What does too much lantus look like?

last condo

Pimp is bouncing up and down every day. Could his dose be too high? Learning the slgs protocol and may have gone too fast in the beginning. Thinking about starting over at 1 or 1.5 units.

 

Too much and too little insulin can loom very much alike. However, I don't think that Pimp is getting too much insulin. I'd be more concerned if your starting dose had been at 3.0u.

You're beginning to see some movement with the 2.25u dose. If you're able to test as much as you've been testing, given the high numbers, I'd think about using the TR Protocol. It's a bit more aggressive in that you evaluate the dose after 3 days vs. a week with SLGS. You've been raising the dose based ore on TR, already.

As far as the bouncing, it's normal. It's annoying, but it's normal. Just keep chipping away at it and you'll see results.

 

Looks like Pimp may still be getting some dry food so that limits you to SLGS

Any chance you can get him completely off the dry? TR will give you the best chance at remission, but it requires wet food only

 

What happens when he doesn't bounce? Is there a risk of his number going too low at that point?

 

Bouncing may happen because:
a) the glucose drops rapidly
b) the glucose drops to an unfamiliar level (ex was in 400s, gets a 200 and bounces)
c) drops below a normal low level - 50 mg/dL on a human meter and 68 mg/dL on a pet meter when doing TR, 90 mg/dL for SLGS
or any combination of the above.
Mid-cycle testing helps ensure that the last one, going too low, is identified quickly and intervention done as needed to raise the glucose to a safe level.

 

Unfortunately his brother is a kibble addict, so no. Have ordered a bag of young again 0 carb, though.
The most I can do during the week right now is stop in for a spot check once in awhile, no guarantee of being able to every day, or what time. Will probably never be able to get a +2 am number during the week. In four to six weeks I should have more free time at home.

 

Too much insulin can look like not enough, but I agree with Sienne, I don't think Pimp's getting too much insulin at this point. Dry food means that the insulin needs are greater.

I think someone mentioned to you yesterday that when you change the dose, your cycle count starts over. With SLGS you're looking for a week at a dose, then evaluate and decide if you need to increase or not. If he drops below 90 on your relion at any point, then you'd reduce his dose.

His spreadsheet looks very typical for a cat that's just starting out. Don't worry about the bouncing - pretty much every cat goes through it. Just focus on the low numbers when you're deciding on dosing. The bounces will work themselves out when Pimp gets to a dose where he's spending a lot of time in normal numbers, his body will "remember" that it's ok and the bouncing will hopefully lessen then.

 

You guys are good at making me feel better

I stuck with the 2.25 dose tonight.
What's worrying me now is the meter has read HI all day today.

 

Are you able to test for ketones? Any time I see a cat in consistently high numbers, I encourage testing for ketones. It's more of a preventative measure because you never know if there's an infection brewing thats causing the high numbers. (Ketones can develop if there's not enough insulin, infection, and poor appetite.)

 

To test for ketones you can grab some keto-diastix from the pharmacy, they're pretty cheap, and test his urine. You can either put the strip under him while he's going, or grab a sample by sticking a tablespoon under him while he's going (that's what I do with Vyktor, I was amazed he didn't object but I think maybe once they get going it's too late to stop ) or replace the litter with something non-absorbent (e.g. acquarium gravel, lentils or even strips of plastic bag) and test the sample. You need to test a pretty fresh sample though, so if you go the litter replacement do it while you're home so you can test the urine quickly.

 

I could pick some up tomorrow, hoping his numbers will be better in the am though.

 

Ketostix test just for ketones. Ketodiastix test for ketones and glucose in the urine.

 

Amps 369. Can I test blood for ketones? That seems like it would be easier.

 

Yes, if your meter can do it (not all do). I have a Freestyle Optium Neo (I'm in Australia, not sure if it's available everywhere) and it does glucose and ketones as well. It needs a bigger blood sample, but nothing drastic.

ETA: The ketone tests use different strips, and they are a lot more expensive than the glucose strips. But apparently it's more accurate to test blood than urine. Or it shows up in the blood earlier, or something like that.

 

I'll shop around for one. Hoping he is surfing yellows today.

 

I purchased this one from Amazon - http://www.amazon.com/Precision-Glu...ef=sr_1_5?s=hpc&ie=UTF8&qid=1445964845&sr=1-5 and the corresponding Ketone strips (strips do either blood glucose or blood ketones but not both) The ketone strips are expensive but no where near what a DKA at the vets would set you back.

Have only used it once when Hyde was acting wonky. Came back as 0.1 which is in the normal range.

You can also smell their breath - if it is sweet (or like nail polish remover) then go to the vet immediately.

 

Andy... I have an alpha track I can donate to you since Sabrina passed away. Please pm me with details, if you want it. Cindy & Angel Sabrina

 

Normal AMPS today (369) but HI all day again. Running out to get some ketosticks.
Everyone agrees dose should stay the same?

 

very much appreciated and sorry for your loss!
already have an alphatrak that i don't use.

 

Although SLGS says to hold the dose for a week, I think I'd go ahead and increase to 2.5 now and then hold it

We don't like to see those "HI" readings for too long, so if you can continue getting at least a spot check during the AM cycle and more tests on the PM, I'd probably go ahead and increase

Others may have other opinions

 

From yesterday:

You can link the threads together - we ask everyone to open one thread, per cat, per day. It does several things - it keeps all the active discussions for each day on the front page, and it keeps all the info on one cat all together. Then we link each day's new thread (we call them condos) to the past ones. You copy the previous thread and paste it into the first post of your new day's thread.

In other words, when you post for the first time tomorrow, copy the URL from this thread and paste it into the first post of the day. That allows people who are helping you to go backwards to get the story, if they need to. It can sometimes be important to see what previous advice has been given. Now you could also go to the last post, copy the URL and edit today's thread (this one) and paste it in the first post of the thread.

Here's what the "New to the Group?" sticky says about it:

*** First stop ***
Lantus & Levemir: Info, Proper Handling, & Storage
*** Daily Threads & Posting Instructions ***

• Please use one thread for all your comments and questions you have that day. This will keep all your questions, comments, and replies together.
• Start your thread with the date, kitty's name, and AMPS
• Your thread will be bumped to the top of the list when you or anyone else posts on your thread.

​

Regarding Pimp's dose, is he eating more dry food than he was before?

 

While it's clearly an exception to SLGS, I would raise the dose.

Were you able to get a ketone test? There are 2 blood ketone meters -- the Precision Xtra and NovoMax. You can get the NomoMax from ADW. I'm not sure where the Precision Xtra is available.

 

Dry food intake seems to depend on if he likes the brand/flavor of wet food for the day. Still zeroing in on what he will eat once/twice/over and over lol.

Haven't caught him in the litterbox yet for a ketone test tonight, but his breath smells like it always has.