PMPS=171, +1=210, +2=124, +3=72, +3.5=56, +4=66, +5=98, +6=120

Discussion in 'Lantus / Levemir / Biosimilars' started by AEHawkeye, Jul 21, 2019.

  1. AEHawkeye

    AEHawkeye Member

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    Jul 17, 2019
    Yesterday my newly diagnosed Velcro dipped down to 68, got him up to 133, then down to 58 in the AM cycle. Did not dose in the PM with guidance from vet. Tested a few times and he’s been pretty flat in the 200s. Need to pretest and decide on insulin in and hour. Full dose or half dose if he’s still in 200s?
     
    Last edited: Jul 21, 2019
  2. AEHawkeye

    AEHawkeye Member

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    He was up in 290s so I gave him a full dose. Will retest throughout the day and let him have another LC meal when he’s hungry.
     
    Last edited: Jul 21, 2019
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  3. Ti-Mousse (GA) Pepe (GA)

    Ti-Mousse (GA) Pepe (GA) Well-Known Member

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    Hope good numbers today for Velcro ! :cool::D
     
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  4. AEHawkeye

    AEHawkeye Member

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    My guy needs his cutey-rest! After a 1.5 hour nap post dosing, he popped up looked around, and headed straight for the food he leftover from this morning’s feeding. I don’t think the twice a day feedings the vet recommended are going to work as long as he has an appetite.
     

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  5. AEHawkeye

    AEHawkeye Member

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    He fell 140 in 2 hours so maybe we are going to be in for another low day. He’s still eating what he left over this morning, so I added a bit more.
     
  6. Ti-Mousse (GA) Pepe (GA)

    Ti-Mousse (GA) Pepe (GA) Well-Known Member

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    It would not work for my Ti-Mousse also. What is suggested is many small meals during the day and no food 2 hours prior AM and PM shooting!
     
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  7. Crista & Ming

    Crista & Ming Well-Known Member

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    Yes, looks like an active cycle! I'd make sure he eats enough but also will be hungry later for when you need him to be aka when he's dropping. But I hope Velcro stays nice and safe for you.
     
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  8. AEHawkeye

    AEHawkeye Member

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    Fell again at +4, down to 90. Being newly diagnosed this is not in my comfort zone. He did eat a bit right around the time I tested him.
     
    Last edited: Jul 21, 2019
  9. AEHawkeye

    AEHawkeye Member

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    +5 79 - maybe the drop is slowing
     
  10. Crista & Ming

    Crista & Ming Well-Known Member

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    Have you given any thought on what dosing method you’d like to follow? I’m getting the impression you may feel more comfortable with SLGS.

    If that’s the case, it would be time to decrease Velcro’s dose to 0.75 units.

    @Wendy&Neko @Sienne and Gabby (GA) @Bron and Sheba What do you think of Velcro’s dose?
     
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  11. Sue and Luci

    Sue and Luci Well-Known Member

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    Keep the food coming - forget that vet advice about twice a day - let's just focus on what your kittieh needs and right now it's food to keep his BG's from going too low...if he's hungry, let him eat his low carb - he's making adjustments to his new diet (I presume you used to feed him dry or other foods?)

    Hang in there and ride that nice wave Velcro! You are looking fabulous today out there in the lagoon - try not to scare mama half to death with any diving today, k?:D:D
     
  12. AEHawkeye

    AEHawkeye Member

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    Yes I think SLGS would be my preferred method. Both due to my nature and the amount of time I can devote regularly to testing.
     
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  13. AEHawkeye

    AEHawkeye Member

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    Thank you. This is so stressful! He mostly was on a wet food diet because I was doing a lot of syringe feeding. I thought it had to do with mouth sores but in retrospect in missed that sign for diabetes . His food was low carb (Sheba perfect portions) but he was also getting a gel supplement and olive oil to boost his calorie intake.
     
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  14. AEHawkeye

    AEHawkeye Member

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    +6 was 72, so that seems like maybe he is bottoming our.
     
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  15. Crista & Ming

    Crista & Ming Well-Known Member

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    Then tonight if things go well, Velcro should get 0.75 units.

