? I'm really getting frustrated: Sparkle

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Sparkle

Sparkle

Member Since 2016
OK, I need to know what you good people will suggest to do at the next shot which is in 1 hour.

Yesterday's PMPS was 222, I gave 1.25u, he ate like crazy, probably too much, so when the numbers went up high, I wasn't worried. I did think it was weird when he was still high at his amps, but I've been wanting to try a slightly higher dose to see if I could get him into more blues and see some consistent greens so I gave 1.5u.
I then went to bed. I'm exhausted from monitoring him and Sammi. I felt it was safe.
So imagine my shock when at +10 he was 50. Rechecked it, 44. He was alert, purring and went right to eating. I picked the Pro Plan chicken and rice with gravy to bring him up. He ate all of that and I retested and got 57. Then Sparkle went and ate some more from the other cats plate. He looks fine. Infact, he is acting better than yesterday. When he was in the high numbers he wouldn't leave his bed and was Mr. Cranky Pants and did not want to be petted. I did see him have the first normal urine that I've seen in a month, so like I said, I thought we were in a good place.

2/14
pmps 222 1.25u, +2 372, +3 380, +6 357
2/15
amps 346, 1.5u, +10 50/44/ 30 minutes later 57, +11 74
I didn't restrict him from eating so he has just eaten a ton. I stopped him to get that +11 and he has now gone back to eating.
Have no idea what to do at the pm shot and if I should stop him from eating or just let him chow.
 
I probably need to rethink the way Sparkle is eating. He just ate every bit of the other cats' buffet. I guess I'm going to need to try feedings more at every 6 hours and just cut his food by half. He loves chowing and sometimes it is hard to get him to start, but once he starts, he doesn't want to stop. And he is probably putting on too much weight too fast.
 
You should never increase doses back to back days. That is dangerous. I know you want to see lower numbers, but following the protocol for dose increases is the safest way to get better numbers. I'm glad Sparkle is okay. Last night he was most likely bouncing from the blue yesterday.

You may need to skip tonight's shot if you cannot stay up all night to monitor if necessary. He earned a reduction with the 44, but I'm not sure what dose you should go back down to since you increased so quickly. Can you stay up all night and monitor? Do you have testing supplies and HC food?

I'm at work and may not be able to stay on very long.
 
I hear what you are saying, but I suspect Sparkle is going to keep climbing from all the food he just ate. His pm is at noon so I can certainly monitor him, I slept the last cycle.
Still, don't know what to dose him at. Will report his pmps and won't be feeding him then since he just finished scarfing. I'm frustrated at all of this.
 
I would suggest you drop him back to the 1F for tonight. It looked like he was just starting to show some progress on that dose. He will most likely bounce tonight from the low numbers, but just in case since he has the extra insulin in his system, I wanted to make sure you can monitor. Once he gets past this incident, you'll be able to see what he does on the 1F unit dose and then you may need to increase. In the future, for the safety of Sparkle, please don't increase doses so fast. You need to give each dose time to work. Bouncing is a normal part of the process.
 
How many cycles should I wait between increases? I did the 1F for 4 cycles, then the 1.25 for 2 and to be honest, even with the half markings I can't really tell the difference in drawing between a F1 and a 1.25. Wish they made syringes that were skinner and could have more markings. I'm also pretty sure I gave a S1.5.
 
There are two protocols: TR and SLGS. Which one are you following? TR is more agressive and you wait at least 6 cycles before you increase the dose with it.
 
When was the last time he ate? Way I am reading it he ate gone +11??

If he has eaten past +10 then the preshot test may be influenced by the food. The normal advice is not to have food two hours before the insulin shot so that when you get the test you know the number is not food influenced.

Back in a tick gotta TFS BFG
 
Gill is right. I forgot about his PMPS being food influenced. You might be better off skipping his dose tonight and getting back on track in the morning. If you do shoot tonight, he could give you really low numbers.
 
I have to log off. If you decide to shoot, make sure you get a +1 and a +2. If you need to feed him to get his numbers back up, just feed a teaspoon at a time and test every 20 to 30 minutes until he gets in safe numbers.
 
