Bella’s new increase part 1

well did a +4 and we have a red 434 seems to be going slowly up last couple days, normal? Or maybe something wrong? Little worried, we haven’t seen red in a bit

 

Very frustrating, he gets to feeling better and then here we go again, I know, patience, he .5u has done all it can, so guess we will see what .75 does

 

Yes, very frustrating but stay the course. It'll get better. The L forum people might have a better take on how SLGS progresses.

 

Posted on L forum, see what they say, I’m sure it will get better since the other dosage had done all it could do and I just saw where he went up the first day of lantus and it slowly went down, sometimes I forget to look at the whole pic and just focus on that stupid red number

 

This is very hard to do but I guarantee it'll save your sanity. I often tell people to sit back and just squint at their SS to see how the colour distribution has changed. I do that from time to time with mine.

 

I used to do that with mine and was saddened by the recent colours from the past few months being all pinks and reds with just a few false hope yellows.

 

I try not to be obsessed with the numbers but hard not to sometimes

 

SO hard. I was obsessed. It was ruling my life.

 

Baby’s goes back & forth... I’m doing everything I can for this little girl & she runs this household, to boot! My day revolves around her most of the time! It’s all about the Baby so you have to feel fine with that! Pat yourself in the back for being awesome caretakers!

 

+7 380

 

Hang in there ... You can take a pokey beak until PMPS I think.

 

I love your new avatar picture!

 

Yes, it's awfully cute!

 

I love it too- new pic! Such a pretty kitty! I’m glad he’s so good for you! Baby has finally settled but makes this little moan sound when I pick her up. She only occasionally flips out now. Progress. I still think she says to herself, “I thought momma loved me; then why is she poking me like this.” Bad way to look at it so I can’t dwell. I’m sure a lot of us feel like this?? No? Yes? Maybe just me...plus I finally found a dry treat for her after shot/test & it gives her diahpoo. Back to the drawing board!
Good luck on the dose increase, I’m pulling for you Bella!

 

Hey! Look at that - lowest BG today at PMPS. Try to get a before bed test every evening.

 

+3 201

 

!!!

 

Amps 201

 

Stumped on what to do, I looked on LL forum and read sticky it gives 3 options at BG 200 no shot, smaller shot, or wait 2 hrs and retest not sure what to do

 

I see you got help on L&L, I just wanted to say that I love the new avatar!!!

ETA I just read that thread and you don’t suck!
ETA In case of confusion about my ETA, those were Bellasmoms words, I was just letting her know she did fine this AM, no one on L&L was rude. It was early and no coffee yet. I need to stop commenting before coffee.....

 

I’ll go check the L forum.

 

No, no one was rude everyone helpful, very helpful, I was talking about myself, sorry for using the word

 

I understood what was meant! Don't be hard on yourself. Learning to treat FD is hard and when you switch insulin it's like starting back at the beginning.

 

It def is

 

I think you did well this AM. We ALL panic with that first lower than normal PS!

 

Thank you, I will know now what to do, thanks to all

 

Well, you saw this AM that he's responding to the Lantus. You also have something to look for when you do future dose increases - a possible early reaction to the new dose. Always something to be learned from these stressful incidents.

 

+10 346, I should have given the .75 ??

 

Possibly, but you have to do what's safest when you can't be home and don't have enough data/experience with the new insulin. Give 0.75 u tonight. Get a before bed test. There could also be a bit of NDW going on.

 

Ok and ,y hubby will be home tomorrow so if’s it’s around amps 200 I’m gonna give the .75, is that,ok

 

Just terrible pmps 466

 

How can it go up that much in 1 hr

 

The dose might have warn off a bit early. Does he have access to food all day when you're at work? Some people find that if the kitty eats after the +6 mark it can reduce the duration of the dose. There's also NDW that many say shows up a few cycles after a dose change. Try not to worry.

 

Yes Dr elseys

 

At what number should I not give a shot if 200 is a maybe what is a NO shot

 

Just something to keep in mind for later. Right now, go back to the 0.75 u dose and follow SLGS. He's only been on Lantus 10 days and it can take a lot longer than that to get him more stable and to pick out patterns in his responses.

 

It will be what the SLGS guidelines suggest along with a lot of data on your SS that shows you his responses. From the SLGS guide with parts I highlighted for emphasis:
______________________________________________________________________________________________

How to handle a lower than normal preshot number:

In the beginning we suggest following the guidelines in the FDMB's FAQ Q4.4:
Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?
A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.

