and Tight Regulation(TR). It is another sticky to read, but reading about your work situation and night time schedule it sounds like Start Low Go Slow(SLGS) might be the best option for you for now (if you decided to follow one of the boards methods that is). SLGS is a more cautious approach because it has less testing and less frequent dose changes, TR requires more testing (at least 1 more test mid cycle than the AM/PMPS) and has more frequent dose changes, which can make it more dangerous if you aren't able to monitor regularly. In SLGS you hold Quincy's dose for a week unless he goes below 90mg/dl, which would earn him an immediate reduction of 0.25u. At the end of the week do a curve. Based on the lowest point on that curve (nadir/ peak) you can decide whether or not Quincy needs a dose increase or decrease using the below criteria: If nadirs are more than 150 mg/dl, increase the dose by 0.25 unit If nadirs are between 90 and 149 mg/dl, maintain the same dose If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit I think this method will work for you for now until you can get a better understanding of how Quincy reacts to Basaglar. Especially since you can set your week to start on a Sunday and end on a Saturday, just in time for a weekend curve! (or you can set it up so your curve is Sunday ) Grabbing the +2 tells us a lot even though there is "food on board" if your +2 is the same or higher than your pre-shot there is less to worry about and you dont need to worry as much about getting additional tests through the night or putting medium / high carb (MC/HC) food out while you're away for the day. If your +2 is quite a bit lower than your pre-shot you should plan to be able to grab another test that night or to leave out MC/HC while you're away for the day. When I am thinking about if the +2 shows whether or not I need to test more or not in that cycle I personally kind of use the spreadsheet colors as a strategy. If I have a pink AMPS and my +2 is blue, it means that a whole "color" has been skipped (yellow) and a +2.5 / +3 would be needed so that I am comfortable. I will even get a +3 if I have a large drop say from High yellow AMPS to mid blue +2, just in case. If I have a yellow AMPS and a Yellow +2 I am less worried about the rest of the cycle, since there hasn't been a lot of action. Of course ECID, that is why it is important to learn Quincy's onset, nadir and duration through testing .
Good to know that the spike is 30-60! I thought for sure it was like 2 hours thus why I have been hesitant to even test then! How much does he have to go down in order for me to leave out high carb food? For example, let's say he's down to only 375. Still leave out some high carb food? I do leave his food out over night and there is usually some left by the morning so I'm not too worried about that. It's rare lately that all of the food is gone.... So when you're saying +11 you mean when I get home at 430? And then again after PMPS +1 or 2? Also...I didn't know I was on TR! Haha. I thought I was on SLGS! That part is very confusing for me and I have read that sticky about 100x.
LOL!! YOU decide which method you're on . Once you decide can you add it to your signature (I know, ANOTHER thing to add to your signature). Knowing what method you're following will help members here provide more meaningful feedback / guidance ETA: I have summarized my strategy on when I think I need to leave food out in my post above
Perfect timing with the SLGS and TR explanation! Yes, I definitely think I'm doing SLGS because of my work schedule. This concerns me though - how do I find his nadir if I'm gone or asleep during each time? The only time would be on the weekend, correct? Because +2 or +1 after his PMPS would really not be the nadir, correct? The color explanation is great. I will be doing more tests and a weekend curve on Saturdays, maaaaybe Sundays depending what's going on, but I'll assume Saturdays mostly. And honestly, I'm tempted to give Quincy's ears a day or two break - NOT totally! by any means - but not do more than AMPS or PMPS for today and tomorrow because they are looking quite mutilated from my horrific attempts at testing.
Yes, following SLGS means sometimes it takes a little longer to define the nadir for your kitty. You don't have to know it every day, but the curves on the weekend will help define it. That is one of the reasons SLGS has a longer amount of time between dose changes, because members who follow it typically don't have schedules that will allow them to do the amount of testing that is required to follow a dose change protocol like TR safely. So, dont worry about defining nadir during the week if you are following SLGS, but do have at least one day a weekend that you can execute a full curve on Quincy, that is key in finding the perfect dose! It works for me, I will say though, there are always times our cat's do something completely different than we expect, so if you're ever unable to sleep in the middle of the night or something, its great to use these times for additional test info I can understand that! Especially right now where Quincy is just getting used to this whole thing. I will say though, those +2's are very important at night to predict if Quincy is safe or not, Like Tanya said, cat's really do go much lower at night. If you look at the difference between Mowgli's Day and night cycles in his SS you will see a good example of this. Sometimes Mowgli nadirs at +3 in the PM! He keeps me on my toes cheers to a bit of a pokie break for Quincy
I just edited the typo. I meant to say "even though you are not on TR". Need some more +11 is 11 hours since the last injection in the AM cycle. Then you take the PMPS and then either +1 or +2 and look at these numbers in combination. If you see the downward movement - all numbers are consecutively lower despite eating the preshot meal - then it is time for higher carbs. If you want to go to bed. How high carbs - is ECID. You'll figure it out after collecting some +1 tests and learning his food reactions at onset. To clarify: solid food like pates types takes between 30 - 60 min to reach the bloodstream and take effect on the BG . Its effect may stay in the system for 2 hours +, it is all ECID, really. There is no set numbers of points as such...I'll try to explain: If he was, let's say, was 480 @PMPS but 375 @+1 and it is 1 hours after eating his regular preshot meal entirely than you likely going to be facing very active cycle because 100 points with meal on board is a lot for any cat. The +1 and +2 tests shows you the onset of insulin action for this current cycle. The main action of the cycle is still ahead. Until you figured out when he nadirs it is better to be cautious and choose what to feed keeping the upcoming nadir in mind. I might be able to make food suggestions and carbs level later on once you have collected more data. Are you using Neosporin, or something like that? to soothe the ears. I am currently using Calendula Herbal Salve on Ducia's ears. And was going to post the recommendation on Health Forum in about a week from now. But I feel comfortable to recommend the product, very satisfactory. Did my explanation help at all?