Gill and George: I fed him at +10 because he was at 50 and 44. I didn't want him to go any lower.
Carfurby: thanks for answering. I do need to look into calipers. Since I can be up and keep an eye on him and I know he is loaded with food, I'm not really comfortable skipping entirely. Maybe I should stall till +1. His latest reading was 164.
 
Sparkle said:
Gill and George: I fed him at +10 because he was at 50 and 44. I didn't want him to go any lower.
Carfurby: thanks for answering. I do need to look into calipers. Since I can be up and keep an eye on him and I know he is loaded with food, I'm not really comfortable skipping entirely. Maybe I should stall till +1. His latest reading was 164.
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I thought that was probably the case, I have been in the same situation myself, check out the 18 hour option

If you can delay the shot, ie don't feed, monitor and see what his numbers do, if he comes up and is shootable after two hours without food you could shoot, the problem with that is that you could end up of schedule and that might be difficult for you (or not), you can only make up time 30min per day max)

Another option is as Carla says to skip the shot altogether and shoot in the morning, that will drain the depot. seeing as he went quite low and dropped so fast may be a good thing.

A third option is to do two 18hr cycles back to back that will drain the depot and get you back on track
here's how that would work
if normal sot time is 7am/7pm
tonight you would shoot 1am (provided he is shootable)
tomorrow 7am you would skip
and you would shoot as normal tomorrow at 7pm

a fourth option is to shoot a token dose

Does that make sense
 
It's good that he has come up, sounds like he got quite a bit of food, I would want to see where he was after two hours if he were mine, before I shoot. So I would at least stall for two. I had to stall for three hours once with George, it was a real pain getting back on schedule. But whatever works best for your situation.

eta woud +1 be two hours after eating?? if so then I think that the one hour stall may be a good plan
 
You did the right thing by feeding the 40s (or the 50s, for that matter). However, if you're going to follow a method for dosing, follow the method -- either Tight Regulation of SLGS vs flying by the seat of your pants. Lantus is not the kind of insulin that's gone in a couple of hours. Please read the sticky note on the depot. If you don't keep the pharmacologic mechanism of the insulin in mind, you will end up with a kitty that's in very low numbers and a big vet bill (or worse).

I think there's a good likelihood that Sparkle will bounce off of those green numbers. If you can delay another 30 min without feeding, then re-test, it may give you an idea of what's going on. Do you happen to know the carb count of the ProPlan?
 
I've read the stickies and I'm pretty sure I just don't get the concepts of this insulin or the protocols.
I can't delay and not feed since he already ate, a lot, because I freaked out of the low numbers.
I can stall and keep testing, I have plenty of supplies and Spaerkle doesn't mind testing at all.
When people say "bounce" I'm assuming that can mean bounce low or bounce high? Because bounce doesn't mean anything to me.
No, I have no idea what the carbs is on the PP chicken and rice, but it has gravy so I was keeping it in case of a low, which is why I fed it, but it was so close to his next shot time so that is what I'm needing help with.
 
Sparkle said:
I can't delay and not feed since he already ate, a lot, because I freaked out of the low numbers.
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If you're going to shoot, you need to delay the shot until it's been at least 2 hours since Sparkle ate.

PS You can take the "911" down , please.
 
He is now at +12.5 222
I can watch and wait 2 hours before shooting, but still need to know what to shoot and also what I'm looking for in the next two hours regarding BGs. Of course, waiting will throw the whole schedule out of whack too.
 
How do you work the spread sheet if you stall and then shoot and then have to change things for days?
 
Sparkle said:
How do you work the spread sheet if you stall and then shoot and then have to change things for days?
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Just note what +time you've shot at in the PS box today. When you move the time by 15 minutes each shot to get back on schedule, you don't need to record that.

For example if the shot was 2 hours late you would enter "(units) @ +14"

Make sense?
 
