First curve

Discussion in 'Lantus / Levemir / Biosimilars' started by Wendy Jones, Jun 28, 2020.

  1. Wendy Jones

    Wendy Jones Member

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    Jun 6, 2020
    This is Tigers first curve. I've been checking him 4 times daily. He's been on Basaglar 1.75 units for 5 days now. Can someone please look at his curve and tell if the dose needs to increase or give more time? I realize he's 1 check short of 12 but he's already over 600. Meter only goes that high so I didn't expect the next check to be different.

    https://docs.google.com/spreadsheet...uxKS_5WnBqF3qQGCv6QihS-EL5M/edit?usp=drivesdk
     
  2. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    You aren’t using our spreadsheet so it disappears when I click on it. Please download ours and put in your results. Are you following TR or SLGS?
     
  3. Wendy Jones

    Wendy Jones Member

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    Jun 6, 2020
    Thank you. I'll download yours and redo the numbers when I can.
     
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  4. Wendy Jones

    Wendy Jones Member

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    Jun 6, 2020
    Im having a hard time finding the correct spreadsheet. Can you direct me to it?
     
  5. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    Looks like Tiger is bouncing. By the time our cats are sick enough that we notice and get them diagnosed, they've usually been diabetic for quite some time.

    Their body gets used to living in those higher numbers, so even if they don't drop into dangerously low numbers, the liver "thinks" it's wrong and releases stored sugars and hormones to bring the blood glucose up fast. They "bounce" high.

    Bounces happen when 1. they drop too low, 2. they drop too quickly, 3. they drop into numbers their body isn't used to anymore (or any combination of all 3)

    Look how quickly Tiger dropped today....127 points in 2 hours is a BIG drop....and then he dropped another 108 points by +4....that's a drop of 235 points in 4 hours

    So although he didn't drop "too low", he dropped quickly and he dropped into numbers his body probably hasn't seen for quite some time.

    Bounces are a normal, but frustrating part of the sugardance. It can take up to 6 cycles to clear the hormones and sugars that the liver releases out of the body so all you can do is wait.

    It IS nice to see Tiger down in the blue's today....just wish he wouldn't have done it so fast!
     
  6. Wendy Jones

    Wendy Jones Member

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    Jun 6, 2020
    Could he be getting too much to make him drop so quickly? What do you mean by it takes 6 cycles?
     
  7. Wendy Jones

    Wendy Jones Member

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    Jun 6, 2020
    I was happy to see the blue number but worried about how fast it came and how fast it went back super high. He doesn't seem as if that bothers him but it can't feel good.
     
  8. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
  9. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    A cycle is 12 hours.....the time between the morning shot and the evening shot so there are 2 cycles each day. An AM and a PM cycle

    6 cycles is 3 days....it can take up to 3 days for the bounce to "clear"
     
  10. Wendy Jones

    Wendy Jones Member

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    Jun 6, 2020
    Oh wow. I thought he would just gradually level down like lower and lower. Is it the dose that causes him to drop that much in the first place so you know it's a good dose or should it be lowered because it's too much too fast?
     
  11. Wendy Jones

    Wendy Jones Member

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    Jun 6, 2020
    Oh I got the spreadsheet instructions. Just need to quit pretending im not too old to do these things on a itty bitty phone I can barely read and use my laptop. Lol
     
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  12. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    I know the feeling!! Print keeps getting smaller and smaller and my arms keep getting shorter and shorter!!

    Don't forget to put the U entries in on the AM cycle!

    It'll also help if you'll go ahead and fill out your "Signature". Having basic information about your cat means people don't have to keep asking the same questions over and over. Here's what we suggest you have there.

    upload_2020-6-28_22-26-29.png
     
  13. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    With Basaglar, dose changes are based on how LOW it takes them. There are 2 dosing methods, Tight Regulation and Start Low, Go Slow. You don't have to make a decision tonight, but at some point soon, you'll want to decide because it affects the advice people will give you.

    On TR, you don't decrease the dose unless your cat drops below 50 on a human meter.

    On SLGS, you reduce the dose if they drop below 90 (either meter)

    Tiger didn't "earn" a reduction yet for either dosing method so you'd hold the dose.

    When you're rested and your brain isn't about to explode, here's some information about how we post in this forum
     
  14. Wendy Jones

    Wendy Jones Member

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    Jun 6, 2020
    I see. I got the spreadsheet copied. I need to read the difference again between the two but id feel better reducing sooner so SLGS sounds better. Thank you. His 3 hour after shot is 390. Is that considered another bounce? He was over 600 3 hours ago. The meter stops at 600 so I really don't know how high it was.
     
  15. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    Bounces go high, not low....they bounce "UP", not down

    That is another pretty significant drop for so early in the cycle. I'd suggest setting an alarm and getting a +6 tonight so we can start to get some different data on what he's doing on the PM cycle
     
  16. Wendy Jones

    Wendy Jones Member

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  17. Wendy Jones

    Wendy Jones Member

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    Jun 6, 2020
    Sorry I was asleep already. His first check this morning was 392. I have my daughter checking him in about an hour since his number was lowest about 4 hours after shot yesterday. He gets his next shot at 7 pm. If he number is much lower 3 hours after like it was last night I'll check him again at +6 or do you think I should check him anyway at that time?
     