I should be able to get in a 2+ tonight since I'm at work late tonight and my bf will be giving his insulin injection. Thanks for all the info...starting to feel overwhelmed again!!
This is so helpful but also so overwhelming. Every time I feel like I've finally grasped something, there's 10 more things to learn! I am not using Neosporin though I did buy some. I'm not sure to put it on before or after the poke. I've heard of both. Either way, they aren't looking so hot right now. When I shine a flashlight or the sun is shining through them, eeeeeek. Yikes. I feel so bad.
it is overwhelming, naturally. Being there myself not very long ago. Do not push yourself to got it all in at once, it'll take time. I use Neo past injection, especially if the multiple tests had to be done, like today. Ducia's ears too pink against the light. This pink-ish-ness maybe an inflammation (some Neo or Calendula helps) but it could be the capillary - the tiniest blood vessels that multiply or expand themselves if ears are exposed to fight cuts, bites or, as in our cases to the ear pokes. Mother Nature already took care of removing the pain nerves from ears. The salve or Neo is to help this natural healing/readjusting process. If it is any consolation - I had no clue what I was doing for maybe a year or so. But now I know enough to know how little I know and that there always be something new to learn, and knowing it makes the overwhelm easier, does it not? It does for me. Will he able to test before the shot?
I will use the Neo then afterwards if it looks like I did a little too much pricking or hit a vein or anything that was out of the ordinary - though I'm still working out what's ordinary. SMH. Wait. Wait. Wait. Are you saying cats don't have pain nerves in their ears!?!?!?! Knowing tends to make it harder at first and then eventually easier... He will try...but he's not the greatest at it.
yep, the ears are made to feel less pain because cat ears got bitten/torn a lot in the fights , and thru the evolutionary processes the sensitivity was reduced by Mother Nature. I am sure you 've already done it but do remind your BF again at which PMPS number NOT to shoot insulin, in case it is too low tonight and you are not there. Better safe than sorry, right? I hit the vein more than several times - used Neo. Sometimes Ducia developes inner Hematomas - a small paddle of blood trapped inside the ear tissue. Sometimes it could be visible only if to look against the light source, or it could be felt to the touch as a small grain, maybe like a rice grain size?.., stuck inside the tissue. In the case it is Hematoma - I use Ledum, just massage a few drops of dissolved Ledum in purified water few times a day, very effective.
I think he might have a hemotoma...or two or three... then. I haven't felt it cause I haven't wanted to hurt him but I will feel to see if it feels like a grain. Thanks for that advice.
I don't think Quincy will be getting his shot tonight. BF told me he is refusing to eat, which he often does when I'm not home. So unless he eats within the next few hours, I think I will err on the safe side of no injection since I'm not home and BF goes to bed right after injection time.
Just FYI....Basaglar is a biosimilar of Lantus so it works pretty much exactly the same. Any advice you'd give for someone on Lantus is the same advice you'd give someone using Basaglar
That's a good call for now. Is there any reason why you think Quincy isn't eating? For future reference, with Lantus, having food on board during shot time isn't 100% critical since onset is usually at +2. As long as they eat around whenever it is onset for kitty, that's usually okay. Sometimes, Ming will eat a few bites at shot time and I'll shoot knowing he'll come back to eat the rest of his dinner in half an hour to an hour later. But I think that was a good decision on your part because 1) you don't know how Quincy is reacting to Lantus without more tests during the cycle, 2) you're not able to monitor throughout the night and 3) you're not sure if Quincy will eat later. I hope Quincy decides to eat for you later
I think he may have separation anxiety? A friend mentioned that yesterday. If someone else feeds him and I'm not home, he will not eat for hours and hours. For example, I went away for the weekend over the summer and he didn't eat for hours and then not very much. As soon as I got home last night, he was fine, excited to see me, and ready to eat. I figured it'd be okay cause he'd eat when I got home but I didn't want to risk it since BF was going to bed anyways. Yes, I'll get some more tests in over the weekend and tonight and tomorrow.
Good morning,, actually it is quite common with cats. We hear a lot of stories here about ppl leaving their cats with a pet sitter to go on vacation and cats do not eat. It could be something like separation anxiety. I hope things will work out well and Q eats his foods. Do post with any questions.
He definitely is eating now! Funny how I was only 4 1/2 hours late and it was like, nope. Mom's not home. I know you, dad, but still. No. So cute but kinda sad. No questions yet - the ear prick went better today, I tried a different angle. I did have to poke twice, and I do think I might have went through again but it was a small poke that gave a decent size drop of blood. My only question is how bad is it if I poke through every time?? I know it's bad but I'm still trying to get the hang of it...
think positive! - if you ever had wanted him to score a nice blink diamond stud you are done on the piercing part of the project , lol. It's neither bad nor good. It happens. Oops, and no judgement here. I promise that your worries are hurting you more than a poke thru does to his ears. Just put some Neo.
Haha, I totally agree my worries are hurting me more! Already anxious in general so this multiplies it BIG TIME!! I keep forgetting to add some Neo. I'll make sure to do that tonight.