• Below 150 mg/dl (8.3 mmol/L), don't give insulin.

• Between 150 and 200 (8.3-11.1 mmol/L), you have three options: a.) give nothing; b.) give a token dose (10-25% of the usual dose); c.) feed as usual, test in a couple of hours, and make a decision based on that value.

• Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.

• In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.

• Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.

Keep in mind these are general guidelines, and they should be personalized to your own cat's response to insulin. If your experience is that your cat does not became hypoglycemic with a dose which is close to her usual, then personal experience should be your guide.

With experience, you may find that lowering these thresholds may work well for your cat. When you have reached that stage, the following guidelines are suggested for Lantus and Levemir users following the Start Low Go Slow approach:

If the preshot number is far below usual preshot numbers:

• Do you need to stay on schedule? Then skip the shot.

• Do you have some flexibility with your schedule? Then stalling to wait for the number to rise might be a good option. Don't feed, retest after 30-60 minutes, and decide if the number is shootable.

• Repeat until the cat either reaches a number at which you are comfortable shooting, or enough time has passed that skipping the shot is necessary.

If the preshot number is near usual preshot numbers:

• Look at your data to see what numbers you have shot in the past and decide what would be a safe, shootable number for your cat. Don't feed. Stall until kitty reaches the preshot number you've decided on and then shoot.

We usually don't suggest or recommend shooting a preshot number less than 90 mg/dL when following the SLGS Method. Remember that with SLGS, your goal is to achieve flat numbers that are greater than 90, so there is no need to push a cat into numbers lower than that.

 

Yeah that’s what I was looking at this am, thanks!!

 

Well we are a little high this am, gave .75 and hubby going to do checks on him today

 

Right now I think you’re seeing the much slower, gentler action of Lantus. Novolin was able to drop Bella’s BG much more aggressively. You might get to a higher dose before seeing blues and better. The two insulins are like apples and oranges. Hubby doesn’t need to do a lot of tests, just a couple of key ones between +4 and +7 or +8.

 

Ok thanks he will be glad

 

I put Bella’s labs from July of last year

 

I have no experience interpreting labs. There are other members who do.

 

It was more of a FYI thing, I didn’t know if we were suppose to put them in

 

They're a good thing to include.. Sometimes people on the L forum will ask about them.

 

Is Abby still vomiting?

 

No not at all
Bella’s +7 314

 

Increase to 2.5? Abby

 

I'm confused... Are you asking about increasing the dose for Bella, or something about Abby? Abby I don't know, but Bella should stay put at 0.75 for a while.

 

You’re referring to Abby’s felimazole dose, right? Had you cut the pills in half? How many days on the half pill?

 

Abby, Kris was asking about her and her thyroid medicine, it was making her nauseous so I cut it in half was asking her if I should give her reg dose now, thanks for asking and watching out for me

 

Abby is Bella’s mom’s hyperthyroid kitty. Sorry for the confusion.

 

Yes, you suggested half 2x a day because of throwing up, started her on sat

 

sorry for confusion

 

You could give it the rest of the week and then go up this Saturday.

 

I think hubby can wait until PMPS for the next test.

 

I wanna ask a question
Ok, if a cat has diabetes and you put them on insulin and take away all or most of their sugar then how does still get so high, like I feed Bella very very low food and he gets insulin nothing changes but his numbers always do, some days good, some days

 

His body must not produce hardly any at all and I see that with a lot of cats the numbers change so much when they are not changing anything. And when people say stress elevates BG does that stress just make the insulin not work as good, yes I think to much but I always like to know WHY

 

Their body can make sugar out of the fat and protein they eat. The sugar they make doesn’t get into their cells properly when they’re diabetic because they aren’t making enough insulin of their own and if you aren’t at the right dose yet there’s not enough injected insulin to do the job.

 

Crazy how the body works

 

There are many really complicated processes involved so no simple answer. One part of it is the stress response causing the body to get glucose into the bloodstream from other forms it’s stored in. That response is part of readying the body to react to or escape from a threat (fight or flight).

 

Re Abby: if you want to phase in the felimazole even more gradually you could give a half pill AM and 2.5 mg PM for several days.

 

She’s does really well, she’s 13 and this is the 1st time ever she’s had something wrong for medication