? We are back, with new dose. Opinions appreciated.

Discussion in 'Lantus (Glargine) / Levemir (Detemir)' started by Silvina, Dec 4, 2017.

  1. Silvina

    Silvina Member

    Joined:
    Feb 21, 2015
    Hello group!

    To make long story short, my brain is about to explode but didnt explode yet so we are good. I am thankful to one of the girls that pm me so she reminded me to update the ss, and also made me feel supported.

    That is not frequent... even between my own friends... so feels really good.

    So, I had to decide to lower Markies dose after some early big drops that I have to give carbs, then also lots of bouncing and also not feeling safe. So I finally made it. And for my surprise I see a flat yellow ss.

    I know I don´t see blues nor greens but at least no bouncings.

    Markies is a very lazy guy, probably will help if he exercises a little bit and also I have to review the ammount of food I give. I might be overfeeding. I feel ok with this dose. Still obviously I am open and willing to read your opinions.

    Im hoping with the time this yellos can turn into blues then greens... :nailbiting::)
     
  2. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

    Joined:
    Jul 18, 2011
    Hi Silvi,

    Since you skipped yesterday morning, it's not surprising to see Markies in pink. I know big drops can be scary, but when a kitty is clearing a bounce, they are not surprising and don't mean he's unsafe. Blues are completely safe, and I don't think Markies was headed for shark territory on the 28th, when you decided to reduce. Please remember that allowing him to stay in numbers over renal threshold (which varies - ECID - but is usually around 200) for long periods can damage his kidneys. I would encourage you to go back to 1 unit as soon as you are able.
     
    Stacy & Asia likes this.
  3. Toro & Ovi

    Toro & Ovi Member

    Joined:
    Aug 6, 2017
    Few theories we've read (we've read a lot about the diabetes since July :) ):

    1. Once you hit the right insulin dose, you'll not see bounces anymore. So increasing the dose till you hit the right one is, unfortunately, mandatory.
    2. The bounces are nothing else that the liver's late reactions (panicking) to lower numbers than used to - and until it doesn't get used to them and reacts in time and normal fashion, the bounces will be there. So increasing the dose till you hit the low BG numbers is, unfortunately, mandatory.

    Both theories proved to be true - for us.
     
    Last edited: Dec 5, 2017
  4. Stacy & Asia

    Stacy & Asia Well-Known Member

    Joined:
    Oct 2, 2017
    Like Tricia said, I don't think the 1 unit dose was doing anything scary. Didn't seem to be a lot of bounce, and Markies got some nice but not too low blues on that dose. I know you have a lot going on and can't always be around for shots and monitoring right at this time, but I think the 1 unit dose would be okay for now to keep his numbers a tad lower while you deal with your mom. You also might consider switching from TR to SLGS for the time being as I think you will worry less going that direction. You can always change back when your situation is different and you have more time to monitor Markies, because bouncing is just part of the dance and you'll be seeing the highs and lows until he settles in to the lower numbers. :bighug:
     
  5. Silvina

    Silvina Member

    Joined:
    Feb 21, 2015
    Ok leets see..

    Markies BG behavior changed a lot. He has early nadirs, at + 2.5 has very low numbers and I have to start correcting with carbs. That puts me in a situation I no longer can handle at all. Im in a situation that I may need to run for mom´s emergency, or going to moms house at Markies nadir, etc..

    And Im no longer willing to be testing and testing at +2, +3,+4 whatever because it simply impossible to afford all this money... I get this stripes as donations and they are gone... Markies ears are hot..

    All is a mess..

    And I understand what you say about the risks but I feels that my situation with mom, my economy, and all this s h i t makes me feel unsafe going back to 1 unit... look how many times he went even to hipo numbers girls.. he did went into hypo numbers not even at +8 when its supposed to be Levemir nadir.

    I know that most of the time was due to the mess I was doing before when I was using rapid but then he was still having early low numbers which puts me in situation when I have to be here and I some times I cannot be here testing because I have to be working, I have to be out with mom at the doctor, I have to be at her house, etc..

    I will read about the SLGS, If anyone would like to copy paste that would appreciate, will read you later. Now I have to leave for 5 hours, to moms house. I had gave him his 1 unit dose I would be suffering adding more stress plus the stress Im having with mom. Probably I will have to decide to take the some risk but cannot do all things perfectly caus I feel I will die first, believem that I feel that I will die first and I need to die afterwards first mom... then whatever but I need to survive all this.

    Sorry, this is incredibly overwellming... and I have two brothers that I would send them directly to the moon to settle there and never come back. They don´t help, no support, no nothing.
     
    Juliet likes this.
  6. Toro & Ovi

    Toro & Ovi Member

    Joined:
    Aug 6, 2017
    SLGS - most important steps (read the SLGS sticker for more details):
    Hold the dose for at least a week:
    • Unless your cat won’t eat or you suspect hypoglycemia
    • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
    After 1 week at a given dose, perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours:
    Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet.
    • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
    • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
    • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
     
    Silvina likes this.
  7. Stacy & Asia

    Stacy & Asia Well-Known Member

    Joined:
    Oct 2, 2017
    I didn't see any hypos on the 1 unit dose, I think it was at 1.25 and 1.5. It looks like the 1 unit dose did much the same as the .75 just with some more mid/high blue numbers in the mix (a good bit away from green).

