Here's what I'm not understanding

Shadow is a high-dose kitty. At one point, she was up to 10u bid. She is slowly working her way down. She has had two 38's in the past few days. If she's is too low to shoot at +12, how long do I hold her dose? And when I give it, do I give her regular dose?

With the 38's, I'was thinking she could have a dose reduction. But I don't know how or when to do that when I have to hold a dose for low BG.

So tonight I tried "winging it," and then I read the advice given in RuBee's thread about holding the same dose consistently 12 hours apart. Because of my work schedule, Shadow gets shots at 10A, 10P. If she gets a dose, say, at +15 or +17, when does she get the next dose and what should the amount be? I have read and re-read the protocol and it's just not sinking in.

I'm working so hard to get a grasp on all this, my husband thinks I'm obsessed with this board. But at times this is so difficult and confusing and upsetting.

long story short, I need some help.

Kim

welcome to Lantus Land, Kim and Shadow!

There are a couple of different ways to answer your question. If Shadow is too low to shoot, one option is to learn how to shoot lower numbers safely. Post when you find yourself in that situation, and someone can walk you through it. It's a LOT easier to figure out by having someone help you through the situation the first time, than to try to understand what is typed.

The other option, if Shadow is frequently too low to shoot, is to reduce the dose. The numbers will go up. Of course, ALL the numbers will go up, the high ones too, so you'll want to use that opportunity to collect lots of data so you can eventually increase the dose again and be comfortable shooting.

If you do shoot late, then the next shot is due 12 hours after that one. It can be hard to sort that schedule out when you work, but we can always help you figure out how to make up the time.

Kim, can I ask how you arrived at your dose? I see that Shadow was diagnosed 6/7/10, and according to the spreadsheet, he was already at 7 units only 3 weeks later. That's a pretty fast increase, how was that dose determined?

kim, quick question because i'm not sure i'm understanding your spreadsheet...
did you shoot 3.5u @ +19 (218) today and then 5 hours later shoot 7.5u on a PMPS of 194?

When she was first diagnosed, our vet encouraged canned food and home testing and I was slow to get on board with that so I don't have a lot of early numbers. She was started on 1 unit bid. We were seen in the clinic every other day and her dose was increased every time. He said 230 was the "renal threshold" and we needed to get her down to that number in short order.

It was some time before I stumbled across this board and we were well into her treatment by that time. I have read of some members that took their cats back to the beginning and started over on low doses and the hubz and I have discussed that at length.

We don't really know how long she's been sick, but looking back, we missed a lot of clues. She has had terrible dandruff for at least 5 years. I had no idea it could be related to FD. The vet feels this is the likely reason she has been insulin resistant. Personally, I am leaning towards the acromegaly thing. She has lots in common with those little acrokitties.

She's quite elderly. I'm not sure I can take her back to the pinks and start over at 1 unit and I don't think she'll live long enough to make it to remission. She was really feeling poorly in those early days. I just don't think I could do that to her again.

So I guess we are doing this backwards. Started high, working on getting low. And she is feeling so much better with these lower numbers.

I wasn't suggesting that you take her back to 1 unit, but I was wondering if she might need bigger reductions, since we can't be 100% sure this dose is safe for her.

Can you answer Jill's question, did you give a shot 5 hours after the first shot today?

Hi Jill and Alex. Yes. That is exactly what we did. I held her dose, longer than I should have, I guess. And at 10 pm we gave her a decreased normal dose trying to get her back on schedule. The vet wants us to shoot her with 1 unit less when her numbers are below 150 but when she was at 90 AMPS, it just didn't feel right. So we held her dose, and fed her regular schedule. We were going to decrease her dose this evening because of the 38's, so we went ahead and did that at her regular time. I realized this was a mistake when I read that you can't be doing that with these long-acting insulins.

the good news is the first shot was greatly reduced and late. the bad news is there's a possibility you'll have nadir from the first shot and onset from the second shot occurring around the same time. you'll want to do a lot of spot checking tonight...

do you have high carb web food (something with gravy) on hand? Or syrup? And lots of test strips?

Sorry, but tonight is going to have to be a test-fest. I see your +1 of 218, please get a +2.

Bigger reductions sound good to me. We've been muddling thru, trying to follow the queensland protocol and it recommends 0.5 unit decrease so we were going to take it slow. Maybe too slow, I don't know. We don't really know what we're doing. Obviously.

I have a hypo kit - karo, HC FF and LOTS of test strips. Just checked her, it is closer to a +2.5 and she is 175.

I could get tearful here for a nickel. I SO appreciate you staying up with me, doing this. I have really been in over my head.

it's ok, I'm glad you're here. Stay with us tonight, ok? How about another test in 30 minutes?

you're doing great, kim! this could very well turn into a non-event, but you're prepared if you need to control the curve.
stick around, ok? and keep your ss updated as you do more tests. it'll help us see what's going on at a glance.

praying for non-event. +3 187

good, it's not lower than last time, that's a good sign. Can you feed a little low carb food (a couple tsp) and test again in an hour? That test should tell us if it will be a non-event. Usually it is, but by testing and feeding we can stay in control.

+4 191. The monsters can tell I've got all this nervous energy so they do too. We've had to get out the fishing pole. If there is a blessing in Shadow getting sick, it is that the others have all gone onto her LC FF and have dropped some lbs. and they are like kittens again. So fun. And it is liable to save their lives.

I agree Kim. This disease was a huge wake up call for me regarding their diets. Shadow's looking good.

I agree with you, I think all my cats are healthier than they were before, and I'm much more in tune with them.

It looks like Shadow is voting for the non-event!!! How about feeding him now, leaving out high carb wet food just to be safe, and going to bed?

And please come back and post regularly. Shadow is in one of those phases where things can change fast, and we can help you get through it. It's a lot easier with support.

i agree with libby. come on back and we'll give you a hand.
ni-ni kim...

Libby and Jill - a big big thank you for your help tonight. I'll be heading to bed shortly but I'll check back by here another time or two. Just so I'm clear, tomorrow I'm going to do 7.50 at Shadow's regular time?

what do you think about reducing a little more, to 7 units? The shot will be due 12 hours after the last one.

I'm going to bed too. You can open a new thread in the morning with tomorrow's numbers. Great job tonight! Good night.

Just want to chime you - you've got two of our best Libby and Jill helping you - you are in good hands and paws.

Listen to them, they know what they talk about and they have helped MANY (probably too many to count) kitties.

This is a learning process with a very steep learning curves. Mistakes happen. The trick is not to beat yourself up for them, rather to learn from it and be open enough to this group to let them guide you.

You are doing great and will continue to do so. And I praise your vet for recommending home testing and canned foods! Not many vets do.