With the spread sheet, when I stalled I stacked the numbers in the +11 slot, indicating BG and test time +12 ** +12.5 ** then when you shoot that becomes your new pmps and you put the number in there with the shot time.

Hope that makes sense, I am pants at explaining stuff like that.

I think I would drop him back to 1u.

Can I ask why you have been shooting Fat and Skinny doses?
Usually folk will skinny a dose or fatten a dose if kitty has a problem holding reductions, and they are trying to get an in between dose, ie one dose takes them too low the other too high.

Just wondering
 
Thanks A & P. My spreadsheet doesn't have anything over +11. I had to have Marje make my spreadsheet since I've never used a spreadsheet in my life.
 
If you're going to shoot, you need to delay the shot until it's been at least 2 hours since Sparkle ate.
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That's not necessarily correct. Remember, HC food works quickly and can be metabolized fairly quickly.

It looks like your next test was 222? Like I asked previously, what's the carb content of the ProPlan that you fed? Knowing what you fed and when helps us to sort out how the food may be influencing the numbers. You wanted to give some food to raise the numbers in the 40s. That was the right thing to do. You may be been a little overzealous, but so is everyone the first time they see lower numbers.

Can you let us know where things are at the moment? What are Sparkle's numbers?
 
Thanks G & G. Not sure I understood about the stacking. I'm not sure about anything. I'm in tears and feel clueless. I'm wondering if I should be on a different insulin since the depot stuff just confuses me. ProZinc makes more sense and some people say it is better for cats than the Lantus. Of course, other people say Lantus is the bees knees, like my vet.
He is now at 271. That's 3 hours since I caught the low numbers and got him eating. Because Sparkle eats so slowly, he nibbled for nearly 1 hour, or maybe scarfed? He ate the full 3oz can of Pro Plan and then more off the other kitties plates.
What I don't get is about the insulin, if he dropped so low isn't the depot empty and then he ate so much which would push the numbers up high especially since he hasn't had any insulin?
 
Yes, definitely gave him too much food, but thinking I'm doing that at every feeding (every 12 hours). When he feels good he doesn't want to be isolated from and the other cats and I don't want to keep him isolated his whole life.
 
Well, it has been 2-3 hours since he ate, depending on how you look at it (start or end eating) and I'm not happy that his numbers are going up and up. I feel like I should give him a shot, maybe a 1? Any alarming reason I should NOT do that?
 
Whoa there...
Deep breath.
Sparkle said:
I've read the stickies and I'm pretty sure I just don't get the concepts of this insulin or the protocols.
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Thats what we are here for. You will get the hang of it. Until you do patience and perseverance are required, that and a leap of faith. We have all been where you are.
Sparkle said:
I guess I'm going to need to try feedings more at every 6 hours and just cut his food by half.
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you should feed him as many calories as needed to maintain ideal weight. There is a rule of thumb (equation) however I can't locate it at the moment. I'm sure someone around here has it and will provide. Establish that amount as a baseline. With time and through close observation you will figure out the best way to distribute the calories over the course of a cycle and if more or less calories are needed for your cat.

Consistently with feeding and insulin is very important and will go a long way in smoothing things out.

That and an occasional adult beverage :cool:
 
So looking at the clock on the meter, he went from 44 to 271 in 3 hours, with a lot of food and no insulin.
 
well, when I wrote that about 3 hours eating, I confused myself and thought it was 3 hours past shot time, so I goofed again. Tested 273 gave 1 u. My spreadsheet won't let me put letters in the grids that are for BG so I just wrote a note. Hate the spreadsheet, hate being confused. Sparkle is sound asleep.
 
You're doing great and monitoring appropriately! My only suggestion is to post daily if possible and continue to ask questions and dosing advise. We've all been in your shoes and FDMB is the best place for you to be. Hang in there.
 
Here you go :
image.jpeg
You do have the option of skipping. Think of it as a 'fur shot' (an unsuccessful shot). Then you can get back on track at your normal shot time next cycle.
It will give you a chance to regroup. Sparkles will be OK.

You are not stupid. It will be alright.
 