    Do you know how to dose in 0.25 u increments?
     
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  16. Crista & Ming

    Crista & Ming Well-Known Member

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    But just a word of warning: you may be giving a smaller dose tonight but his cycle may still be influenced by the 1 unit dose this morning. So you may see lower numbers through the night. That’s the depot talking. But you also drained the depot last night by not shooting. Or Velcro may bounce and produce high numbers and let you sleep. ;) Basically, continued low numbers may or may not happen tonight.
     
  17. AEHawkeye

    AEHawkeye Member

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    I don’t - and also my syringes don’t have partial units. I have read the sticky on the method, will read again.
     
  18. AEHawkeye

    AEHawkeye Member

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    So I ideally want low numbers right, it’s just that his body hasn’t regulated that this is such a problem, right?
     
  19. Figaro's Liz

    Figaro's Liz Member

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    Cutey rest! Ain't that right :joyful:
     
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  20. Crista & Ming

    Crista & Ming Well-Known Member

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    Yes, ideally you want Velcro to stay within 120 - 50. But because Velcro is so new to insulin, we want to stay safe. Until you gather enough data and know what Velcro will do with insulin, it’s best to play it safe. The numbers you’re getting today are perfect and beautiful though.

    You may need to eyeball the 0.75 unit dose for now. I’d suggest getting calipers and syringes that have half unit marks.

    Take a look at this post: http://www.felinediabetes.com/FDMB/threads/dosing-with-calipers-updated-w-videos.79851/
     
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  21. AEHawkeye

    AEHawkeye Member

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    Thank you!
     
  22. AEHawkeye

    AEHawkeye Member

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    Coming up to 77 at +7.5. Yesterday he spiked up and then fell lower between +7 and +9, but yesterday I gave him honey twice per vet (68 and then later 58), so maybe we can ride out this cycle and see what it really looks like without further intervention.
     
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  23. Perry & Jenn

    Perry & Jenn Member

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    That pic of Velcro zonked out is adorable! We free-feed around here, there's no way feeding Perry only twice a day would work. Does anyone (maybe @JeffJ or @Crista & Ming ?) know whether there's a sticky on managing the curve with food? I've read about it here and there, but I can't remember if there's a sticky somewhere that specifically addresses it.
     
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  24. AEHawkeye

    AEHawkeye Member

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    We have 2 other cats, one of which won’t touch wet food. The other will eat anything, and as fast as possible. So we’ve never free fed - but we did feed small meals 6 times a day. The meal times were convenient for work and bed, but don’t necessarily revolve around Velcro’s BG needs right now. I have until mid-August to have it sorted out.
     
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  25. JeffJ

    JeffJ Well-Known Member

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    Kudos to you for getting the spreadsheet, the signature, and the consistent dosing all setup and going. It gets easier from here.:bighug::bighug::bighug:

    Perfect numbers today. Agree with Crista on 0.75 to be safe. And the need for more tests to get some nadir patterns established.

    I don't know about regulating the daily curve with food.
     
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  26. AEHawkeye

    AEHawkeye Member

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    Thanks. I’ve worked as an analyst before so using a data points in a spreadsheet to identify trends is a natural step! Will retest before dosing and yes, probably do a .75.
     
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  27. Crista & Ming

    Crista & Ming Well-Known Member

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  28. AEHawkeye

    AEHawkeye Member

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    Ok guys - do I shoot a 171 (0.75) or not? Last night I did not shoot at 218 based on advise from the vet, but today’s curve was less scary. Also probably would have been fine yesterday but I was nervous.

    Or do I stall? I couldn’t keep him from eating any longer. So he’s eaten.
     
  29. Crista & Ming

    Crista & Ming Well-Known Member

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    If you’re stocked with HC and honey I would shoot. Get a +1 and +2

    You can stall 20 mins for your own peace of mind but he has eaten so it’s most likely food influenced
     
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  30. JeffJ

    JeffJ Well-Known Member

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    I can monitor now thru +6. If he hypos tonight, then another dose reduction.
     