  18. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    It's always good to get more data, but nobody expects you to get up every night to get a mid-cycle test. A lot of it will depend on the +2 or +3.....sometimes those tests can act almost like a crystal ball in predicting what's going to happen later in the cycle.

    If there's a big difference between the PMPS and the +2 (or +3) and the 2nd test is lower than the PS, that's your "early warning" that he might be going much lower later in that cycle so you'd want to plan on getting at least 1 more test in later on.
     
  19. Wendy Jones

    Wendy Jones Member

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    Jun 6, 2020
    How mitch lower do you consider much lower? He was 299 when I got him before dinner just now which is different for him. Usually in the high 4's or 5's. He wasn't fond of breakfast though.
     
  20. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    From the Sticky "The Basics: New to the group? Start here"

    Example of an ACTIVE, but NOT necessarily typical Lantus/Basaglar cycle:
    NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus/Basaglar cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.

    +0 - PreShot number.
    +1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
    +2 - Often similar to the PreShot number. Onset begins around +2 for most cats. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
    +3 - Often lower than the PreShot number.
    +4 - Lower.
    +5 - Lower.
    +6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
    +7 - Surf (hang around the nadir number).
    +8 - Slight rise.
    +9 - Slight rise.
    +10 - Rising.
    +11 - Rising (one of the quirks of Lantus/Basaglar/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
    +12 - PreShot number.

    Usually, the +2 should be about the same as the Pre-Shot....if it's lower (by more than just meter variance) that's your "early warning" that it could be a very active cycle with Tiger dropping a lot lower later in the cycle.

    In some cats, the +3 is a better "predicter" of what's going to happen later. It's too early to know which one Tiger is going to be....or if he's going to just break all the "rules" and do his own thing!

    Meter variance---all meters are allowed a 15-20% variance which means the number you get could be anywhere from 15 to 20% different than the number you'd get on "professional" lab equipment.

    That being said, any time you get an early test that's obviously lower than the PS, it's best to plan on continuing to test if you can. If for some reason you absolutely can't continue testing, leave some high carb food out so if he starts to drop, he can get some food to help prop himself up.

    It's always better to be too high for a day than too low for a moment.
     
  21. Wendy Jones

    Wendy Jones Member

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    Jun 6, 2020
    Thank you! Im afraid Tiger will try to do his own thing! Lol. I need to be ready.
     
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  22. Wendy Jones

    Wendy Jones Member

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    Jun 6, 2020
    I don't think I've mentioned it but Tiger has anxiety issues. He gets all upset about things. Sometimes legit like an annoying little brother bugging him but other times no good reason. He starts hissing and biting at his tail. He's never actually harmed himself so I haven't medicated him over it but do you think that will raise his BG and should I allow for it with his high numbers and possibly see about meds to help? I hate to medicate if I don't have to.
     
  23. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    I don't think you should consider medication just yet.

    When he does it, have you ever tried to redirect him? Catnip or maybe a wand toy like Da Bird?
     
  24. Wendy Jones

    Wendy Jones Member

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    Jun 6, 2020
    Oh yes. Used to give him a treat or take his attention. I usually just end up petting him and often holding his tail down so he doesn't see it. If he sees it moving he gets angry and attacks on top of aggressive bathing. He's been like that for many years. He seems to go though fases of bad days then good days but usually manageable with lots of soothing. Also tried all the cat calming things sold with no help there. I just wondered how much that increases his BG
     
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  25. Wendy Jones

    Wendy Jones Member

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    Jun 6, 2020
    He was 299 at 6pm now he's 472 so I guess I don't need to stay up and recheck him tonight. He's been upset tonight
     
  26. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    Poor buddy :(

    Tomorrow, it's probably a good idea to start a new thread. We usually start a new one every day.

    Your subject line should have this in it:

    Date (mo/day) Kitty’s Name AMPS or AMBG subsequent test numbers PMPS or PMBG subsequent test numbers

    As an example: 06/26 Fluffy AMPS 220 +2 160 +3 120 +5 100 +8 132 PMPS 200 +2 287 +5 300

    If the line gets too long you can delete all the a.m. cycle info and start over with the PMPS/PMBG

    By doing it like that, it makes it easier for the people who are scanning the forums to see how Tiger is doing throughout the day....and if they see something that concerns them, they'll let you know! If all you can do is the AMPS and 1 mid-cycle due to work, that's fine too!

    If your post includes a question, use the ? prefix in your subject line. When your question is answered, you can edit it and go back to "no prefix"

    It's also good to put the link to the previous post into the body of your new one. That makes it easier for people to quickly go back and see what's been going on with Tiger. Just copy the address in the address bar and paste it into the body of your new one.

    I know it may seem overwhelming right now, but it really will get easier, I promise! Once you get it down, it'll become second nature.

    Here's a few hugs for you. I think you need them about now :bighug::bighug::bighug::bighug::bighug:
     
  27. Wendy Jones

    Wendy Jones Member

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    Jun 6, 2020
    Thank you! You are such a great help.
     

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