    Here's a link to SLGS, it's more in line with people who can't test as often and more conservative in dose increase and deacrease time amounts:

    http://www.felinediabetes.com/FDMB/threads/lantus-levemir-start-low-go-slow-method-slgs.129446/

    I think you still have a little bit of wiggle room to get Markies numbers down a little bit AND he keep him safe/juggle your other responsibilities and your mom. But at the end of the day, you have to do what you feel is the best thing to keep your life managed.

    I sure hope things start looking up for you soon, it sounds impossibly overwhelming, but you are doing remarkably well, all things considered. :bighug:
     
    Silvina likes this.
  8. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    ECID - each cat is different.
    Neko bounced for all 5 years she was on insulin. But the height of the bounce got a little lower as she got used to normal numbers. Dyana's JD bounced even more, for all 9 years. Try to ignore the bounces - it could just be that Markies is a bouncy cat. Focus on the nadirs. The low points are much more important than the high ones.

    Even under SLGS you'd have room to increase the dose back to 1.0 units. His nadirs are still over 150. Good luck. :bighug:
     
  9. Juliet

    Juliet Well-Known Member

    Joined:
    Sep 8, 2017
    I understand. This is VERY overwhelming. I hope things settle for you soon. I hear you.
     
    Silvina likes this.
  10. Silvina

    Silvina Member

    Joined:
    Feb 21, 2015
    @Tricia Cinco(GA) & Harvey look 11/10 then 11/8, etc.. Although the dose was 1.25 this is what was going on at that time... look what happened after lowering the dose.. the numbers settled. I know that what happened on the 28th is not terrible but that is bad for Markies, that is a very low number for a +2 very far from nadir and then that ends in a bouncing and so on... And considering this moment in life when I will not be able to be home to test safely etc.. thats my concern to be using a dose that can risk numbers that had to be manipulated with food then that require a lot of testing stripes and then bouncing.

    I will read about SLGS I need to be well trained on that.. I don´t even know what it is...
     
  11. Silvina

    Silvina Member

    Joined:
    Feb 21, 2015
    yes, I m lost about Markis nadir now... I cant even tell at what time is his nadir since he started to drop early in the cycle (he used to be a very regular Levemir cat) but then he showed early drops (we need to take into account tha Ive been not doing things right, that I was using probably not a right dose and what is worst, I was using Rapid, so... just a mess)

    But We are kind of far from that and he still shows some early drops at times and that scares me a little. And I still need to know when is Markeis nadir... need to identify at + what time is his nadir and what average number.

    so far he obviously he is in yellows. But No Hypos.., no honey administered, no vomitting frequently like before, though he needs to improve his numbers.. but difficult to put this all together being in this such difficult moment.
     
  12. Silvina

    Silvina Member

    Joined:
    Feb 21, 2015
    Thank you dear!!!! it really is crazy what is going and never imagined that things were going to be ALL TOGETHER, DAD, MOM, MARKIES, THE FOSTER CATS.. BAD HELP FROM MY BROTHERS... BUT GOD NEVER LETS ME DOWN..

    THANK YOU!!! I WILL READ THE LINK!!!
     
  13. Silvina

    Silvina Member

    Joined:
    Feb 21, 2015
    AMPS 330. HE ATE A CHICKEN WING THEN +3 (199) STARTING TO FREAK OUT...
    I KNOW I SHOULDNT BUT WE ARE FAR FROM NADIR AND HE DROPS FAST...

    SHUT.. I CANT STAY ALL NIGHT UP
     
  14. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    199 is a good number. It's not close to being too low. We are trying to get numbers in the mid to low 100's.... Then eventually double digits. She's doing good.
     
  15. Stacy & Asia

    Stacy & Asia Well-Known Member

    Joined:
    Oct 2, 2017
    He's okay. Take a breath. What do you think his nadir is? It's hard for me to tell because it seems to move around quite a bit, but there's not too much data to get to the bottom of it. Give the 1 unit a little time. You can do this! :bighug:
     
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  16. Silvina

    Silvina Member

    Joined:
    Feb 21, 2015
    @Stacy & Asia look this bouncing. He is 346 at +9.75, so I know this will probably be like this specially during night cycles.

    Is this better than all yellows? I will never be able to test during the night cause I need to have a life, I will try to test during the day how he behaves, but now he will be behaving according to the bouncing.

    However he may drop early anyway as he did before.

    If this dose reaches blues but for that also brings pinks and reds, is that a good business? (that is a hispanic expression)
     
  17. Stacy & Asia

    Stacy & Asia Well-Known Member

    Joined:
    Oct 2, 2017
    As bounces go, it's not overly dramatic or even entirely out of the range Markies was in on .75, with the exception of some blue. It didn't bring any reds yet or the last time on 1 unit, so wait and see what happens and go from there. Bouncing is normal, and hopefully, once he adjusts to the blues you are seeing, the bouncing will lessen. I do think it's better than all yellows because instead of staying flat in higher numbers, he's trying to adjust to slightly lower numbers, and the goal is to keep him even there. I'm hopeful the pinks will be less pink over time, or at least a bit lower once he adjusts, but you have to give it a little time. I think when he drops is not as much of an issue as how low he drops, and I believe that 1 unit is still a bit off from that, so hopefully it will stay in a range that doesn't worry you much.

    Here's a great thread about bounces, see post 19, it helped change my perspective on bouncing:

    http://www.felinediabetes.com/FDMB/threads/10-29-jetta-pmps-328-2-339.55306/
     
  18. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    The bouncing may settle as he gets used to being in lower numbers. Stick with 1 for a while
     

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