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  31. AEHawkeye

    AEHawkeye Member

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    Ok I dosed him what was probably closer to 0.5 than 0.75 since my syringe doesn’t have half marks but I want to be safe - Velcro is too new for me to know what is going to happen.
     
  32. AEHawkeye

    AEHawkeye Member

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    Got him between 0.5 and 0.75 as I don’t have half marks.
     
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  33. JeffJ

    JeffJ Well-Known Member

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    I used to get syringes from Walgreens $18 for 100. Dosing consistency is important. Some people are using calipers (I always eyeballed it).
     
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  34. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    This may sound like a dumb question but how much does Velco weigh? The starting dose of Lantus (if using TR) is based on weight: initial dose = 0.25 x ideal weight in kilograms. Usually, this calculates out to around 1.0u unless your cat is a smaller sized kitty. (With SLGS, the starting dose is lower -- 0.5u if your cat is on a low carb, canned food diet.
     
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  35. CandyH & Catcat

    CandyH & Catcat Well-Known Member

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    NO question is dumb, not here (actually not anywhere) -- if that was in your introduction, I either missed it or forgot

    and by the way, love the name, is there a story behind it?
     
  36. AEHawkeye

    AEHawkeye Member

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    Velcro weighs between 8 and 8.5 lbs. I know that is a decently wide range but he has been a finicky eater for the last year. I guess at least recently because of diabetes, but he has stomatitis and sometimes his mouth hurts so much he can’t eat easily.

    He came out of a 4 day hospital stay on a Thursday. The vet gave me no method to follow, just the following instructions. 1 unit of Lantus at 8am and 8 pm. Test and feed before. No real guidance about what I was testing for and they really don’t want him to eat between doses. But in his whole life he has never been a large meal all at once kind of kitty. Before all of this, he got 6 very small meals a day. That feeding hasn’t been working as his blood sugar drops in the afternoon, so now he gets a little more food when he is hungry.
     
  37. AEHawkeye

    AEHawkeye Member

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    Behind Velcro’s name? Yes, and kinda long and probably only funny to my husband and I. But when we were dating, and before we had Velcro, we moved him 4 hours away from where we were living. It was a long day by time we got the truck loaded, drove, and unloaded. My future in-laws came to take us to dinner and my MIL was talking about this cat their daughter had to Velcro in his cage. So, after such a long day, we were laughing hysterically and picturing a cat strapped against the back of the cage in a Velcro suit stuck to the cage. What she meant, but didn’t provide any of the detail for up front, was that the clip was broken and she had to Velcro it shut. No kitties were injured in the storey :)
     
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  38. AEHawkeye

    AEHawkeye Member

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    +1 was 210. Checking the SS, this is my first +1 reading I’ve done. Is the rise likely from the feeding?
     
  39. JeffJ

    JeffJ Well-Known Member

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    Yes, that BG rise is food influenced. All is fine.
     
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  40. AEHawkeye

    AEHawkeye Member

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    Oh no, fell a lot in an hour. +2=124
     
  41. JeffJ

    JeffJ Well-Known Member

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    That is fine, and that is a safe number.

    Let's say we get into lower numbers tonight - not likely but possible. Have you prepped for a hypo?
     
  42. AEHawkeye

    AEHawkeye Member

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    Ya. HC food and honey within reach. Emergency vet 15 min away.
     
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  43. AEHawkeye

    AEHawkeye Member

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  44. CandyH & Catcat

    CandyH & Catcat Well-Known Member

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    LOL -- loved the story -- totally different than the one I'd imagined ...

    was imagining a kitten clinging to you with all four paws with claws extended, imbedded in sweater or hoodie or ....

    I've known cats who could unlatch carriers .. might be that Velcro is one of the most secure ways to hold doors shut
     
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  45. AEHawkeye

    AEHawkeye Member

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    Well he does that too!
     
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  46. AEHawkeye

    AEHawkeye Member

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    +3=72. Shoot - I think this is going to be a long night.
     
  47. JeffJ

    JeffJ Well-Known Member

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    Still safe for now. Let's get a +3.5 test to be safe (at PMPS+3.5).
     