@Sparkle I'm not giving dosing advice, but just wanted you to know you will be ok, it truly does get easier. Tears just mean you care, not that you are clueless. If anyone tells you they 100% understood feline diabetes as soon as their kitty was diagnosed, they are either lying or diabetic themselves (and maybe not even then!). I cannot tell you how many "occasional adult beverages" this sugar-dance has led me to consume ;)
 
deep breaths..... it does get easier and we have all felt helpless at some point when we realized what we are dealing with. You will get more confidant and it will be more routine.
The protocols seem difficult in the beginning -- I felt like I had bad vision most of the time and it was in a different language.
Now 5 months later I am starting to "get it" --- patience cannot be stressed enough.
1 thing that sticks in my mind from when I was starting was the phrase "lantus likes consistency " .... you can read more about that in the stickys- trust the protocol as it has been tried and tested -it would not have been published if it was not safe. It is important to know that altering it is not safe. Lantus is a gentle insulin yet it is powerful as it builds a depot.
Trust the protocol and ask questions... you will be just fine :bighug:
 
Hi There, :bighug::bighug::bighug::bighug:
and some more adult beverage
drinking24.gif
itsonly Monday but what the heck!

The depot confuses and confounds us all at times. Think of part of the dose you shoot going to work straight away and part of it being stored in the body for slow release, Every Cat is Different, but for George when I have gone down or up a dose it takes 3 cycles for the depot to settle and usually a full 6 before I see if the reduction has failed or increase has got us into good numbers, I've had to buy some Patience Pants and I whip them out when I feel a case of the ITF coming on (itchy trigger finger).
When I have taken him down 0.25 because we have had a drop into the 30's or 40's and consequently he has had a kitty banquette (one day he had his regular meal, LC snacks and 60z of HC food!) the depot was still in play the following 3 cycles or so and I had to strategically feed to keep him from dropping again, you'd think that all the insulin in the depot would be 'used up' by the extra food, but apparently not....

Over time and as you collect data you will learn Sparkles patterns, focus on the disappearance of Mr Cranky Pants, think how much better Sparkles must be feeling:) you are doing great keeping him safe and you are taking steps to get him better regulated it just takes time, follow the protocol and you will get there, we are all here to help, and we totally empathize.

That +10 result must have given you a shock!! One way you might catch that a bit earlier is if you did a +1 or +2 and a +6 or +7 testing at those times even when the preshot is high is useful and might have given you a clue to the slide. If George is bouncing I will usually get a +2 and +5 and a+9 in just to try and stay ahead of the game, on an active cycle I test more.(not everyone does, that's just me, I have time and I can so I do, but probably hasn't been necessary a lot of the time).

I had a similar problem where George was to low to shoot, and since then I try and get a test in around +9 and if he looks like he is low and dropping I feed him a snack to prop him till ps test, by doing that at +9 I can avoid stalling. I know you have your hands full at the moment these are just suggestions and what I have found works for me, please don't fee bad if it's not a good fit for you, I am a self confessed testaholic, but the data I've collected makes it easier now for me to sense when George is going to throw me a curve ball (antijinx) and preempt his shark hunting shenanigans, he's a sneaky guy though so I have to keep on my toes.

One other thing I wanted to ask was about the food, are you feeding him just twice a day?? (obviously unless he drops and you have to carb him up)
 
Tara & Ivana said:
either lying or diabetic themselves (and maybe not even then!)
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I've seen a few human diabetics come on here recently -thinking they could apply their knowledge to their cat. Not so. Feline Diabetes is a whole different ball game. A kitty's fast metabolism presents a new set of challenges.

@Sparkle You're doing great. You're here, and there is no where better to be for support and guidance. We've all been in your shoes (5 months ago myself), we all remember what it was like, and we all want to help.

So keep asking questions about the things you don't understand. You're not stupid, and no one thinks that. Not a single one of us "got it" right away. It's a steep learning curve, with a lot of information to process. The stress of wanting to learn so you can help your kitty better only compounds the problem. No one can function rationally under that kind of pressure, and we don't expect you to. That's why FDMB exists.

