6/22 Coleman AMPS 261...new to TR forum

hello all. First time in TR so I will give Coleman a brief intro. He's a rescue, so age unknown but probably ~13. Excellent health (well, except for this), excellent coat, excellent appetite, excellent attitude. Original dx 12/2/13 (and mild keto...overnight one night only at vets and then fine), last dose 1/1/14...and now testing high again...started insulin 6/14/14. Was testing regularly after being OTJ...then less often as it was always low. Then missed 3 weeks and BOOM. So, here we are again. Vet visit Monday had urine cultures come back negative and check for pancreatitis negative. His exam was normal also.

I feed only canned from Dr. Lisa's list. Lantus dose currently 1.0 BID. We test every 6 hrs (apx...I tend to oversleep the middle of the night test by an hour...or two). My work schedule is odd today, so he will get a +4 test before I leave and a +7 or 8 when my husband gets home. Negative for ketones. Coleman is awesome to test...very easy and loves the process.

His #s are staying higher longer this time so I am more worried. Any advice (or hand holding) would be appreciated nailbite_smile

 

Welcome to LantusLand (TR Forum.) Sunday can be a little slow but others should be by soon. It has been said that cats coming back from OTJ need a more aggressive dosing protocol, keep on top of the numbers and adjust promptly when numbers start to creep up, don't "wait and see."

 

Welcome to LantusLand. What a nice looking kitty Coleman is. I'm glad you came to this forum, and hope we can help you to get him more regulated and perhaps back to OTJ, soon.

 

Hi Kathy,

Just dropping by to welcome you to LL. I think what you were seeing was an adjustment to getting insulin. He is coming down now which is good. Random testing is really helpful as they don't all nadir at +6 or +7 and just when you think you have it figured out they change!! So getting in 4 tests each 12 hour cycle is great. A +3 at night will let you know if you are in for an active cycle. My Max is now getting into better numbers so I often need a +1 or +2. The experts will stop by soon to give you their take.

 

Hi Kathy!

just want to add my welcome to Lantus/Lev Land! Hopefully we can help you get Coleman back on track.

If you have any dates or numbers from the January-June period where he was first diagnosed and then OTJ, could you put them in the spreadsheet as well? Even if you're just giving approx dates or numbers, it's helpful to see what happened before. Like when you'd tested and he was low, what does that mean - approximately what BG numbers?

A couple of things i'd suggest. I'm thinking it's pretty likely that his highs in the past couple of days are from bouncing from the blue numbers mid-week. It might be that yesterday's 400 was the apex of the bounce - i'm not sure. Bouncing is a really normal reaction. There are a couple of times when high numbers don't mean the cat needs a dose increase. They're described on this link: New Dose Wonkiness & Bouncing.

In Coleman's case, I think i'd hold the dose another couple of days and try to get some varied tests. I'm guessing this is a bounce. I think of the spreadsheet like a jigsaw puzzle. If you have only the corners and edge pieces, it's pretty hard to see what the picture is. But if you have pieces spread here and there all over the puzzle, it becomes easier to decipher the picture. That's exactly what the spreadsheet is for us. It helps us to see what the Lantus is doing when we can see the past 3 or more days with a sprinkling of tests here and there. Right now you've done a super job of getting tests in - it's giving us edge pieces and a couple of stripes down the middle of the "puzzle." It would really help to see some variety in the test times. Does your schedule allow you to get some different times? Your plan for a +4 and +8 today is super.

I'd suggest one day getting a +2 or +3, then maybe a +5 (since you have a lot of +6's), or +8, and then in the evening cycle get some different times, maybe a +4 or right before you go to bed. Your total per day doesn't necessarily need to be more tests, just vary the times. Does that make sense?

Glad you got right on it with Coleman - good job keeping an eye on him! Keep asking questions!

 

Welcome to Lantus Land!!

I agree with Julie -- getting tests at random times can help to fill in some of the blanks on Coleman's SS. To do TR, the minimum testing is at pre-shot times and one additional test per cycle. Getting a curve every so often or testing a bit more on weekends/days off since you're working may also be a means of sorting out if Coleman is bouncing or needs a bit more insulin.

Please let us know if you have questions. The folks here are very generous with their time and information.

 

We're also adding our "Welcome aboard!" It's great that Coleman is cool with the whole testing process...that makes things so much easier for you! Grabbing those random tests will definitely help fill in the blanks and give you a better picture about what is going on with Coleman. Hopefully he'll go OTJ again for you - and quickly do so!