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  48. JeffJ

    JeffJ Well-Known Member

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    I've been on a bunch of threads tonight. Can you please summarize Velcro's feeding habits, and food tonight?
     
  49. CandyH & Catcat

    CandyH & Catcat Well-Known Member

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    my, that curve is looking more like a Vetsulin curve than one on Lantus -- wishing you the best, I'll be around for another half hour at least
     
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  50. AEHawkeye

    AEHawkeye Member

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    He ate just before dosing, probably a little less than I would have liked, maybe 55 - 65 calories (1/3 of 5.5 oz can). I did let him have two small meals this afternoon as he was visibly hungry and his BG was falling, so that probably had to do with tonight’s volume. I think earlier he at a little more than half a can combined, 80-90 calories. He eats Friskies Pate.

    His feeding since coming home from the hospital Thursday has been a big improvement as to before where I was mostly syringe feeding him. I think he had about 20 calories less then the vet would say is optimal. But that’s been typical over the last 4 days.
     
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  51. JeffJ

    JeffJ Well-Known Member

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    Ok, thanks. Sounds like normal intake for him. We'll see at the +3.5 reading.
     
  52. JeffJ

    JeffJ Well-Known Member

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    By the way, I've been through dozens of hypos with Leo. And dozens with members here.
     
  53. AEHawkeye

    AEHawkeye Member

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    +3.5 = 56 - time for HC or honey?
     
  54. CandyH & Catcat

    CandyH & Catcat Well-Known Member

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    rooting for you -- my vote would be yes -- been there done that -- honey in a squeeze bottle is much easier than honey in a jar (for the next time) only make sure it really IS honey and not that adulterated-with-corn-syrup junk -- I get mine from a neighbor who keeps bees
     
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  55. JeffJ

    JeffJ Well-Known Member

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    He is still not technically hypo. But I would say he is headed there. And I don't like messing around. How about some HC for the little guy.

    HC or honey is fine.
     
  56. AEHawkeye

    AEHawkeye Member

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    Ok - he got a teaspoon of HC food.
     
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  57. JeffJ

    JeffJ Well-Known Member

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    Please test at +4hr. He will probably go to 90+. A teaspoon is pretty small. We'll give a larger amount if +4 is low.
     
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  58. AEHawkeye

    AEHawkeye Member

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    So I opened the can and he got right up in there. And now he’s looking at me like where’s the food? Perhaps I should have just offered him regular food?
     
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  59. JeffJ

    JeffJ Well-Known Member

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    The problem with that strategy of - regular food. If he goes lower, then we need to shove carbs in him. The regular food will interfere.

    We could do it at 12:00 if he comes up from that HC you just gave him. I'm also CST timezone (Austin TX).
     
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  60. AEHawkeye

    AEHawkeye Member

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    Shoot. I just freaked out and I didn’t want to ruin all the work we’ve done with his curve today :( Will test again and +4.
     
  61. AEHawkeye

    AEHawkeye Member

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    BTW - love Austin!
     
  62. JeffJ

    JeffJ Well-Known Member

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    Not to worry. You're doing fine. Sometimes it takes a bit to fine tune their insulin and balance it with food.:bighug:
     
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  63. JeffJ

    JeffJ Well-Known Member

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    except in the SUMMER - boiling hot
     
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  64. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    A couple things, when you have time. First, put “SLGS” in your signature, so we can better help you with dosing. On SLGS, if a kitty goes below 90, the dose should be reduced by 0.25 units.

    When kitties first go below 100, it is a good idea to give a couple tsp of regular low carb food, to slow them down a bit. And to encourage them to spend time in healthy but safe healing numbers. Save the high carb and honey for numbers below 50.