Just remember, we're here for you.
:bighug:
 
Sparkle said:
When people say "bounce" I'm assuming that can mean bounce low or bounce high? Because bounce doesn't mean anything to me.
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A bounce is when the cat's numbers go high after they have dropped lower than their body is used to. Right now Sparkle's body thinks high numbers are normal, so when he gets into blues and greens his body panics and he bounces. Eventually his body will get used to normal numbers and he won't bounce so much. A fast drop can also cause a bounce.

Hang in there. You're doing your best to take care of Sparkle and this is the best place to get help with that. Ask as many questions as you need to. :bighug::bighug:
 
Sparkle said:
When people say "bounce" I'm assuming that can mean bounce low or bounce high?
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Bounce is used when kitties numbers fly up high and stay high and flat usually after they have seen a lower than usual BG number or had a fast drop.

'Clearing the Bounce' is used when after having bounced kitties numbers suddenly drop, some kitties can gather quite a lot of momentum when clearing a bounce.
When they go low quickly we some times refer to it as a' dive'
Looking at Sparkles SS it looks like he was bouncing pm cycle of the 14th (probaby from lower numbers than he is used to in the am cycle of the 14th)
He also 'cleared the bounce' this morning, that combined with the increased dose is possibly what led to the 'dive' and low numbers @ +10

Positive from this: Sparkles cleared the bounce quickly, some Kitties can bounce for 3 days/6cycles, then you really need a big pair of Patience Pants.
 
Oh boy, Sparkles..I hear you so loud and so clear. Cried my eyes raw thinking how could I be SO stupid. Why can't I get this right?!
My big boy Harry was diagnosed and spend three days at the Vet's where they tested him every 4 hours and his numbers were all over the chart! He started at 497. After the 3 days he came home. I test, feed 1/2 can of Purina DM. Based on his number I insulin him 1/2- 1 unit. He is tested 2x's a day 12 hours apart, then fed.One month of testing and insuliating and he now is off insulin. Seriously, it can get better. When his number goes below 70 I add a small bit of regular cat food to his 1/2 can of DM. You can't rush the results. You know your cat best. Cry, drink if you must:I mainlined Chardonnay, IV straight, didn't bother putting it in a glass. Although he is only supposed to eat every 12 hours, Harry will on rare occasion start acting weird. When this happens I test him and usually he is the low 70's. A small bit of REGULAR canned will set him right. Oh, and he had weakness in his back legs which is why I took him to the Vet. That has gotten much better as he has lost weight. He started at 21 and is now a trim 16 lbs. he lost 24% of his body weight. I wonder if I ate only 1 can of Dm per day if I could loose 24% of my body weight?:confused:
All numbers are BG. You are lucky to have this wonderful site to help you.cat_wings>o You and Sparkles are going to be OK:bighug:
 
My Max was a bouncy kitty for the first year. He didn't hold reductions either. I learned part of the problem was the syringes I was using. Max is also very carb and insulin sensitive. I started using calipers and different syringes. The ones I use are no longer being made and eve these have such different markings for the beginning line. Digital calipers help that. I've also given up on trying to get rid of bubbles whuch can make a difference. Max finally leveled out at around the one year mark but never achieved remission. I've seen many cats with much higher numbers than Max reach remission so don't get discouraged. It helps to look at lots of spreadsheets and see what has worked for others.
 
Well, I laid down after all that confusion earlier and missed all these great comments and also Sparkle's alarm. So I got a +4 and 23 minutes: 257. I do feel better, only scanned the responses, but they made me smile and B-R-E-A-T-H-E. Sammi, the semi-feral cat that had to have emergency dental surgery has been playing all day. He even let me pick him up and take him to the window where we got lots of cuddling, kisses and purrs. Must feel good to have those rotten teeth out.
Unfortunately...... sigh... I see that a small black cat has taken up residence in my backyard. I saw him earlier when Sam and I were cuddling and then he disappeared. Freaked me out some since he looked so much like my outdoor cat Bits that recently died. Now I see where he has his little lair. Poor baby. Will quietly take him some canned food...but then what...argh!
 
OK, messed that up, it was a +3 (gave the shot at 1:30, tested at 4:23). I sure hope Sparkle survives all his Mommie's oops.
 
The beginning of this is overwhelming for most people. Don't worry one bit about it - that's the reason why so many of us stick around and help new people learn what to do. We remember how hard it is in the beginning.

Now that the crisis is past, I'd encourage you to go back and reread what people have posted. Take your time and try to get it.

Let me try to explain a couple of the concepts:

The depot - think of it as a timed release medicine. Only this particular medicine timed releases over about 3 days. Your shot on Monday morning can still be slow releasing Thursday morning - 3 days later. The size of the depot in the body is in equilibrium to the size of the dose. A 1u dose has a depot that corresponds in size. If you increase the dose, the depot has to "grow" to "catch up" to this newly larger dose. That can take up to 3 days for the depot to grow to be in equilibrium with the new larger dose. Once the depot has "grown" then you can see what the dose is capable of doing.

By the same token, if you decrease a dose, the depot has to shrink to match the size of the newly smaller dose. That larger depot can still bring down blood sugar. The 1.5u that you shot yesterday morning can still help bring down blood sugar after you've reduced the dose.

Changing doses too frequently means that you're going to see wonky numbers. It's not taking advantage of how the depot works, and you don't get the benefit of the depot action. The depot is the reason that Lantus and Levemir can cause cats to have almost flat blood sugar once they become tightly regulated. Take a look at Pimp's blood sugar for today - it's been a perfect flat cycle - that comes from the depot. I really liked this particular link that explains the differences between Lantus and Levemir, because in explaining the difference it also tells you how it works.

What it means in real life is that you want to hold a dose for at least 3 days unless Sparkle earns a reduction by dropping below the reduction point of whichever dosing method you are using. You're going to need to choose which guideline you want to follow.

Let me sum up some of the differences between the Tight Reg Protocol and Start Low Go Slow and perhaps that will help you.

With the Tight Regulation Protocol, doses are held about 3 days, then re-evaluated and increased if needed.
With the Start Low Go Slow, doses are held for a week at a time.

With Tight Reg, you need to test multiple times a day (which you are already doing). The goal of Tight Reg is to get the cat into normal numbers (50-120 on a human meter) as quickly as is safely possible. Because one is pushing the cat's blood sugar into normal numbers, it means testing enough to keep the cat from becoming hypoglycemic.

With SLGS, one needs to get preshot tests and ideally, a spot check here and there, and once a week do a curve. Because Lantus dosing is based upon how LOW the dose gets the cat, you've got to get enough tests in to be confident about how low the cat is getting. Most people using SLGS don't test much.

Tight Reg requires low carb canned food or raw food.
SLGS allows dry food - if a cat is eating any dry food, they cannot follow Tight Reg.

There is far more than this on the stickies, but they can be overwhelming to people. Do take a look at the stickies and ask questions if things are confusing. We're going to need to you make a decision about how we help you with dosing. Just looking at your dosing style and how much you test, and how much you want to adjust the dose to move his blood sugar down, I'd think you would want to use the Tight Reg protocol. It helps us if you put the dosing method in your signature line.

Bouncing - there is one explanation in the second post in this thread.

You may have said, but I haven't caught your name. What do you want us to call you?
 
Julie, my name is Pepper. You have written the best explanation yet and I thank you for being gracious and allowing me my frustrations and time to learn.
For everyone who responded to my 911 with humor, it was the best medicine EVER and I greatly appreciate it. I will reread all the comments later. Right now I am glad this day is over, Sparkle is fed and has had his shot and half the other cats have been fed. I'm going to the other part of the house now to get those cats situated for the night and get to bed. I feel much better prepared if Sparkle throws some crazy low numbers. I learned that today- don't need to feed him the whole cabinet of canned food, just a few spoonfuls of HC and monitoring are OK.
Rest well my fellow dancers and your four pawed partners
 
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