    Next, numbers below 50 are not hypos, unless kitty is experiencing hypo symptoms. We call them low numbers events. In five years, my girl never had a true hypo, in spite of occasionally dropping into the 30’s. However, we do what we can to get the, above 50 as fast as possible, as it is not a good place for cats on insulin. Is Velcro experiencing hypo symptoms? If not, please don’t call it a hypo as it raises alarm bells here,
     
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  65. CandyH & Catcat

    CandyH & Catcat Well-Known Member

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    Austin is great, DH has a bunch of relatives in the area -- his one grandmother was a Wimberley from Wimberley ...
    actually pick most any town in Texas, he's got a cousin there

    oh, and don't worry about "ruining" anything, it's amazing what our cats can and will do --- it does take a while and a lot of work to get things a bit more stable -- then they throw some sabots into the machinery and dare you to figure it all out
     
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  66. AEHawkeye

    AEHawkeye Member

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    Thanks :) ❤️
     
  67. AEHawkeye

    AEHawkeye Member

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    Gosh I read back through my strings the last two days and I don’t think I called it a hypo, though the emergency vet who’s care he’s been under did call it that yesterday when I called them about the low numbers. My sincere apologies for any trouble I caused or I missed a reference. No, Velcro has not expressed any hypo symptoms. And ya, shoot I wish I had offered him more regular food earlier. He just doesn’t normally eat this late.
     
  68. JeffJ

    JeffJ Well-Known Member

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    Let's get the +4 value and see where his BG reads.
     
  69. CandyH & Catcat

    CandyH & Catcat Well-Known Member

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    saying a gentle good night, cannot stop yawning, catch you in the morning, sending good vines for a shallow dip only and a good recovery
     
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  70. AEHawkeye

    AEHawkeye Member

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    +4 = 66
     
  71. AEHawkeye

    AEHawkeye Member

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    Thank you, and good night.
     
  72. JeffJ

    JeffJ Well-Known Member

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    I would give some regular LC food (now) and continue to monitor with BG tests at 1am and 2am.
    I'll check at 1am here. Your kitteh should be fine tonight.
     
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  73. AEHawkeye

    AEHawkeye Member

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    Ok thank you for the support. So scary.
     
  74. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    No worries. Not saying you called it a hypo, but others did here. I was really wondering if he was exhibiting hypo symptoms.

    I would not go to bed just yet. The down side of feeding high carb food is that it can raise the numbers for a couple hours. When the carbs wear off, the numbers can go back down. So, best to test for a couple hours after feeding high carb. For next time, try low carb first, then if his numbers go up, you know it’s his cycle naturally going up and it is safe to go to bed.
     
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  75. JeffJ

    JeffJ Well-Known Member

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  76. JeffJ

    JeffJ Well-Known Member

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    Well, I did not call it a hypo. I said I had experience with hypos.
     
  77. AEHawkeye

    AEHawkeye Member

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    He’s happily lapping away at his normal LC food, not acknowledging his mama’s stress at all. And his non-diabetic brothers are enjoying part of the open HC can as a treat. Testing again at 1 (+5).
     
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  78. JeffJ

    JeffJ Well-Known Member

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    He will be fine tonight. One good way to learn more about managing Velcro's diabetes is to follow a few other cats who are regulated. You can then see the habits they are applying.
     
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  79. AEHawkeye

    AEHawkeye Member

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    I have been stalking spreadsheets the last 2 days. Perhaps my takeaway is that he needs another small meal 2 or so hours after he dose. That seems to be the pattern; and in line with his natural eating habits before we were dealing with stomatitis and diabetes.
     
  80. JeffJ

    JeffJ Well-Known Member

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    That's great - monitoring other spreadsheets.

    Some people free feed, and some do controlled feeding. The +2 meal works. Leo used to get a bunch of small meals, and others have used that method as well.
     
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  81. AEHawkeye

    AEHawkeye Member

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    +5 = 98. He ate food to the size of a small meal and finished all in the plate. About 35-40 calories. Acting fine, and in fact he has decided to head to bed. I will test at 2 just in case - yesterday after I gave him honey he went up then fell sharply a couple hours out.
     
  82. JeffJ

    JeffJ Well-Known Member

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    He should be okay for tonight.

    The HC and honey/karo are short acting, and generally not that healthy. We are really looking for 2 hours of same or higher BG after the last food. With his current numbers tonight, he should be fine.
     
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  83. AEHawkeye

    AEHawkeye Member

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    Thanks for your help tonight.
     
  84. AEHawkeye

    AEHawkeye Member

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    +6= 120. Good night all.
     
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